The Premium plan offers the lowest deductible for in-network services. Wellness benefits are available at no charge when obtained by a participating provider. This plan offers out of network coverage at a higher cost share. The plan allows medical and pharmacy copays, coinsurance, and deductible amounts to count towards the True Out-of-Pocket Maximum (TrOOP) for cost sharing. The information provided highlights benefit coverage information for the 2025 contract year.
Plan highlights
- No referrals required
- Access to an extensive network of Arkansas doctors and hospitals
- Access out-of-state doctors and hospitals
- Discounts at health and fitness clubs
- Online access to Personal Health Record information, claims and benefits through Blueprint Portal
Premium plan benefits
| Benefit | In-Network | Out-of-Network |
|---|---|---|
| Annual Deductible (Individual) | $750 | $2,000 |
| Out-of-Pocket Maximum (Individual) | $3,250 | N/A |
| Annual Deductible (Family) | $1,500 | $4,000 |
| Out-of-Pocket Maximum (Family) | $6,500 | N/A |
| Pharmacy Copayment* Tier I (Generic) Tier II (Preferred) Tier III (Non-Preferred) Tier IV (Specialty) | $15 $40 $80 $100 | N/A |
| RX Out-of-Pocket Maximum (Individual) | $3,100 | N/A |
| RX Out-of-Pocket Maximum (Family) | $6,200 | N/A |
Common services
| Service | In-Network Copayment | In-Network Coinsurance | Out-of-Network Coinsurance |
|---|---|---|---|
| Primary Care Doctor's Office Visit | $25 | $0 | 40% |
| Specialist Office Visit | $50 | $0 | 40% |
| In-Patient Services | $0 | 20% | 40% |
| Outpatient Services | $0 | 20% | 40% |
| ER Visit and Observation Services | $250 | 0% | 0% |
Classic plan
The Classic plan is a high deductible plan that qualifies for a Health Savings Account (HSA). Classic plan members can enroll in a Health Savings Account through Connect Your Care. Wellness benefits are available at no charge when obtained by an in network provider. This plan offers out of network coverage at a higher cost share. The information provided highlights benefit coverage information for the 2025 contract year.
Plan highlights
- No referrals required
- Access to an extensive network of Arkansas doctors and hospitals
- Access out-of-state doctors and hospitals
- Discounts at health and fitness clubs
- Online access to Personal Health Record information, claims and benefits through Blueprint Portal
Classic plan benefits
| Benefit | In-Network | Out-of-Network |
|---|---|---|
| Annual Deductible (Individual) | $1,750 | $3,000 |
| Out-of-Pocket Maximum (Individual) | $6,450 | N/A |
| Annual Deductible (Family) | $3,300 / $3,500 | $6,000 |
| Out-of-Pocket Maximum (Family) | $9,675 | N/A |
| Paid by Plan After Deductible | 80% | 60% |
| Pharmacy Copayment* Tier I (Generic) Tier II (Preferred) Tier III (Non-Preferred) Tier IV (Specialty) | 20% 20% 20% 20% | N/A |
Classic individuals on a family plan must meet $3,300 individual deductible.
Basic plan
The Basic plan is a high deductible plan that qualifies for a Health Savings Account (HSA). Wellness benefits are available at no charge when obtained by a participating provider. Basic plan members can enroll in a Health Savings Account through Connect Your Care. There is no coverage for out of network providers. The information provided highlights benefit coverage information for the 2025 contract year.
Plan highlights
- No referrals required
- Access to an extensive network of Arkansas doctors and hospitals
- Access out-of-state doctors and hospitals
- Discounts at health and fitness clubs
- Online access to Personal Health Record information, claims and benefits through Blueprint Portal
Basic plan benefits
| Benefit | In-Network | Out-of-Network |
|---|---|---|
| Annual Deductible (Individual) | $4,000 | N/A |
| Out-of-Pocket Maximum (Individual) | $6,450 | N/A |
| Annual Deductible (Family) | $8,000 | N/A |
| Out-of-Pocket Maximum (Family) | $12,900 | N/A |
| Paid by Plan After Deductible | 80% | N/A |
| Pharmacy Copayment* Tier I (Generic) Tier II (Preferred) Tier III (Non-Preferred) Tier IV (Specialty) | 20% 20% 20% 20% | N/A |
More information
If you are considering COBRA, contact the Employee Benefits Division at 877-815-1017 for rates and enrollment information.
The rates and benefits stated above are set by the Arkansas State and Public School Life and Health Insurance Board. Health Advantage is the claims administrator for the Premium, Classic, and Basic plans.
*Excluded drugs, reference price drugs and brand drugs where generic is available does not apply toward the prescription drugs out-of-pocket maximum.