Benefit Information

Welcome to the UACCB Human Resources Benefits Page. You will find a Benefits Summary and Notice of Privacy Practices along with listings for: Superior Vision; Delta Dental; United Medical health; MedImpact prescription drug plan; Long Term Disability; Retirement information - specifically ATRS, APERS, TIAA-CREF, and VALIC; Life Insurance Plans; Voluntary benefits, including Arkansas Federal Credit Union (AFCU), Long Term Care, MetLife Critical Illness; and Liberty Mutual Home and Auto insurance. Every effort is made to keep the posted benefit data current. Should you suspect errors or have specific questions, please do not hesitate to contact the HR Benefits Office at 870-612-2165 or email

Open Enrollment Fall 2015 for January 1, 2016

Notices Open Enrolllment Summary

2016 Health Plan Comparison Grid (revised 12.11.2015)

2016 Health Plan Deductibles and OOP Maximums

Notice regarding Dependent Eligibility

Dependent Audit Beginning 2016

Open Enrollment Signature Form 2016 Coverage

Note to Benefit Eligible Employees - Fall 2015 Open Enrollment Info.

FSA Enrollment Form

Life and AD&D Change Form

Open Enrollment Fall 2016 for January 1, 2017

2017 Health Plan Comparison Grid


Family and Medical Leave Act - Revised April 2016

Same Sex Marriage and UA Benefits Eligibility

Pre/Post Tax Election Form

Notice of Privacy Practices (HIPAA)

COBRA rates 2016

1557 Nondiscrimination Statement


United Medical Resources

UMR Login Instructions

United Medical Resources Plan Comparison 2015

Glossary of Health Coverage and Medical Terms

Health Rates effective 7/1/2015

UA Health Plan SPD rev. 2015 and Health Benefit Plan Amendment - Care Management


Classic and POS In-Network

$200 copay + $1000 Deductible + Coinsurance

POS Out-of-Network

$200 copay + $2000 Deductible + Coinsurance

Maternity Management

Adding your newborn to the UMR health plan

UMR Health Preauthorization Listing 2015

UMR Authorization for Release of Information form

Physician Attestation form (weight loss program)


UA Classic Summary Benefit Plan 2016

UA POS Summary Benefit Plan 2016

UA Classic Wellness Summary

UA POS Wellness Summary

UA Classic Summary Benefit Plan 2015 (effective July 2015)

UA POS Summary Benefit Plan 2015 (effective July 2015)

UA Classic Summary Benefit Plan 2015

UA POS Summary Benefit Plan 2015

UMR Health Brochures

UMR Diabetes Management

UMR Healthy Heart

UMR Nutritional Counseling

UMR Preventative Care Services - Women

UMR Preventative Care Services - Men and Children


Creditable Coverage Disclosure Notice

MedImpact Prescription Benefit Summary - January 2016

MedImpact prescription Drug Formulary - April 2016

UAS MedImpact Formulary Exception

Appeals Form

MedImpact Prescription Claim Form

Test Strips and Meters

MedVantx Mail Order Prescription Form

Delta Dental

Delta Dental Enrollment Application - add/drop/change

Choosing Your Dentist

Delta Dental Schedule of Benefits (effective January 1, 2012 - Current)

Delta Dental Benefit Plan Summary

Delta Dental Member User Guide

Superior Vision

Superior Vision Basic/Enhanced Rate Sheet

Superior Vision Membership Claim Form

Superior Vision Member Guide - Using Your Vision Plan

Getting Started

Finding Network Providers

Superior Vision Benefit - Amendment

Superior Vision Enrollment Rules

FSA (Flexible Spending Plan)

FSA 2015 Information

FSA Login Instructions


Long Term Disability

Basic and Optional Long Term Disability Group Insurance (UNUM)

LTD Claim Form (UNUM)

  • LTD Amendment


Arkansas Teachers Retirement System (ATRS)

Arkansas Public Employees Retirement System (APERS)

University of Arkansas Retirement Plan - January 2014

University of Arkansas System 457 (B) Plan

University of Arkansas System 403 (B) Plan

Merger Amendment


Online Enrollment for TIAA-CREF

Valic Retirement

University of Arkansas Retirement Plan Highlight

University of Arkansas Retirement Plan Discription (SPD)


Medicare Advantage Information

Retirement Plan Contributions for Non-Benefits Eligible Employees

All employees on the university payroll (except student workers) are eligible to participate in an unmatched 403(B) on a voluntary basis. If you are not in a benefits-eligible role you will not receive any employer contributions to your retirement plan, but you can make voluntary unmatched contributions. You may select TIAA-CREF and/or VALIC for your retirement plan options. Within the IRS limits, you may enroll, end, increase, decrease or suspend your contributions at any time. Contact Human Resources for additional information or assistance.


Life Insurance

Standard Life Portability and Conversion

Voluntary Benefits

Arkansas Federal Credit Union Internet Branch

Long Term Care - The University of Arkansas benefits includes the offereing of a Long Term Care Plan. Information, rates, and enrollment forms may be located at The password to access the UA group information is UALTC.

MetLife Critical Illness - Outline of Coverage January 2015

Metlife Critical Illness Open Enrollment Fall 2014

Liberty Mutual Home and Auto

Printable Liberty Mutual information sheet

Workers' Compensation

Incident Report Form

Company Nurse

Acknowledgement Form

Temporary Prescription Form