Vendor Partners

Information Needed and Whom to Contact

Plan Administrator

Medical Claims Administrator/Third Party Administrator

(Medical, Short-Term Disability, and Dialysis)

  • Request Medical ID Card

  • Claim Forms (Medical)

  • Medical Claims and Appeals

  • Eligibility for Coverage

  • Plan Benefit Information

AmeriBen
P.O. Box 7186
Boise, ID 83707
Phone: 1-877-635-2912
www.MyAmeriBen.com

Medical Management Administrator

  • Pre-Certification, Concurrent Review, and Case Management

  • Appeals of Pre-Certification

PPO Provider Network

Names of Physicians
& Hospitals

  • Network Provider Directory – see website

Blue Cross Blue Shield of Arizona
Phone: 1-877-635-2912
www.azblue.com/chsnetwork

Wellness Program

  • Health Screening Questions

  • Wellness Challenge Questions

  • Livongo Questions

Diabetes Management
Pre-diabetes and Weight Management
Hypertension Management

Telemedicine

Teladoc
Phone: 1-800-835-2362
www.teladoc.com

 

 

AZLGEBT Enrollment Portal

Names of Physicians
& Hospitals

  • Qualifying Life Event Changes

  • Annual Benefit Elections

  • Update Demographic Information

Prescription Drug Program

  • Retail Network Pharmacies

  • Mail Order (Home Delivery) Pharmacy

  • Prescription Drug Information & Formulary

  • Preauthorization of Certain Drugs

  • Reimbursement for Non-preferred Retail Pharmacy Use

  • Specialty Pharmacy Program

Retail/Mail Order
Navitus Health Solutions
Appleton, WI 54912-0999
Phone: 1-866-333-2757
www.navitus.com

Specialty Pharmacy
Navitus Specialty Rx
Madison, WI 53717
Phone: 1-855-847-3553
www.lumicera.com

Employee Assistance Program (EAP)

  • EAP Counseling and Referral Services

  • Mental Health/Substance Abuse Pre-Certification

Jorgensen Brooks Group
Phone: 1-888-520-5400
www.jorgensenbrooks.com

COBRA Administrator

  • Continuation Coverage

AmeriBen
P.O. Box 7565
Boise, ID 83707
Phone: (877) 635-2912
Fax: (208) 424-0595

Health Savings Account (HSA)/Flexible Spending Account (FSA) Administrator

  • Request Debit Card

  • Claim Forms

  • Balance Inquiries

HealthEquity
Phone: (630) 673-2413
www.healthequity.com

Dental Claims Administrator / Third Party Administrator

  • Request Dental ID Card

  • Claim Forms

  • Claims and Appeals

  • Eligibility for Coverage

  • Plan Benefit Information

Vision Claims Administrator/Third Party Administrator (EyeMed & VSP)

  • ID Cards

  • Claim Forms

  • Claims and Appeals

  • Eligibility for Coverage

  • Plan Benefit Information

Life Carrier

  • Group Basic Life

  • Voluntary Term Life

  • Waiver of Premium

  • Portability Information

  • Conversion Information

  • Death Claims

Voluntary Benefits

  • Accident

  • Critical Illness

  • Hospital Indemnity

  • Claims