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23-86-504. Health insurance purchasing group health benefits coverage requirements.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-504. Health insurance purchasing group health benefits coverage requirements.
(a)(1) In conjunction with a health insurance purchasing group health carrier, each health insurance purchasing group that offers health benefit plans to small employers as defined by § 23-86-303 shall guarantee the availability of coverage to small employers as required by § 23-86-312(a).
(2) All health benefit plans provided through a health insurance purchasing group shall be offered at rates, including employer's and employees' share, on a policy-specific or product-specific basis that may vary only as permitted under law.
(b) Subject to subsection (c) of this section, a health insurance purchasing group shall not offer a health benefits plan that unfairly discriminates against eligible employees.
(c) Nothing in this subchapter shall be construed as requiring a health insurance purchasing group health carrier to provide coverage outside the service area of the insurer or organization.
(d) Each health insurance purchasing group shall provide a health benefits plan only through contracts with health insurance purchasing group health carriers and shall not assume insurance risk with respect to the coverage.
(e) Except as provided in this subchapter, the health insurance purchasing group may provide a health benefits plan in whole or in part, not subject to state-mandated health benefits, except those required in the Arkansas Health Insurance Portability and Accountability Act of 1997, § 23-86-301 et seq.
(f) The health insurance purchasing group shall offer at least two (2) types of plans including one (1) plan providing a choice of deductibles with state-mandated health benefits.
(g) The health insurance purchasing group may also offer a health benefits plan not subject
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-504
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:23-86-504
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 3116a31b29af4cffec6c11b11510d25fa46e74d9bc81c736d18104de20cc05c5
Source location: content.xml paragraph 52690
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23-86-504. Health insurance purchasing group health benefits coverage requirements.
(a)(1) In conjunction with a health insurance purchasing group health carrier, each health insurance purchasing group that offers health benefit plans to small employers as defined by § 23-86-303 shall guarantee the availability of coverage to small employers as required by § 23-86-312(a).
(2) All health benefit plans provided through a health insurance purchasing group shall be offered at rates, including employer's and employees' share, on a policy-specific or product-specific basis that may vary only as permitted under law.
(b) Subject to subsection (c) of this section, a health insurance purchasing group shall not offer a health benefits plan that unfairly discriminates against eligible employees.
(c) Nothing in this subchapter shall be construed as requiring a health insurance purchasing group health carrier to provide coverage outside the service area of the insurer or organization.
(d) Each health insurance purchasing group shall provide a health benefits plan only through contracts with health insurance purchasing group health carriers and shall not assume insurance risk with respect to the coverage.
(e) Except as provided in this subchapter, the health insurance purchasing group may provide a health benefits plan in whole or in part, not subject to state-mandated health benefits, except those required in the Arkansas Health Insurance Portability and Accountability Act of 1997, § 23-86-301 et seq.
(f) The health insurance purchasing group shall offer at least two (2) types of plans including one (1) plan providing a choice of deductibles with state-mandated health benefits.
(g) The health insurance purchasing group may also offer a health benefits plan not subject to state-mandated health benefits that does not contain standard provisions or rights required to be present in a health benefits plan pursuant to law or regulations unrelated to a specific health illness, injury, or condition of the insured, for the provisions as may be determined by rules of the Insurance Commissioner.
(h)(1) Every health benefits plan offered through a health insurance purchasing group shall:
(A) Be underwritten by a health insurance purchasing group health carrier that:
(i) Is licensed or otherwise regulated under state law;
(ii) Meets all applicable state standards relating to consumer protection, including, but not limited to, state solvency and market conduct; and
(iii) Offers the coverage under a contract with the health insurance purchasing group;
(B) Be approved or otherwise permitted to be offered under law;
(C) Provide full portability of creditable coverage for individuals who remain members of the same health insurance purchasing group, notwithstanding that they change the eligible employer through which they are members; and
(D) Comply with the provisions of the Arkansas Insurance Code in their sales and solicitation of insurance, including, but not limited to, the Trade Practices Act, § 23-66-201 et seq., and the requirements of §§ 23-64-102(1) and 23-64-201 that all insurance must be sold by an agent licensed by the State Insurance Department.
(2)(A) Any agent referenced in subdivision (h)(1)(D) of this section shall be required to obtain at least two (2) hours of continuing education on a health insurance purchasing group or the plans the health insurance purchasing group sponsors each year, or both.
(B) The requirement in subdivision (h)(2)(A) of this section shall be considered as part of the continuing education requirements provided in § 23-64-301 and shall not preempt or conflict with the provision.
(i) A health insurance purchasing group shall be exempt from the requirements of § 23-86-201 et seq.
(j) Nothing in this subchapter shall be construed as precluding a health insurance purchasing group health carrier from offering a health benefits plan through a health insurance purchasing group by establishing premium discounts for members or from modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention, so long as the programs are agreed to in advance by the health insurance purchasing group and comply with all other provisions of this subchapter and do not discriminate among similarly situated members.
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-66-201. Title.
This subchapter may be referred to as the “Trade Practices Act”.
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-66-201
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 23-66-201. This identifies an authority to review, not proof of applicability.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-301. Title.
This subchapter may be cited as the “Arkansas Health Insurance Portability and Accountability Act of 1997”.
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-301
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 23-86-301. This identifies an authority to review, not proof of applicability.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-303. Definitions.
As used in this subchapter:
(1) “Affiliation period” means a period that, under the terms of the coverage offered by the health maintenance organization, must expire before the coverage becomes effective;
(2) “Bona fide association” means, with respect to health insurance coverage offered in Arkansas, an association that:
(A) Has been actively in existence for at least five (5) years;
(B) Has been formed and maintained in good faith for purposes other than obtaining insurance;
(C) Does not condition membership in the association on any health status-related factor relating to an individual, including an employee of an employer or a dependent of an employee;
(D) Makes health insurance coverage offered through the association available to all members regardless of any health status-related factor relating to the members or individuals eligible for coverage through a member;
(E) Does not make health insurance coverage offered through the association available other than in connection with a member of the association; and
(F) Meets the additional requirements that may be imposed under Arkansas law;
(3) “Church plan” has the meaning given the term under section 3(33) of the Employee Retirement Income Security Act of 1974 (ERISA);
(4) “COBRA continuation provision” means any of the following:
(A) Part 6 of Subtitle B of Title 1 of the Employee Retirement Income Security Act of 1974, other than section 609 of the act;
(B) Section 4980B of the Internal Revenue Code of 1986, other than subsection (f)(1) of the section insofar as it relates to pediatric vaccines;
(C) Title XXII of the Public Health Service Act;
(5) “Commissioner” means the Insurance Commissioner;
(6) “Creditable coverage” means, with respect to an individual,
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-303
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 23-86-303. This identifies an authority to review, not proof of applicability.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-86-312. Guaranteed availability of coverage for employers in the small-group market.
(a) Issuance of Coverage in the Small-Group Market — In General. Subject to subsections (b)-(e) of this section, each health insurance issuer that offers health insurance coverage in the small-group market in Arkansas:
(1) Must accept every small employer in Arkansas that applies for that health insurance coverage; and
(2) Must accept for enrollment under the health insurance coverage every eligible individual as defined in § 23-86-303(8) who applies for enrollment during the period in which the individual first becomes eligible to enroll under the terms of the group health plan and may not place any restriction which is inconsistent with § 23-86-306 on an eligible individual's being a participant or beneficiary.
(b)Special Rules for Network Plans.
(1) In General. In the case of a health insurance issuer that offers health insurance coverage in the small-group market through a network plan, the health insurance issuer may:
(A) Limit the employers that may apply for that health insurance coverage to those with eligible individuals who live, work, or reside in the service area for the network plan; and
(B) Within the service area of the network plan, deny that health insurance coverage to the employers if the health insurance issuer has demonstrated, if required, to the Insurance Commissioner that:
(i) It will not have the capacity to deliver services adequately to enrollees of any additional groups because of its obligations to existing group contract holders and enrollees; and
(ii) It is applying this subsection uniformly to all employers without regard to the claims experience of those employers and their employees and their dependents or any health status-relate
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-86-312
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 23-86-312. This identifies an authority to review, not proof of applicability.