Cooperative Extension Service
Departments
Human Resources - Group Benefits
Medical Insurance
The University of Arkansas medical insurance plan is administered by
QualChoice of Arkansas, Inc. QualChoice processes all claims. There are two
different programs available: the Classic Plan and the Point of Service Plan.
The Classic Plan has the lowest monthly premium because all health
care is handled through in-network physicians and specialists. A Primary Care
Physician (PCP) is selected by each covered family member from the QualChoice
Directory of Network Providers located under the Visitor Tab on the QualChoice
website at
www.qcark.com.
The Point of Service Plan is for those who need the flexibility of
choosing one of two benefits options each time a health care need develops, in
other words at the “point of service.” When you choose In-Network, your health
care is provided by an in-network physician or specialists. In-Network is much
like the Classic Plan. If you choose to go to a physician who is not in the
QualChoice Network, you will be choosing the Out-Of-Network option and incurring
the most out-of-pocket expense. Your Benefit payments for covered services will
be based on the Maximum Allowable Payment as determined by QualChoice. Charges
in excess of the Maximum Allowable Payments do not count toward meeting the
deductible or meeting the limitation of your Out of Pocket maximum. Non-QualChoice
Providers may bill the patient for amounts in excess of the Maximum Allowable
Payment.
Prescription Drug coverage is a part of both the Classic and Point of Service
Plans. The 3-tier prescription drug program requires a $10 copayment for generic
drugs, $35 copayment for formulary preferred brand-name drugs, and $70 copayment
for formulary non-preferred drugs. The formulary can be viewed at MedImpact’s
website
www.medimpact.com/members. If you have questions about the prescription
drug coverage, you may call the Extension Human Resources Office; MedImpact
(1-800-788-2949) or QualChoice (1-866-724-3570).
Exclusions and Limitations - The following is a partial listing of
procedures that are not covered under the University of Arkansas medical
insurance plan:
- Operations or treatment of the teeth or the supporting tissues
of the teeth, other than for tumors, dental services in connection with an
accidental injury, treatment of diseases of the jaw, or extraction of
impacted teeth
- Elective cosmetic surgery (certain reconstructive surgeries are
covered)
- Eyeglasses or hearing aids
- Treatment of weak, strained, flat, or unstable feet and corns,
calluses, or toenails
- Organ donation services
- Non-prescription drugs and supplies
- Infertility treatment
- Services or supplies as a result of on-the-job injuries covered under
Workers’ Compensation
- Services or supplies as a result of an act of war
Coordination of Benefits - This plan coordinates with other group plans
under which an individual is covered so that the total benefits available will
not exceed 100% of the allowable expenses.
Resignation - Under the federal regulation called COBRA (Consolidated
Omnibus Budget Reconciliation Act), you have the option of continuing your
current group health insurance coverage for up to 18 months after termination
(or 36 months under certain conditions). To keep this coverage, you must pay the
total premium (employee and employer share of the cost) plus 2%.
Retirement - You may continue the UA health insurance by paying both the
employee and employer share of premiums if you have been insured under the plan
for at least 10 continuous years prior to retirement and your age plus
length of service equals at least 70.
Note: Enrollment in the medical insurance plan gives employees access to
two services provided free of charge to the employee.
e-DocAmerica: internet access to Board Certified Physicians to answer all
your Medical questions personally and quickly at:
www.edocamerica.com
or by phone at: 1-866-525-3362.
Medical Insurance Enrollment Checklist
Current employees must enroll through
Banner Self
Service during open enrollment.
New hires wishing to enroll in medical insurance, complete and return the following forms
to the Extension Human Resources Office:
|
Return to
Group Benefits
|
