ANNUAL NOTICE: 2025 summary of benefits and coverage

Available November 15 for individual/family policyholders

As required by the Patient Protection and Affordable Care Act (PPACA), the Summary of Benefits and Coverage (SBC) (OMB Control Numbers 1545-2229, 1210-0147 and 0938-1146) provides information regarding coverage specifications and limitations that apply to the health insurance plan you have selected.

Before the end of each year, Arkansas Blue Cross and Blue Shield provides members who have individual/family health insurance policies* (but do not have Medicare policies) with an SBC.

This official communication includes information about the coverage provided by your health insurance plan in a summary format for the upcoming year. Beginning November 15, 2024, you may access this information:

• Online in the “Benefits” section of the Arkansas Blue Cross secure member self-service center, Blueprint Portal, at blueprintportal.com
• By calling Arkansas Blue Cross customer service at 800-800-4298 to receive a printed version

After that date, you also may go to arkbluecross.com/sbc and enter your member number (found on your member ID card) into the SBC locator tool to review the document online and print it.

If you make changes to your Arkansas Blue Cross health plan benefits that differ from your current coverage, a new summary will be created for you within seven work days of our receipt of your change request. It will be available to you in the same manner described above.

Arkansas Blue Cross, Health Advantage, BlueAdvantage Administrators of Arkansas, and Octave Blue Cross and Blue Shield members who receive health coverage through an employer group will get their SBC from their employer group plan administrator at the appropriate time.

* These are members who do not have health insurance through an employer, a Medicare health plan or short-term, limited-duration Blue policies.