Members
Arkansas State Employees 2022: Premium plan
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 2022 contract year.
All benefit plans and rates are set by the Arkansas State and Public School Life and Health Insurance Board. For a complete schedule of benefits, or specific information regarding your health plan summary and/or rates please refer to the Summary Plan of Benefits online at transform.ar.gov/employee-benefits/arkansas-state-employees/ or contact the Employee Benefits Division at 877-815-1017.
Sign in or register for Blueprint Portal for additional online tools via our Health Advantage website self-service center.
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
| Benefits | In-Network | Out-of-Network |
|---|---|---|
| Annual deductible (Ind.) | $500 | $2,000 |
| Out-of-Pocket Max (Ind.) | $3,000 | N/A |
| Annual Deductible (Fam.) | $1,000 | $4,000 |
| Out-of-Pocket Max (Fam.) | $6,000 | 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 (Ind.) | $3,100 | N/A |
| RX Out-of-Pocket Maximum (Fam.) | $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% |
*Excluded drugs, reference price drugs and brand drugs where generic is available does not apply toward the prescription drugs out-of-pocket maximum.
More info
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.