reglab/housing_qa huggingface dataset:
AR Code § 23-86-104 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-104. Blanket accident and health insurance — Payment of benefits

 (a)  (1) All benefits under any blanket accident and health insurance policy shall be payable to the person insured, to the designated beneficiaries, or to his or her estate.  (2) However, if the person insured is a minor or mental incompetent, the benefits may be made payable to the parent, guardian, or other person actually supporting the minor or mental incompetent. If the entire cost of the insurance has been borne by the employer, the benefits may be made payable to the employer.    (b)  (1) However, the policy may provide that all or any portion of any indemnities provided by the policy on account of hospital, nursing, medical, or surgical services, at the insurer's option, may be paid directly to the hospital or person rendering the services, but the policy may not require that the service be rendered by a particular hospital or person.  (2) Payment so made shall discharge the insurer's obligation with respect to the amount of insurance paid.
AR Code § 23-86-107 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-107. Group accident and health insurance — Authorized insurer required

 (a) All group accident and health insurance placed by an employer on employees who are residents of this state shall be placed by the employer with an insurer authorized to transact insurance in this state.  (b) This section shall not apply to group insurance lawfully placed in an insurer transacting insurance as a surplus lines insurer under § 23-65-101 et seq., the Unauthorized Insurers Process Act, § 23-65-201 et seq., and the Surplus Lines Insurance Law, § 23-65-301 et seq.
AR Code § 23-86-109 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-109. Group accident and health insurance — Optional continuation of benefit provisions

 Any group accident and health insurance policy that contains provisions for the payment by the insurer of benefits for expenses incurred on account of hospital, nursing, medical, or surgical services for members of the family or dependents of a person in the insured group may provide for the continuation of the benefit provisions, or any parts thereof, after the death of the person in the insured group.
AR Code § 23-86-110 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-110. Group accident and health insurance — Administration of benefits

 (a)  (1) All group accident and health insurance carriers including hospital and medical service corporations shall be subject to the “primary” and “secondary” carrier rules promulgated by the Insurance Commissioner.  (2) The secondary carrier shall administer benefits on a timely basis.    (b) This section applies to group contracts of accident and health insurance sold, delivered, or issued for delivery, renewed, or offered for sale in this state.
AR Code § 23-86-112 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-112. Group accident and health insurance — Direct payment of hospital or medical services

 (a) On request by the group policyholder, any group accident and health insurance policy may provide that all or any portion of any indemnities provided by any policy on account of hospital, nursing, medical, or surgical services may be paid, at the insurer's option, directly to the hospital or person rendering such services, but the policy may not require that the service be rendered by a particular hospital or person.  (b) Payment so made shall discharge the insurer's obligation with respect to the amount of insurance paid.
AR Code § 23-86-116 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-116. Continuation of benefits upon termination of policy

 (a) Every group accident and health insurance policy, contract, or certificate that provides coverage for hospital or medical services or expenses shall provide that the insurer shall continue its obligation for benefits under the policy or contract for any person insured under the policy or contract who is hospitalized on the date of termination, if the policy or contract is terminated and replaced by a group health insurance policy or contract issued by another insurer or by a self-funded healthcare plan.  (b) Any payment required under this section is subject to all terms, limitations, and conditions of the policy or contract except those relating to termination of benefits. Any obligation by an insurer under this section continues until the hospital confinement ends or hospital benefits under the policy or contract are exhausted, whichever is earlier.
AR Code § 23-86-117 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-117. Standard claim form required

 (a) All accident and health insurers transacting business in this state shall use Form HCFA 1500 and Form UB-92/HCFA 1450 or in the claim format required by the Health Insurance Portability and Accountability Act of 1996 as the standard claim forms until and unless the Insurance Commissioner prescribes otherwise.  (b) Pursuant to the applicable provisions of the Arkansas Insurance Code, the commissioner may suspend or revoke the certificate of authority of any insurance company that refuses to use and accept the standard claim form required by this section, or the commissioner may utilize any remedy provided in § 23-66-210.
AR Code § 23-86-118 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-118. In vitro fertilization coverage required

 (a) All accident and health insurance companies doing business in this state shall include, as a covered expense, in vitro fertilization.  (b) Pursuant to the applicable provisions of the Arkansas Insurance Code, the Insurance Commissioner may suspend or revoke the certificate of authority of any insurance company failing to comply with the provisions of this section.  (c) After conducting appropriate studies and public hearings, the commissioner shall establish minimum and maximum levels of coverage to be provided by the accident and health insurance companies.  (d) Coverage required under this section shall include services performed at a medical facility licensed or certified by the Department of Health, those performed at a facility certified by the department that conforms to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization clinics, or those performed at a facility certified by the department that meets the American Society for Reproductive Medicine minimal standards for programs of in vitro fertilization.
AR Code § 23-86-119 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-119. Disclosure to policyholders

 (a) Upon request from a policyholder with more than twenty-five (25) insured employees under a comprehensive health insurance policy, any insurer issuing or delivering group accident and health insurance policies in this state shall provide to the policyholder the following information for the most recent twelve-month period or for the entire period of coverage, whichever is shorter:  (1) Claims incurred by month;  (2) Premiums paid by month;  (3) Number of insureds to include dependents by month; and  (4) Claims exceeding ten thousand dollars ($10,000) on any individual with diagnosis during the same period.    (b) This section does not require the insurer to disclose any information that is required by law to be confidential.
AR Code § 23-86-120 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-120. Hospice care coverage for terminally ill patients

 (a)  (1) Every accident and health insurance company, hospital service corporation, health maintenance organization, or other health insurance provider in the State of Arkansas shall offer to each master group contract holder, coverage for hospice facilities and hospice programs as defined under § 20-7-117.  (2)  (A) The offer of these benefits shall be subject to the right of the policy or contract holder to reject the coverage.  (B) The rejection by the policy or contract holder shall be in writing.      (b) The insurance coverage required in subsection (a) of this section shall provide terminally ill patients with coverage for prognosis and treatment of at least the rates of reimbursement as are provided for hospice care under Medicare and the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965, as in effect January 1, 1999.  (c) This section does not apply to contracts or policies providing disability income insurance, specified disease insurance, hospital indemnity insurance, long-term care insurance, short-term limited duration insurance, accident only insurance, Medicare supplement insurance, or all other supplemental insurance.
AR Code § 23-86-122 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-122. Prior approval process for experimental and investigational surgical products and medical devices — Definition

 (a) As used in this section:  (1) “Health carrier” means a:  (A) Health maintenance organization;  (B) Hospital medical service corporation; and  (C) Disability insurance company;    (2) “Health carrier” includes a:  (A) Self-insured governmental or church plan; and  (B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan; and    (3) “Health carrier” does not include:  (A) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or  (B) A person, company, or organization licensed or registered to issue or that issues an insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability.      (b) A health carrier that excludes or denies coverage for a specific surgical product or medical device approved for marketing by the United States Food and Drug Administration as experimental or investigational, or both, shall develop a process by which a surgeon, before utilizing the surgical product or medical device, may present medical evidence to obtain a review for the individual patient for coverage of the surgical product or medical device.
AR Code § 23-86-123 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 1 - General Provisions|§ 23-86-123. Prior authorization by physician — Definitions

 (a) As used in this section:  (1) “Prior authorization” means the process by which a health carrier determines the medical necessity or eligibility for coverage of a healthcare service before a covered person receives the healthcare service in order to provide coverage and reimbursement for the healthcare service; and  (2) “Telemedicine” means the same as defined in § 23-79-1601.    (b) When conducting prior authorization, whether for healthcare services provided through telemedicine or provided in person, a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas shall make all adverse determinations for healthcare services, medications, or equipment prescribed by a physician.
AR Code § 23-86-201 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 2 - Small-Employer Health Insurance|§ 23-86-201. Purpose

 The intent of this subchapter is to:   (1) Promote the availability of health insurance coverage to small employers;  (2) Prevent abusive rating practices; and  (3) Improve the efficiency and fairness of the small group health insurance marketplace.
AR Code § 23-86-203 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 2 - Small-Employer Health Insurance|§ 23-86-203. Health insurance plans subject to this subchapter

 (a) Except as provided in subsection (b) of this section, the provisions of this subchapter apply to any health benefit plan that provided coverage to two (2) or more employees of a small employer.  (b) The provisions of this subchapter shall not apply to individual health insurance policies that are subject to policy form and premium rate approval as provided in § 23-79-109 and § 23-85-101 et seq.
AR Code § 23-86-207 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 2 - Small-Employer Health Insurance|§ 23-86-207. Maintenance of records

 (a) Each small employer carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation which demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.  (b) Each small employer carrier shall file each March 1 with the Insurance Commissioner an actuarial certification that the carrier is in compliance with this section and that the rating methods of the carrier are actuarially sound. A copy of the certification shall be retained by the carrier at its principal place of business.  (c) A small employer carrier shall make the information and documentation described in subsection (a) of this section available to the commissioner upon request. The information shall be considered proprietary and trade secret information and shall not be subject to disclosure by the commissioner to persons outside of the State Insurance Department except as agreed to by the carrier or as ordered by a court of competent jurisdiction.
AR Code § 23-86-208 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 2 - Small-Employer Health Insurance|§ 23-86-208. Discretion of commissioner

 The Insurance Commissioner may suspend all or any part of § 23-86-204 as to the premium rates applicable to one (1) or more small employers for one (1) or more rating periods upon a filing by the small employer carrier and a finding by the commissioner that either the suspension is reasonable in light of the financial condition of the carrier or that the suspension would enhance the efficiency and fairness of the marketplace for small employer health insurance.
AR Code § 23-86-209 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 2 - Small-Employer Health Insurance|§ 23-86-209. Effective date

 (a) The provisions of this subchapter shall apply to each health benefit plan for a small employer that is delivered, issued for delivery, renewed, or continued in this state after July 1, 1997.  (b) For purposes of this section, the date a plan is continued is the first rating period which commences after July 1, 1997.
AR Code § 23-86-301 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 3 - Arkansas Health Insurance Portability and Accountability Act of 1997|§ 23-86-301. Title

 This subchapter may be cited as the “Arkansas Health Insurance Portability and Accountability Act of 1997”.
AR Code § 23-86-305 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 3 - Arkansas Health Insurance Portability and Accountability Act of 1997|§ 23-86-305. Group health plan — Application of certain rules in determination of employer size

 (a) Application of Aggregation Rule for Employers. All persons treated as a single employer under subsection (b), subsection (c), subsection (m), or subsection (o) of section 414 of the Internal Revenue Code of 1986 shall be treated as one (1) employer.  (b) Employers Not in Existence in Preceding Year. In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether the employer is a small employer or a large employer shall be based on the average number of employees that it is reasonably expected the employer will employ on business days in the current calendar year.  (c) Predecessors. Any reference in this section to an employer shall include a reference to any predecessor of the employer.
AR Code § 23-86-306 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 3 - Arkansas Health Insurance Portability and Accountability Act of 1997|§ 23-86-306. Prohibiting discrimination against individual participants and beneficiaries based on health status

 (a) Ineligibility to Enroll.  (1) In General. Subject to subdivision (a)(2) of this section, a group health plan and a health insurance issuer offering group health insurance coverage in connection with a group health plan may not establish rules for eligibility including continued eligibility of any individual to enroll under the terms of the group health plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual:  (A) Health status;  (B) Medical condition, including both physical and mental illnesses;  (C) Claims experience;  (D) Receipt of health care;  (E) Medical history;  (F) Genetic information;  (G) Evidence of insurability including conditions arising out of acts of domestic violence; or  (H) Disability.    (2) No Application to Benefits or Exclusions. To the extent consistent with § 23-86-304, subdivision (a)(1) of this section shall not be construed:  (A) To require a group health plan or group health insurance coverage to provide particular benefits other than those provided under the terms of such a group health plan or group health insurance coverage; or  (B) To prevent such a group health plan or group health insurance coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the group health plan or group health insurance coverage.    (3) Construction. For purposes of subdivision (a)(1) of this section, rules for eligibility to enroll under a group health plan include rules defining any applicable waiting periods for such enrollment.    (b) In Premium Contributions.  (1) In General. A group health plan and a health insurance issuer offering health insurance coverage in connection with a group health plan may not require any individual as a condition of enrollment or continued enrollment under the group health plan to pay a premium or contribution which is greater than the premium or contribution for a similarly situated individual enrolled in the group health plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the group health plan as a dependent of the individual.  (2) Construction. Nothing in subdivision (b)(1) of this section shall be construed to:  (A) Restrict the amount that an employer may be charged for coverage under a group health plan; or  (B) Prevent a group health plan and a health insurance issuer offering group health insurance coverage from establishing otherwise lawful premium discounts, rebates, or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.
AR Code § 23-86-307 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 3 - Arkansas Health Insurance Portability and Accountability Act of 1997|§ 23-86-307. Guaranteed renewability in multiemployer plans and multiple employer welfare arrangements

 A group health plan which is a multiemployer plan or which is a multiple employer welfare arrangement may not deny an employer whose employees are covered under such a plan continued access to the same or different coverage under the terms of such a plan, other than:   (1) For nonpayment of contributions;  (2) For fraud or other intentional misrepresentation of material fact by the employer;  (3) For noncompliance with material plan provisions;  (4) Because the plan is ceasing to offer any coverage in a geographic area;  (5) In the case of a plan that offers benefits through a network plan, there is no longer any individual enrolled through the employer who lives, resides, or works in the service area of the network plan and the plan applies this subdivision (5) uniformly without regard to the claims experience of employers or any health status-related factor in relation to the individuals or their dependents; and  (6) For failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other agreement requiring or authorizing contributions to the plan, or to employ employees covered by such an agreement.
AR Code § 23-86-308 (2020)
2020 Arkansas Code|Title 23 - Public Utilities and Regulated Industries|Subtitle 3 - Insurance|Chapter 86 - Group and Blanket Accident and Health Insurance|Subchapter 3 - Arkansas Health Insurance Portability and Accountability Act of 1997|§ 23-86-308. Rules of construction

 Nothing in this subchapter shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such a group health plan or health insurance coverage.