Arkansas Administrative Code

23 CAR § 152-104. Pharmacy claims. All pharmacy claims processed by a pharmacy that participates in 340B drug pricing are final at the point of adjudication.

23 CAR § 152-105. Penalties. The penalties, actions, or orders, as authorized under Arkansas Code §§ 23-66-209 and 23-66-210, shall apply to violations of this part.

23 CAR § 153-101. Purpose. The purpose of this part is to authorize the Insurance Commissioner to establish an effective state audit process to ensure compliance with the requirements of the No Surprises Act related to the determination and development of methodology concerning t…

23 CAR § 153-102. Definitions. (a) Unless otherwise separately defined in this part and consistent with state law, the terms or phrases as used in this part shall follow the definitions of such terms or phrases as defined in Arkansas Code § 23-66-216, and the Consolidated Appropr…

23 CAR § 153-103. Applicability and scope. This part applies to all health carriers that offer health benefit plans in this state that are issued or renewed on or after January 1, 2024.

23 CAR § 153-104. Audit requirement. (a) The Insurance Commissioner shall develop a state audit process to ensure that a health benefit plan or health carrier calculates the qualified payment amount established under the No Surprises Act of the Consolidated Appropriations Act, 20…

23 CAR § 153-105. Enforcement. The penalties, license actions, or orders as authorized under Arkansas Code § 23-66-210 shall apply to violations of this part.

23 CAR § 154-101. Purpose and intent. (a) The purpose and intent of this part is to establish uniform, national standards governing reserve financing arrangements pertaining to life insurance policies containing guaranteed nonlevel gross premiums, guaranteed nonlevel benefits, an…

23 CAR § 154-102. Applicability. (a) This part shall apply to reinsurance treaties that cede liabilities pertaining to covered policies, as that term is defined in 23 CAR § 154-104(2), issued by any life insurance company domiciled in this state. (b) This part and Credit for Rein…

23 CAR § 154-103. Exemptions from this part. This part does not apply to the situations described in subdivisions (1) – (6) of this section, as follows: (1) Reinsurance of: (A) Policies that satisfy the criteria for exemption set forth in 23 CAR § 104-105(f) or (g) and that are i…

23 CAR § 154-104. Definitions. As used in this part: (1) "Actuarial method" means the methodology used to determine the required level of primary security, as described in 23 CAR § 154-105; (2) "Covered policies" means the following: subject to the exemptions described in 23 CAR …

23 CAR § 154-105. Actuarial method. (a) Actuarial method. The actuarial method to establish the required level of primary security for each reinsurance treaty subject to this part shall be VM-20, applied on a treaty-by-treaty basis, including all relevant definitions, from the Va…

23 CAR § 154-106. Requirements applicable to covered policies to obtain credit for reinsurance — Opportunity for remediation. (a) Requirements. Subject to the exemptions described in 23 CAR § 154-103 and the provisions of subsection (b) of this section, credit for reinsurance sha…

23 CAR § 154-107. Prohibition against avoidance. No insurer that has covered policies as to which this part applies, as set forth in 23 CAR § 154-102, shall take any action or series of actions, or enter into any transaction or arrangement or series of transactions or arrangement…

23 CAR § 80-101. Purpose. The purpose of this part is to: (1) Set the minimum and maximum benefit levels for in vitro fertilization coverage; and (2) Set out standards and guidelines to be followed when determining if the policy or certificate must include in vitro fertilization …

23 CAR § 80-102. Applicability and scope. (a) This part shall apply to each individual, group, or blanket disability insurance policy issued, renewed, or delivered within this state and each certificate of disability insurance issued to a resident of this state under a group disa…

23 CAR § 80-103. Coverage. Every applicable policy or certificate must provide benefits for in vitro fertilization procedures when: (1) The patient is the policyholder or the spouse of the policyholder/certificate holder and a covered dependent under that policy or certificate; (…

23 CAR § 80-104. Benefit level. (a) The benefits for in vitro fertilization shall be the same as the benefits provided under maternity benefit provisions and may be subject to the same deductibles, coinsurance, and out- of-pocket limitations provided in the policy or certificate …

23 CAR § 80-105. Other coverage. (a) Nothing in this part shall prohibit an insurer from including as a benefit coverage other infertility procedures or treatments. (b) These coverages may be considered as an in vitro fertilization benefit and subject to the same benefit levels. …

23 CAR § 80-106. Cryopreservation. Cryopreservation, the procedure whereby embryos are frozen for late implantation, shall be included as an in vitro fertilization procedure.

23 CAR § 81-101. Definitions. As used in this part: (1) "Agent" means any person, corporation, partnership, or other legal entity which under the laws of this state is licensed as a life insurance agent or broker; (2) "Securities examination" as used in 23 CAR § 81-108(c) and § 8…

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23 CAR § 81-103. Separate account or separate accounts. (a) A domestic company issuing variable contracts shall establish one (1) or more separate accounts pursuant to Arkansas Statutes § 66-2633, § 66-3523, or § 66-3524, subject to the following provisions of this section: (1) E…

23 CAR § 81-104. Filing of contracts. The filing requirements applicable to variable contracts shall be those filing requirements otherwise applicable under existing statutes and rules of this state with respect to individual and group life insurance and annuity contract form fil…

23 CAR § 81-105. Contract providing for variable benefits. (a)(1) Any variable contract providing benefits payable in variable amounts delivered or issued for delivery in this state shall contain a statement of the essential features of the procedures to be followed by the insura…

23 CAR § 81-106. Required reports. (a)(1) Any company issuing individual variable contracts shall mail to the contractholder at least once in each contract year after the first at his or her last address known to the company, a statement or statements reporting the investments he…

23 CAR § 81-107. Foreign companies. If the law or regulation in the place of domicile of a foreign company provides a degree of protection to the policyholders and the public which is substantially equal to that provided by this part, the Insurance Commissioner, to the extent dee…

23 CAR § 81-108. Examination of agents and other persons. (a)(1) No agent shall be eligible to sell or offer for sale a variable annuity contract unless, prior to making any solicitation or sale of such a contract, he or she also be licensed as a variable annuity agent. (2) Any a…

23 CAR § 81-109. Information to be furnished to an applicant for a variable contract. (a) The following information shall be furnished to an applicant for a variable life insurance contract prior to execution of the application: (1) A summary description of the insurance company …

23 CAR § 82-101. Purpose. (a) The purpose of this part is to protect prospective purchasers with respect to the advertisement of disability insurance in the same manner as the rules governing advertisements of Medicare supplement insurance. (b) This rule ensures the clear and tru…

23 CAR § 82-102. Applicability. (a)(1) Except for Medicare supplement insurance, this part shall apply to any "advertisement", as that term is defined herein unless otherwise specified in this part, that the insurer, hereinafter defined, knows or reasonably should know is intende…

23 CAR § 82-103. Definitions. As used in this part: (1)(A) “Advertisement” means: (i) Printed and published material, audiovisual material, and descriptive literature of an insurer used in: (a) Direct mail; (b) Newspapers; (c) Magazines; (d) Radio scripts; (e) TV scripts; (f) Bil…

23 CAR § 82-104. Method of disclosure of required information. All information required to be disclosed by this part shall be set out conspicuously and in close conjunction with the statements to which such information relates or under appropriate captions of such prominence that…

23 CAR § 82-105. Form and content of advertisements. (a)(1) The format and content of an advertisement of a disability insurance policy shall be sufficiently complete and clear to avoid deception or the capacity or tendency to mislead or deceive. (2) Whether an advertisement has …

23 CAR § 82-106. Advertisements of benefits payable, losses covered, or premiums payable. (a) Deceptive words, phrases, or illustrations prohibited. (1)(A) No advertisement shall omit information or use words, phrases, statements, references, or illustrations if the omission of s…

23 CAR § 82-107. Necessity for disclosing policy provisions relating to renewability, cancellability, and termination. An advertisement that is an invitation to contract shall disclose the provisions relating to renewability, cancellability, and termination and any modification o…

23 CAR § 82-108. Testimonials or endorsements by third parties. (a)(1) Testimonials and endorsements used in advertisements must: (A) Be genuine; (B) Represent the current opinion of the author; (C) Be applicable to the policy advertised; and (D) Be accurately reproduced. (2) The…

23 CAR § 82-109. Use of statistics. (a)(1)(A) An advertisement relating to the dollar amounts of claims paid, the number of persons insured, or similar statistical information relating to any insurer or policy shall not use irrelevant facts and shall not be used unless it accurat…

23 CAR § 82-110. Identification of plan or number of policies. (a) When a choice of the amount of benefits is referred to, an advertisement which is an invitation to contract shall disclose that the: (1) Amount of benefits provided depends upon the plan selected; and (2) Premium …

23 CAR § 82-111. Disparaging — Comparisons and statements. (a) An advertisement: (1) Shall not directly or indirectly make unfair or incomplete comparisons of policies or benefits or comparisons of noncomparable policies of other insurers; (2) Shall not disparage competitors or t…

23 CAR § 82-112. Jurisdictional licensing and status of insurer. (a) An advertisement which is intended to be seen or heard beyond the limits of the jurisdiction in which the insurer is licensed shall not imply licensing beyond those limits. (b) An advertisement shall not create …

23 CAR § 82-113. Identity of insurer. (a)(1) The name of the actual insurer shall be stated in all of its advertisements. (2) The form number or numbers of the policy advertised shall be stated in an advertisement that is an invitation to contract. (3) An advertisement shall not …

23 CAR § 82-114. Group or quasi-group implications. (a) An advertisement of a particular policy shall not state or imply that prospective insureds become group or quasi-group members covered under a group policy and as such enjoy special rates or underwriting privileges, unless s…

23 CAR § 82-115. Introductory, initial, or special offers. (a)(1)(A) An advertisement of an individual policy shall not directly or by implication represent that a contract or combination of contracts is an introductory, initial, or special offer, that applicants will receive sub…

23 CAR § 82-116. Statements about an insurer. (a) An advertisement shall not contain statements which are untrue in fact, or by implication misleading, with respect to the assets, corporate structure, financial standing, age, or relative position of the insurer in the insurance b…

23 CAR § 82-117. Enforcement procedures. (a) Advertising file. (1) Each insurer shall maintain at its home or principal office a complete file containing every printed, published, or prepared advertisement of its individual policies and typical printed, published, or prepared adv…

23 CAR § 82-118. Filing for prior review. (a) The Insurance Commissioner may, at his or her discretion, require the filing with the State Insurance Department, for review and approval prior to use, of any disability insurance advertising material. (b) Such advertising material mu…