§ 23-86-122. Prior approval process for experimental and investigational surgical products and medical devices — Definition
(a) As used in this section: (1) “Health carrier” means a: (A) Health maintenance organization; (B) Hospital medical service corporation; and (C) Disability insurance company; (2) “Health carrier” includes a: (A) Self-insured governmental or church plan; and (B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health […]
§ 23-86-123. Prior authorization by physician — Definitions
(a) As used in this section: (1) “Prior authorization” means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and (2) “Telemedicine” means the same as […]
§ 23-86-116. Continuation of benefits upon termination of policy
(a) Every group accident and health insurance policy, contract, or certificate that provides coverage for hospital or medical services or expenses shall provide that the insurer shall continue its obligation for benefits under the policy or contract for any person insured under the policy or contract who is hospitalized on the date of termination, if […]
§ 23-86-117. Standard claim form required
(a) All accident and health insurers transacting business in this state shall use Form HCFA 1500 and Form UB-92/HCFA 1450 or in the claim format required by the Health Insurance Portability and Accountability Act of 1996 as the standard claim forms until and unless the Insurance Commissioner prescribes otherwise. (b) Pursuant to the applicable provisions […]
§ 23-86-101. Blanket accident and health insurance — Definition
Blanket accident and health insurance is declared to be that form of accident and health insurance covering groups of persons as enumerated in one (1) of the following subdivisions: (1) Under a policy or contract issued to any common carrier or to any operator, owner, or lessee of a means of transportation, who or which […]
§ 23-86-118. In vitro fertilization coverage required
(a) All accident and health insurance companies doing business in this state shall include, as a covered expense, in vitro fertilization. (b) Pursuant to the applicable provisions of the Arkansas Insurance Code, the Insurance Commissioner may suspend or revoke the certificate of authority of any insurance company failing to comply with the provisions of this […]
§ 23-86-102. Blanket accident and health insurance — Required provisions
(a) Any insurer authorized to write accident and health insurance in this state shall have the power to issue blanket accident and health insurance. (b) No blanket policy may be issued or delivered in this state unless a copy of the form shall have been filed in accordance with § 23-79-109. (c) Every blanket policy […]
§ 23-86-119. Disclosure to policyholders
(a) Upon request from a policyholder with more than twenty-five (25) insured employees under a comprehensive health insurance policy, any insurer issuing or delivering group accident and health insurance policies in this state shall provide to the policyholder the following information for the most recent twelve-month period or for the entire period of coverage, whichever […]
§ 23-86-103. Blanket accident and health insurance — Application and certificates not required
An individual application shall not be required from a person covered under a blanket accident and health insurance policy or contract, nor shall it be necessary for the insurer to furnish each person a certificate.
§ 23-86-120. Hospice care coverage for terminally ill patients
(a) (1) Every accident and health insurance company, hospital service corporation, health maintenance organization, or other health insurance provider in the State of Arkansas shall offer to each master group contract holder, coverage for hospice facilities and hospice programs as defined under § 20-7-117. (2) (A) The offer of these benefits shall be subject to […]