§ 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 […]
§ 23-86-120. 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 […]
§ 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.
§ 23-86-121. Coverage for anesthesia and hospitalization for dental procedures
(a) As used in this section, “health benefit plan” means any policy, contract, or agreement offered by an insurance company, health maintenance organization, or hospital and medical service corporation to provide, reimburse, or pay for healthcare services, but does not include the following: (1) Workers’ compensation coverage; (2) Self-funded or self-insured health plans, unless the […]
§ 23-86-104. Blanket accident and health insurance — Payment of benefits
(a) (1) All benefits under any blanket accident and health insurance policy shall be payable to the person insured, to the designated beneficiaries, or to his or her estate. (2) However, if the person insured is a minor or mental incompetent, the benefits may be made payable to the parent, guardian, or other person actually […]
§ 23-86-106. Group accident and health insurance — Definition
Group accident and health insurance is declared to be that form of accident and health insurance covering groups of persons as defined in this section, with or without one (1) or more members of their families or one (1) or more of their dependents, or covering one (1) or more members of the families or […]
§ 23-86-107. Group accident and health insurance — Authorized insurer required
(a) All group accident and health insurance placed by an employer on employees who are residents of this state shall be placed by the employer with an insurer authorized to transact insurance in this state. (b) This section shall not apply to group insurance lawfully placed in an insurer transacting insurance as a surplus lines […]
§ 23-86-108. Group accident and health insurance — Required provisions
Each group accident and health insurance policy shall contain in substance the following provisions: (1) A provision that, in the absence of fraud, all statements made by applicants or the policyholder or by an insured person shall be deemed representations and not warranties and that no statement made for the purpose of effecting insurance shall […]
§ 23-86-109. Group accident and health insurance — Optional continuation of benefit provisions
Any group accident and health insurance policy that contains provisions for the payment by the insurer of benefits for expenses incurred on account of hospital, nursing, medical, or surgical services for members of the family or dependents of a person in the insured group may provide for the continuation of the benefit provisions, or any […]