§ 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 […]
§ 23-86-110. Group accident and health insurance — Administration of benefits
(a) (1) All group accident and health insurance carriers including hospital and medical service corporations shall be subject to the “primary” and “secondary” carrier rules promulgated by the Insurance Commissioner. (2) The secondary carrier shall administer benefits on a timely basis. (b) This section applies to group contracts of accident and health insurance sold, delivered, […]
§ 23-86-111. Group accident and health insurance — Payment of benefits when other like insurance exists
(a) (1) No contract of group accident and health insurance coverage sold, delivered or issued for delivery, renewed, or offered for sale in this state by an insurer, hospital and medical service corporation, or health maintenance organization, directly or indirectly providing indemnity, services, healthcare services, or cash to an individual as a result of hospitalization, […]
§ 23-86-112. Group accident and health insurance — Direct payment of hospital or medical services
(a) On request by the group policyholder, any group accident and health insurance policy may provide that all or any portion of any indemnities provided by any policy on account of hospital, nursing, medical, or surgical services may be paid, at the insurer’s option, directly to the hospital or person rendering such services, but the […]
§ 23-86-113. Minimum benefits for mental illness in group accident and health insurance policies or subscriber’s contracts — Definition
(a) Unless refused in writing, every group accident and health insurance policy or group contract of hospital and medical service corporations issued or renewed after July 1, 1983, providing hospitalization or medical benefits to Arkansas residents for conditions arising from mental illness shall provide the following minimum benefits on and after July 1, 1983: (1) […]
§ 23-86-114. Group accident and health insurance — Continuation of coverage beyond termination of employment, change in marital status, etc
(a) Every group accident and health insurance policy, contract, or certificate providing hospital, surgical, or major medical coverage, other than accident only or specified disease policies, shall contain a provision that any certificate holder, member, or spouse whose coverage under the policy would otherwise terminate due to termination of employment or membership or a change […]
§ 23-86-115. Group accident and health insurance — Entitlement to conversion policy upon termination of group policy
(a) (1) Every group policy, contract, or certificate of accident and health insurance delivered or issued for delivery in this state that provides hospital, surgical, or major medical coverage on an expense-incurred basis, other than coverage limited to expenses from accidents or specified diseases, shall provide that an employee, member, or covered dependent whose insurance […]
§ 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 […]