Arkansas Administrative Code › Agency 054 - Arkansas Insurance Department › Rule 054.00.98-007 - Rule and Regulation 71 - Mental Health Parity

Current through Register Vol. 49, No. 6, June, 2024
Section 1. Purpose
The purpose of this regulation is to set forth standards for
			 eligible health care insurers to follow in certifying that the application of
			 "The Arkansas Mental Health Parity Act", Act 1020 of 1997 (codified at Ark.
			 Code Ann. §§
								23-99-501,
			 etseq.), to a particular health benefit plan, will result in an increase in the
			 cost under the plan of at least one and one-half percent (1.5%).
Section 2. Authority and Scope
This regulation is promulgated pursuant to the authority granted
			 to the Arkansas Insurance Commissioner ("Commissioner") by Ark. Code Ann.
			 §§
								23-99-510,
			 23-61-108 and
			 25-15-201 et
			 seq. It is intended to apply to health benefit plans as defined under Ark. Code
			 Ann. §
								23-99-503(4).
Section 3. Effective Date
The provisions of this regulation shall be effective August 1,
			 1998, upon statutory filing per Arkansas law.
Section 4. Increased Cost Exemption
		  Requirements
a. State Requirements
Pursuant to Ark. Code Ann. §
									23-99-505,
			 the provisions of "the Arkansas Mental Parity Act" shall not apply to health
			 benefit plans, if the Act's application to such plans will result in an
			 increase in the cost under the health benefit plan of at least one and one-half
			 percent (1.5%). In order for a health care insurer to seek this increased cost
			 exemption, it must provide the Arkansas Insurance Department ("Department") an
			 actuarial certification with supporting documentation, that costs will increase
			 one and one-half percent (1.5%) or more. This actuarial certificate and
			 accompanying documentation may be based on either a retrospective or
			 prospective basis. It shall consider all Actuarial Standards of Practice,
			 including but not limited to Actuarial Standards of Practice 5, 8,16 and
			 23.
This actuarial certificate and documentation shall be provided at
			 the time of filing of individual policy forms and group policy forms or
			 certificates, and/or the filing of rates, rate increases, and rate
			 certifications as required in the small group market. In addition, all domestic
			 health care insurers shall make the actuarial certifications available to
			 Department Examiners at the time of a financial examination, for all products
			 that are sold in the State of Arkansas. Note, that if the actuarial certificate
			 and documentation that are filed with the Department demonstrate that costs
			 exceed one and one-half percent (1.5%), offers of coverage need not be
			 made.
b. Federal
		  Requirements
Pursuant to the federal "Mental Health Parity Act of 1996", its
			 provisions shall not apply to small employers who have between two (2) and
			 fifty (50) employees or to any group health plan whose costs increase one
			 percent (1%) or more due to its application. Therefore, upon the filing of a
			 group policy or certificate applicable to more than fifty (50) lives, the
			 Department will seek verification of whether mental health benefits will, in
			 fact, be offered. If they are offered, the Department will seek verification
			 that the annual and lifetime limits are equal to those provided for medical
			 coverage. If mental health benefits are offered and annual and lifetime limits
			 are not equal to similar medical coverage limits, then the health care insurer
			 shall provide an actuarial certification that the cost calculated
			 retrospectively, has increased by one percent (1%) or more, with supporting
			 documentation based on the appropriate Actuarial Standards of Practice
			 including but not limited to those referenced in Section 4(a) above.