Short-Term Disability Benefits for City of Mesa
Short Term Disability (STD) is voluntary insurance for City of Mesa
active employees who enroll in the program during open enrollment.
Coverage for short-term disability covers non-work related disabilities, and
pays 66 2/3% of an employee's base pay at the time of disability (after
waiting period) for a maximum of six months. Please be aware during the
first six months of STD coverage, pre-existing conditions may not be covered
under this plan.
STD Policy Certificates
The City of Mesa's Voluntary Short Term
Disability (STD) plan is a group policy that is administered by Mutual of
Omaha. Active Employees who are enrolled in STD through the City can review
the policy and payment of claims provision in the certificates below. The
certificates are based on the elimination period (waiting period) that the
member enrolled in.
How to Apply for Short Term Disability (STD)
- Call (800) 877-5176 to file your claim with a Disability Customer
- The Customer Service Representative will complete the telephonic
claim form. You will need to provide your personal information as well
as your injury/illness and employment information.
- Once the call is complete, Customer Service will mail you an
Authorization to Disclose Personal Information form.
Please complete, sign and fax or mail the form directly to Mutual of
Omaha (fax 402-997-1865). It is best to write on the top of the form
your claim number that will be given to you when you call in your
disability. Mutual of Omaha will send the authorization form to your attending
physician(s) as necessary to obtain medical records.
- The claim will then be submitted for processing.
Follow Up On a Claim
Mutual of Omaha will contact your employer and physician to
request additional information. There may be a delay in processing your
STD claim due to missing information (i.e. medical records, Attending
Physician Statement, Authorization to Disclose Personal Information,
verification of information, etc.).
Mutual of Omaha will follow up on missing physician information until
it is received. If Mutual of Omaha does not receive a timely response
form the physician's office, Mutual of Omaha may recommend that you
contact your physician's office in order to expedite the request.
Mutual of Omaha - Disability Customer Service at
Noel Vera at (480) 644-6706 or email
Benefits at benefits.Info@mesaaz.gov
Main Street, Suite 600
Mesa, AZ 85201
Open Mon -Thurs 7am-6pm
(480) 644-2299 - Phone
(480) 644-4548 - Fax
Option 3: Claim Status
E-mail (password resets cannot be done via email)
Federally Mandated Notices