Medical

The University of Arkansas Health Plan is self-insured and self-funded. UMR is our third party administrator effective 1-1-2013 and processes your medical claims. MedImpact is our pharmacy benefit manager and processes your prescription claims.

You have two plans to choose from: Point of Service or Classic. Both cover a wide range of traditional expenses such as doctor visits, surgical services, pregnancy, emergency room services, hospital stays, mental health services and diagnostic testing. With a goal of assisting you in being healthy, most preventive care performed in-network is covered in full (such as annual physicals, flu shots, cancer screenings and well baby care).

Classic Managed Care Plan, or “Classic”

The majority of employees elect the Classic plan and enjoy a lower premium cost. However, benefits are only provided if you access care through providers that are in-network, similar to an HMO. There are no benefits if you go outside the network, except for emergencies that arise while traveling.

Classic Summary Plan Description (insurance booklet)
Uniform Summary of Coverage (legally required format so you can compare this plan to other plans)

Point of Service Plan, or “POS”

This is a “dual option” plan.  Your out-of-pocket costs are determined by whether you seek care from an in-network provider or an out-of-network provider. You enjoy the same in-network benefits as the Classic plan.  You also have some coverage if you seek health care outside the network, although those benefits have  more cost-sharing.

Point of Service Summary Plan Description (insurance booklet)
Uniform Summary of Coverage (legally required format so you can compare this plan to other plans)

Which plan?

Refer to the side-by-side comparison of the two plans to help you decide which is best for you and your family.  The savings you would enjoy under UAMS SmartCare are the same under both plans.

January 2013 medical plans comparison
Glossary of Medical Terms

Pharmacy

Prescription drug benefits are the same under both plans.  The University uses a drug formulary where you would pay a $10/$35/$70 copay for most drugs.  For more details:

Summary of Drug Benefits
Drug Formulary

Provider Network

There are many doctors and providers that are in-network.  Please note that in the Little Rock area, the in-network hospitals are UAMS, St. Vincent’s Infirmary and Arkansas Children’s Hospital.   Baptist and Heart Hospital are not in the network.

UMR network for University of Arkansas (including UAMS) employees

Who can I cover?  What does it cost?

You can cover your spouse, as legally recognized by the State of Arkansas. You can also cover your children until they reach their 26th birthday, regardless of their marital, employment or student status. If you wish to cover a disabled adult child, contact our office.

Your premium cost is based on which plan you elect, the percent of time you work and the family members you are covering. UAMS pays up to 75% of the premium for full-time employees.

Rates

How do I enroll?

New employees may enroll within their first 30 days by completing an enrollment form at orientation.  There is a waiting period before coverage takes effect. Once you enroll and complete the required forms, coverage takes effect the first of the following month.

Current employees may enroll when the University offers an open enrollment period. However, annual open enrollments are not guaranteed.

If you experience a qualifying event, you may have a special 30-day window to make changes to your coverage.

How do I file a claim?

Show your insurance card to your doctor’s office or pharmacist and they will file the claim for you.  Use manual claim forms only if you did not have your insurance card and had to pay the bill up front. An administrative fee may be added to manual claims.

Forms

What else do I need to know?

You save the most when you use UAMS physicians, clinics and facilities. The savings under SmartCare will automatically be applied when you get your care at a UAMS SmartCare facility.

After you get your insurance card with your member ID number, visit UMR’s website and register for on-line access.  You can view your claims, print a temporary ID card, and access resources to lead a healthier life.

Here are other resources:

Medical care while traveling abroad
Maternity Management
Pre-Authorization Listing
Nurseline
Nutritional Counseling and Weight Management Program (go to  Forms for required forms)
Diabetes Management Program; free glucometers from Abbot or Bayer
Healthy Heart Program (free meds and blood pressure monitor)
Kick the Nic (free Chantix, smoking cessation)
Medicare and Your UA Medical Benefits (what happens when you turn 65) 
Medicare Part D Creditable Coverage Letter
UA Notice of Privacy Practices

Benefit plan information on these web pages is in a summary format and is not intended to replace actual plan documents. UAMS reserves the right to amend or terminate all or any part of any benefit plan.