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CITY OF TOMBSTONE OPEN ENROLLMENT RESOURCES

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)

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 Tombstone - Aetna Summary of Benefits & Coverage - Basic PPO Plan (pdf)Download
City of Tombstone - Aetna Summary of Benefits & Coverage - Premiere PPO Plan (pdf)Download
2024 - City of Tombstone - HRA SBC (PPO Basic) - 07-2024-06-2025 (pdf)Download
2024 - City of Tombstone - HRA SBC (PPO Premiere) - 07-2024-06-2025 (pdf)Download
City of Tombstone - Aetna Dental Plan (pdf)Download
Aetna Vision Plan PLUS 12M (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 Tombstone 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

Download PDF

FSA Eligible Expenses List

Download PDF

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

Download PDF

ERISA Plan Documents

Review Rules and Eligibility of the 7/1/24-6/30/25 Benefit Plans

2024-2025 City of Tombstone FSA HRA Summary Plan Description (pdf)Download

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