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Summary of Benefits
(326 KB PDF)
Evidence of Coverage Option 1
(1028 KB PDF)
Evidence of Coverage Option 2
(1472 KB PDF)
Evidence of Coverage Option 1
(1448 KB PDF)
Evidence of Coverage Option 2
(1319 KB PDF)
Evidence of Coverage
(1444 KB PDF)
Useful Telephone Numbers
Enrollment Guidelines
Forms
Formulary Search
Out-of-Network Pharmacy
(90 KB PDF)
Low-Income Subsidy Table
(70 KB PDF)
Low-Income Subsidy Table
(70 KB PDF)
Low-Income Subsidy Table
(70 KB PDF)
Pharmacy Directory
(139 KB PDF)
Drug Transition Policy (What if my drug is not on the formulary?)
(28 KB PDF)
Appeals & Exceptions
(157 KB PDF)
Medication Therapy Management (MTM)
(80 KB PDF)
Medication Therapy Management Newsletter - 1st Quarter
(462 KB PDF)
Medication Therapy Management Newsletter - 2nd Quarter
(1651 KB PDF)
Rights & Responsibilities Upon Disenrollment
(19 KB PDF)
Report Fraud and Abuse
Privacy Notice
(196 KB PDF)
Disclaimers
You may qualify for
extra help
with your monthly premium and drug costs.
H4213_Advantage_REV Website Submission (12/03/09)
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Shield Association and is licensed to offer health plans in all 75 counties of Arkansas.
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