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CITY OF BENSON OPEN ENROLLMENT

Aetna Resources

See helpful links below provided by Banner Aetna

Find a Doctor Link (Arizona Banner Open Access POPS II Network)Pharmacy Rx Drug (OTC Allowance)Additional Resources Site Member Portal Login (Member #, Virtual Card, EOBs)

Plan Year 7/1/2024 - 6/30/2025 Enrollment Materials

Employee Benefit Election Form 1July24 (Printable) (pdf)Download

ESG HRA Reimbursement Claim Form (Fillable) (pdf)Download

ESG Direct Deposit Authorization Form (Fillable) (pdf)Download

City of Benson - Aetna Summary of Benefits & Coverage (SBC) - PPO Plan (pdf)Download

City of Benson - Aetna Summary of Benefits & Coverage (SBC) - HSA Plan (pdf)Download

COB AETNA PPO - HRA Benefit Illustration (pdf)Download

COB AETNA HSA - HRA Benefit Illustration (pdf)Download

2024 - City of Benson - HRA SBC (PPO) - 07-2024-06-2025 (pdf)Download

2024 - City of Benson - HRA SBC (HSA) - 07-2024-06-2025 (pdf)Download

Open Enrollment Video Presentation

Open Enrollment PDF Slideshow Deck (same as above video)

Please note: Must download file as a PDF for carrier website and contact links to work in benefit resources section.

2024 - City of Benson Open Enrollment Presentation (pdf)Download

Plan Participant - Account Setup Guides

After electing to participant in a plan during open enrollment, use these guides to confirm and complete setup of your ESG account.

2024 HSA Instructions - Account Setup Guide (docx)Download

2024 HRA Instructions - Account Setup Guide (docx)Download

2024 FSA Instructions - Account Setup Guide (docx)Download

Flexible Spending Account (FSA) Summary

FSA & HSA Eligible Expenses List

Tutorial: How to use Benefits by ESG smartphone app

Manage accounts and submit claims with our mobile app!

For further assistance, contact customerservice@esgcorp.biz

ESG Mobile App & Online Consumer Portal Access Guide

ERISA Plan Documents

City of Benson Participant Plan Rules and Eligibility for Benefit Plan Year 7/1/24-6/30/25

City of Benson Wrap Plan - Summary Plan Description Eff 1Jul24 (pdf)Download

City of Benson Premium Only Plan - Benefit Summary Eff 1Jul24 (pdf)Download

City of Benson Health Reimbursement Arrangement - Summary Plan Description Eff 1Jul24 (pdf)Download

City of Benson Flexible Spending Account with HSA Feature - Summary Plan Description Eff 1Jul24 (pdf)Download

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