Stricken language would be deleted from and underlined language would be added to present law.
Act 307 of the Regular Session
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State of Arkansas As Engrossed: H2/11/25 1
95th General Assembly A Bill 2
Regular Session, 2025 HOUSE BILL 1298 3
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By: Representative L. Johnson 5
By: Senator Irvin 6
7
For An Act To Be Entitled 8
AN ACT TO MODIFY PAYMENT OF BENEFITS FOR CERTAIN 9
HEALTHCARE PROVIDERS UNDER A HEALTH BENEFIT PLAN; AND 10
FOR OTHER PURPOSES. 11
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Subtitle 14
TO MODIFY PAYMENT OF BENEFITS FOR 15
CERTAIN HEALTHCARE PROVIDERS UNDER A 16
HEALTH BENEFIT PLAN. 17
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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 19
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SECTION 1. Arkansas Code § 23 -85-114 is amended to read as follows: 21
23-85-114. Payment of claims Payment-of-claims provision. 22
(a) There Except as provided under subsection (c) of this section, 23
there shall be a provision as follows: 24
“Payment of Claims: Indemnity for loss of life will be payable 25
in accordance with the beneficiary designation and the provisions respecting 26
such payment which may be prescribed herein and effective at the time of 27
payment. If no such designation or provision is then effective, such 28
indemnity shall be payable to the estate of the insured. Any other accrued 29
indemnities unpaid at the insured's death may, at the option of the insurer, 30
be paid either to such beneficiary or to such estate. All other indemnities 31
will be payable to the insured.” 32
(b) The Except as provided under subsection (c) of this section, 33
either of the following provisions , or either of them, may be included with 34
the foregoing provision subsection (a) of this section at the option of the 35
healthcare insurer: 36 As Engrossed: H2/11/25 HB1298
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(1) “If any indemnity of this policy shall be payable to the 1
estate of the insured, or to an insured or beneficiary who is a minor or 2
otherwise not competent to give a valid release, the insurer may pay such 3
indemnity, up to an amount not exceeding $............. (insert an amount 4
which shall not exceed one thousand dollars ($1,000)), to any relative by 5
blood or connection by marriage of the insured or beneficiary who is deemed 6
by the insurer to be equitably entitled thereto. Any payment made by the 7
insurer in good faith pursuant to this provision shall fully discharge the 8
insurer to the extent of payment.” 9
(2) “Subject to any written direction of the insured in the 10
application or otherwise, all or a portion of any indemnities provided by 11
this policy on account of hospital, nursing, medical, or surgical services 12
may be paid, at the insurer's option and unless the insured requests 13
otherwise in writing not later than the time of filing proofs of such loss, 14
directly to the hospital or person rendering such services, but it is not 15
required that the service be rendered by a particular hospital or person.” 16
(c) A healthcare insurer shall pay a claim for any indemnity provided 17
by a health benefit plan on account of hospital, nursing, medical, or 18
surgical services directly to the healthcare provider that provided the 19
service for an out-of-network claim. 20
(d) As used in this section: 21
(1)(A) "Health benefit plan" means: 22
(i) An individual, blanket, or group plan or a 23
policy or contract for healthcare services offered, issued, renewed, 24
delivered, or extended in this state by a healthcare insurer; and 25
(ii) A health benefit program receiving state or 26
federal appropriations from the State of Arkansas, including the Arkansas 27
Medicaid Program and the Arkansas Health and Opportunity for Me Program 28
established by the Arkansas Health and Opportunity for Me Act of 2021, § 23 -29
61-1001 et seq., or any successor program. 30
(B) “Health benefit plan” includes: 31
(i) Indemnity and managed care plans; and 32
(ii) Nonfederal governmental plans as defined in 29 33
U.S.C. § 1002(32), as it existed on January 1, 2025. 34
(C) “Health benefit plan” does not include: 35
(i) A plan that provides only dental benefits or eye 36 As Engrossed: H2/11/25 HB1298
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and vision care benefits; 1
(ii) A disability income plan; 2
(iii) A credit insurance plan; 3
(iv) Insurance coverage issued as a supplement to 4
liability insurance; 5
(v) A medical payment under an automobile or 6
homeowners insurance plan; 7
(vi) A health benefit plan provided under Arkansas 8
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11 -9-101 et 9
seq., or the Public Employee Workers' Compensation Act, § 21 -5-601 et seq.; 10
(vii) A plan that provides only indemnity for 11
hospital confinement; 12
(viii) An accident-only plan; 13
(ix) A specified disease plan; or 14
(x) A long-term-care-only plan; and 15
(2)(A) "Healthcare insurer" means an entity subject to the 16
insurance laws of this state or the jurisdiction of the Insurance 17
Commissioner that contracts or offers to contract to provide health insurance 18
coverage, including without limitation an insurance company, a hospital and 19
medical service corporation, a health maintenance organization, a self -20
insured governmental or church plan in this state, or the Arkansas Medicaid 21
Program. 22
(B) "Healthcare insurer" does not include an entity that 23
provides only dental benefits or eye and vision care benefits. 24
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SECTION 2. Arkansas Code § 23 -86-104 is amended to read as follows: 27
23-86-104. Blanket accident and health insurance — Payment of 28
benefits. 29
(a)(1) All Except as provided under subsection (c) of this section, 30
all benefits under any blanket accident and health insurance policy or health 31
benefit plan shall be payable to the person insured, to the designated 32
beneficiaries, or to his or her estate. 33
(2) However, if the person insured is a minor or mental 34
incompetent, the benefits may be made payable to the parent, guardian, or 35
other person actually supporting the minor or mental incompetent. If the 36 As Engrossed: H2/11/25 HB1298
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entire cost of the insurance has been borne by the employer, the benefits may 1
be made payable to the employer. 2
(b)(1) However, except as provided under subsection (c) of this 3
section, the policy or health benefit plan may provide that all or any 4
portion of any indemnities provided by the policy or health benefit plan on 5
account of hospital, nursing, medical, or surgical services, at the 6
healthcare insurer's option, may be paid directly to the hospital or person 7
rendering the services, but the policy or health benefit plan may not shall 8
not require that the service be rendered by a particular hospital or person. 9
(2) Payment so made shall discharge made under subdivision 10
(b)(1) of this section discharges the healthcare insurer's obligation with 11
respect to the amount of insurance paid. 12
(c) A healthcare insurer shall pay a claim for any indemnity provided 13
by a health benefit plan on account of hospital, nursing, medical, or 14
surgical services directly to the healthcare provider that provided the 15
service for an out-of-network claim. 16
(d) As used in this section: 17
(1)(A) "Health benefit plan" means: 18
(i) An individual, blanket, or group plan or a 19
policy or contract for healthcare services offered, issued, renewed, 20
delivered, or extended in this state by a healthcare insurer; and 21
(ii) A health benefit program receiving state or 22
federal appropriations from the State of Arkansas, including the Arkansas 23
Medicaid Program and the Arkansas Health and Opportunity for Me Program 24
established by the Arkansas Health and Opportunity for Me Act of 2021, § 23 -25
61-1001 et seq., or any successor program. 26
(B) “Health benefit plan” includes: 27
(i) Indemnity and managed care plans; and 28
(ii) Nonfederal governmental plans as defined in 29 29
U.S.C. § 1002(32), as it existed on January 1, 2025. 30
(C) “Health benefit plan” does not include: 31
(i) A plan that provides only dental benefits or eye 32
and vision care benefits; 33
(ii) A disability income plan; 34
(iii) A credit insurance plan; 35
(iv) Insurance coverage issued as a supplement to 36 As Engrossed: H2/11/25 HB1298
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liability insurance; 1
(v) A medical payment under an automobile or 2
homeowners insurance plan; 3
(vi) A health benefit plan provided under Arkansas 4
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11 -9-101 et 5
seq., or the Public Employee Workers' Compensation Act, § 21 -5-601 et seq.; 6
(vii) A plan that provides only indemnity for 7
hospital confinement; 8
(viii) An accident-only plan; 9
(ix) A specified disease plan; or 10
(x) A long-term-care-only plan; and 11
(2)(A) "Healthcare insurer" means an entity subject to the 12
insurance laws of this state or the jurisdiction of the Insurance 13
Commissioner that contracts or offers to contract to provide health insurance 14
coverage, including without limitation an insurance company, a hospital and 15
medical service corporation, a health maintenance organization, a self -16
insured governmental or church plan in this state, or the Arkansas Medicaid 17
Program. 18
(B) "Healthcare insurer" does not include an entity that 19
provides only dental benefits or eye and vision care benefits. 20
21
SECTION 3. Arkansas Code § 23 -86-112 is amended to read as follows: 22
23-86-112. Group accident and health insurance — Direct payment of 23
hospital or medical services. 24
(a) On Except as provided under subsection (c) of this section, on 25
request by the group policyholder, any group accident and health insurance 26
policy or health benefit plan may provide that all or any portion of any 27
indemnities provided by any policy or health benefit plan on account of 28
hospital, nursing, medical, or surgical services may be paid, at the 29
healthcare insurer's option, directly to the hospital or person rendering 30
such services, but the policy or health benefit plan may not shall not 31
require that the service be rendered by a particular hospital or person. 32
(b) Payment so made made under subsection (a) of this section shall 33
discharge the healthcare insurer's obligation with respect to the amount of 34
insurance paid. 35
(c) A healthcare insurer shall pay a claim for any indemnity provided 36 As Engrossed: H2/11/25 HB1298
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by a health benefit plan on account of hospital, nursing, medical, or 1
surgical services directly to the healthcare provider that provided the 2
service for an out-of-network claim. 3
(d) As used in this section: 4
(1)(A) "Health benefit plan" means: 5
(i) An individual, blanket, or group plan or a 6
policy or contract for healthcare services offered, issued, renewed, 7
delivered, or extended in this state by a healthcare insurer; and 8
(ii) A health benefit program receiving state or 9
federal appropriations from the State of Arkansas, including the Arkansas 10
Medicaid Program and the Arkansas Health and Opportunity for Me Program 11
established by the Arkansas Health and Opportunity for Me Act of 2021, § 23 -12
61-1001 et seq., or any successor program. 13
(B) “Health benefit plan” includes: 14
(i) Indemnity and managed care plans; and 15
(ii) Nonfederal governmental plans as defined in 29 16
U.S.C. § 1002(32), as it existed on January 1, 2025. 17
(C) “Health benefit plan” does not include: 18
(i) A plan that provides only dental benefits or eye 19
and vision care benefits; 20
(ii) A disability income plan; 21
(iii) A credit insurance plan; 22
(iv) Insurance coverage issued as a supplement to 23
liability insurance; 24
(v) A medical payment under an automobile or 25
homeowners insurance plan; 26
(vi) A health benefit plan provided under Arkansas 27
Constitution, Article 5, § 32, the Workers' Compensation Law, § 11 -9-101 et 28
seq., or the Public Employee Workers' Compensation Act, § 21 -5-601 et seq.; 29
(vii) A plan that provides only indemnity for 30
hospital confinement; 31
(viii) An accident-only plan; 32
(ix) A specified disease plan; or 33
(x) A long-term-care-only plan; and 34
(2)(A) "Healthcare insurer" means an entity subject to the 35
insurance laws of this state or the jurisdiction of the Insurance 36 As Engrossed: H2/11/25 HB1298
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Commissioner that contracts or offers to contract to provide health insurance 1
coverage, including without limitation an insurance company, a hospital and 2
medical service corporation, a health maintenance organization, a self -3
insured governmental or church plan in this state, or the Arkansas Medicaid 4
Program. 5
(B) "Healthcare insurer" does not include an entity that 6
provides only dental benefits or eye and vision care benefits . 7
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/s/L. Johnson 9
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APPROVED: 3/18/25 12
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