Medical Resources

Medical, Dental Insurance, Vision Insurance

DocFind (click to find a participating physician/provider use Aetna PPO List)





Health Plan Enrollment form 2017

Claims Reimbursement Request

Declination of Health Plan Coverage form

  • Provider PPO Network for both Medical and Dental

  • Contracted rates and pre-determined discounting for provider services

All eligibility verification must be done through HealthSCOPE, not the local Aetna group.

 Eligibility Benefits

888.276.4732

When creating your HealthSCOPE online account enter Adventist Risk Management under Company Name and leave Group or Plan ID # blank

  • Member Services (for all HCAP product lines except prescription)

  • Phone line open 9:00 am – 7:00 pm M-TH; 9:00 am – 4:00 pm FR

  • Eligibility and Benefit Verification for providers (IVR available 24x7)

  • Claims processing Center (for medical, dental and vision claims)

  • Pre-Certification and Case Management Functions

  • On-line member portal to track claims, order new ID cards, credible medical information

Prescription

 Express Scripts 

800.841.5396

Member Services 888.276.4732 or email Healthcare@adventistrisk.org

  • Prescription Benefit Manager

  • Member Services (for prescription benefits only)

  • Pre-certification functions (prescription related only)

  • On-line member portal to review and track prescription claims, setup mail-order payment, shipping address . . . 

  • Retail (30-day supply) – $10/$20/$40

  • Mail (90-day supply) – $20/$40/$80

  • Plan year Maximums out-of-pocket – $750/$1,500

No CAPS network required. Review paid claims history or request new card call Member Services 888.276.4732 or email Healthcare@adventistrisk.org


Chiropractic, Acupuncture, Massage, Refractive Eye Surgery, Hearing Aids, etc. No PPO Network required. Review paid claims history or request new card call Member Services 888.276.4732 or email Healthcare@adventistrisk.org
Request replacement medical/dental/vision card

To replace your card, please call 888.276.4732
Please verify what address they have on file. If it is different than your current address, you will need to complete a
Change Request Form to change your address. 

To make any changes to your medical enrollment (address, phone number, name, adding or subtracting dependents), please complete a Change Request Form and email to Human Resources at cbrown@azconference.org or fax to 480.991.4833 attention HR.

Flexible Spending Account

All regular full time and part-time benefited employees are eligible to set aside pre-tax dollars, through payroll deductions, to spend on un-reimbursed medical and dependent care expenses. This pre-tax benefit is available through a Section 125 Cafeteria Plan program. The term Section 125 refers to a section of the Internal Revenue Code. Section 125 programs allow employees to save taxes on money they pay toward their group sponsored health plans.

Available upon hire and at annual open enrollment. Contact Human Resources for more information.

Common examples of health FSA eligible expenses can be found here.

Summary Plan Description

International Insurance

Our current Medical plan covers emergencies only. Additional coverage options are available.

Affordable Care Act Notice

New health insurance marketplace coverage options and your health coverage

Family and Medical Leave Act (FMLA)

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Arizona Conference requires use of paid leave accruals prior to non-paid leave commencing. Eligible employees are entitled to:

  • Twelve workweeks of leave in a rolling 12-month period for:

    • the birth of a child and to care for and bond with the newborn child within one year of birth;

    • the placement with the employee of a child for adoption or foster care and to care for and bond with the newly placed child within one year of placement;

    • to care for the employee’s spouse, child, or parent who has a serious health condition;

    • the employee’s own serious health condition that makes him/her unable to perform the essential functions of his/her job;

    • any “qualifying exigency” arising out of the deployment to a foreign country of the employee’s spouse, son, daughter, or parent who is in the Regular Armed Forces or National Guard or Reserves; and

  • Twenty-six workweeks of leave in a single, rolling 12-month period to care for a covered service member or veteran with a qualifying serious injury or illness incurred or aggravated in the line of duty on active duty. The eligible employee must be the spouse, son, daughter, parent, or next of kin of the service member or veteran. (Military Caregiver Leave)

FMLA Request – Employee’s Serious Health Condition 

FMLA Request – Family Member’s Serious Health Condition

Certification of Qualifying Exigency for Military Family Leave 

Certification for Serious Injury or Illness of Covered Service member 

Certification for Serious Injury or Illness of Veteran 

FMLA Employee Rights and Responsibilities 

FMLA Fitness For Duty Certificate

Employee’s Guide to FMLA 

2017 Health Plan Monthly Contributions  LEGACY

Employee

$40

Spouse

$40

Per Child

$20


2017 Health Plan Monthly Contributions  STANDARD

Employee

$80

Spouse

$80

Per Child

$40