UAMS.EDU

Medical

    Useful Links, Contacts

 

UMR
(medical claims starting 2013)
1-888-438-6105
UMR provider search
How to access online services

 QualChoice
(medical claims through 2012) 501-219-5133 local
1-866-724-3570 toll-free 

MedImpact (pharmacy benefits)
1-800-788-2949

OnLife (wellness)

The University of Arkansas Health Plan is self-insured and self-funded. UMR is our third party administrator 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.  Our network is nationwide.

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.

Which plan?

Refer to the side-by-side comparison of the two plans to help you decide which is better for you and your family.  To see more details, click on the Summary Plan Description.  The savings you enjoy under UAMS SmartCare are the same under both plans.

2014 side-by-side comparison
Summary Plan Description (insurance booklet)
Glossary of Medical Terms 

Uniform Summary of Benefits and Coverage or “SBC” (legally required format so you can compare our plans to others):  2014 Classic2014 POS

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. 

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.

Other resources:
     Maternity Management;  how to save $300    
     Medical care while traveling abroad
     Pre-Authorization Listing
     Nurseline
     Nutritional Counseling and Weight Management Program (go to  Forms for required forms)
     Diabetes Management Program; free test strips and meters from Abbott or Bayer
     Healthy Heart Program (free meds and blood pressure monitor)
     Tobacco-free 4 life program (2 free office visits and Chantix prescription)
     Medicare and Your UA Medical Benefits (what happens when you turn 65) 

Legal Notices:
     Health Insurance Marketplace letter, form
     Medicare Part D Creditable Coverage Letter
     UA Notice of Privacy Practices 
     Children’s Health Insurance Program (CHIP) Premium Assistance

 

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.