Arkansas State Employees

Our Premium Plan is the highest level plan we offer that is an ideal option for those who visit the doctor and specialists regularly. This plan features:

• Highest premium
• Lowest deductible
• Co-pays and coinsurance
• Separate out-of-pocket limit for pharmacy coverage
• Eligibility to contribute to a Flexible Spending Account (FSA)

• 2024 Summary of Benefits

Classic Plan

Our Classic Plan is a great mid-level plan option for you and your family. This plan features:

• Coinsurance
• Eligibility to contribute to a Health Savings Account (HSA)

• 2024 Summary of Benefits

Basic Plan

The Basic Plan is a great option for those who are looking for the most affordable option. This Plan features:

• Lowest Premium
• Highest deductible
• Eligibility to contribute to a Health Savings Account (HSA)
• No out-of-network coverage

• 2024 Summary of Benefits

Rates

• 2024 ASE Active Employee Rates
• 2024 ASE COBRA Rates

Enrolling, Canceling, and Making Changes to your ARBenefits Coverage

You can enroll in ARBenefits coverage within 60 days of your hire date or during Open Enrollment To enroll during either of these periods, you will need to log into your ARBenefits Member Portal. Check out our How to Enroll Online Guide to view more information on how to do this through your ARBenefits Member Portal.

You can enroll, cancel or make changes to your ARBenefits coverage within 60 days of a qualifying event (marriage, divorce, birth/adoption, gain/loss of other coverage.) To make changes or cancel coverage due to a qualifying event, you must submit an ARBenefits Change Form along with the supporting documentation below if applicable. To enroll for the first time due to a qualifying event, you must submit an ARBenefits Election Form along with the following documentation if applicable.

• Marriage License – to add a spouse or stepchild
• ARBenefits Spousal Affidavit form – to add a spouse
• Birth Certificate/adoption paperwork – to add a child
• Proof of prior coverage (must include names and dates of coverage) – to add yourself, a spouse, or a child due to loss of group coverage

• Divorce Decree – to drop a spouse due to divorce
• Proof of other group coverage (must include names and dates of group coverage) – to drop ARBenefits coverage on yourself, a child, or a spouse due to gaining other group coverage.

Pharmacy Benefits

• Participating Pharmacy Network Listing
• Arkansas Drug List – Updated 7/5/2024
• Pharmacy Reimbursement Claim Form
• Standard Prior Authorization Form
• Appeal Request Form

Coverage Policies

• EBRx Medical Benefit Criteria
• Health Advantage Coverage Policies

Voluntary Products

Voluntary products are additional insurance plans offered by the State. This includes enrolling in a Health Savings Account (HSA), Flexible Spending Account (FSA), life insurance, dental and vision insurance

An HSA allows you to use pre-tax funds to cover eligible expenses. These are offered through Optum Financial

Eligibility: Must be on the Basic Plan or Classic Plan
Contributions: Can be adjusted anytime
Account Access: Will still be available even after you leave
your employer
Enrollment: Do not need to re-enroll each year
Rollover of Funds: Funds will rollover

• 2024 HSA Enrollment Form
• HSA Claim Form
• Change of Status Form
• HSA Transfer Request Form
• Optum HSA Employee Reference Guide

An FSA allows you to use pre-tax funds to cover eligible expenses. Medical FSA can be used on eligible medical expenses . Dependent Care FSA (or DCAP ) can be used on expenses relating to daycare and elder care. Limited Purpose FSA can be paired with an HSA to be used on dental and vision expenses .

Eligibility: Must be on the Premium Plan or No Health to enroll
Contributions: Can only be adjusted during Open Enrollment, the new hire period, or if you have a qualifying event
Account Access: Will be lost after you leave your employer
Enrollment: Must re-enroll each year
Rollover of Funds: Funds over $610 do not rollover

• 2024 FSA Enrollment Form
• FSA Claim Form
• 2023 Optum Plan Design
• Optum FSA Employee Reference Guide

Delta Dental and Humana Vision are both available to State employees through Arkansas State Employee Benefits Advisors (ARSEBA).

Colonial Life’s group term life insurance can help provide financial security for your family. See below for more information on options through Colonial Life.

• 2024 Colonial Life Enrollment and Rates
• Basic and Enhanced Basic Coverage Brochure
• Supplemental Coverage Brochure
• Colonial Life LawAssure
• Knowledge of Financial Education
• Employee Assistance Program