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.
When should I report a new vehicle/building/etc.?
The MMIA recommends reporting all new acquisitions as soon as possible. While you do have 18 months to list all acquisitions on your property schedule, the MMIA has annual renewal process to catch items purchased mid-year.
What is Boiler Coverage?
Coverage extends to all Property program members for boiler and machinery mechanical breakdown. If you have a State of Montana licensed boiler, it must be scheduled in order to take advantage of a free annual inspection.
What is Replacement Value?
This amount is an estimate of what the cost would be to replace the item if it were lost or damaged. The value is a basis for determining coverage cost. If your car has a replacement value of $45,000, but the actual replacement will cost $52,000, we will pay up to $52,000 to replace it.
What is Stated Value?
This is the maximum amount your item is covered for. If the property is scheduled for a stated value of $1,000, we will only pay up to $1,000.
When do I have to notify MMIA of changes?
All changes must be submitted at least once each year with your property renewal (occurs January through March). Any change in covered structures/real property, regardless of value, must be reported as it occurs throughout the year. Any change in personal property with a value of $100,000 or more must be reported as it occurs throughout the year. Changes in vehicles with values of $100,000 or more must be reported throughout the year. Changes in vehicles and equipment valued at less than $100,000 need only be reported at renewal. Note: Any single change of $700,000 or more, reported in the first six months of a policy period is subject to additional premium.
What happens if a piece of equipment or real property is not listed on the Member’s property schedule?
Coverage will be the actual cash value. This is typically less than the Stated or Replacement Value. This is why it is important to make sure all property is reported to the MMIA.
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 email@example.com
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.