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23-79-505. Plan of operation.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-79-505. Plan of operation.
(a)(1) The Board of Directors of the Arkansas Comprehensive Health Insurance Pool shall adopt a plan of operation pursuant to this subchapter and shall submit to the Insurance Commissioner for approval the plan of operation including the Arkansas Comprehensive Health Insurance Pool's articles, bylaws and operating rules, and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the pool. The plan of operation shall become effective upon approval in writing by the commissioner.
(2) If the board fails to submit a suitable plan of operation within one hundred eighty (180) days after the appointment of the board of directors, or at any time thereafter fails to submit suitable amendments to the plan of operation, the commissioner shall adopt and promulgate such rules as are necessary or advisable to effectuate the provisions of this section. The rules shall continue in force until modified by the commissioner or superseded by a plan of operation submitted by the board and approved by the commissioner.
(b) The plan of operation shall:
(1) Establish procedures for operation of the pool;
(2) Establish procedures for selecting a plan administrator in accordance with § 23-79-508;
(3) Create a fund, under management of the board, to pay administrative claims and other expenses of the pool;
(4) Establish procedures for the handling, accounting, and auditing of assets, moneys, and claims of the pool and the plan administrator;
(5) Develop and implement a program to publicize the existence of the plan, the eligibility requirements, and the procedures for enrollment and to maintain public awareness of the plan;
(6)(A) Establish procedures under which applicants and participants may h
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-79-505
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.
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Stable record: arkansas_code:legal_authorities:23-79-505
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 66326fd959d33485ca269a23ac5371bd172e5bf7b59c187e0949e2e21b97386d
Source location: content.xml paragraph 47018
Stored source content
23-79-505. Plan of operation.
(a)(1) The Board of Directors of the Arkansas Comprehensive Health Insurance Pool shall adopt a plan of operation pursuant to this subchapter and shall submit to the Insurance Commissioner for approval the plan of operation including the Arkansas Comprehensive Health Insurance Pool's articles, bylaws and operating rules, and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the pool. The plan of operation shall become effective upon approval in writing by the commissioner.
(2) If the board fails to submit a suitable plan of operation within one hundred eighty (180) days after the appointment of the board of directors, or at any time thereafter fails to submit suitable amendments to the plan of operation, the commissioner shall adopt and promulgate such rules as are necessary or advisable to effectuate the provisions of this section. The rules shall continue in force until modified by the commissioner or superseded by a plan of operation submitted by the board and approved by the commissioner.
(b) The plan of operation shall:
(1) Establish procedures for operation of the pool;
(2) Establish procedures for selecting a plan administrator in accordance with § 23-79-508;
(3) Create a fund, under management of the board, to pay administrative claims and other expenses of the pool;
(4) Establish procedures for the handling, accounting, and auditing of assets, moneys, and claims of the pool and the plan administrator;
(5) Develop and implement a program to publicize the existence of the plan, the eligibility requirements, and the procedures for enrollment and to maintain public awareness of the plan;
(6)(A) Establish procedures under which applicants and participants may have grievances reviewed by a grievance committee appointed by the board. The grievances shall be reported to the board after completion of the review.
(B) The board shall retain all written complaints regarding the plan for at least three (3) years; and
(7) Provide for other matters as may be necessary and proper for the execution of the board's powers, duties, and obligations under this subchapter.
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-79-508. Plan administrator.
(a) The Board of Directors of the Arkansas Comprehensive Health Insurance Pool shall select an insurer through a competitive bidding process to administer the plan. However, the administering insurer designated by the board created by Acts 1995, No. 1339, shall serve as the plan administrator under this subchapter until the expiration of the current contract of the administering insurer. The board shall evaluate bids submitted under this section based upon criteria established by the board which shall include, but not be limited to, the following:
(1) The plan administrator's proven ability to handle large group accident and health benefit plans;
(2) The efficiency and timeliness of the plan administrator's claim processing procedures;
(3) An estimate of total charges for administering the plan;
(4) The plan administrator's ability to apply effective cost containment programs and procedures and to administer the plan in a cost efficient manner; and
(5) The financial condition and stability of the plan administrator.
(b)(1) The plan administrator shall serve for a period of three (3) years subject to removal for cause and subject to the terms, conditions, and limitations of the contract between the board and the plan administrator.
(2) The board shall advertise for and accept bids to serve as the plan administrator for the succeeding three-year periods.
(c) The plan administrator shall perform functions related to the plan as may be assigned to it, including:
(1) Determination of eligibility;
(2) Payment and processing of claims;
(3) Establishment of a premium billing procedure for collection of premiums. Billings shall be made on a periodic basis as determined by the board; and
(4) Other necessary functions to ass
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-79-508
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. The source passage cites 23-79-508. This identifies an authority to review, not proof of applicability.