Skip to main content
DistrictCampus
CAMPUS

Insurance Forms & Information

Log in to ARBenefits

PO Box 15610

Little Rock, AR  72231-5610

877-815-1017

2024 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 copy of your dependents Birth Certificates AND Social Security Cards.

Enrollment Form

Enrollment Form

Spousal Affidavit

Qualifying Event Change Form

 

1-844-559-3521

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

Employee Benefit Guide 2024

Image result for usable

PO Box 1650

Little Rock, AR  72203

800-370-5856

Group Life

Beneficiary Change Form

 

Colonial Life

855-868-6009

Colonial Life Rate Information

Enrollment Form

Change of Beneficiary

Change-Cancel Form

Evidence of Insurability Form

Image result for datapath hsa

888-523-4308

Data Path Enrollment Form

Data Path Claim Form

Instructions on How to Log Into Your HSA

Replacement Card Request

 

Image result for delta dental

PO Box 1789

Lowell, AR  72745

800-971-4108

Delta Dental Information

Delta Dental Enrollment/Change Form

Image result for vsp

PO Box 45262

San Francisco, CA  94145-0262

800-877-7195

VSP Information

 



WELLNESS FORMS

Image result for usable

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

 

Image result for Lincoln financial group

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