Arkansas Health Insurance (AR)

Arkansas (AR)
Individual Health Insurance Regulations

Learn more about Arkansas Individual Health Insurance

Your eligibility to obtain individual health insurance in Arkansas is strongly influenced by your current and previous health status and history. Health insurance companies are permitted to accept or decline and individual for coverage is the believe that assuming the health care costs for an individual would pose a risk on their claims ratios. For existing members, the insurance companies are permitted to look back 60 months at medical records to determine if any claim classifies as a pre-existing medical condition, in which case they may be able to deny payment of claim. Insurance companies may accept you for coverage, but place an elmination rider on the policy that exempts them from paying claims on the disclosed pre-existing medical condition. Health insurance companies are also permitted to exclude any pre-existing medical condition for 24 months, regardless if the insured member has had prior health insurance or not.

Arkansas (AR)
Small Group Health Insurance Regulations

Arkansas law defines a small group as any employer with 2-50 employees. Insurance companies offering a small group product are required to accept any qualified group for coverage, regardless of the health status of any employee participating in that group. Health questions are permitted for new group health insurance applications and these answers may affect the rate that the insurance company charges the employer. The maximum rate adjustment factor is 25% over the standard rate the is published and approved by the Arkansas Department of Insurance. For new members without prior health insurance coverage, as defined by federal HIPAA regulations, the insurance company can exlude paying benefits on pre-existing medical conditions for up to 12 months. To qualify for small group coverage, your company must have at least 2 employees that are working at least 20 hours per week for that business.

Arkansas COBRA and Continuation Coverage

Groups with 20 or more employees must fallow federal COBRA regulations which state that a departing employee is entitled to remain on the group health plan for a period of 18 months, provided that group health plan remains in existence. The COBRA recipient will be responsible for paying the insurance premium, which may not exceed 2% of the amount that the employer was paying for his coverage. Arkansas also has a mini-COBRA that applies to qualified employers with less than 20 employees. Under this law, continuation of coverage under the group health plan must be made available to individuals for 120 days, if that individual was insured under the group plan for at least 3 months. Once the 4 months of mini-COBRA coverage expires, the individual may receive an option for a conversion policy. Arkansas also offers a state sponsored program (see below) for individuals that have lost their COBRA coverage and are not eligible for individual coverage.

(Act 997 of 1997 requires employers with 2-19 employees to offer COBRA for 4 months.)

Additional Arkansas Resources

• ARKids First
  Provides health care coverage to children in Arkansas that are under the age of 18 who are without a group health insurance option or have lost their insurance coverage involuntarily. Income requirements apply.
  
• Arkansas Comprehensive Health Insurance Pool
  Provides guaranteed health insurance coverage to individuals that have had at least 18 months of continuous coveage and are losing their current beneftis and are not eligible for standard issue health coverage due to a pre-existing medical condition.
• Arkansas Medicaid
  Manages health care programs for needy families, including ARKids First, ConnectCare and TEFRA.

AR Medical Insurance Statistics

Total Population: 2,760,000
With Health Insurance: 2,266,000 / 82.1%
Without Health Insurance: 494,000 / 17.9%
*According to 2005 CPS Reports / U.S. Census Bureau

Note: There perecentage of Arkansas resdidents without health insurance increased from 16.4% in 2004.

Arkansas Insurance Department
Phone: 800-282-9134
Primary mission of the AID is to provide consumer protection by reviewing insurance company stability and conduct. They are also responsible for fraud prosecution and establishing laws that deter unacceptable practices or behaviours within the insurance industry.

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