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Services Provided through Arkansas Employee Benefits Division
The Annual Benefits Guide
includes information on the new 2010 plan, what changes can be made, how to enroll, who to call with
questions, benefit coverage, rates, retirement information and frequently asked questions.
The Annual Benefits Guide contains important information about pre-certification, appeals and case management. Please read to avoid denials for services not pre-certified.
Health Advantage
Arkansas State and Public School Employee Benefits Division (EBD) and Health Advantage partnered in 2005 to offer the ARHealth plan to retirees with Medicare.
All Medicare and non-Medicare Arkansas State and Public School Retirees are enrolled automatically in the ARHealth Plan upon retirement.
Health Advantage, a subsidiary company of Arkansas Blue Cross and Blue Shield, has offered
health insurance products to public school employees and their dependents for more than 10
years. We understand the importance of having local access to customer service for you and
your family. If you need to walk in and speak with someone, we are there to help you, with
local offices in Texarkana, Little
Rock, Hot Springs, Jonesboro, Fort Smith, Pine Bluff and Fayetteville. These local offices
provide services to all the counties within their region.
If Medicare is not your primary coverage, the 2010 ARHealth plan features as follows:
- You will be automatically enrolled in this plan upon retirement.
- You do not have to select a primary care physician (PCP).
- You will have many preventive services (65 KB PDF) covered at 100 percent.
- One vision screening will be covered every 24 months with a $35 copayment.
- One hearing screening will be covered every 36 months with a $35 copayment.
- Hearing aids will be covered — $1400 per ear per every three years. You may use any provider of your choice for this benefit.
- Your copayment will be $25 for PCP visits and $35 for specialist visits.
- Your in-network coinsurance will be 20 percent on many services.
- You can use any in-state provider in the Health Advantage network without a referral.
- If you elect to use an out-of-network provider within the state of Arkansas, your out-of-network coinsurance will be 40 percent and the out-of-network deductible amount will be $1000 per individual and $2,000 per family,
with a maximum out-of-pocket expense of $5,000 per individual and $10,000 per family.
- If you wish to obtain services from an out-of-state provider, you can use any provider in the BlueCard® PPO network.
PPO network.
- Your prescription drug benefits and mental health benefits will remain the same.
If Medicare is your primary coverage, the 2010 ARHealth plan features remain as follows:
- If Medicare is your primary coverage, you will be enrolled in this plan upon retirement.
- If you become Medicare eligible during the year, your coverage will be supplemental to traditional Medicare A and B benefits. Send the Employee Benefits Division a copy of your Medicare card as soon as you receive it.
- Your ARHealth plan coordinates with any qualified Medicare plan (Medicare A, Medicare B and Medicare C- also called Medicare Advantage or Medicare replacement plans)
- You do not have to select a primary care physician (PCP).
- You can see any physician — anywhere in the United States.
- If you are a public school retiree, your ARHealth premium has been substantially reduced to enable you to purchase a Medicare Part D Prescription Drug Plan of your choice.
- Your mental health benefits are covered by Medicare and ARHealth.
- Your ARHealth plan will cover on vision screening every 24 months, with a $35 copayment, even if not covered by Medicare.
- Your ARHealth plan will cover one hearing screening every 36 months, with a $35 copayment, even if not covered by Medicare.
- Your ARHealth plan will provide coverage for hearing aids — $1400 per ear every three years. You may use any provider you choose for this benefit.
Refer to your Annual Enrollment Guide for specific
benefits and rates, or call Health Advantage Customer Service at 1-800-482-8416 or Employee Benefits
Customer Service at 1-877-815-8017 or 501-682-9656.
BlueCard®
As an ARHealth member through Health Advantage, you have more freedom to choose the doctors and
hospitals that best suit you and your family. Your coverage gives you a world of choices through
the BlueCard® Program.
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