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About Us
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Director Shelby Johnson
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GIS Staff
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CISO Gary Vance
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Shared Technology Services (STS)
Data Center Services
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Microsoft 365
SharePoint Hosting
UNIX/Linux Server Hosting
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Networking Equipment
Network Security
Professional Services
Applications Management & Development
Database Administration
Disaster Recovery Services
Windows Desktop Support
Storage & Backup Services
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Enterprise Backup
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Voice Over IP
Support
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Customer Relationship Managers
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Arkansas State Employees
ARBenefits Forms
Election Form
Change Form
Spousal Affidavit
Appeal Request Form
2nd Level Appeal Form
Continuation of Insurance due to Incapacity
Authorization to Release Information Form
Authorization to Revoke Release of Health Information Form
Health Savings Account (HSA) Forms
2024 HSA Enrollment Form
HSA Claim Form
HSA Change in Status Form
HSA Transfer Request
Flexible Spending Account (FSA) Forms
2024 FSA Enrollment Form
FSA Claim Form
Voluntary Coverage Forms
Delta Dental Enrollment Form
Humana Vision Application
Colonial Life Enrollment Form
Colonial Life Change Form
Colonial Life Beneficiary Change Form
Colonial Life Evidence of Insurability Form
Other Forms
Non-AASIS Matching Form
Non-AASIS Termination or Retirement Form
EBD Event Request Form
Pharmacy Reimbursement Claim Form
AR Diamond Plan Opt-Out Form
Request to Remove/Change IT168-Life & IT377-Misc. Plans Form
Public School Employees
ARBenefits Forms
Election Form
Change Form
Spousal Affidavit
Appeal Request Form
2nd Level Appeal Form
Continuation of Insurance Due to Incapacity
Authorization to Release Information Form
Authorization to Revoke Release of Health Information Form
Voluntary Coverage Forms
Colonial Life Enrollment Form
Colonial Life Change Form
Colonial Life Change of Beneficiary Form
Colonial Life Evidence of Insurability Form
Other Forms
2023 Transfer Form
EBD Event Request Form
Pharmacy Reimbursement Claim Form
Health Savings Account Forms
*Only use the forms below if your District uses
Optum Financial
through the State*
2024 HSA Enrollment Form
HSA Claim Form
HSA Change in Status Form
HSA Transfer Request
Retirees
ARBenefits Forms
Retirement Election Form
Spousal Affidavit
Appeal Request Form
Bank Draft Authorization
Change to Bank Draft Authorization
Retiree Change of Address Form
Pharmacy Reimbursement Claim Form *For Health Advantage Retirees Only*
Billing Recap
Voluntary Coverage Forms
Dental and Vision Application
Colonial Life Retiree Enrollment Form
Colonial Life Retiree Change Form
Colonial Life Retiree Beneficiary Change Form
Retirement Packets
2024 State Employee Retirement Packet
2024 Public School Employee Retirement Packet
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