The MMIA EB program now uses secure, HIPPA-compliant online forms. Choose an option below to enroll, make a change, or terminate your coverage. Once an online form is submitted, it will go to both your city/town benefit representative and the MMIA.
For questions, contact your city or town representative or the MMIA Employee Benefits staff at 1-800-635-3089 option 4.
Choose this option if you are enrolling for the first time such as:
Or if you are removing all MMIA EB coverages for an employee/retiree and all spouse/dependents covered under their benefits.
Choose this option if you are an existing employee or retiree and you want to make a change to your benefits such as:
Use the following forms to manually request claim reimbursement or visit the vendor’s website to do it online.
Medical Claim Reimbursement PDF Form
- Vendor: www.AskAllegiance.com
Vision Out-of-Network Claim Reimbursement PDF Form
- Vendor: www.VSP.com
Proact Prescription Reimbursement Proact Prescription Reimbursement Form 1PDF Form
- Vendor: https://secure.ProActRX.com/
Ridgeway Mail Order Prescription PDF Form
- Vendor: https://Ridgeway.Pharmacy/
CRx formerly known as MMIA Scripts (web ID: MMIA) https://www.crxintl.com/