(FAQ) Frequently Asked Questions
Who processes medical claims?
Allegiance Benefit Plan Management based in Missoula, MT has entered into a contract with the MMIA EB Program to process claims for our membership. Most healthcare providers will submit claims on our members’ behalf, but if you need to file a claim manually, you can do it online at https://www.askallegiance.com/Submissions/Health/Claim or mail it to Allegiance at to PO Box 5066, Missoula, MT 59806-5006.
How can I find a participating or in-network provider?
- Medical Providers: www.askallegiance.com/ProviderSearch or call Allegiance customer service at 800-877-1122
- Dental Providers: www.deltadentalins.com/individuals/ and use the ‘Find a Dentist’ feature on the right side of the screen or contact Delta customer service at 800-521-2651
- Vision Providers: www.vsp.com/find-eye-doctors.html or call 800-877-7195
- Air Ambulance Providers: Call SAMA 877-542-8828
How can I get help with a medical claim?
Allegiance Customer Service personnel are available at 800-877-1122 to answer questions regarding benefits and claims processing. Claims inquiries can also be made securely online at www.askallegiance.com/Home/Contact.
How can I get a replacement I.D. Card?
You can request a replacement benefit I.D. card by calling Allegiance at 800-877-1122. You can also get a temporary ID card by following these instructions:
- Log into www.askallegiance.com
- Select your Health Account
- Under the “Resources” tab, select, “ID Card Image”
- Click the “Submit” button on the far right of the screen. It may take a moment to load the image.
- Print or download your card image.
When should a new employee enroll?
A new employee is eligible to enroll in the Program after the employee has met the City or Town’s waiting or probation period as determined by the City or Town’s personnel policy. Application must be made within 31 days of the eligibility date; otherwise, the employee would be considered a late enrollee and would not be able to apply for benefits until the next annual open enrollment period, which is May 15 through June 15.
How do I obtain proof of Creditable Coverage?
A Certificate of Creditable Coverage is presented to the group health or individual plan with enrollment application. When a covered member of the MMIA loses health benefits, a Certificate of Creditable coverage is generated within 30 days of the loss of coverage. If the employee requests a Certificate of Creditable Coverage, it will be generated within 24 hours of the request.
What is a special enrollment period?
Employees and eligible dependents may enroll or make certain changes to their benefits if certain qualifying events occur. Written application must be made within 31 days of the event. Such events include marriage, birth or adoption of a child, change in employment status or involuntary loss of coverage.
How do I enroll my newborn?
Babies are NOT automatically added to your coverage. You must submit an enrollment form (PDF) to your City or Town representative within 31 days of your baby’s birth. The baby’s coverage will be retroactive to its date of birth.
What is the maximum age for dependents to remain on the plan?
In compliance with federal health requirements, eligible dependents can remain on the plan through age 26 regardless of student or marital status. Refer to the Summary Plan Description (SPD) in the Plan Documents on this site for complete eligibility guidelines.
What is Reference Based Pricing?
Reference Based Pricing is a method of paying hospitals and other medical facilities based on a standard reference point, in this case, Medicare. Reference based pricing closes the gap in how much different hospitals in Montana charge for the same services and saves MMIA and our participants’ money.
What does the Program cover?
Per the terms of the Memorandum of Liability Coverage in effect at the time of occurrence:
- General Liability
- Professional Liability
- Public Officials Errors & Omissions
- Auto Liability
- Employee Benefit Liability
- Land Use Practices
- Defense of Non-Monetary Claims for Open Meeting & Public Documents Claims
- No-Fault Coverage Sewer Backup/Water Main Breaks
Does the Program cover Employment Practices Liability?
There is an optional Employment Practices Liability (EPLI) coverage available through an endorsement. To obtain the endorsement, a member must submit their personnel policies to MMIA for review. Please see the EPLI application for details.
Does MMIA offer notary bonding?
Yes, through Alliant, MMIA’s Broker. Visit our Notary Page to access additional information and the application.
State law (section 2-9-803, MCA) requires: “All elected and appointed city or town officers or employees must be bonded for the faithful performance of all official duties required by law.”
Does the MMIA provide this bonding?
Montana code further allows a municipality to meet this bonding obligation by purchasing coverage provided “by a self-insurance pool insuring cities or towns" as authorized under 2-9-211, MCA, i.e. the MMIA.
Like all of the MMIA coverage our Crime and Fidelity endorsement is unique. It is only offered to our property program participants (who must also be enrolled in our liability program) and comes in a form that relates most closely to the Commercial Blanket Bond described above, call 800-635-3089 option 3 for more information.
Does MMIA provide liability coverage for miscellaneous items like skate parks?
The answer is yes if the city is willing to comply with certain requirements. An application is available which outlines the requirements that the city must meet in order to have the endorsement for the respective item in question.
What is Special Events Coverage?
Visit our Special Events Coverage page to access information regarding this coverage.
What type of property coverage does MMIA offer?
Property coverage includes:
- Real property: Real property or real estate is typically the structure or building improvement located on a site.
- Personal property: Personal property is the loose items (non-fixtures) or contents within the structures.
- Cyber liability and property: A commercial standalone policy that provides coverage for information security and privacy with electronic media liability coverage.
Why does MMIA conduct an annual review of scheduled items and their values?
Conducting an annual review of scheduled items and the accuracy of their values helps to ensure rate accuracy and stability. MMIA requests information on an annual basis to identify the Total Insured Value for the property program. This value is used to set future rates for coverage. If scheduled values are lower than their true value, losses may exceed the amount collected and result in significant rate increases. Accurate reporting of the true value of property is key in maintaining stable rates.
What is a stated value?
An amount defined by the member for a scheduled asset. It is the maximum amount payable in the event of a loss.
- Example: An equipment trailer is scheduled at a stated value of $5,000. The trailer is in an accident, with a total cost to repair of $5,000. The amount payable is $5,000 minus the deductible.
- Example 2: A vehicle is scheduled at a stated value of $35,000. The vehicle is in an accident, with a total cost to repair of $40,000. The amount payable is $40,000 minus the deductible, up to the maximum amount of $35,000.
What is a replacement value?
An amount defined by the member for a scheduled asset. It is an estimate of the cost to replace the item in its entirety if it were lost or damaged. Unlike stated value, replacement value coverage provides for the repair or replacement of the asset without regard to a maximum amount payable.
- Example: A police passenger vehicle is scheduled at a replacement value of $45,000. The vehicle is totaled in an accident. A new police vehicle with the necessary equipment costs $47,000. The amount payable is $47,000 minus the deductible.
What is a minimum replacement value?
An amount defined by the MMIA for a type of asset. It is the minimum amount that an asset’s value may be scheduled to be eligible for replacement value coverage. For a list of minimum replacement values, please contact MMIA at 800-635-3089.
What if coverage for a property isn’t needed?
Even if coverage for a property has been deemed by the member to be unnecessary, MMIA asks members to list the property on their schedule at a $0 value. By scheduling at $0, it is confirmation that no coverage is desired by the member and helps to avoid any confusion if a claim is filed for that property. Assets listed at $0 value do not result in an assessment cost to the member.
- Example: A member has an equipment trailer that is valued at $1,000. Because the member’s deductible is also $1,000, the member elects not to have property coverage for the trailer. They list the trailer on their schedule at $0. The member is not charged for coverage and MMIA has documented confirmation that no coverage is desire.
Who can participate in the trainings offered by MMIA?
Training is open to any city/town staff and city/town elected officials of participating MMIA members.
Who can utilize risk management services offered by MMIA?
Risk management services are available to participating MMIA members.
Is there a fee for MMIA sponsored training or risk management services?
No, there are no fees. Training and risk management services are provided at no cost to our members.
How do I get more information regarding on-site training opportunities or scheduling an on-site workplace evaluation?
Contact us at firstname.lastname@example.org
What if I have an injury on the job?
Montana Workers' Compensation statutes require injuries be reported to your employer within 30 days of the occurrence. MMIA strongly recommends you report all injuries to your employer as soon as possible. We recommend, whether or not you receive medical treatment, that you report minor injuries as well to your employer. An electronic First Report of Injury will be submitted to the MMIA by your employer which will be mailed to you for signature.
What if I can't work for a while?
If you suffer a total loss of wages due to your injury or occupational disease, you may be eligible for temporary total disability (TTD) benefits until your physician releases you to return to employment. You may receive weekly compensation of 66 ⅔% of your gross wages at the time of injury – up to the state’s maximum temporary total diability rate. Per Montana statute, compensation may not be paid for the first 32 hours or 4 days’ loss of wages, whichever is less, that the claimant is totally disabled and unable to work because of an injury. A claimant is eligible for compensation starting with the 5th day of wage loss. If you are totally disabled and unable to work for 21 days or longer, compensation may be paid retroactively to the first day of total wage loss. You can draw sick leave or vacation for the first four days.
Can I choose my treating physician?
You may choose the treating physician for initial treatment. Any time after acceptance of liability by an insurer, the insurer may designate a different treating physician, or approve your choice of the treating physician.
What medical benefits are provided?
Once MMIA accepts your injury or occupational disease claim, you are entitled to reasonable doctor, hospital, prescription and medical care costs. Allowable charges are paid according to a medical fee schedule. You do not have to pay the balance between what the medical provider charges and what the MMIA pays.
Visit the Montana Department of Labor and Industry website for more information.