Health Insurance – Group Medical

Health Insurance Eligibility

UA Little Rock employees who work half-time or more on a regular appointment basis (not hourly) are eligible to participate in the Group Medical insurance programs. The University provides a self-insured medical plan, which is administered by a third-party administrator, UMR.

If you are a full-time employee, the University will pay a larger cost share percentage towards your premiums than if you are less than 100%. Eligible dependents of employees may also be covered.

Enrollment & Effective Dates

Employees must enroll in the medical plan within 31 days of their benefits eligible appointment date. All optional benefits are effective the first of the month following the enrollment date as long as the enrollment forms are completed and received in Department of Human Resources within the 31 day enrollment eligibility window. There is no late enrollment for health coverage.

NOTICE

This website provides a summary of the medical insurance plan and not an actual contract. For more information, visit or call Department of Human Resources for specific details of the University’s health insurance plan, including eligibility criteria, enrollment forms, plan benefits and exclusions, and lists or participating physicians, hospitals, and other health care providers.

• Prescriptions
• UMR Provider Search
• Behavior Health Providers Network
• UAMS Smartcare Provider Search
• UMR Foreign Claim Submission
• Affordable Care Act (ACA)

Coverage Plans

Classic Plan

The Classic Plan is similar to a managed care plan, however, you are not required to obtain referrals from your Primary Care Physician (PCP).

Like most medical plans, there are deductibles, co-payment, co-insurance and maximum out-of-pocket amounts.

Under the Classic Plan you select a doctor from the United Healthcare Options PPO Network prior to seeking services. You file no claim forms and only pay a $35 co-payment at the time of your physician visit.

Covered Services under Classic Plan

• Preventive Care Services (physical exams, well baby/child visit, immunizations, and routine gynecological visits, mammograms, prostate screening and other “wellness services”)
• Physician Services (office visits, surgical services, inpatient medical care, diagnostic testing)
• Outpatient Services (surgical services, ER visits, urgent care, ambulance, home health, hospice, etc.)
• Routine Vision Exam
• Inpatient Services (room & board, ICU/CCU)
• Maternity Services (physician, hospital)

Note: Some services may require Pre-authorization. Please refer to the Summary Plan Description Booklet.

Premier Plan

This is a “gold” plan with the highest premiums.  But you’ll pay the least out-of-pocket of the three medical plans when you receive care from in-network providers.  Benefits are also available out-of-network, although at a reduced benefit.

Here’s how the plan works:

• You pay co-payments for doctor and specialist visits, certain other expenses and prescription drugs.
• You will pay all other expenses in full until you meet your plan deductible.
• Once you meet your deductible, you and the University share in the cost of covered services.
• If you reach the medical out-of-pocket maximum, the plan pays 100% of all eligible expenses for the rest of the calendar year.
• You will have the option to see an out-of-network provider, but you will pay more for your care

Premier Plan Highlights

Health Savings Plan

This is a high-deductible, consumer-driven health plan.  It has the lowest premiums.  But until you meet the deductible, you pay  ALL medical expenses out of your pocket. Once you meet the deductible, you share the cost of covered medical and prescription drug expenses with the plan through coinsurance. This plan includes a Health Savings Account (HSA) – a tax-advantaged account used to pay eligible medical, dental, vision and prescription expenses.  Money in your HSA stays with you year after year, no “use it or lose.”  The HSA belongs to you, which means you can take it with you if you leave the University. Your HSA grows through contributions made by you and the University.  You cannot enroll in this plan if you have other health coverage or are eligible for Medicare.

Here’s how the plan works:

• Until you meet your deductible, you pay for all medical expenses, including prescription drugs, yourself or with money from your HSA. There are no co-payments.
• Once you meet the deductible, you and the plan share in the cost of covered medical and prescription drug expenses through coinsurance.
• If you reach the medical out-of-pocket maximum, the plan plans 100% of all eligible expenses for the rest of the calendar year.
• You have the option to see an out-of-network provider, but you will pay more for your care.

Out of Country Travel

• Claim Submission Process