reglab/statecodes huggingface dataset:
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-114 - Annual report - Examination

(a)
(1)
Not later than March 1 of each year, every corporation shall file with the Insurance Commissioner a statement sworn to by at least two (2) of its principal officers, showing its condition on the last day of the next preceding calendar year.
(2)
In accordance with the specifications applicable to annual financial reports, each licensed hospital or medical service corporation shall prepare and file with the commissioner a quarterly financial report on forms and at such times as the commissioner shall prescribe. The quarterly statement shall be verified by the officers of the corporation.
(b)
(1)
The commissioner may appoint an examiner, deputy examiner, or other person to examine into the affairs of the corporation. The person:
(A)
Shall have the power of visitation and examination;
(B)
Shall have and must be given free access to all the books, papers, and documents relating to the business of the corporation; and
(C)
May summon the officers, agents, or employees thereof or any other persons and require them to testify under oath concerning the affairs, transactions, and condition of the corporation.
(2)
An examination shall be conducted at least every three (3) years.
(3)
(A)
The cost of any examination and audit shall be paid by the corporation.
(B)
All costs shall be paid upon the completion of the examination.
Acts 1959, No. 148, § 681; A.S.A. 1947, § 66-4911; Acts 2001, No. 1604, § 76.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-115 - Use of surplus

Any surplus in excess of all reserves established by the directors of the corporation and shown in the annual report of a corporation may be used by the corporation for the following purposes in the order of priority shown:
(1)
To liquidate on a pro rata basis any losses incurred by hospitals, physicians, and surgeons, or other similar institutions or persons, upon the settlement of bills with the corporation in any previous years;
(2)
To return the original working capital contribution to the corporation, or any part thereof, on a pro rata basis; and
(3)
To reduce rates charged subscribers or to expand the services rendered to them.
Acts 1959, No. 148, § 682; 1963, No. 54, § 4; A.S.A. 1947, § 66-4912.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-116 - Nonliability

No liability shall attach to any corporation holding a certificate of authority under this chapter by reason of the failure on the part of any hospital or physician to render service to any of its subscribers, nor for the negligence, malpractice, or other acts of hospitals or physicians.
Acts 1959, No. 148, § 683; A.S.A. 1947, § 66-4913.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-118 - Review of decisions

All orders of the Insurance Commissioner made pursuant to this chapter shall be subject to the provisions of §
23-61-101
et seq. and §
23-61-201
et seq., including the right of hearing, rehearing, and appeal.
Acts 1959, No. 148, § 686; A.S.A. 1947, § 66-4916.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-119 - Premium tax

(a)
The officers of every foreign or alien corporation, and the officers of every domestic corporation, transacting business under this chapter shall, at the time of making its annual statement, file with the Insurance Commissioner a sworn statement of its net direct written premiums for the year ending December 31 next preceding from subscribers residing in this state and shall pay into the State Treasury a premium tax of two and one-half percent (2.5%) on its net direct written premiums in compliance with the provisions of §
26-57-601
et seq. as a tax for the privilege of transacting business in this state.
(b)
No certificate of authority shall be renewed for any corporation until the tax is paid.
(c)
(1)
The tax shall be in lieu of other taxes, district or state, county or municipal, based on premiums written by the corporation in this state.
(2)
No subdivision of this state may impose any license fee for the privilege of conducting business in any portion thereof.
(d)
Pursuant to and subject to the conditions expressed in the provisions of §
26-57-604
, the corporation is entitled to take against its premium taxes due an offset or credit for the salaries or wages of noncommissioned Arkansas employees of the corporation.
(e)
Absent an extension granted by the commissioner for good cause, failure of any licensed corporation to report this net direct written premium tax or pay this net direct written premium tax, or both, shall subject the corporation to the applicable penalties of this chapter and §
26-57-601
et seq.
(f)
Each hospital or medical service corporation shall have one (1) fiscal year following the reporting and payment year of a premium tax obligation to request a refund or credit for any premium tax overpayment amount, after which demands or requests for such monetary overpayment refund or credit against premium tax due shall be disallowed. Any corporation thus failing or neglecting to request the overpayment refund or credit against premium taxes due and payable to this state during the year allowable as specified in this section shall not be allowed to carry over the overpayment credit for the following year or years and shall not be entitled to an overpayment refund.
Acts 1959, No. 148, § 687; A.S.A. 1947, § 66-4917; Acts 1991, No. 1123, § 9; 1995, No. 408, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-120 - Tax exemptions

(a)
Every corporation doing business pursuant to this chapter is declared to be a nonprofit and benevolent institution.
(b)
The corporations are exempt from state, county, district, municipal, and school tax, including the taxes prescribed by this code, and excepting only tax on net direct written premiums under §
23-75-119
and §
26-57-601
et seq. and applicable fees prescribed by §
23-61-401
and other sections of this code, or the Insurance Commissioner's rules applicable to hospital and medical service corporations, and taxes on real and tangible personal property situated in this state.
Amended by Act 2019, No. 315,§ 2696, eff. 7/24/2019.
Acts 1959, No. 148, § 688; A.S.A. 1947, § 66-4918; Acts 1995, No. 408, § 2.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-121 - Power to make donations for the public welfare

Hospital and medical service corporations shall have power to make donations for the public welfare or for charitable, scientific, or educational purposes, subject to such limitations, if any, as may be contained in its articles of incorporation or any amendment thereto.
Acts 1981, No. 508, § 1; A.S.A. 1947, § 66-4921.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 75 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 23-75-101 — 23-75-122) › Section 23-75-122 - Conversion to legal reserve mutual life insurer

(a)
A hospital and medical service corporation, as defined in §
23-75-101
, may be converted to a legal reserve mutual life insurer, as defined in §
23-69-102
, under a plan or procedure which shall be approved by the order of the Insurance Commissioner.
(b)
The commissioner shall approve any such plan or procedure if he or she finds that the plan:
(1)
Would not be contrary to law and would not be contrary to the interests of subscribers or contract holders or to the public;
(2)
Has been approved by the corporation in accordance with its articles of incorporation, bylaws, and with the law;
(3)
Provides for definite conditions to be fulfilled by a designated early date upon which the mutualization will be deemed effective; and
(4)
Provides for the protection of all existing contractual rights of the corporation's subscribers or contract holders for medical and hospital service or case or claims for reimbursement therefor, and for the mutualizing insurer to assume, without reincorporation, all assets and liabilities of the corporation.
(c)
Upon conversion, the corporation will have the minimum surplus required of legal reserve mutual life insurers.
(d)
Upon completion of its conversion to a legal reserve mutual life insurer as provided in this section, the corporation shall be subject to and comply with all laws and rules applicable to legal reserve mutual life insurers.
(e)
The corporation shall have the period of time which shall be specified in the commissioner's order to complete its conversion to a legal reserve mutual life insurer.
Amended by Act 2019, No. 315,§ 2697, eff. 7/24/2019.
Acts 1985, No. 997, §§ 1-3; A.S.A. 1947, §§ 66-4922 -- 66-4924.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-101 - Purpose

(a)
The General Assembly determines that health maintenance organizations, when properly regulated, encourage methods of treatment and controls over the quality of care which effectively contain costs and provide for continuous health care by undertaking responsibility for the provision, availability, and accessibility of services.
(b)
For this reason, and because the primary responsibility of a health maintenance organization lies in providing quality healthcare services on a prepaid basis without regard to the type and number of services actually rendered, rather than providing indemnification against the cost of the services, the General Assembly finds it necessary to provide a statutory framework for the establishment and continuing regulation of health maintenance organizations which is separate from the insurance laws of this state, except as otherwise provided in this chapter.
Acts 1975, No. 454, § 1; A.S.A. 1947, § 66-5201.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-102 - Definitions

As used in this chapter:
(1)
"Commissioner" means the Insurance Commissioner;
(2)
"Domestic corporation" means any corporation organized pursuant to the Arkansas Business Corporation Act, §
4-26-101
et seq., and the Arkansas Nonprofit Corporation Act, §
4-28-201
et seq.;
(3)
"Enrollee" means an individual who has been enrolled in a healthcare plan;
(4)
"Evidence of coverage" means any certificate, agreement, contract, identification card, or document issued to an enrollee setting out the coverage to which the enrollee is entitled;
(5)
"Healthcare plan" means any arrangement whereby any person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any healthcare services through an individually underwritten or group master contract, and at least part of the arrangement consists of arranging for, or the provision of, healthcare services as distinguished from mere indemnification against the cost of the services on a prepaid basis through insurance or otherwise;
(6)
"Healthcare services" means any services included in the furnishing to any individual of medical or dental care, or hospitalization, or services incident to the furnishing of care or hospitalization, as well as the furnishing to any person of all other services or goods for the purpose of preventing, alleviating, curing, or healing human illness or injury;
(7)
"Health maintenance organization" means any person which undertakes to provide or arrange for one (1) or more healthcare plans;
(8)
"Health professional" means physicians, dentists, optometrists, nurses, podiatrists, pharmacists, and other individuals engaged in the delivery of health services as are or may be designated under the Health Maintenance Organization Act of 1973 or any amendment thereto or regulation adopted thereunder;
(9)
"Person" means any natural or artificial person, including, but not limited to, individuals, partnerships, associations, trusts, or corporations; and
(10)
"Provider" means any person who is licensed in this state to furnish healthcare services as a health professional.
Acts 1975, No. 454, § 2; A.S.A. 1947, § 66-5202; Acts 1987, No. 456, § 21; 2005, No. 1697, § 20.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-103 - Applicability of Arkansas Insurance Code and laws concerning hospital and medical service corporations

(a)
(1)
Except as otherwise provided in this chapter, provisions of the insurance law and provisions of hospital and medical service corporation laws shall not be applicable to any health maintenance organization granted a certificate of authority under this chapter.
(2)
Subdivision (a)(1) of this section shall not apply to an insurer or hospital and medical service corporation licensed and regulated pursuant to the insurance laws or the hospital and medical service corporation laws of this state, except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.
(b)
The provisions of this chapter, the Arkansas Insurance Code, and the law concerning hospital and medical service corporations, §
23-75-101
et seq., shall not be applicable to any nonprofit vision service plan corporation composed of at least fifty (50) participating licensed optometrists or ophthalmologists licensed by the State of Arkansas to provide vision care services on a prepaid basis, when each licensed optometrist or ophthalmologist is subject to the rules of the professional's respective state board, and when each participating licensed optometrist or ophthalmologist agrees to assume responsibility for completion of the provisions of the vision care services contracted for, so that no element of risk is incurred by any subscriber group or person.
(c)
This chapter does not apply to a:
(1)
Healthcare sharing ministry as defined in §
23-60-104(b)
;
(2)
Direct healthcare agreement as defined in §
23-60-104(b)
; or
(3)
Nonprofit agricultural membership organization as defined in §
23-60-104
.
Amended by Act 2023, No. 626,§ 3, eff. 8/1/2023.
Amended by Act 2021, No. 381,§ 2, eff. 7/28/2021.
Amended by Act 2019, No. 315,§ 2698, eff. 7/24/2019.
Amended by Act 2017, No. 1020,§ 2, eff. 8/1/2017.
Amended by Act 2015, No. 101,§ 2, eff. 7/22/2015.
Amended by Act 2013, No. 1163,§ 2, eff. 8/16/2013.
Acts 1975, No. 454, § 15; A.S.A. 1947, § 66-5215; Acts 1999, No. 881, § 10; 2001, No. 1605, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-105 - Penalties - Enforcement

(a)
In lieu of suspension or revocation of a certificate of authority under §
23-76-123
, the Insurance Commissioner may levy an administration penalty in an amount not less than two hundred fifty dollars ($250), nor more than two thousand five hundred dollars ($2,500), if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time within which to remedy the defect in its operations which gave rise to the penalty citation. The commissioner may augment this penalty by an amount equal to the sum that he or she calculates to be the damages suffered by the enrollees or other members of the public.
(b)
Any person who willfully violates this chapter shall be guilty of a Class A misdemeanor.
(c)
(1)
If the commissioner shall for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the commissioner may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in the suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to the suspected violation and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing the violations.
(2)
Proceedings under this subsection shall not be governed by formal procedural requirements and may be conducted in the manner the commissioner deems appropriate under the circumstances.
(d)
(1)
The commissioner may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter.
(2)
Within thirty (30) days after service of the order of cease and desist, the respondent may request a hearing on the questions of whether acts or practices in violation of this chapter have occurred. The hearings shall be conducted pursuant to the provisions of §§
23-61-303
-
23-61-307
, and judicial review shall be available as provided in §
23-66-212
.
(e)
In the case of any violation of the provisions of this chapter, if the commissioner elects not to issue a cease and desist order or in the event of noncompliance with a cease and desist order issued pursuant to subsection (d) of this section, the commissioner may institute a proceeding to obtain injunctive relief or, seeking other appropriate relief, in Pulaski County Circuit Court for actions of this nature.
Amended by Act 2013, No. 1433,§ 1, eff. 8/16/2013.
Acts 1975, No. 454, § 24; A.S.A. 1947, § 66-5224; Acts 1987, No. 456, § 25; 2005, No. 1994, § 231.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-106 - License to practice, sell, or dispense required

No person shall perform any of the services or procedures or sell or dispense any goods or devices in the field of the healing arts for which a license is required under the laws of the State of Arkansas unless the person holds a valid license authorizing him or her to perform the procedures, render the services, or sell or dispense the goods or devices.
Acts 1975, No. 454, § 2; A.S.A. 1947, § 66-5202.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-108 - Issuance of certificate of authority

(a)
Upon receipt of an application for issuance of a certificate of authority, the Insurance Commissioner shall determine whether the applicant furnishes or proposes to furnish adequate and accessible healthcare services for its healthcare plans subject to the requirements or rules of the State Insurance Department.
(b)
The commissioner shall issue a certificate of authority to any person filing an application pursuant to §
23-76-107
within sixty (60) days of receipt of the application if the commissioner is satisfied that:
(1)
The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy, and possess good reputations;
(2)
The health maintenance organization's proposed plan of operation meets the requirements of subsection (a) of this section;
(3)
The healthcare plan will allow the health maintenance organization effectively to provide or arrange for the provision of basic healthcare services through insurance or otherwise on a prepaid basis, subject to reasonable requirements for copayments;
(4)
The health maintenance organization is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees;
(5)
The healthcare plan's arrangements for healthcare services and the schedule of charges for use therewith are financially sound and reasonable;
(6)
Any agreements with insurers, hospitals, medical service corporations, governmental entities, or any other organizations for insuring the payment of the cost of healthcare services or the provision for automatic applicability of alternative coverage in the event of discontinuance of the healthcare plan are reasonable and adequate;
(7)
Agreements with providers for the provision of healthcare services are reasonable and adequate;
(8)
The enrollees will be afforded an opportunity to participate in matters of policy and operation pursuant to §
23-76-110
;
(9)
Nothing in the proposed method of operation, as shown by the information submitted pursuant to §
23-76-107
or by independent investigation, is contrary to the public interest; and
(10)
[Repealed.]
(11)
The applicant has paid-in capital in an amount not less than one hundred thousand dollars ($100,000) and additional working capital or surplus funds in an amount deemed by the commissioner to be adequate in relation to the proposed plan of operation.
(c)
A certificate of authority shall be denied by the commissioner only after compliance with the requirements of §
23-76-126
.
Amended by Act 2023, No. 469,§ 9, eff. 8/1/2023.
Amended by Act 2013, No. 1433,§ 3, eff. 8/16/2013.
Acts 1975, No. 454, § 4; 1979, No. 942, § 16; A.S.A. 1947, § 66-5204; Acts 1987, No. 456, § 23.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-110 - Advisory board

(a)
The advisory board of any health maintenance organization shall include at least one (1) physician, one (1) dentist, one (1) pharmacist, one (1) nurse, one (1) consumer, and one (1) enrollee.
(b)
The advisory board shall establish a mechanism to afford the enrollees an opportunity to participate in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms.
(c)
The advisory board shall not be deemed to be the governing body of the health maintenance organization licensed under this chapter.
Acts 1975, No. 454, § 6; A.S.A. 1947, § 66-5206; Acts 2005, No. 506, § 37.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-111 - Fiduciary responsibilities of director, officer, or partner

(a)
Any director, officer, or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of the health maintenance organization shall be responsible for the funds in a fiduciary relationship to the enrollees.
(b)
A health maintenance organization shall maintain in force a fidelity bond or fidelity insurance on these employees, officers, directors, and partners in an amount not less than two hundred fifty thousand dollars ($250,000) for each health maintenance organization or a maximum of five million dollars ($5,000,000) in aggregate maintained on behalf of health maintenance organizations owned by a common parent corporation, or the sum prescribed by the Insurance Commissioner.
Acts 1975, No. 454, § 7; A.S.A. 1947, § 66-5207; Acts 2001, No. 1605, § 4.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-114 - Information to enrollees

(a)
A health maintenance organization shall make available to its subscribers a list of providers upon enrollment and re-enrollment.
(b)
Every health maintenance organization shall provide within thirty (30) days to its subscribers a notice of any material change in the operation of the health maintenance organization, including any major change in its provider network, that will affect them directly.
(c)
(1)
An enrollee shall be notified in writing by the health maintenance organization of the termination of the primary care provider who provided healthcare services to that enrollee.
(2)
The health maintenance organization shall provide assistance to the enrollee in transferring to another participating primary care provider.
(d)
The health maintenance organization shall provide to subscribers information on how services may be obtained, where additional information on access to services can be obtained, and a telephone number where the enrollee can contact the health maintenance organization, at no cost to the enrollee.
Acts 1975, No. 454, § 10; A.S.A. 1947, § 66-5210; Acts 2001, No. 1605, § 6.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-115 - Open enrollment

(a)
(1)
After a health maintenance organization has been in operation twenty-four (24) months, it shall have an annual open enrollment period of at least one (1) month during which it accepts enrollees up to the limits of its capacity, as determined by the health maintenance organization, in the order in which they apply for enrollment.
(2)
A health maintenance organization may apply to the Insurance Commissioner for authorization to impose such underwriting restrictions upon enrollment as are necessary to preserve its financial stability, to prevent excessive adverse selection by prospective enrollees, or to avoid unreasonably high or unmarketable charges for enrollee coverage for healthcare services.
(3)
The commissioner shall approve or deny the application within sixty (60) days of its receipt from the health maintenance organization.
(b)
Health maintenance organizations providing or arranging for services on a group contract basis may limit the open enrollment provided for in subsection (a) of this section to all members of the groups covered by the contracts.
Acts 1975, No. 454, § 11; A.S.A. 1947, § 66-5211.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-116 - Complaint system

(a)
(1)
Every health maintenance organization shall establish and maintain a complaint system that has been approved by the Insurance Commissioner to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning healthcare services.
(2)
Each health maintenance organization shall submit to the commissioner an annual report in a form prescribed by the commissioner that shall include:
(A)
A description of the procedures of the complaint system;
(B)
The total number of complaints handled through the complaint system and a compilation of causes underlying the complaints filed; and
(C)
The number, amount, and disposition of malpractice claims settled during the year by the health maintenance organization.
(b)
(1)
The health maintenance organization shall maintain records of written complaints filed with it concerning issues and persons other than healthcare services and shall submit to the commissioner a summary report at such times and in such format as the commissioner may require.
(2)
Complaints involving other persons shall be referred to the persons with a copy to the commissioner.
(c)
The commissioner may examine the complaint system, subject to the limitation concerning medical records of individuals set forth in §
23-76-122(c)
.
Amended by Act 2013, No. 1433,§ 6, eff. 8/16/2013.
Acts 1975, No. 454, § 12; A.S.A. 1947, § 66-5212; Acts 2001, No. 1605, § 7.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-117 - Investments

With the exception of investments made in accordance with §
23-76-109(a)(1) and (2)
and §
23-76-109(b)
, the investable funds of a health maintenance organization shall be invested only in securities or other investments permitted by the laws of this state for the investment of assets constituting the legal reserves of life insurance companies or other securities or investments as the Insurance Commissioner may permit.
Acts 1975, No. 454, § 13; A.S.A. 1947, § 66-5213.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-118 - [Repealed]

Repealed by Act 2021, No. 367,§ 22, eff. 7/28/2021.
Acts 1975, No. 454, § 14; A.S.A. 1947, § 66-5214; Acts 1997, No. 958, § 1; Acts 2001, No. 1702, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-120 - Regulation of agents - Definition

(a)
After notice and hearing, the Insurance Commissioner may promulgate such reasonable rules as are necessary to provide for the licensing of agents.
(b)
"Agent" means a person directly or indirectly associated with a healthcare plan who engages in solicitation or enrollment.
Amended by Act 2019, No. 315,§ 2702, eff. 7/24/2019.
Acts 1975, No. 454, § 16; A.S.A. 1947, § 66-5216.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-121 - Powers of insurers and hospital and medical service corporations

(a)
An insurance company licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may either directly, or through a subsidiary or affiliate, organize and operate a health maintenance organization under the provisions of this chapter.
(b)
(1)
Notwithstanding any provision of the Hospital and Medical Service Corporations Act, §
23-75-101
et seq., an insurer or a hospital and medical service corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations.
(2)
The enrollees of a health maintenance organization constitute a permissible group under such laws.
(3)
Among other things, under the contracts, the insurer or hospital or medical service corporation may make benefit payments to health maintenance organizations for healthcare services rendered by providers pursuant to the healthcare plan.
Acts 1975, No. 454, § 17; A.S.A. 1947, § 66-5217.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-122 - Examinations

(a)
The Insurance Commissioner may make an examination of the affairs of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every five (5) years.
(b)
The commissioner may make an examination concerning the quality of healthcare services of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every five (5) years.
(c)
(1)
Every health maintenance organization shall submit its books and records relating to the healthcare plan to the examinations and in every way facilitate them.
(2)
For the purpose of examinations, the commissioner may administer oaths to and examine the officers and agents of the health maintenance organization.
(3)
Medical records of individuals and records of physicians and hospitals providing services under a contract to the health maintenance organization shall be subject to the examination.
(d)
The expenses of examinations under this section shall be assessed against the health maintenance organization being examined and remitted to the commissioner.
(e)
In lieu of the examination, the commissioner may accept the report of an examination made by the insurance commissioner of another state or director of the department of health of another state.
(f)
(1)
Any examination under this section that is to commence within one (1) year prior to the date a health maintenance organization shall cease to provide healthcare services in this state, may be reduced in scope or waived in its entirety, upon application of the health maintenance organization and approval of the commissioner.
(2)
The commissioner shall consider the following in determining whether a full or partial waiver may be granted:
(A)
Claims payment history;
(B)
Consumer complaint history; and
(C)
Financial condition.
(3)
[Repealed.]
Amended by Act 2023, No. 469,§ 11, eff. 8/1/2023.
Amended by Act 2023, No. 469,§ 10, eff. 8/1/2023.
Amended by Act 2013, No. 1433,§ 7, eff. 8/16/2013.
Acts 1975, No. 454, § 18; A.S.A. 1947, § 66-5218; Acts 2001, No. 1605, § 8.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-124 - Rehabilitation, liquidation, or conservation of health maintenance organization

(a)
Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the Insurance Commissioner pursuant to the law governing the rehabilitation, liquidation, or conservation of insurance companies.
(b)
The commissioner may apply for an order directing him or her to rehabilitate, liquidate, or conserve a health maintenance organization upon any one (1) or more grounds set out in §
23-68-107
or when in his or her opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state.
Acts 1975, No. 454, § 20; A.S.A. 1947, § 66-5220.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-125 - Rules

(a)
After notice and hearing, the Insurance Commissioner may promulgate reasonable rules, not inconsistent with existing statutes of this state, as are necessary or proper to carry out the provisions of this chapter.
(b)
The rules shall be subject to review in accordance with §
23-61-307
.
Amended by Act 2019, No. 315,§ 2703, eff. 7/24/2019.
Acts 1975, No. 454, § 21; A.S.A. 1947, § 66-5221.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-126 - Administrative proceedings

(a)
(1)
If the Insurance Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority exist, the commissioner shall:
(A)
Notify the health maintenance organization in writing of the grounds for suspension or revocation of the certificate of authority; and
(B)
Schedule a hearing on the matter at least twenty (20) days after giving written notice of the hearing.
(2)
After the hearing or upon the failure of the health maintenance organization to appear at the hearing, the commissioner shall take appropriate action and mail written findings to the health maintenance organization.
(b)
(1)
The action of the commissioner may be appealed to Pulaski County Circuit Court upon the record of the proceedings, hearing, and findings of the commissioner.
(2)
The commissioner's decision shall be affirmed if it is supported by the preponderance of the evidence in the record.
(c)
The Arkansas Administrative Procedure Act, §
25-15-201
et seq., applies to proceedings under this section to the extent it is not in conflict with this section.
Amended by Act 2013, No. 1433,§ 9, eff. 8/16/2013.
Acts 1975, No. 454, § 22; 1979, No. 942, § 17; 1985, No. 804, § 18; A.S.A. 1947, § 66-5222; Acts 1987, No. 456, § 24.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-127 - Fees

A health maintenance organization subject to this chapter shall pay to the State Insurance Department Trust Fund as special revenues the following fees:
(1)
For filing and reviewing all documents necessary for issuance of an original certificate of authority, one thousand dollars ($1,000);
(2)
For issuance of the original certificate of authority, two hundred dollars ($200);
(3)
For annual renewal of the certificate of authority, one hundred dollars ($100);
(4)
For filing an annual statement, fifty dollars ($50.00); and
(5)
For filing amendments to documents required under §
23-76-107
, one hundred dollars ($100).
Amended by Act 2013, No. 1433,§ 10, eff. 8/16/2013.
Acts 1975, No. 454, § 23; 1985, No. 804, § 13; A.S.A. 1947, § 66-5223; Acts 1987, No. 264, §§ 1, 2; 1993, No. 901, § 36.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-128 - Applications, filings, and reports public

All applications, filings, and reports required under this chapter shall be treated as public documents.
Acts 1975, No. 454, § 26; A.S.A. 1947, § 66-5226.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-129 - Medical information confidential - Exceptions

(a)
Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from the person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this chapter, upon the express consent of the enrollee or applicant, pursuant to statute or court order for the production of evidence or the discovery thereof or in the event of claim of litigation between the person and the health maintenance organization wherein the data or information is pertinent.
(b)
A health maintenance organization shall be entitled to claim any statutory privileges against the disclosure which the provider who furnished the information to the health maintenance organization is entitled to claim.
Acts 1975, No. 454, § 27; A.S.A. 1947, § 66-5227.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-130 - Insurance Commissioner's authority to contract

(a)
The Insurance Commissioner may contract with qualified persons to make recommendations concerning the adequacy, network adequacy, or accessibility of healthcare services under a healthcare plan furnished or proposed to be furnished by a health maintenance organization.
(b)
The commissioner may accept all or part of the recommendations.
Amended by Act 2013, No. 1433,§ 11, eff. 8/16/2013.
Acts 1975, No. 454, § 28; A.S.A. 1947, § 66-5228.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-131 - Tax on premiums and copayments

(a)
(1)
(A)
(i)
Each health maintenance organization shall pay a tax on the premiums for coverages provided during the calendar year.
(ii)
The tax shall be paid on an annual basis and on a quarterly estimate basis as prescribed by the Insurance Commissioner and reconciled at the time of filing the annual statement.
(B)
The taxes due from licensed health maintenance organizations under this section shall be computed on net direct written premiums at the rate described in this section and in §§
26-57-603
and
26-57-604
.
(C)
(i)
Further, the premium taxes at the same rate due under this section for health maintenance organization copayments shall only be computed, reported, and paid on the copayments actually received and collected by the health maintenance organization.
(ii)
Copayments paid by the patient directly to the doctor, hospital, or other medical providers shall not be subject to taxation.
(2)
(A)
The tax shall be paid to the Treasurer of State through the commissioner as a tax imposed for the privilege of transacting business in this state.
(B)
The tax shall be computed at the rate of two and one-half percent (21/2%), except as provided in subsection (b) of this section.
(3)
(A)
The taxes shall be paid on a quarterly estimate basis as prescribed by the commissioner and reconciled annually at the time of filing the annual statement.
(B)
In his or her discretion, the commissioner may suspend or revoke the certificate of authority of any health maintenance organization that fails to pay the tax levied under this section on the date due or during any reasonable extension of time therefor which may have been expressly granted by the commissioner for good cause upon the health maintenance organization's request.
(b)
(1)
For health maintenance organizations maintaining a home office or a regional office in this state, the tax shall be computed at the rate of two and one-half percent (21/2%), except for the credit as provided in §
26-57-604
. For purposes of this subsection, any office in this state shall be deemed a health maintenance organization's home or regional office if the office performs substantially the following functions in this state:
(A)
Underwriting;
(B)
Medical;
(C)
Legal;
(D)
Issuance of certificates or contracts;
(E)
Claims servicing, information, and service;
(F)
Advertising and publications;
(G)
Public relations; and
(H)
Hiring, testing, and training of sales or service forces.
(2)
On or before March 1 of each year, any health maintenance organization desiring to qualify an office in this state as a home or regional office shall furnish to the commissioner on forms prescribed by the commissioner proof that it is operating a home or regional office in this state.
(c)
The commissioner shall deposit all taxes collected under this section into the State Treasury as general revenues.
Acts 1987, No. 1033, § 3; 1999, No. 881, § 12.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 76 - HEALTH MAINTENANCE ORGANIZATIONS (§§ 23-76-101 — 23-76-132) › Section 23-76-132 - College students

If a health maintenance organization requires the selection or assignment of a primary care physician, the health maintenance organization shall provide an enrollee who is a student enrolled at a postsecondary institution one (1) of the following options:
(1)
To select two (2) primary care physicians, one (1) located near the enrollee's domicile and one (1) located near the postsecondary institution, provided both primary care physicians have provider contracts with the health maintenance organization; or
(2)
To select a primary care physician when the enrollee resides near the enrollee's domicile and then change primary care physicians when the enrollee attends the postsecondary institution, the effective date of the change to be the first of the month following notification, provided both primary care physicians have provider contracts with the health maintenance organization.
Acts 2001, No. 1289, § 1.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 77 - AUTOMOBILE CLUBS OR ASSOCIATIONS (§§ 23-77-101 — 23-77-109) › Section 23-77-102 - Exclusive authority of chapter

(a)
This chapter shall be deemed and held exclusive authority for the organization and operation of automobile clubs or associations within this state, and the automobile clubs or associations shall not be subject to any other laws respecting insurance companies of any class, kind, or character, except as to the conduct of hearings by the Insurance Commissioner and appeals therefrom.
(b)
However, this chapter shall not affect the validity of any membership certificate of any automobile club or association issued and outstanding prior to March 24, 1955.
Acts 1955, No. 377, § 8; A.S.A. 1947, § 75-1608.
Arkansas Code of 1987 (2023) › Title 23 - PUBLIC UTILITIES AND REGULATED INDUSTRIES (§§ 23-1-101 — 23-119-105) › Subtitle 3 - INSURANCE (§§ 23-60-101 — 23-103-417) › Chapter 77 - AUTOMOBILE CLUBS OR ASSOCIATIONS (§§ 23-77-101 — 23-77-109) › Section 23-77-103 - Penalty

(a)
It shall be unlawful for any person, firm, association, copartnership, corporation, company, or other organization to organize, operate, or in any way solicit members for an automobile club or association or offer any of the motor club services as defined in §
23-77-101
, except in the manner provided in this chapter and under the rules promulgated by the Insurance Commissioner.
(b)
Any person, firm, association, copartnership, corporation, company, or other organization violating the provisions of this section shall be guilty of a Class A misdemeanor.
Amended by Act 2019, No. 315,§ 2704, eff. 7/24/2019.
Acts 1955, No. 377, § 7; A.S.A. 1947, § 75-1607; Acts 2005, No. 1994, § 357.