ABOUT THE OFFICE

HUMAN RESOURCES - ACTIVE EMPLOYEE RESOURCES

Due to the complexity of instructions, some forms may only be obtained in the Human Resources Office. If you do not see the forms you need or have additional questions, please contact a member of the Human Resources Staff for assistance.

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General Forms

• Direct Deposit Form - PDF

• Employee Emergency Contact Form - PDF

• Family Medical Leave Request Form - PDF

• Federal W-4 Form - PDF

• State W-4 Form - PDF

Arkansas Public Employees Retirement System (APERS)

• Change of Address - PDF

• Change of Beneficiary - PDF

• Change Name - PDF

• Drop Application - PDF

• Termination of Employment Refund program - PDF

Citistreet 457b Retirement Savings

• Retirement Savings Information - PDF

Employee Benefits Division (EBD) / Health Insurance

• 2008 Enrollment Guide for Active Employees - PDF

• 2008 Enrollment Guide for Retirees - PDF

• Cafeteria Plan Family Status Change Form - PDF

• Health Insurance Change Form - PDF

• Health Insurance Enrollment Form - PDF

• Health Ins Rate Table for Actives 2008 Plan Year - PDF

• Health Ins Rate Table for LWOP 2008 Plan Year - PDF

• Student Verification Form - PDF

• 2008 Summary of Common Services - PDF

American Health Holding

• Case and Utilization Management - PDF

Insurance Links

• American Health Holding Inc.

• AR Benefits

• Arkansas Public Employees Retirement System (APERS)

• Corphealth & ARWellness

• Datapath Administrative Services HSA

• Fringe Benefits management Company (FBMC)

• Health Advantage

• Health Risk Assessment Survey

• NMHC Total Healthcare Solutions

• NovaSys Health

• Minnesota Life

Life Insurance

• Minnesota Life Benefit Guide and Rates - PDF

Fringe Benefits Management Company (FBMC)
Copies of the 2008 Cafeteria Plan Benefit Guide are available in the HR Office. These guides are provided on an annual basis by FBMC. To obtain a copy, please email the hr office at hrsos@sos.arkansas.gov or contact an HR Staff member.

• Claim Form - PDF

• FSA Worksheets - PDF

Datapath Administrative Services HSA

• State Employee Salary Reduction Agreement (SRA) - PDF

• HSA FAQ's - PDF

Corphealth and ARWellness, & EAP

• FAQ's on Arkansas Wellness Program - PDF

• ARWellness - PDF

• EAP Program - PDF

Voluntary/Supplemental Insurance

Please see Harmony Daniels for additional information and/or to obtain enrollment and change forms.

• Voluntary/Supplemental Insurance Products - PDF

General Announcements

Please select the links below to read further detail on announcements.

• State Employee Orlando Vacation Travel Discount Program - PDF

• Walmart and Sam's Club implement compatible computer system - PDF

• Alltel Cell Phone Update - PDF

• September 2007 Corphealth Newsletter - PDF

• Qual Choice Health Insurance Rates Increase Effective 5/1/2007 - PDF

• Cell Phone Discounts Available for State Employees - PDF

• EBD and Corphealth announce new ARWellness Programs available for State Employees - PDF

• Health Advantage and Blue cross Blue Shield announce contract with UAMS
  and Cooper Clinic - PDF

• Met Life has announced “open enrollment” period to open soon for state employees,
  eligible spouses, children and grandchildren - PDF

• Qual Choice has contracted with Baptist Medical centers - PDF

• Office Depot Employee Discount Program

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