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Insurance Forms & Information

Log in to ARBenefits

PO Box 15610

Little Rock, AR  72231-5610

877-815-1017

2022 Insurance Rates

Open Enrollment for AR Benefits is during the month of October.

To cover a spouse, you will need to submit a copy of a marriage license and complete a Spousal Affadavit.

To cover dependents, you will need to submit a coy of your dependents Birth Certificates AND Social Security Cards.

Enrollment Form

Spousal Affidavit

 

2023 Wellness Discount Information – will be announced at a later time

 

 

 


 

1-844-559-3521

Employees must work at least 30 hours to qualify for benefits.

2022 Employee Benefit Guide

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PO Box 1650

Little Rock, AR  72203

800-370-5856

Group Life

Beneficiary Change Form

 

Colonial Life

855-868-6009

Colonial Life Information

Enrollment Form

Change of Beneficiary Form

Evidence of Insurability Form

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888-523-4308

Data Path Enrollment Form

Data Path Claim Form

Instructions on How to Log Into Your HSA

Replacement Card Request

 

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PO Box 1789

Lowell, AR  72745

800-971-4108

Delta Dental Information

Delta Dental Enrollment/Change Form

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PO Box 45262

San Francisco, CA  94145-0262

800-877-7195

VSP Information

 


 

WELLNESS FORMS

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For Hospital Care & Accident Policies 

By Mail: PO Box 1650, Little Rock, AR 72203-1650

FAX: 501-235-8400

USAble Wellness Claim Form

 

Allstate Insurance Company Logo

By Mail: 1776 American Heritage Life Drive, Jacksonville, FL 32224

FAX: 800-430-4188

Allstate Wellness Claim Form

 

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By Mail: PO Box 2609, Omaha, NE 68103-2609

FAX: 877-668-5331

Lincoln Wellness Claim Form

 

Transamerica employee benefits offerings with stop loss quotes - National  Underwriting Services

Questions about TransAmerica Cancer Wellness Claims

Call the Claims Customer Service Department

at 800-251-7254 and press 2.

Transamerica Cancer Wellness Claim Information