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§ 23-79-802. Definitions

AR Code § 23-79-802 (2018) (N/A)
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(1) "Health benefits plan" means any individual, blanket, or group plan, policy, or contract for healthcare services, issued or delivered by a healthcare insurer, health maintenance organization, or hospital and medical service corporation, excluding plans, policies, or contracts providing healthcare benefits or healthcare services pursuant to Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., the Public Employee Workers' Compensation Act, § 21-5-601 et seq., and the no-fault medical and hospital benefit requirements under § 23-89-202; and

(2) (A) (i) "State-mandated health benefits" means coverages for healthcare services or benefits required by state law or state regulations, requiring the reimbursement or utilization related to a specific health illness, injury, or condition of the covered person or inclusion of a specific category of licensed healthcare practitioner to be provided to the covered person in a health benefits plan for a health-related condition of a covered person.

(ii) However, for the purposes of the options provided by this subchapter, state-mandated health benefits that may be excluded, in whole or in part, shall not include any healthcare services or benefits that were mandated by Acts 1971, No. 34.

(B) "State-mandated health benefits" does not mean standard provisions or rights required to be present in a health benefit plan pursuant to state law or regulations unrelated to a specific health illness, injury, or condition of the insured, including, but not limited to, those related to continuation of benefits in § 23-86-114, or entitlement to a conversion policy under § 23-86-115.

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§ 23-79-802. Definitions