Arkansas 2025 Regular Session

Arkansas House Bill HB1361 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		Stricken language would be deleted from and underlined language would be added to present law.
2		-	Act 177 of the Regular Session
3	2		ANS002 01/31/2025 10:34:07 AM ANS002
4	3		State of Arkansas 1
5	4		95th General Assembly A Bill 2
6	5		Regular Session, 2025 HOUSE BILL 1361 3
7	6		4
8	7		By: Representatives Gazaway, M. Shepherd 5
9	8		By: Senators C. Tucker, J. Bryant 6
10	9		7
11	10		For An Act To Be Entitled 8
12	11		AN ACT TO MAKE TECHNICAL CORRECTIONS TO TITLE 23 OF 9
13	12		THE ARKANSAS CODE CONCERNING PUBLIC UTILITIES AND 10
14	13		REGULATED INDUSTRIES; AND FOR OTHER PURPOSES. 11
15	14		12
16	15		13
17	16		Subtitle 14
18	17		TO MAKE TECHNICAL CORRECTIONS TO TITLE 15
19	18		23 OF THE ARKANSAS CODE CONCERNING 16
20	19		PUBLIC UTILITIES AND REGULATED 17
21	20		INDUSTRIES. 18
22	21		19
23	22		BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 20
24	23		21
25	24		SECTION 1. Arkansas Code § 23 -3-117(a)(2)(C)(i), concerning contracts 22
26	25		for interruptible utility services, is reenacted to ratify the decision by 23
27	26		the Arkansas Code Revision Commission to change “Specify” to “Shall specify” 24
28	27		in order to correct a grammatical error. 25
29	28		(i) Shall specify the amount of interruptible load 26
30	29		to be achieved by the customer. 27
31	30		28
32	31		SECTION 2. Arkansas Code § 23 -55-611(b), concerning refunds under the 29
33	32		Uniform Money Services Act, is reenacted to ratify the decision by the 30
34	33		Arkansas Code Revision Commission to insert the phrase “all money received 31
35	34		for transmission” and combine former subdivisions (b)(1)(A) -(D) with former 32
36	35		subdivision (b)(2) to create subdivisions (b)(1) -(5), in order to clarify a 33
37	36		reference and correct designation errors. 34
38	37		(b) Every licensee shall refund all money received for transmission to 35
39	38		the sender within 10 days of receipt of the sender's written request for a 36 HB1361
40	39
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42	41		refund of all money received for transmission unless any of the following 1
43	42		occurs: 2
44	43		(1) the money has been forwarded within 10 days of the date that 3
45	44		the money was received for transmission; 4
46	45		(2) instructions have been given committing an equivalent amount 5
47	46		of money to the person designated by the sender within 10 days of the date 6
48	47		that the money was received for transmission; 7
49	48		(3)(A) the agreement between the licensee and the sender 8
50	49		instructs the licensee to forward the money at a time that is beyond 10 days 9
51	50		of the date that the money was received for transmission. 10
52	51		(B) If funds have not yet been forwarded according to the 11
53	52		terms of the agreement between the licensee and the sender, then the licensee 12
54	53		shall issue a refund under this section; 13
55	54		(4) the refund is requested for a transaction that the licensee 14
56	55		has not completed based on a reasonable belief or a reasonable basis to 15
57	56		believe that a crime or violation of law, rule, or regulation has occurred, 16
58	57		is occurring, or may occur; or 17
59	58		(5) the refund request does not enable the licensee to: 18
60	59		(A) identify the sender's name and address or telephone 19
61	60		number; or 20
62	61		(B) identify the particular transaction to be refunded in 21
63	62		the event the sender has multiple transactions outstanding. 22
64	63		23
65	64		SECTION 3. Arkansas Code § 23 -55-702(a)(6), concerning types of 24
66	65		permissible investments under the Uniform Money Services Act, is reenacted to 25
67	66		ratify the decision by the Arkansas Code Revision Commission to redesignate 26
68	67		the subdivision from (b)(6) to (a)(6) in order to correct a designation 27
69	68		error. 28
70	69		(6) 100 percent of the surety bond provided for under § 23 -55-29
71	70		204 that exceeds the average daily money transmission liability in this 30
72	71		state. 31
73	72		32
74	73		SECTION 4. Arkansas Code § 23 -55-702(b)(2)(A), concerning types of 33
75	74		permissible investments under the Uniform Money Services Act, is reenacted to 34
76	75		ratify the decision by the Arkansas Code Revision Commission to change “If” 35
77	76		to “Upon” in order to correct a grammatical error. 36 HB1361
78	77
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80	79		(2)(A) Upon any notice of expiration or nonextension of a letter 1
81	80		of credit issued under subdivision (b)(1)(D), then the licensee shall be 2
82	81		required to demonstrate to the satisfaction of the commissioner, 15 days 3
83	82		before expiration, that the licensee maintains and will maintain permissible 4
84	83		investments under § 23 -55-701(a) upon the expiration of the letter of credit. 5
85	84		6
86	85		SECTION 5. Arkansas Code § 23 -61-503(b), concerning the jurisdiction 7
87	86		of the State Insurance Department and the application of the Arkansas 8
88	87		Insurance Code, is amended to read as follows to repeal obsolete language: 9
89	88		(b) This subchapter shall not apply to : 10
90	89		(1) A a trust established under §§ 14 -54-101 and 25-20-104 to 11
91	90		provide benefits such as accident and health benefits, death benefits, dental 12
92	91		benefits, and disability income benefits ; or 13
93	92		(2) The Comprehensive Health Insurance Pool Act, § 23-79-501 et 14
94	93		seq. 15
95	94		16
96	95		SECTION 6. Arkansas Code § 23 -63-1801(4)(B), concerning definitions 17
97	96		under the Arkansas Health Insurance Marketplace Act, is amended to read as 18
98	97		follows to repeal obsolete language: 19
99	98		(B) "Health insurance coverage" does not include policies 20
100	99		or certificates covering only accident, credit, disability income, long -term 21
101	100		care, hospital indemnity, Medicare supplemental policy as defined in 42 22
102	101		U.S.C. § 1395ss(g)(1), a specified disease, other limited benefit health 23
103	102		insurance, automobile medical payment insurance, or claims under the Workers' 24
104	103		Compensation Law, § 11 -9-101 et seq., or the Public Employee Workers' 25
105	104		Compensation Act, § 21 -5-601 et seq., or the Comprehensive Health Insurance 26
106	105		Pool Act, § 23-79-501 et seq.; and 27
107	106		28
108	107		SECTION 7. Arkansas Code Title 23, Chapter 79, Subchapter 5 is 29
109	108		repealed because the subchapter expired in 2016. 30
110	109		23-79-501. Purpose. 31
111	110		(a)(1) Acts 1995, No. 1339, established the Arkansas Comprehensive 32
112	111		Health Insurance Pool as a state program that was intended to provide an 33
113	112		alternate market for health insurance for certain uninsurable Arkansas 34
114	113		residents, and further this subchapter is intended to provide for the 35
115	114		successor entity that will provide the acceptable alternative mechanism as 36 HB1361
116	115
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118	117		described in the Health Insurance Portability and Accountability Act of 1996 1
119	118		for providing portable and accessible individual health insurance coverage 2
120	119		for federally eligible individuals as defined in this subchapter. 3
121	120		(2) This subchapter further is intended to provide a health 4
122	121		insurance coverage option for persons eligible for a federal income tax 5
123	122		credit under section 35 of the Internal Revenue Code, as created by the Trade 6
124	123		Adjustment Assistance Reform Act of 2002 or as subsequently amended. 7
125	124		(b) The General Assembly declares that it intends for this program to 8
126	125		provide portable and accessible individual health insurance coverage for 9
127	126		every individual who qualifies for coverage in accordance with § 23 -79-509(b) 10
128	127		as a federally eligible individual or as a qualified trade adjustment 11
129	128		assistance eligible person but does not intend for every eligible person who 12
130	129		qualifies for pool coverage in accordance with § 23 -79-509 to be guaranteed a 13
131	130		right to be issued a policy under this pool as a matter of entitlement. 14
132	131		15
133	132		23-79-502. Short title. 16
134	133		This subchapter may be cited as the “Comprehensive Health Insurance 17
135	134		Pool Act”, and is amendatory to the Arkansas Insurance Code and the 18
136	135		provisions of the Arkansas Insurance Code which are not in conflict with this 19
137	136		subchapter are applicable to this subchapter. 20
138	137		21
139	138		23-79-503. Definitions. 22
140	139		As used in this subchapter: 23
141	140		(1) “Agent” means any person who is licensed to sell health 24
142	141		insurance in this state; 25
143	142		(2) “Board” means the Board of Directors of the Arkansas 26
144	143		Comprehensive Health Insurance Pool; 27
145	144		(3) “Church plan” has the same meaning given that term in the 28
146	145		Health Insurance Portability and Accountability Act of 1996; 29
147	146		(4) “Commissioner” means the Insurance Commissioner; 30
148	147		(5) “Continuation coverage” means continuation of coverage under 31
149	148		a group health plan or other health insurance coverage for former employees 32
150	149		or dependents of former employees that would otherwise have terminated under 33
151	150		the terms of that coverage pursuant to any continuation provisions under 34
152	151		federal or state law, including the Consolidated Omnibus Budget 35
153	152		Reconciliation Act of 1985 (COBRA), as amended, § 23 -86-114 of the Arkansas 36 HB1361
154	153
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156	155		Insurance Code, or any other similar requirement in another state; 1
157	156		(6) “Covered person” means a person who is and continues to 2
158	157		remain eligible for pool coverage and is covered under one (1) of the plans 3
159	158		offered by the pool; 4
160	159		(7)(A) “Creditable coverage” means, with respect to a federally 5
161	160		eligible individual or a qualified trade adjustment assistance eligible 6
162	161		person, coverage of the individual under any of the following: 7
163	162		(i) A group health plan; 8
164	163		(ii) Health insurance coverage, including group 9
165	164		health insurance coverage; 10
166	165		(iii) Medicare; 11
167	166		(iv) Medical assistance; 12
168	167		(v) 10 U.S.C. § 1071 et seq.; 13
169	168		(vi) A medical care program of the Indian Health 14
170	169		Service or of a tribal organization; 15
171	170		(vii) A state health benefits risk pool; 16
172	171		(viii) A health plan offered under 5 U.S.C. § 8901 17
173	172		et seq.; 18
174	173		(ix) A public health plan, as defined in regulations 19
175	174		consistent with section 104 of the Health Insurance Portability and 20
176	175		Accountability Act of 1996 that may be promulgated by the Secretary of the 21
177	176		United States Department of Health and Human Services; and 22
178	177		(x) A health benefit plan under section 5(e) of the 23
179	178		Peace Corps Act, 22 U.S.C. § 2504(e). 24
180	179		(B) “Creditable coverage” does not include: 25
181	180		(i) Coverage consisting solely of coverage of 26
182	181		excepted benefits as defined in section 2791(C) of Title XXVII of the Public 27
183	182		Health Service Act, 42 U.S.C. § 300gg -91; or 28
184	183		(ii)(a) Any period of coverage under 29
185	184		subdivisions (7)(A)(i) -(x) of this section that occurred before a break of 30
186	185		more than sixty-three (63) days during all of which the individual was not 31
187	186		covered under subdivisions (7)(A)(i) -(x) of this section. 32
188	187		(b) Any period that an individual is in a 33
189	188		waiting period for any coverage under a group health plan or for group health 34
190	189		insurance coverage or is in an affiliation period under the terms of health 35
191	190		insurance coverage offered by a health maintenance organization shall not be 36 HB1361
192	191
193	192		6 01/31/2025 10:34:07 AM ANS002
194	193		taken into account in determining if there has been a break of more than 1
195	194		sixty-three (63) days in any creditable coverage; 2
196	195		(8) “Department” means the State Insurance Department; 3
197	196		(9) “Excess or stop -loss coverage” means an arrangement whereby 4
198	197		an insurer insures against the risk that any one (1) claim will exceed a 5
199	198		specific dollar amount or that the entire loss of a self -insurance plan will 6
200	199		exceed a specific amount; 7
201	200		(10) “Federally eligible individual” means an individual 8
202	201		resident of Arkansas: 9
203	202		(A) For whom: 10
204	203		(i) As of the date on which the individual seeks 11
205	204		pool coverage under § 23 -79-509, the aggregate of the periods of creditable 12
206	205		coverage is eighteen (18) or more months; and 13
207	206		(ii) The most recent prior creditable coverage was 14
208	207		under group health insurance coverage offered by an insurer, a group health 15
209	208		plan, a governmental plan, a church plan, or health insurance coverage 16
210	209		offered in connection with any such plans; 17
211	210		(B) Who is not eligible for coverage under: 18
212	211		(i) A group health plan; 19
213	212		(ii) Part A or Part B of Medicare; or 20
214	213		(iii) Medical assistance and does not have other 21
215	214		health insurance coverage; 22
216	215		(C) With respect to whom the most recent coverage within 23
217	216		the coverage period described in subdivision (10)(A)(i) of this section was 24
218	217		not terminated based upon a factor related to nonpayment of premiums or 25
219	218		fraud; 26
220	219		(D) If the individual has been offered the option of 27
221	220		continuation coverage under a Consolidated Omnibus Budget Reconciliation Act 28
222	221		of 1985 (COBRA) continuation provision or under a similar state program, who 29
223	222		elected such coverage; and 30
224	223		(E) Who, if the individual elected the continuation 31
225	224		coverage, has exhausted the continuation coverage under such a provision or 32
226	225		program; 33
227	226		(11) “Governmental plan” has the same meaning given that term in 34
228	227		the federal Health Insurance Portability and Accountability Act of 1996; 35
229	228		(12) “Group health plan” has the same meaning given that term in 36 HB1361
230	229
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232	231		the federal Health Insurance Portability and Accountability Act of 1996; 1
233	232		(13)(A) “Health insurance” means any hospital and medical 2
234	233		expense-incurred policy, certificate, or contract provided by an insurer, 3
235	234		hospital or medical service corporation, health maintenance organization, or 4
236	235		any other healthcare plan or arrangement that pays for or furnishes medical 5
237	236		or healthcare services whether by insurance or otherwise and includes any 6
238	237		excess or stop-loss coverage. 7
239	238		(B) “Health insurance” does not include long -term care, 8
240	239		disability income, short -term, accident, dental -only, vision-only, fixed 9
241	240		indemnity, limited-benefit or credit insurance, coverage issued as a 10
242	241		supplement to liability insurance, insurance arising out of workers' 11
243	242		compensation or similar law, automobile medical -payment insurance, or 12
244	243		insurance under which benefits are payable with or without regard to fault 13
245	244		and that is statutorily required to be contained in any liability insurance 14
246	245		policy or equivalent self -insurance; 15
247	246		(14) “Health maintenance organization” shall have the same 16
248	247		meaning as defined in § 23 -76-102; 17
249	248		(15) “Hospital” shall have the same meaning as defined in § 20 -18
250	249		9-201; 19
251	250		(16) “Individual health insurance coverage” means health 20
252	251		insurance coverage offered to individuals in the individual market but does 21
253	252		not include short-term, limited-duration insurance; 22
254	253		(17)(A) “Insurer” means any entity that provides health 23
255	254		insurance, including excess or stop -loss health insurance, in the State of 24
256	255		Arkansas. 25
257	256		(B) For the purposes of this subchapter, “insurer” 26
258	257		includes an insurance company, medical services plans, hospital plans, 27
259	258		hospital medical service corporations, health maintenance organizations, 28
260	259		fraternal benefits society, or any other entity providing a plan of health 29
261	260		insurance or health benefits subject to state insurance regulation; 30
262	261		(18) “Medical assistance” means the state medical assistance 31
263	262		program provided under Title XIX of the Social Security Act or under any 32
264	263		similar program of healthcare benefits in a state other than Arkansas; 33
265	264		(19)(A)(i) “Medically necessary” means that a service, drug, 34
266	265		supply, or article is necessary and appropriate for the diagnosis or 35
267	266		treatment of an illness or injury in accord with generally accepted standards 36 HB1361
268	267
269	268		8 01/31/2025 10:34:07 AM ANS002
270	269		of medical practice at the time the service, drug, or supply is provided. 1
271	270		(ii) When specifically applied to a confinement, 2
272	271		“medically necessary” further means that the diagnosis or treatment of the 3
273	272		covered person's medical symptoms or condition cannot be safely provided to 4
274	273		that person as an outpatient. 5
275	274		(B) A service, drug, supply, or article shall not be 6
276	275		medically necessary if it: 7
277	276		(i) Is investigational, experimental, or for 8
278	277		research purposes; 9
279	278		(ii) Is provided solely for the convenience of the 10
280	279		patient, the patient's family, physician, hospital, or any other provider; 11
281	280		(iii) Exceeds in scope, duration, or intensity that 12
282	281		level of care that is needed to provide safe, adequate, and appropriate 13
283	282		diagnosis or treatment; 14
284	283		(iv) Could have been omitted without adversely 15
285	284		affecting the covered person's condition or the quality of medical care; or 16
286	285		(v) Involves the use of a medical device, drug, or 17
287	286		substance not formally approved by the United States Food and Drug 18
288	287		Administration; 19
289	288		(20) “Medicare” means coverage under Part A and Part B of Title 20
290	289		XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq.; 21
291	290		(21) “Physician” means a person licensed to practice medicine as 22
292	291		duly licensed by the State of Arkansas; 23
293	292		(22) “Plan” means the comprehensive health insurance plan as 24
294	293		adopted by the board or by rule; 25
295	294		(23) “Plan administrator” means the insurer designated under § 26
296	295		23-79-508 to carry out the provisions of the plan of operation; 27
297	296		(24) “Plan of operation” means the plan of operation of the 28
298	297		pool, including articles, bylaws, and operating rules adopted by the board 29
299	298		pursuant to this subchapter; 30
300	299		(25) “Provider” means any hospital, skilled nursing facility, 31
301	300		hospice, home health agency, physician, pharmacist, or any other person or 32
302	301		entity licensed in Arkansas to furnish medical care, articles, and supplies; 33
303	302		(26) “Qualified high -risk pool” has the same meaning given that 34
304	303		term in the Health Insurance Portability and Accountability Act of 1996; 35
305	304		(27) “Qualified trade adjustment assistance eligible person” 36 HB1361
306	305
307	306		9 01/31/2025 10:34:07 AM ANS002
308	307		means a person who is a trade adjustment assistance eligible person as 1
309	308		defined by this section and for whom, on the date an application for the 2
310	309		individual is received by the pool under § 23 -79-509, has an aggregate of at 3
311	310		least three (3) months of creditable coverage without a break in coverage of 4
312	311		sixty-three (63) days or more; 5
313	312		(28) “Resident eligible person” means a person who: 6
314	313		(A) Has been legally domiciled in the State of Arkansas 7
315	314		for a period of at least: 8
316	315		(i) Ninety (90) days and continues to be domiciled 9
317	316		in Arkansas; or 10
318	317		(ii) Thirty (30) days, continues to be domiciled in 11
319	318		Arkansas, and was covered under a qualified high -risk pool in another state 12
320	319		up until sixty-three (63) days or less prior to the date that the pool 13
321	320		receives his or her application for coverage; and 14
322	321		(B) Is not eligible for coverage under: 15
323	322		(i) A group health plan; 16
324	323		(ii) Part A or Part B of Medicare; or 17
325	324		(iii) Medical assistance as defined in this section 18
326	325		and does not have other health insurance coverage as defined in this section; 19
327	326		and 20
328	327		(29) “Trade adjustment assistance eligible person” means a 21
329	328		person who is legally domiciled in the State of Arkansas on the date of 22
330	329		application to the pool and is eligible for the tax credit for health 23
331	330		insurance coverage premiums under section 35 of the Internal Revenue Code of 24
332	331		1986. 25
333	332		26
334	333		23-79-504. Arkansas Comprehensive Health Insurance Pool. 27
335	334		(a) There is created a nonprofit legal entity to be known as the 28
336	335		“Arkansas Comprehensive Health Insurance Pool” as the successor entity to the 29
337	336		nonprofit legal entity established by Acts 1995, No. 1339. 30
338	337		(b)(1) The pool shall operate subject to the supervision and control 31
339	338		of the Board of Directors of the Arkansas Comprehensive Health Insurance 32
340	339		Pool. The pool is created as a political subdivision, instrumentality, and 33
341	340		body politic of the State of Arkansas, and, as such, is not a state agency. 34
342	341		(2) Except to the extent defined in this subchapter, the pool 35
343	342		will be exempt from: 36 HB1361
344	343
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346	345		(A) All state, county, and local taxes; 1
347	346		(B) The Arkansas Procurement Law, § 19 -11-201 et seq.; 2
348	347		(C) The Freedom of Information Act of 1967, § 25 -19-101 et 3
349	348		seq.; and 4
350	349		(D) The Arkansas Administrative Procedure Act, § 25 -15-201 5
351	350		et seq. 6
352	351		(3) The board shall consist of the following seven (7) members 7
353	352		to be appointed by the Insurance Commissioner: 8
354	353		(A) Two (2) current or former representatives of insurance 9
355	354		companies licensed to do business in the State of Arkansas; 10
356	355		(B) Two (2) current or former representatives of health 11
357	356		maintenance organizations licensed to do business in the State of Arkansas; 12
358	357		(C) One (1) member of a health -related profession licensed 13
359	358		in the State of Arkansas; 14
360	359		(D) One (1) member from the general public who is not 15
361	360		associated with the medical profession, a hospital, or an insurer; and 16
362	361		(E) One (1) member to represent a group considered to be 17
363	362		uninsurable. 18
364	363		(4) In making appointments to the board, the commissioner shall 19
365	364		strive to ensure that at least one (1) person serving on the board is at 20
366	365		least sixty (60) years of age. 21
367	366		(5) All terms shall be for three (3) years. 22
368	367		(6) The board shall elect one (1) of its members as chair. 23
369	368		(7) Any vacancy in the board occurring for any reason other than 24
370	369		the expiration of a term shall be filled for the unexpired term in the same 25
371	370		manner as the original appointment. 26
372	371		(8) Members of the board may be reimbursed from moneys of the 27
373	372		pool for actual and necessary expenses incurred by them in the performance of 28
374	373		their official duties as members of the board but shall not otherwise be 29
375	374		compensated for their services. 30
376	375		(c) All insurers, as a condition of doing business in the State of 31
377	376		Arkansas, shall participate in the pool by paying the assessments, submitting 32
378	377		the reports, and providing the information required by the board or the 33
379	378		commissioner to implement the provisions of this subchapter. 34
380	379		(d)(1) Neither the board nor its employees shall be liable for any 35
381	380		obligations of the pool. 36 HB1361
382	381
383	382		11 01/31/2025 10:34:07 AM ANS002
384	383		(2) No board member or employee of the board shall be liable, 1
385	384		and no cause of action of any nature may arise against them, for any act or 2
386	385		omission related to the performance of their powers and duties under this 3
387	386		subchapter. 4
388	387		(3) The board may provide in its bylaws or rules for 5
389	388		indemnification of, and legal representation for, the board members and 6
390	389		employees. 7
391	390		8
392	391		23-79-505. Plan of operation. 9
393	392		(a)(1) The Board of Directors of the Arkansas Comprehensive Health 10
394	393		Insurance Pool shall adopt a plan of operation pursuant to this subchapter 11
395	394		and shall submit to the Insurance Commissioner for approval the plan of 12
396	395		operation including the Arkansas Comprehensive Health Insurance Pool's 13
397	396		articles, bylaws and operating rules, and any amendments thereto necessary or 14
398	397		suitable to assure the fair, reasonable, and equitable administration of the 15
399	398		pool. The plan of operation shall become effective upon approval in writing 16
400	399		by the commissioner. 17
401	400		(2) If the board fails to submit a suitable plan of operation 18
402	401		within one hundred eighty (180) days after the appointment of the board of 19
403	402		directors, or at any time thereafter fails to submit suitable amendments to 20
404	403		the plan of operation, the commissioner shall adopt and promulgate such rules 21
405	404		as are necessary or advisable to effectuate the provisions of this section. 22
406	405		The rules shall continue in force until modified by the commissioner or 23
407	406		superseded by a plan of operation submitted by the board and approved by the 24
408	407		commissioner. 25
409	408		(b) The plan of operation shall: 26
410	409		(1) Establish procedures for operation of the pool; 27
411	410		(2) Establish procedures for selecting a plan administrator in 28
412	411		accordance with § 23 -79-508; 29
413	412		(3) Create a fund, under management of the board, to pay 30
414	413		administrative claims and other expenses of the pool; 31
415	414		(4) Establish procedures for the handling, accounting, and 32
416	415		auditing of assets, moneys, and claims of the pool and the plan 33
417	416		administrator; 34
418	417		(5) Develop and implement a program to publicize the existence 35
419	418		of the plan, the eligibility requirements, and the procedures for enrollment 36 HB1361
420	419
421	420		12 01/31/2025 10:34:07 AM ANS002
422	421		and to maintain public awareness of the plan; 1
423	422		(6)(A) Establish procedures under which applicants and 2
424	423		participants may have grievances reviewed by a grievance committee appointed 3
425	424		by the board. The grievances shall be reported to the board after completion 4
426	425		of the review. 5
427	426		(B) The board shall retain all written complaints 6
428	427		regarding the plan for at least three (3) years; and 7
429	428		(7) Provide for other matters as may be necessary and proper for 8
430	429		the execution of the board's powers, duties, and obligations under this 9
431	430		subchapter. 10
432	431		11
433	432		23-79-506. Powers. 12
434	433		(a)(1) The Arkansas Comprehensive Health Insurance Pool shall have the 13
435	434		general powers and authority granted under the laws of the State of Arkansas 14
436	435		to health insurers and, in addition thereto, the specific authority to: 15
437	436		(A) Enter into contracts as are necessary or proper to 16
438	437		carry out the provisions and purposes of this subchapter; 17
439	438		(B) Sue or be sued, including taking any legal actions 18
440	439		necessary or proper; 19
441	440		(C) Take such legal action as necessary, including without 20
442	441		limitation: 21
443	442		(i) Avoiding the payment of improper claims against 22
444	443		the pool or the coverage provided by or through the pool; 23
445	444		(ii) Recovering any amounts erroneously or 24
446	445		improperly paid by the pool; 25
447	446		(iii) Recovering any amounts paid by the pool as a 26
448	447		result of mistake of fact or law; 27
449	448		(iv) Recovering other amounts due the pool; or 28
450	449		(v) Coordinating legal action with the Insurance 29
451	450		Commissioner to enforce the provisions of this subchapter; 30
452	451		(D)(i) Establish and modify from time to time as 31
453	452		appropriate, rates, rate schedules, rate adjustments, expense allowances, 32
454	453		agent referral fees, claim reserve formulas, deductibles, copayments, 33
455	454		coinsurance, and any other actuarial function appropriate to the operation of 34
456	455		the pool. 35
457	456		(ii) Rates and rate schedules may be adjusted for 36 HB1361
458	457
459	458		13 01/31/2025 10:34:07 AM ANS002
460	459		appropriate factors such as age, sex, and geographical variation in claim 1
461	460		costs and shall take into consideration appropriate factors in accordance 2
462	461		with established actuarial and underwriting practices; 3
463	462		(E) Issue policies of insurance in accordance with the 4
464	463		requirements of this subchapter. All policy forms shall be subject to the 5
465	464		approval of the commissioner; 6
466	465		(F) Authorize the plan administrator to prepare and 7
467	466		distribute certificate of eligibility forms and enrollment instruction forms 8
468	467		to agents and to the general public; 9
469	468		(G) Provide and employ cost -containment measures and 10
470	469		requirements, including without limitation preadmission screening, second 11
471	470		surgical opinion, concurrent utilization review, and individual case 12
472	471		management for the purposes of making the plan more cost effective; 13
473	472		(H) Design, utilize, contract, or otherwise arrange the 14
474	473		delivery of cost-effective healthcare services, including establishing or 15
475	474		contracting directly or through the plan administrator with preferred 16
476	475		provider organizations, health maintenance organizations, physician hospital 17
477	476		organizations, or other limited network provider arrangements; 18
478	477		(I) Borrow money to effect the purposes of the pool. Any 19
479	478		notes or other evidence of indebtedness of the pool not in default shall be 20
480	479		legal investments for insurers and may be carried as admitted assets; 21
481	480		(J) Pledge, assign, and grant a security interest in any 22
482	481		of the assessments authorized by this subchapter or other assets of the pool 23
483	482		in order to secure any notes or other evidences of indebtedness of the pool; 24
484	483		(K) Provide reinsurance of risks incurred by the pool; 25
485	484		(L) Provide additional types of plans to provide optional 26
486	485		coverages, including Medicare supplement health insurance and health savings 27
487	486		accounts that comply with applicable federal law as in effect January 1, 28
488	487		2005; 29
489	488		(M) Enter into reciprocal agreements with other comparable 30
490	489		state plans in order to provide coverage for persons who move between states 31
491	490		and are covered by such other states' plans; and 32
492	491		(N) Establish lifetime maximum benefits under § 23 -79-33
493	492		510(a)(2)(W) for any person covered by a plan. 34
494	493		(2) In addition to the other powers granted by the Arkansas 35
495	494		Insurance Code, the commissioner may impose, after notice and hearing in 36 HB1361
496	495
497	496		14 01/31/2025 10:34:07 AM ANS002
498	497		accordance with the provisions of the Arkansas Insurance Code, a monetary 1
499	498		penalty upon any insurer or suspend or revoke the certificate of authority to 2
500	499		transact insurance in the State of Arkansas of any insurer that fails to pay 3
501	500		an assessment or otherwise file any report or furnish information required to 4
502	501		be filed with the Board of Directors of the Arkansas Comprehensive Health 5
503	502		Insurance Pool pursuant to the board's direction that the board believes is 6
504	503		necessary in order for the board to perform its duties under this subchapter. 7
505	504		(b) All outstanding contracts executed by the Board of Directors of 8
506	505		the State Comprehensive Health Insurance Pool created by Acts 1995, No. 1339, 9
507	506		shall be deemed continuing obligations of the board created by this 10
508	507		subchapter. 11
509	508		(c) As provided for in § 23 -79-502, any health insurance benefit not 12
510	509		provided for in this subchapter shall be deemed to be in conflict with and 13
511	510		therefore inapplicable to the provisions of this subchapter. 14
512	511		15
513	512		23-79-507. Funding of pool. 16
514	513		(a) Premiums. 17
515	514		(1)(A) The Arkansas Comprehensive Health Insurance Pool shall 18
516	515		establish premium rates for plan coverage as provided in subdivision (a)(2) 19
517	516		of this section. 20
518	517		(B) Separate schedules of premium rates based on age, sex, 21
519	518		and geographical location may apply for individual risks. 22
520	519		(C) Premium rates and schedules shall be submitted to the 23
521	520		Insurance Commissioner for approval prior to use. 24
522	521		(2)(A)(i) With the assistance of the commissioner, the pool 25
523	522		shall determine a standard risk rate by considering the premium rates charged 26
524	523		by other insurers offering health insurance coverage to individuals in 27
525	524		Arkansas. 28
526	525		(ii) The standard risk rate shall be established 29
527	526		using reasonable actuarial techniques and shall reflect anticipated 30
528	527		experience and expenses for the coverage. 31
529	528		(B)(i) Rates for plan coverage shall not exceed one 32
530	529		hundred fifty percent (150%) of rates established as applicable for 33
531	530		individual standard risks in Arkansas. 34
532	531		(ii) Subject to the limits provided in this 35
533	532		subdivision (a)(2), subsequent rates shall be established to help provide for 36 HB1361
534	533
535	534		15 01/31/2025 10:34:07 AM ANS002
536	535		the expected costs of claims, including recovery of prior losses, expenses of 1
537	536		operation, investment income of claim reserves, and any other cost factors 2
538	537		subject to the limitations described in this section. 3
539	538		(b) Sources of Additional Revenue. 4
540	539		(1) In addition to the powers enumerated in § 23 -79-506, the 5
541	540		pool shall have the authority to: 6
542	541		(A) Assess insurers in accordance with the provisions of 7
543	542		this section; and 8
544	543		(B)(i) Make advance interim assessments as may be 9
545	544		reasonable and necessary for the pool's organizational and interim operating 10
546	545		expenses. 11
547	546		(ii) Any such interim assessments may be credited as 12
548	547		offsets against any regular assessments due following the close of the fiscal 13
549	548		year. 14
550	549		(2)(A) Following the close of each fiscal year, the plan 15
551	550		administrator shall determine the net premiums, that is, premiums less 16
552	551		administrative expense allowances, the pool expenses of administration and 17
553	552		operation, and the incurred losses for the year, taking into account 18
554	553		investment income and other appropriate gains and losses. 19
555	554		(B) The deficit incurred by the pool not otherwise 20
556	555		recouped under either subdivision (b)(9) of this section or subsection (e) of 21
557	556		this section [repealed], or both, shall be recouped by assessments 22
558	557		apportioned among insurers by the Board of Directors of the Arkansas 23
559	558		Comprehensive Health Insurance Pool. 24
560	559		(3) Each insurer's assessment shall be determined by multiplying 25
561	560		the total assessment of all insurers as determined in subdivision (b)(2) of 26
562	561		this section by a fraction, the numerator of which equals that insurer's 27
563	562		premium and subscriber contract charges for health insurance written in the 28
564	563		state during the preceding calendar year and the denominator of which equals 29
565	564		the total of all health insurance premiums by all insurers. 30
566	565		(4)(A) If assessments or other funds received under either 31
567	566		subdivision (b)(9) of this section or subsection (e) of this section 32
568	567		[repealed], or both, or any combination of the assessments and funds exceed 33
569	568		the pool's actual losses and administrative expenses, the excess shall be 34
570	569		held at interest and used by the board to offset future losses or to reduce 35
571	570		future assessments. 36 HB1361
572	571
573	572		16 01/31/2025 10:34:07 AM ANS002
574	573		(B) As used in this subsection, “future losses” includes 1
575	574		reserves for incurred but not reported claims. 2
576	575		(5) Each insurer's assessment shall be determined annually by 3
577	576		the board based on annual statements and other reports deemed necessary by 4
578	577		the board and filed by the insurer with the board or the commissioner. 5
579	578		(6)(A)(i) An insurer may petition the commissioner for an 6
580	579		abatement or deferment of all or part of an assessment imposed by the board. 7
581	580		(ii) The commissioner may abate or defer, in whole 8
582	581		or in part, the assessment if, in the opinion of the commissioner, payment of 9
583	582		the assessment would endanger the ability of the insurer to fulfill its 10
584	583		contractual obligations. 11
585	584		(B)(i) In the event an assessment against an insurer is 12
586	585		abated or deferred, in whole or in part, the amount by which the assessment 13
587	586		is abated or deferred shall be assessed against the other insurers in a 14
588	587		manner consistent with the basis for assessments set forth in this 15
589	588		subsection. 16
590	589		(ii) The insurer receiving the abatement or 17
591	590		deferment shall remain liable to the plan for the deficiency for four (4) 18
592	591		years. 19
593	592		(7) For all assessments issued by the board, beginning January 20
594	593		1, 1998, only those individuals, corporations, associations, or other 21
595	594		entities defined as an insurer in § 23 -79-503 shall be subject to assessment. 22
596	595		(8) In the event the board fails to act within a reasonable 23
597	596		period of time to recoup by assessment any deficit incurred by the pool, the 24
598	597		commissioner shall have all the powers and duties of the board under this 25
599	598		chapter with respect to assessing insurers. 26
600	599		(9) The General Assembly further intends that the pool be 27
601	600		eligible for, and for the pool, its board, or other officers of state 28
602	601		government, as appropriate, to take steps necessary to obtain federal grant 29
603	602		funds to offset losses of the pool, including any funds made available under 30
604	603		the Trade Adjustment Assistance Reform Act of 2002. 31
605	604		(c) Assessment Offsets. 32
606	605		(1) Any assessment may be offset in an amount equal to the 33
607	606		amount of the assessment paid to the pool against the premium tax payable by 34
608	607		that insurer for the year in which the assessment is levied or for the four 35
609	608		(4) years subsequent to that year. 36 HB1361
610	609
611	610		17 01/31/2025 10:34:07 AM ANS002
612	611		(2) No offset shall be allowed for any penalty assessed under 1
613	612		subdivision (d)(1) of this section. 2
614	613		(d)(1) All assessments and fees shall be due and payable upon receipt 3
615	614		and shall be delinquent if not paid within thirty (30) days of the receipt of 4
616	615		the notice by the insurer. 5
617	616		(2) Failure to timely pay the assessment will automatically 6
618	617		subject the insurer to a ten percent (10%) penalty, which will be due and 7
619	618		payable within the next thirty -day period. 8
620	619		(3) The board and the commissioner shall have the authority to 9
621	620		enforce the collection of the assessment and penalty in accordance with the 10
622	621		provisions of this subchapter and the Arkansas Insurance Code. 11
623	622		(4) The board may waive the penalty authorized by this 12
624	623		subsection if it determines that compelling circumstances exist that justify 13
625	624		such a waiver. 14
626	625		15
627	626		23-79-508. Plan administrator. 16
628	627		(a) The Board of Directors of the Arkansas Comprehensive Health 17
629	628		Insurance Pool shall select an insurer through a competitive bidding process 18
630	629		to administer the plan. However, the administering insurer designated by the 19
631	630		board created by Acts 1995, No. 1339, shall serve as the plan administrator 20
632	631		under this subchapter until the expiration of the current contract of the 21
633	632		administering insurer. The board shall evaluate bids submitted under this 22
634	633		section based upon criteria established by the board which shall include, but 23
635	634		not be limited to, the following: 24
636	635		(1) The plan administrator's proven ability to handle large 25
637	636		group accident and health benefit plans; 26
638	637		(2) The efficiency and timeliness of the plan administrator's 27
639	638		claim processing procedures; 28
640	639		(3) An estimate of total charges for administering the plan; 29
641	640		(4) The plan administrator's ability to apply effective cost 30
642	641		containment programs and procedures and to administer the plan in a cost 31
643	642		efficient manner; and 32
644	643		(5) The financial condition and stability of the plan 33
645	644		administrator. 34
646	645		(b)(1) The plan administrator shall serve for a period of three (3) 35
647	646		years subject to removal for cause and subject to the terms, conditions, and 36 HB1361
648	647
649	648		18 01/31/2025 10:34:07 AM ANS002
650	649		limitations of the contract between the board and the plan administrator. 1
651	650		(2) The board shall advertise for and accept bids to serve as 2
652	651		the plan administrator for the succeeding three -year periods. 3
653	652		(c) The plan administrator shall perform functions related to the plan 4
654	653		as may be assigned to it, including: 5
655	654		(1) Determination of eligibility; 6
656	655		(2) Payment and processing of claims; 7
657	656		(3) Establishment of a premium billing procedure for collection 8
658	657		of premiums. Billings shall be made on a periodic basis as determined by the 9
659	658		board; and 10
660	659		(4) Other necessary functions to assure timely payment of 11
661	660		benefits to covered persons under the plan, including: 12
662	661		(A) Making available information relating to the proper 13
663	662		manner of submitting a claim for benefits under the plan and distributing 14
664	663		forms upon which submissions shall be made; and 15
665	664		(B) Evaluating the eligibility of each claim for payment 16
666	665		under the plan. 17
667	666		(d)(1) The plan administrator shall submit regular reports to the 18
668	667		board regarding the operation of the plan. 19
669	668		(2) Frequency, content, and form of the report shall be 20
670	669		determined by the board. 21
671	670		(e)(1) The plan administrator shall pay claim expenses from the 22
672	671		premium payments received from or on behalf of plan participants and 23
673	672		allocated by the board for claim expenses. 24
674	673		(2) If the plan administrator's payments for claims expenses 25
675	674		exceed the portion of premiums allocated by the board for payment of claims 26
676	675		expenses, the board shall provide additional funds to the plan administrator 27
677	676		for payment of claims expenses. 28
678	677		(f) The plan administrator shall be governed by the requirements of 29
679	678		this subchapter and shall be compensated as provided in the contract between 30
680	679		the board and the plan administrator. 31
681	680		32
682	681		23-79-509. Plan eligibility. 33
683	682		(a) General Eligibility Requirements. The following requirements 34
684	683		apply to a resident eligible person or a trade adjustment assistance eligible 35
685	684		person in order for the person to be eligible for plan coverage: 36 HB1361
686	685
687	686		19 01/31/2025 10:34:07 AM ANS002
688	687		(1) Except as provided in subdivision (a)(2) of this section or 1
689	688		subsection (b) of this section, any individual person who meets the 2
690	689		definition of resident eligible person as defined by § 23 -79-503 or a trade 3
691	690		adjustment assistance eligible person as defined by § 23 -79-503 and is either 4
692	691		a citizen of the United States or an alien lawfully admitted for permanent 5
693	692		residence who continues to be a resident of this state shall be eligible for 6
694	693		plan coverage if evidence is provided of: 7
695	694		(A) A notice of rejection or refusal by an insurer to 8
696	695		issue substantially similar individual health insurance coverage by reason of 9
697	696		the existence or history of a medical condition or upon such other evidence 10
698	697		that the Board of Directors of the Arkansas Comprehensive Health Insurance 11
699	698		Pool deems sufficient in order to verify that the applicant is unable to 12
700	699		obtain the coverage from an insurer due to the existence or history of a 13
701	700		medical condition; 14
702	701		(B)(i) A refusal by an insurer to issue individual health 15
703	702		insurance coverage except at a rate that the board determines is 16
704	703		substantially in excess of the applicable plan rate. 17
705	704		(ii) A rejection or refusal by a group health plan 18
706	705		or insurer offering only stop -loss or excess-of-loss insurance or contracts, 19
707	706		agreements, or other arrangements for reinsurance coverage with respect to 20
708	707		the applicant shall not be sufficient evidence under this subsection; 21
709	708		(C)(i) Until September 30, 2011, a refusal by an insurer 22
710	709		to issue individual health insurance coverage to a child under nineteen (19) 23
711	710		years of age. 24
712	711		(ii) After September 30, 2011, the eligibility of a 25
713	712		child under nineteen (19) years of age for individual health insurance 26
714	713		coverage shall be determined by the board; or 27
715	714		(D) Evidence that the applicant was covered under a 28
716	715		qualified high-risk pool of another state, provided that the coverage 29
717	716		terminated no more than sixty -three (63) days prior to the date the pool 30
718	717		receives the applicant's application for coverage and the other state's 31
719	718		qualified high-risk pool did not terminate the person's coverage for fraud; 32
720	719		(2) A person shall not be eligible for coverage under the plan 33
721	720		if: 34
722	721		(A) The person has or obtains health insurance coverage 35
723	722		substantially similar to or more comprehensive than a plan policy or would be 36 HB1361
724	723
725	724		20 01/31/2025 10:34:07 AM ANS002
726	725		eligible to have coverage if the person elected to obtain it except that: 1
727	726		(i) A person may maintain other coverage for the 2
728	727		period of time the person is satisfying any waiting period for a preexisting 3
729	728		condition under a plan policy; and 4
730	729		(ii) A person may maintain plan coverage for the 5
731	730		period of time the person is satisfying a waiting period for a preexisting 6
732	731		condition under another health insurance policy intended to replace the plan 7
733	732		policy; 8
734	733		(B) The person is determined to be eligible for healthcare 9
735	734		benefits under Title XIX of the Social Security Act; 10
736	735		(C) The person has previously terminated plan coverage 11
737	736		unless twelve (12) months have elapsed since termination of coverage; 12
738	737		(D) The person fails to pay the required premium under the 13
739	738		covered person's terms of enrollment and participation, in which event the 14
740	739		liability of the plan shall be limited to benefits incurred under the plan 15
741	740		for the same period for which premiums had been paid and the covered person 16
742	741		remained eligible for plan coverage; 17
743	742		(E) The plan has paid on behalf of the covered person the 18
744	743		maximum lifetime benefit established by the board in accordance with § 23 -79-19
745	744		510(a)(2)(W); 20
746	745		(F) The person is a resident of a public institution; 21
747	746		(G) All or part of the person's premium is paid for or 22
748	747		reimbursed: 23
749	748		(i) By one (1) of the following in connection with a 24
750	749		group health plan: 25
751	750		(a) The person’s current employer; 26
752	751		(b) If the person is retired, by the person's 27
753	752		former employer; or 28
754	753		(c) If the person is a dependent of an 29
755	754		employee or retiree, by the current or former employer of the employee or 30
756	755		retiree; or 31
757	756		(ii) Under any government -sponsored program or by 32
758	757		any government agency, foundation, healthcare facility, or healthcare 33
759	758		provider except for premiums paid on behalf of: 34
760	759		(a) A trade adjustment assistance eligible 35
761	760		person or a qualified trade adjustment assistance eligible person in 36 HB1361
762	761
763	762		21 01/31/2025 10:34:07 AM ANS002
764	763		accordance with section 35 of the Internal Revenue Code; or 1
765	764		(b) An otherwise qualifying full -time employee 2
766	765		or dependent of a qualifying full -time employee of a government agency, 3
767	766		foundation, healthcare facility, or healthcare provider; or 4
768	767		(H) The person commits a fraudulent insurance act as 5
769	768		defined in § 23-66-501(4) against the Arkansas Comprehensive Health Insurance 6
770	769		Pool; 7
771	770		(3) The board or the plan administrator shall require 8
772	771		verification of residency and may require any additional information, 9
773	772		documentation, or statements under oath whenever necessary to determine plan 10
774	773		eligibility or residency; 11
775	774		(4) Coverage shall cease: 12
776	775		(A) On the date a person is no longer a resident of the 13
777	776		State of Arkansas; 14
778	777		(B) On the date a person requests coverage to end; 15
779	778		(C) On the death of the covered person; 16
780	779		(D) On the date state law requires cancellation of the 17
781	780		policy; or 18
782	781		(E) At the plan's option, thirty (30) days after the plan 19
783	782		makes any written inquiry concerning a person's eligibility or place of 20
784	783		residence to which the person does not reply; and 21
785	784		(5) Except under the conditions set forth in subdivision (a)(4) 22
786	785		of this section, the coverage of any person who ceases to meet the 23
787	786		eligibility requirements of this section terminates at the end of the month 24
788	787		that the person ceases to meet the eligibility requirements of this section. 25
789	788		(b) Persons Eligible for Guaranteed Issuance of Coverage. The 26
790	789		following requirements apply to a federally eligible individual or a 27
791	790		qualified trade adjustment assistance eligible person in order for such an 28
792	791		individual to be eligible for plan coverage: 29
793	792		(1) Notwithstanding the requirements of subsection (a) of this 30
794	793		section, any federally eligible individual or a qualified trade adjustment 31
795	794		assistance eligible person for whom a plan application and such enclosures 32
796	795		and supporting documentation as the board may require is received by the 33
797	796		board within sixty-three (63) days after the termination of prior creditable 34
798	797		coverage for reasons other than nonpayment of premium or fraud that covered 35
799	798		the applicant shall qualify to enroll in the plan under the portability 36 HB1361
800	799
801	800		22 01/31/2025 10:34:07 AM ANS002
802	801		provisions of this subsection; 1
803	802		(2) Any individual seeking plan coverage under this subsection 2
804	803		must submit with his or her application evidence, including acceptable 3
805	804		written certification of previous creditable coverage, that will establish to 4
806	805		the board's satisfaction that he or she meets all of the requirements to be a 5
807	806		federally eligible individual or a qualified trade adjustment assistance 6
808	807		eligible person and is currently and permanently residing in the State of 7
809	808		Arkansas as of the date his or her application was received by the board; 8
810	809		(3) A period of creditable coverage shall not be counted, with 9
811	810		respect to qualifying an applicant for plan coverage as an individual under 10
812	811		this subsection, if after such a period and before the application for plan 11
813	812		coverage was received by the board, there was at least a sixty -three-day 12
814	813		period during all of which the individual was not covered under any 13
815	814		creditable coverage; 14
816	815		(4) Any individual who the board determines qualifies for plan 15
817	816		coverage under this subsection shall be offered his or her choice of 16
818	817		enrolling in one (1) of the alternative portability plans that the board is 17
819	818		authorized under this subsection to establish for those individuals; 18
820	819		(5)(A)(i) The board shall offer a choice of healthcare coverages 19
821	820		consistent with major medical coverage under the alternative plans authorized 20
822	821		by this subsection to every individual qualifying for coverage under this 21
823	822		subsection. 22
824	823		(ii) The coverages to be offered under the plans, 23
825	824		the schedule of benefits, deductibles, copayments, coinsurance, exclusions, 24
826	825		and other limitations shall be approved by the board. 25
827	826		(B) One (1) optional form of coverage shall be comparable 26
828	827		to comprehensive health insurance coverage offered in the individual market 27
829	828		in the State of Arkansas or a standard option of coverage available under the 28
830	829		individual health insurance laws of the State of Arkansas. The standard plan 29
831	830		that is authorized by § 23 -79-510 may be used for this purpose. 30
832	831		(C) The board also may offer a preferred provider option 31
833	832		and such other options as the board determines may be appropriate for 32
834	833		individuals who qualify for plan coverage pursuant to this subsection; 33
835	834		(6) Notwithstanding the requirements of § 23 -79-510(f), any plan 34
836	835		coverage that is issued to individuals who qualify for plan coverage pursuant 35
837	836		to the portability provisions of this subsection shall not be subject to any 36 HB1361
838	837
839	838		23 01/31/2025 10:34:07 AM ANS002
840	839		preexisting conditions exclusion, waiting period, or other similar limitation 1
841	840		on coverage; 2
842	841		(7) Individuals who qualify and enroll in the plan pursuant to 3
843	842		this subsection shall be required to pay such premium rates as the board 4
844	843		shall establish and approve in accordance with the requirements of § 23 -79-5
845	844		507(a); 6
846	845		(8) The total premium, without regard to any subsidy of premium, 7
847	846		for individuals who qualify and enroll in the plan pursuant to this 8
848	847		subsection shall not be greater than a similarly situated individual 9
849	848		qualifying for pool coverage under subsection (a) of this section; and 10
850	849		(9) A federally eligible individual who qualifies and enrolls in 11
851	850		the plan pursuant to this subsection must continue to satisfy all of the 12
852	851		other eligibility requirements of this subchapter to the extent not 13
853	852		inconsistent with the Health Insurance Portability and Accountability Act of 14
854	853		1996 in order to maintain continued eligibility for coverage under the plan. 15
855	854		(c) Any person who was issued a policy pursuant to the provisions of 16
856	855		Acts 1995, No. 1339, shall be deemed continuously covered consistent with the 17
857	856		terms of this subchapter and reissued a new policy in accordance with the 18
858	857		provisions of this subchapter. 19
859	858		20
860	859		23-79-510. Outline of benefits. 21
861	860		(a)(1) Subject to the contractual policy form language adopted by the 22
862	861		Board of Directors of the Arkansas Comprehensive Health Insurance Pool, 23
863	862		expenses for the following services, supplies, drugs, or articles when 24
864	863		prescribed by a physician and determined by the plan to be medically 25
865	864		necessary shall be covered, subject to provisions of subsection (b) of this 26
866	865		section: 27
867	866		(A) Hospital services; 28
868	867		(B) Professional services for the diagnosis or treatment 29
869	868		of injuries, illnesses, or conditions, other than mental or dental, that are 30
870	869		rendered by a physician or by other licensed professionals at his or her 31
871	870		direction; 32
872	871		(C) Drugs requiring a physician's prescription; 33
873	872		(D) Skilled nursing services of a licensed skilled nursing 34
874	873		facility for not more than one hundred twenty (120) days during a policy 35
875	874		year; 36 HB1361
876	875
877	876		24 01/31/2025 10:34:07 AM ANS002
878	877		(E) Services of a home health agency up to a maximum of 1
879	878		two hundred seventy (270) services per year; 2
880	879		(F) Use of radium or other radioactive materials; 3
881	880		(G) Oxygen; 4
882	881		(H) Prostheses other than dental; 5
883	882		(I) Rental of durable medical equipment, other than 6
884	883		eyeglasses and hearing aids, for which there is no personal use in the 7
885	884		absence of the conditions for which such equipment is prescribed; 8
886	885		(J) Diagnostic X rays and laboratory tests; 9
887	886		(K) Oral surgery for excision of partially or completely 10
888	887		unerupted, impacted teeth or the gums and tissues of the mouth when not 11
889	888		performed in connection with the extraction or repair of teeth; 12
890	889		(L) Services of a physical therapist; 13
891	890		(M) Emergency and other medically necessary transportation 14
892	891		provided by a licensed ambulance service to the nearest facility qualified to 15
893	892		treat a covered condition; 16
894	893		(N) Services for diagnosis and treatment of mental and 17
895	894		nervous disorders or chemical and drug dependency, provided that a covered 18
896	895		person shall be required to make a fifty percent (50%) copayment and that the 19
897	896		plan's payment shall not exceed four thousand dollars ($4,000) annually; and 20
898	897		(O) Such additional benefits deemed appropriate by the 21
899	898		board in accordance with the provisions of subsection (b) of this section. 22
900	899		(2) Exclusions. Unless the contractual policy form language 23
901	900		adopted by the board provides otherwise, the following services, supplies, 24
902	901		drugs, or articles whether or not prescribed by a physician, shall not be 25
903	902		covered: 26
904	903		(A) Any charge for treatment for cosmetic purposes other 27
905	904		than surgery for the repair or treatment of an injury or a congenital bodily 28
906	905		defect to restore normal bodily functions; 29
907	906		(B) Care that is primarily for custodial or domiciliary 30
908	907		purposes; 31
909	908		(C) Any charge for confinement in a private room to the 32
910	909		extent it is in excess of the institution's charge for its most common 33
911	910		semiprivate room unless a private room is medically necessary; 34
912	911		(D) That part of any charge for services rendered or 35
913	912		articles prescribed by a physician, dentist, or other healthcare personnel 36 HB1361
914	913
915	914		25 01/31/2025 10:34:07 AM ANS002
916	915		that exceeds the prevailing charge in the locality or for any charge not 1
917	916		medically necessary; 2
918	917		(E) Any charge for services or articles the provision of 3
919	918		which is not within the scope of authorized practice of the institution or 4
920	919		individual providing the services or articles; 5
921	920		(F) Any expense incurred prior to the effective date of 6
922	921		coverage by the plan for the person on whose behalf the expense is incurred; 7
923	922		(G) Dental care except as provided in subdivision 8
924	923		(a)(1)(K) of this section; 9
925	924		(H) Eyeglasses and hearing aids; 10
926	925		(I) Illness or injury due to acts of war; 11
927	926		(J) Services of blood donors and any fee for failure to 12
928	927		replace the first three (3) pints of blood provided to a covered person each 13
929	928		policy year; 14
930	929		(K) Personal supplies or services provided by a hospital 15
931	930		or nursing home or any other nonmedical or nonprescribed supply or service; 16
932	931		(L) Any expense or charge for services, articles, drugs, 17
933	932		or supplies that are not provided in accord with generally accepted standards 18
934	933		of current medical practice; 19
935	934		(M) Any expense for which a charge is not made in the 20
936	935		absence of insurance or for which there is no legal obligation on the part of 21
937	936		the patient to pay; 22
938	937		(N) Any expense incurred for benefits provided under the 23
939	938		laws of the United States and the State of Arkansas, including Medicare and 24
940	939		Medicaid and other medical assistance, military service -connected disability 25
941	940		payments, medical services provided for members of the armed forces and their 26
942	941		dependents or employees of the United States Armed Forces, and medical 27
943	942		services financed on behalf of all citizens by the United States; 28
944	943		(O) Any expense or charge for in vitro fertilization, 29
945	944		artificial insemination, or any other artificial means used to cause 30
946	945		pregnancy; 31
947	946		(P) Any expense or charge for oral contraceptives used for 32
948	947		birth control or any other temporary birth control measures; 33
949	948		(Q) Any expense or charge for sterilization or 34
950	949		sterilization reversals; 35
951	950		(R) Any expense or charge for weight -loss programs, 36 HB1361
952	951
953	952		26 01/31/2025 10:34:07 AM ANS002
954	953		exercise equipment, or treatment of obesity except when certified by a 1
955	954		physician as morbid obesity, i.e., at least two (2) times normal body weight; 2
956	955		(S) Any expense or charge for acupuncture treatment unless 3
957	956		used as an anesthetic agent for a covered surgery; 4
958	957		(T) Any expense or charge for organ or bone marrow 5
959	958		transplants other than those performed at a hospital with a board -approved 6
960	959		organ transplant program that has been designated by the board as a preferred 7
961	960		provider organization for that specific organ or bone marrow transplant; 8
962	961		(U) Any expense or charge for procedures, treatments, 9
963	962		equipment, or services that are provided in special settings for research 10
964	963		purposes or in a controlled environment, are being studied for safety, 11
965	964		efficiency, and effectiveness, and are awaiting endorsement by the 12
966	965		appropriate national medical specialty college for general use within the 13
967	966		medical community; 14
968	967		(V) Such additional exclusions deemed appropriate by the 15
969	968		board in accordance with the provisions of subsection (b) of this section; 16
970	969		and 17
971	970		(W)(i) Any benefits that exceed the maximum lifetime 18
972	971		benefit for plan coverage established by the board under § 23 -79-19
973	972		506(a)(1)(N). 20
974	973		(ii) The maximum lifetime benefit shall not be less 21
975	974		than one million dollars ($1,000,000) and shall not exceed three million 22
976	975		dollars ($3,000,000). 23
977	976		(b) In establishing the plan coverage, the board shall take into 24
978	977		consideration the levels of health insurance provided in the state and 25
979	978		medical economic factors as may be deemed appropriate and promulgate 26
980	979		benefits, deductibles, copayments, coinsurance factors, exclusions, and 27
981	980		limitations determined to be generally reflective of and commensurate with 28
982	981		health insurance provided through a representative number of large employers 29
983	982		in the state. 30
984	983		(c) The board may adjust any deductibles, copayments, and coinsurance 31
985	984		factors annually according to the medical component of the Consumer Price 32
986	985		Index for All Urban Consumers. 33
987	986		(d) Nonduplication of Benefits. 34
988	987		(1)(A) The pool shall be payer of last resort of benefits 35
989	988		whenever any other benefit or source of third -party payment is available. 36 HB1361
990	989
991	990		27 01/31/2025 10:34:07 AM ANS002
992	991		(B) Benefits otherwise payable under plan coverage shall 1
993	992		be reduced by all amounts paid or payable through any other health insurance 2
994	993		or any other source providing benefits because of a sickness or injury and by 3
995	994		all hospital and medical expense benefits paid or payable under any workers' 4
996	995		compensation coverage, automobile medical payment, or liability insurance 5
997	996		whether provided on the basis of fault or nonfault and by any hospital or 6
998	997		medical benefits paid or payable under or provided pursuant to any state or 7
999	998		federal law or program. 8
1000	999		(2) The pool shall have a cause of action against a covered 9
1001	1000		person for the recovery of the amount of benefits paid that are not covered 10
1002	1001		by the pool. Benefits due from the pool may be reduced or refused as a set -11
1003	1002		off against any amount recoverable under this subdivision (d)(2). 12
1004	1003		(e) Right of Subrogation — Recoveries. 13
1005	1004		(1)(A) Whenever the pool has paid benefits because of sickness 14
1006	1005		or an injury to any covered person resulting from a third party's wrongful 15
1007	1006		act or negligence or for which an insurance company or self -insured entity is 16
1008	1007		liable in accordance with the provisions of any policy of insurance, and the 17
1009	1008		covered person has recovered or may recover damages from a third party that 18
1010	1009		is liable for damages, the pool shall have the right to recover the benefits 19
1011	1010		it paid from any amounts that the covered person has received or may receive 20
1012	1011		regardless of the date of the sickness or injury or the date of any 21
1013	1012		settlement, judgment, or award resulting from the sickness or injury. 22
1014	1013		(B) The pool shall be subrogated to any right of recovery 23
1015	1014		the covered person may have under the terms of any private or public 24
1016	1015		healthcare coverage or liability coverage including coverage under a workers' 25
1017	1016		compensation act without the necessity of assignment of claim or other 26
1018	1017		authorization to secure the right of recovery. 27
1019	1018		(C) To enforce its subrogation right, the pool may: 28
1020	1019		(i) Intervene or join in an action or proceeding 29
1021	1020		brought by the covered person or his or her personal representative, 30
1022	1021		including his or her guardian, conservator, estate, dependents, or survivors, 31
1023	1022		against any third party or the third party's insurance carrier or self -32
1024	1023		insured entity that may be liable; or 33
1025	1024		(ii) Institute and prosecute legal proceedings 34
1026	1025		against any third party or the third party's insurance carrier or self -35
1027	1026		insured entity that may be liable for the sickness or injury in an 36 HB1361
1028	1027
1029	1028		28 01/31/2025 10:34:07 AM ANS002
1030	1029		appropriate court either in the name of the pool or in the name of the 1
1031	1030		covered person or his or her personal representative including his or her 2
1032	1031		guardian, conservator, estate, dependents, or survivors. 3
1033	1032		(2)(A)(i) If any action or claim is brought by or on behalf of a 4
1034	1033		covered person against a third party or the third party's insurance carrier 5
1035	1034		or self-insured entity, the covered person or his or her personal 6
1036	1035		representative, including his or her guardian, conservator, estate, 7
1037	1036		dependents, or survivors, shall notify the pool by personal service or 8
1038	1037		registered mail of the action or claim and of the name of the court in which 9
1039	1038		the action or claim is brought, filing proof thereof in the action or claim. 10
1040	1039		(ii) The pool may, at any time thereafter, join in 11
1041	1040		the action or claim upon its motion so that all orders of court after hearing 12
1042	1041		and judgment shall be made for its protection. 13
1043	1042		(B) No release or settlement of a claim for damages and no 14
1044	1043		satisfaction of judgment in the action shall be valid without the written 15
1045	1044		consent of the pool to the extent of its interest in the settlement or 16
1046	1045		judgment and of the covered person or his or her personal representative. 17
1047	1046		(3)(A) In the event that the covered person or his or her 18
1048	1047		personal representative fails to institute a proceeding against any 19
1049	1048		appropriate third party before the fifth month before the action would be 20
1050	1049		barred, the pool, in its own name or in the name of the covered person or 21
1051	1050		personal representative, may commence a proceeding against any appropriate 22
1052	1051		third party for the recovery of damages on account of any sickness, injury, 23
1053	1052		or death to the covered person. 24
1054	1053		(B) The covered person shall cooperate in doing what is 25
1055	1054		reasonably necessary to assist the pool in any recovery and shall not take 26
1056	1055		any action that would prejudice the pool's right to recovery. 27
1057	1056		(C) The pool shall pay to the covered person or his or her 28
1058	1057		personal representative all sums collected from any third party by judgment 29
1059	1058		or otherwise in excess of amounts paid in benefits under the pool and amounts 30
1060	1059		paid or to be paid as costs, attorney's fees, and reasonable expenses 31
1061	1060		incurred by the pool in making the collection or enforcing the judgment. 32
1062	1061		(4)(A)(i) In the event of judgment or award in either a suit or 33
1063	1062		claim against a third party, the court shall first order paid from any 34
1064	1063		judgment or award the reasonable litigation expenses incurred in preparation 35
1065	1064		and prosecution of the action or claim, together with reasonable attorney's 36 HB1361
1066	1065
1067	1066		29 01/31/2025 10:34:07 AM ANS002
1068	1067		fees. 1
1069	1068		(ii) After payment of those expenses and attorney's 2
1070	1069		fees, the court shall apply out of the balance of the judgment or award an 3
1071	1070		amount sufficient to reimburse the pool the full amount of benefits paid on 4
1072	1071		behalf of the covered person under this subchapter, provided that the court 5
1073	1072		may reduce and apportion the pool's portion of the judgment proportionately 6
1074	1073		to the recovery of the covered person. 7
1075	1074		(B)(i) The burden of producing sufficient evidence to 8
1076	1075		support the exercise by the court of its discretion to reduce the amount of a 9
1077	1076		proven charge sought to be enforced against the recovery shall rest with the 10
1078	1077		party seeking the reduction. 11
1079	1078		(ii) The court may consider the nature and extent of 12
1080	1079		the injury, economic and noneconomic loss, settlement offers, comparative or 13
1081	1080		contributory negligence as it applies to the case at hand, hospital costs, 14
1082	1081		physician costs, and all other appropriate costs. 15
1083	1082		(C) The pool shall pay its pro rata share of the 16
1084	1083		attorney's fees based on the pool's recovery as it compares to the total 17
1085	1084		judgment. 18
1086	1085		(D) Any reimbursement rights of the pool shall take 19
1087	1086		priority over all other liens and charges existing under the laws of the 20
1088	1087		State of Arkansas. 21
1089	1088		(5) The pool may compromise or settle and release any claim for 22
1090	1089		benefits provided under this subchapter or waive any claims for benefits, in 23
1091	1090		whole or in part, for the convenience of the pool or if the pool determines 24
1092	1091		that collection will result in undue hardship upon the covered person. 25
1093	1092		(f) Preexisting Conditions. 26
1094	1093		(1) Except for federally eligible individuals or qualified trade 27
1095	1094		adjustment assistance eligible persons qualifying for plan coverage under § 28
1096	1095		23-79-509(b) or resident eligible persons or trade adjustment assistance 29
1097	1096		eligible persons who qualify for and elect to purchase the waiver authorized 30
1098	1097		in subdivision (f)(2) of this section, plan coverage shall exclude charges or 31
1099	1098		expenses incurred during the first six (6) months following the effective 32
1100	1099		date of coverage as to any condition if: 33
1101	1100		(A) The condition has manifested itself within the six -34
1102	1101		month period immediately preceding the effective date of coverage in such a 35
1103	1102		manner as would cause an ordinary prudent person to seek diagnosis, care, or 36 HB1361
1104	1103
1105	1104		30 01/31/2025 10:34:07 AM ANS002
1106	1105		treatment; or 1
1107	1106		(B) Medical advice, care, or treatment was recommended or 2
1108	1107		received within the six -month period immediately preceding the effective date 3
1109	1108		of the coverage. 4
1110	1109		(2) Waiver. The preexisting condition exclusions as set forth 5
1111	1110		in subdivision (f)(1) of this section will be waived to the extent to which 6
1112	1111		the resident eligible person or trade adjustment assistance eligible person: 7
1113	1112		(A) Has satisfied similar exclusions under any prior 8
1114	1113		individual health insurance coverage that was involuntarily terminated; and 9
1115	1114		(B)(i) Has applied for plan coverage not later than thirty 10
1116	1115		(30) days following the involuntary termination. 11
1117	1116		(ii) For each resident eligible person or trade 12
1118	1117		adjustment assistance eligible person who qualifies for and elects this 13
1119	1118		waiver, there shall be added on a prorated basis to each payment of premium a 14
1120	1119		surcharge of up to ten percent (10%) of the otherwise applicable annual 15
1121	1120		premium for as long as that individual's coverage under the plan remains in 16
1122	1121		effect or sixty (60) months, whichever is less. 17
1123	1122		(3)(A) Whenever benefits are due from the plan because of 18
1124	1123		sickness or an injury to a covered person resulting from a third party's 19
1125	1124		wrongful act or negligence and the covered person has recovered or may 20
1126	1125		recover damages from a third party or its insurance carrier or self -insured 21
1127	1126		entity, the plan shall have the right to reduce benefits or to refuse to pay 22
1128	1127		benefits that otherwise may be payable in the amount of damages that the 23
1129	1128		covered person has recovered or may recover regardless of the date of the 24
1130	1129		sickness or injury or the date of any settlement, judgment, or award 25
1131	1130		resulting from that sickness or injury. 26
1132	1131		(B)(i) During the pendency of any action or claim that is 27
1133	1132		brought by or on behalf of a covered person against a third party or its 28
1134	1133		insurance carrier or self -insured entity, any benefits that would otherwise 29
1135	1134		be payable except for the provisions of this subsection shall be paid if 30
1136	1135		payment by or for the third party has not yet been made and the covered 31
1137	1136		person or, if capable, that person's legal representative agrees in writing 32
1138	1137		to pay back properly the benefits paid as a result of the sickness or injury 33
1139	1138		to the extent of any future payments made by or for the third party for the 34
1140	1139		sickness or injury. 35
1141	1140		(ii) This agreement is to apply whether or not 36 HB1361
1142	1141
1143	1142		31 01/31/2025 10:34:07 AM ANS002
1144	1143		liability for the payments is established or admitted by the third party or 1
1145	1144		whether those payments are itemized. 2
1146	1145		(C) Any amounts due the plan to repay benefits may be 3
1147	1146		deducted from other benefits payable by the plan after payments by or for the 4
1148	1147		third party are made. 5
1149	1148		(4) Benefits due from the plan may be reduced or refused as an 6
1150	1149		offset against any amount otherwise recoverable under this section. 7
1151	1150		8
1152	1151		23-79-511. Confidentiality. 9
1153	1152		(a)(1) All steps necessary under state and federal law to protect 10
1154	1153		confidentiality of applicants and covered persons shall be undertaken by the 11
1155	1154		Board of Directors of the Arkansas Comprehensive Health Insurance Pool to 12
1156	1155		prevent the identification of individual records of covered persons under the 13
1157	1156		plan, rejected by the plan, or who may become ineligible for further 14
1158	1157		participation in the plan. 15
1159	1158		(2) Procedures shall be written by the board to assure the 16
1160	1159		confidentiality of records of persons covered under, rejected by, or who 17
1161	1160		became ineligible for further participation in the plan when gathering and 18
1162	1161		submitting data to the board or any other entity. 19
1163	1162		(b) Any information submitted to the board by hospitals or any other 20
1164	1163		provider pursuant to this subchapter from which the identity of a particular 21
1165	1164		individual can be determined shall be privileged and confidential and shall 22
1166	1165		not be disclosed in any manner. The foregoing includes, but shall not be 23
1167	1166		limited to, disclosure, inspection, or copying under the Freedom of 24
1168	1167		Information Act of 1967, § 25 -19-101 et seq. 25
1169	1168		26
1170	1169		23-79-512. Collective action. 27
1171	1170		Neither the participation in the plan as insurers, the establishment of 28
1172	1171		rates, forms, or procedures nor any other joint or collective action required 29
1173	1172		by this subchapter shall be the basis of any legal action, criminal or civil 30
1174	1173		liability, or penalty against the plan or any insurer. 31
1175	1174		32
1176	1175		23-79-513. Unfair referral to plan — Prohibited practices by 33
1177	1176		employers. 34
1178	1177		(a) It shall constitute an unfair trade practice under the Trade 35
1179	1178		Practices Act, § 23-66-201 et seq., for an insurer, agent, broker, or third -36 HB1361
1180	1179
1181	1180		32 01/31/2025 10:34:07 AM ANS002
1182	1181		party administrator to refer an individual to the Arkansas Comprehensive 1
1183	1182		Health Insurance Pool or arrange for an individual to apply to the pool for 2
1184	1183		the purpose of: 3
1185	1184		(1) Separating the individual from group health insurance 4
1186	1185		coverage provided by a group health plan; or 5
1187	1186		(2) Facilitating enrollment in the pool by any of the following 6
1188	1187		individuals associated with an employer, with the knowledge that the employer 7
1189	1188		intends to pay or is paying all or part of the premium payments owed by the 8
1190	1189		individual for pool coverage: 9
1191	1190		(A) An employee of the employer; 10
1192	1191		(B) A retired employee of the employer; or 11
1193	1192		(C) A dependent of an employee or retired employee of the 12
1194	1193		employer. 13
1195	1194		(b) Because pool coverage is not intended to cover participants who 14
1196	1195		are eligible for a group health plan, an individual described in subdivision 15
1197	1196		(a)(2) of this section is not eligible: 16
1198	1197		(1) For pool coverage if the employer associated with the 17
1199	1198		applicant intends to pay for all or part of the pool premium payments for the 18
1200	1199		individual; or 19
1201	1200		(2) To continue pool coverage if the employer associated with 20
1202	1201		the individual directly or indirectly pays all or part of the pool premium 21
1203	1202		payments for the individual. 22
1204	1203		23
1205	1204		23-79-515. Orderly cessation of operations. 24
1206	1205		(a)(1) The Arkansas Comprehensive Health Insurance Pool shall cease 25
1207	1206		enrollment and coverage under the plan on and after January 1, 2014, as 26
1208	1207		required by federal law. 27
1209	1208		(2) After taking all reasonable steps, including those specified 28
1210	1209		in this section, to timely and efficiently assist in the transition of 29
1211	1210		individuals receiving plan coverage to the individual health insurance 30
1212	1211		market, the Board of Directors of the Arkansas Comprehensive Health Insurance 31
1213	1212		Pool shall cease operating the pool after paying health insurance claims for 32
1214	1213		plan coverage and meeting all other obligations of the board under this 33
1215	1214		section. 34
1216	1215		(b) The board may take all actions it deems necessary to: 35
1217	1216		(1) Cease enrollment for plan coverage effective December 1, 36 HB1361
1218	1217
1219	1218		33 01/31/2025 10:34:07 AM ANS002
1220	1219		2013; 1
1221	1220		(2)(A) Terminate all existing plan coverage effective at the end 2
1222	1221		of the calendar day on December 31, 2013. 3
1223	1222		(B) The board shall provide at least ninety (90) days 4
1224	1223		notice to current policyholders of the termination; and 5
1225	1224		(3) Amend plan policies and provide adequate notice to 6
1226	1225		policyholders, agents, and providers that to be paid or reimbursed, a claim 7
1227	1226		for plan services is required to be filed by the earlier of one hundred 8
1228	1227		eighty (180) days after plan coverage ends or three hundred sixty -five (365) 9
1229	1228		days after the date of service giving rise to the claim. 10
1230	1229		(c) This section does not require the board to revise plan benefits to 11
1231	1230		comply with federal law or to maintain plan coverage for any individual after 12
1232	1231		December 31, 2013. 13
1233	1232		(d)(1) After all plan coverage terminates under this section, the 14
1234	1233		board shall take reasonable steps to wind up all significant operations of 15
1235	1234		the pool by December 31, 2014. 16
1236	1235		(2) Notwithstanding any other provision of this subchapter, to 17
1237	1236		facilitate an efficient cessation of operations: 18
1238	1237		(A) The board may continue to use existing contractors 19
1239	1238		until cessation of operations without the need to issue competitive requests 20
1240	1239		for proposals; 21
1241	1240		(B) The board may continue to fund operations of this 22
1242	1241		subchapter under § 23 -79-507; 23
1243	1242		(C) The board shall remain in effect: 24
1244	1243		(i) As provided by § 23 -79-504(b); and 25
1245	1244		(ii) Until a judgment, order, or decree in any 26
1246	1245		action, suit, or proceeding commenced against or by the pool is fully 27
1247	1246		executed; and 28
1248	1247		(D)(i) The term of each current board member shall be 29
1249	1248		extended until the date the pool concludes all business as provided under 30
1250	1249		this section and the Insurance Commissioner certifies the cessations of 31
1251	1250		operations under subsection (g) of this section. 32
1252	1251		(ii) The term of a board member expires when the 33
1253	1252		commissioner certifies the cessations of operations under subsection (g) of 34
1254	1253		this section. 35
1255	1254		(e) On or before June 30, 2013, the board shall amend the plan of 36 HB1361
1256	1255
1257	1256		34 01/31/2025 10:34:07 AM ANS002
1258	1257		operation to reflect the actions necessary to implement this section. 1
1259	1258		(f) If the board has excess funds after the cessation of operations of 2
1260	1259		the pool, the funds shall be returned to the general revenue funds of the 3
1261	1260		state. 4
1262	1261		(g)(1) On or before March 1, 2016, or a later date if necessary to 5
1263	1262		complete the cessation of operations of the pool, the board shall file a 6
1264	1263		report with the General Assembly and commissioner that reflects completion of 7
1265	1264		the requirements of this section and includes an independent auditor's report 8
1266	1265		on the financial statements of the pool. 9
1267	1266		(2) If satisfied upon review of the report that the board has 10
1268	1267		complied with this section and accomplished the pool's cessation of 11
1269	1268		operations in a reasonable manner, the commissioner shall certify that the 12
1270	1269		business of the pool has concluded in accordance with this section and 13
1271	1270		publish the certification on the State Insurance Department website. 14
1272	1271		(h) Upon certification under subsection (g) of this section, the 15
1273	1272		operations of the pool are suspended indefinitely unless reactivated by the 16
1274	1273		General Assembly. 17
1275	1274		(i) The commissioner may address any matters regarding the pool 18
1276	1275		arising after the certification under subsection (g) of this section, and the 19
1277	1276		Attorney General shall defend a legal action filed after the certification, 20
1278	1277		including seeking the dismissal of the action under § 23 -79-516 or for any 21
1279	1278		other purpose. 22
1280	1279		(j) Unless inconsistent with this section, the remainder of this 23
1281	1280		subchapter continues to apply to the pool and the board. 24
1282	1281		25
1283	1282		23-79-516. Statute of limitations and repose. 26
1284	1283		Because winding up the operations of the Arkansas Comprehensive Health 27
1285	1284		Insurance Pool requires the expeditious determination of its outstanding 28
1286	1285		liabilities, a cause of action against the pool or the Board of Directors of 29
1287	1286		the Arkansas Comprehensive Health Insurance Pool shall be commenced within 30
1288	1287		the earlier of one (1) year after the cause of action accrues or December 31, 31
1289	1288		2015. 32
1290	1289		33
1291	1290		23-79-517. Individuals moving to Arkansas and previously covered by 34
1292	1291		another qualified high -risk pool. 35
1293	1292		(a) Notwithstanding § 23 -79-510(f), if a resident eligible person is 36 HB1361
1294	1293
1295	1294		35 01/31/2025 10:34:07 AM ANS002
1296	1295		eligible for plan coverage because the person previously was covered under a 1
1297	1296		qualified high-risk pool of another state, a preexisting condition exclusion 2
1298	1297		otherwise applicable to the resident eligible person: 3
1299	1298		(1) Shall be reduced by each month of coverage in which the 4
1300	1299		resident eligible person was subject to a preexisting condition exclusion in 5
1301	1300		the other state's qualified high -risk pool; or 6
1302	1301		(2) Does not apply if the resident eligible person was not 7
1303	1302		subject to a preexisting condition exclusion in the other state's qualified 8
1304	1303		high-risk pool. 9
1305	1304		(b) This section expires on the last day an individual may be enrolled 10
1306	1305		into plan coverage under this subchapter. 11
1307	1306		12
1308	1307		SECTION 8. DO NOT CODIFY. CONSTRUCTION AND LEGISLATIVE INTENT. 13
1309	1308		It is the intent of the General Assembly that: 14
1310	1309		(1) The enactment and adoption of this act shall not expressly 15
1311	1310		or impliedly repeal an act passed during the regular session of the Ninety -16
1312	1311		Fifth General Assembly; 17
1313	1312		(2) To the extent that a conflict exists between an act of the 18
1314	1313		regular session of the Ninety -Fifth General Assembly and this act: 19
1315	1314		(A) The act of the regular session of the Ninety -Fifth 20
1316	1315		General Assembly shall be treated as a subsequent act passed by the General 21
1317	1316		Assembly for the purposes of: 22
1318	1317		(i) Giving the act of the regular session of the 23
1319	1318		Ninety-Fifth General Assembly its full force and effect; and 24
1320	1319		(ii) Amending or repealing the appropriate parts of 25
1321	1320		the Arkansas Code of 1987; and 26
1322	1321		(B) Section 1-2-107 shall not apply; and 27
1323	1322		(3) This act shall make only technical, not substantive, changes 28
1324	1323		to the Arkansas Code of 1987. 29
1325	1324		30
1326	1325		31
1327		-	~~APPROVED: 2/25/25~~ 32
	1326	+	32
1328	1327		33
1329	1328		34
1330	1329		35
1331	1330		36