BlueAdvantage Administrators of Arkansas
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Arkansas State Retirees

Plan Information



New Benefits Effective Jan. 1, 2011


Services Provided through Arkansas Employee Benefits Division

The Employee Benefits Division (EBD) of the Department of Finance and Administration is the administrator for the ARHealth Plan. Visit www.arbenefits.org to find information for your plan. EBD maintains all member eligibility, including dependent status and required documentation. EBD also is the COBRA administrator for the ARHealth plan.

If you are a retiree with the State of Arkansas, eligibility questions should be directed to EBD. If you are a COBRA retiree, or are considering COBRA, please contact EBD.


Health Advantage

Arkansas State and Public School Employee Benefits Division (EBD) and Health Advantage began offering the ARHealth plan to retirees with Medicare in 2005. Health Advantage, a subsidiary company of Arkansas Blue Cross and Blue Shield, has offered health insurance products to Arkansas State 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 our offices in Texarkana, Little Rock, Hot Springs, Jonesboro, Fort Smith, Pine Bluff and Fayetteville. Please feel free to visit the office nearest you.


If Medicare is not your primary coverage, the ARHealth plan features are as follows:

  • Automatic enrollment upon retirement.
  • No need to select a primary care physician (PCP).
  • Many preventive services (PDF) covered at 100 percent.
  • Your copayment will be $25 for PCP visits and $35 for specialist visits.
  • In-network coinsurance will be 20 percent on many services.
  • You can use any doctor or hospital in the state in the Health Advantage network without a referral.
  • If you elect to use an out-of-network provider within 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 doctor or hospital, visit the BlueCard® PPO network.
  • Prescription drug benefits and mental health benefits will remain the same.
  • 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.

If Medicare is your primary coverage, the 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 will coordinate with any qualified Medicare plan (Medicare A, Medicare B and Medicare C — also called Medicare Advantage plans).
  • No need to select a primary care physician (PCP).
  • You can see any physician — anywhere in the United States.
  • If you are a state retiree, the premium for the ARHealth plan covers your prescription drugs, unlike other Medicare supplemental policies. Under federal guidelines, since state retirees have a qualified prescription plan, they cannot select a Medicare D drug plan, or a part C plan that has prescription coverage.
  • 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.
  • Mental health benefits are covered by Medicare and ARHealth.
  • You will have coverage for one vision exam every 24 months with a $35 copayment, even if Medicare does not cover it.
  • You will have coverage for one hearing exam every 36 months with a $35 copayment, even if Medicare does not cover it.
  • Your ARHealth plan now covers hearing aids. The benefit is $1400 per ear every three years. You may use any supplier you choose.

Pre-certification: Some services may require advance approval (pre-certification). Please read this important information about pre-certification, appeals and case management.


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.

More Information
Summary Plan Description
Rates (PDF)
FAQs
Forms for Members
My Blueprint
My BlueLine
Pharmacy Benefits


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