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Arkansas Employee Benefits Division (EBD) – Department of Finance and Administration / Department of Shared Administrative Services fax number

(501) 683-0983

Employee Benefits Division (EBD)

Used for: Submitting enrollment, eligibility and other benefits documentation for Arkansas state employees (e.g., health/life benefits, PSE transfers).

Fax destination details

Department
Employee Benefits Division (EBD)
Purpose
Submitting enrollment, eligibility and other benefits documentation for Arkansas state employees (e.g., health/life benefits, PSE transfers).
Form
Affadavit — Affadavit of Spousal Health Care Coverage
Address
501 Woodlane Street, Little Rock, AR 72201
Voice phone
501-682-5500

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Submit the form to the Employee Benefits Division; instructions are included with the form. Filing methods commonly include fax to 501-683-0983 or upload via the ARBenefits portal.

Official form instructions are published as a downloadable file on the organization's website.

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