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23-86-306. Prohibiting discrimination against individual participants and beneficiaries based on health status.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-306. Prohibiting discrimination against individual participants and beneficiaries based on health status.
(a)Ineligibility to Enroll.
(1) In General. Subject to subdivision (a)(2) of this section, a group health plan and a health insurance issuer offering group health insurance coverage in connection with a group health plan may not establish rules for eligibility including continued eligibility of any individual to enroll under the terms of the group health plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
(A) Health status;
(B) Medical condition, including both physical and mental illnesses;
(C) Claims experience;
(D) Receipt of health care;
(E) Medical history;
(F) Genetic information;
(G) Evidence of insurability including conditions arising out of acts of domestic violence; or
(H) Disability.
(2) No Application to Benefits or Exclusions. To the extent consistent with § 23-86-304, subdivision (a)(1) of this section shall not be construed:
(A) To require a group health plan or group health insurance coverage to provide particular benefits other than those provided under the terms of such a group health plan or group health insurance coverage; or
(B) To prevent such a group health plan or group health insurance coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the group health plan or group health insurance coverage.
(3) Construction. For purposes of subdivision (a)(1) of this section, rules for eligibility to enroll under a group health plan include rules defining any applicable waiting periods for such enrollment.
(b)In Premium Con
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-306
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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Record provenance
Stable record: arkansas_code:legal_authorities:23-86-306
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 745b1e5d484959efc88b38eb9eb25f95aeac55b25b8b21f5364219aa8fb69944
Source location: content.xml paragraph 52354
Stored source content
23-86-306. Prohibiting discrimination against individual participants and beneficiaries based on health status.
(a)Ineligibility to Enroll.
(1) In General. Subject to subdivision (a)(2) of this section, a group health plan and a health insurance issuer offering group health insurance coverage in connection with a group health plan may not establish rules for eligibility including continued eligibility of any individual to enroll under the terms of the group health plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
(A) Health status;
(B) Medical condition, including both physical and mental illnesses;
(C) Claims experience;
(D) Receipt of health care;
(E) Medical history;
(F) Genetic information;
(G) Evidence of insurability including conditions arising out of acts of domestic violence; or
(H) Disability.
(2) No Application to Benefits or Exclusions. To the extent consistent with § 23-86-304, subdivision (a)(1) of this section shall not be construed:
(A) To require a group health plan or group health insurance coverage to provide particular benefits other than those provided under the terms of such a group health plan or group health insurance coverage; or
(B) To prevent such a group health plan or group health insurance coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the group health plan or group health insurance coverage.
(3) Construction. For purposes of subdivision (a)(1) of this section, rules for eligibility to enroll under a group health plan include rules defining any applicable waiting periods for such enrollment.
(b)In Premium Contributions.
(1) In General. A group health plan and a health insurance issuer offering health insurance coverage in connection with a group health plan may not require any individual as a condition of enrollment or continued enrollment under the group health plan to pay a premium or contribution which is greater than the premium or contribution for a similarly situated individual enrolled in the group health plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the group health plan as a dependent of the individual.
(2) Construction. Nothing in subdivision (b)(1) of this section shall be construed to:
(A) Restrict the amount that an employer may be charged for coverage under a group health plan; or
(B) Prevent a group health plan and a health insurance issuer offering group health insurance coverage from establishing otherwise lawful premium discounts, rebates, or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.
Cross-references
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-304. Increased portability through limitation on preexisting conditions exclusions.
(a) Limitation on Preexisting Condition Exclusion Period — Crediting for Periods of Previous Coverage. Subject to subsection (d) of this section, a group health plan and a health insurance issuer offering group health insurance coverage may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if:
(1) The preexisting condition exclusion relates to a condition, whether physical or mental, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the six-month period ending on the enrollment date;
(2) The preexisting condition exclusion extends for a period of not more than twelve (12) months, or eighteen (18) months in the case of a late enrollee, after the enrollment date; and
(3) The period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage, if any, as defined in subdivision (c)(1) of this section, applicable to the participant or beneficiary as of the enrollment date.
(b) Treatment of Genetic Information. Genetic information shall not be treated as a condition described in subdivision (a)(1) of this section in the absence of a diagnosis of the condition related to that information.
(c)Creditable Coverage — Rules Relating to Crediting Previous Coverage.
(1)Not Counting Periods Before Significant Breaks in Coverage.
(A) In General. A period of creditable coverage shall not be counted, with respect to enrollment of an individual under a group health plan, if, after such a period and before the enrollment date, there was a sixty-three-day period during all of which the individual was not covered u
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-304
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 23-86-304. This identifies an authority to review, not proof of applicability.