Arkansas Administrative Code

23 CAR § 89-106. Minimum benefit standards for prestandardized Medicare supplement benefit plan policies or certificates issued for delivery prior to May 1, 1992. (a)(1) No policy or certificate may be advertised, solicited, or issued for delivery in Arkansas as a Medicare supple…

23 CAR § 89-107. Benefit standards for 1990 standardized Medicare supplement benefit policies or certificates issued or delivered on or after May 1, 1992, and with an effective date of coverage prior to June 1, 2010. (a)(1) The following standards are applicable to all Medicare s…

23 CAR § 89-108. Benefit standards for 2010 standardized Medicare supplement benefit plan policies or certificates issued with an effective date of coverage for delivery on or after June 1, 2010. (a)(1) The following standards are applicable to all Medicare supplement policies or…

23 CAR § 89-109. Standard Medicare supplement benefit plans for 1990 standardized Medicare supplement benefit plan policies or certificates issued for delivery on or after May 1, 1992, and with an effective date of coverage prior to June 1, 2010. (a) An issuer shall make availabl…

23 CAR § 89-110. Standard Medicare supplement benefit plans for 2010 standardized Medicare supplement benefit plan policies or certificates issued for delivery with an effective date of coverage on or after June 1, 2010. (a)(1) The following standards are applicable to all Medica…

23 CAR § 89-111. Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020. (a)(1) The Medicare Access and CHIP Reauthorizat…

23 CAR § 89-112. Medicare Select policies and certificates. (a)(1) This section shall apply to Medicare Select policies and certificates, as defined in this section. (2) No policy or certificate may be advertised as a Medicare Select policy or certificate unless it meets the requ…

23 CAR § 89-113. Open enrollment. (a)(1) An issuer shall not deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in Arkansas nor discriminate in the pricing of a policy or certificate because of the health status, cl…

23 CAR § 89-114. Guaranteed issue for eligible persons. (a) Guaranteed issue. (1) Eligible persons are those individuals described in subsection (b) of this section who: (A) Seek to enroll under the policy during the period specified in subsection (c) of this section; and (B) Sub…

23 CAR § 89-115. Standards for claims payment. (a) An issuer shall comply with Section 1882(c)(3) of the Social Security Act (as enacted by Section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA), Pub. L. No. 100-203) by: (1) Accepting a notice from a Medica…

23 CAR § 89-116. Loss ratio standards and refund or credit of premium. (a) Loss ratio standards. (1)(A) A Medicare supplement policy form or certificate form shall not be delivered or issued for delivery unless the policy form or certificate form can be expected, as estimated for…

23 CAR § 89-117. Filing and approval of policies and certificates and premium rates. (a) An issuer shall not deliver or issue for delivery a policy or certificate to a resident of this state unless the policy form or certificate form has been filed with and approved by the Insura…

23 CAR § 89-118. Permitted compensation arrangements. (a) An issuer or other entity may provide commission or other compensation to an agent or producer or other representative for the sale of a Medicare supplement policy or certificate only if the first-year commission or other …

23 CAR § 89-119. Required disclosure provisions. (a) General rules. (1)(A) Medicare supplement policies and certificates shall include a renewal or continuation provision. (B) The language or specifications of the provision shall be consistent with the type of contract issued. (C…

23 CAR § 89-120. Requirements for application forms and replacement coverage. (a)(1)(A) Application forms shall include the following questions designed to elicit information as to whether: (i) As of the date of the application, the applicant has another Medicare supplement, Medi…

23 CAR § 89-121. Filing requirements for advertising. An issuer shall provide a copy of any Medicare supplement advertisement intended for use in Arkansas, whether through written, radio, or television medium or internet, to the Insurance Commissioner for review or approval by th…

23 CAR § 89-122. Standards for marketing. (a) An issuer, directly or through its producers, shall: (1) Establish marketing procedures to assure that any comparison of policies by its agents or other producers will be fair and accurate; (2) Establish marketing procedures to assure…

23 CAR § 89-123. Appropriateness of recommended purchase and excessive insurance. (a) In recommending the purchase or replacement of any Medicare supplement policy or certificate, an agent or producer shall make reasonable efforts to determine the appropriateness of a recommended…

23 CAR § 89-124. Reporting of multiple policies. (a) On or before March 1 of each year, an issuer shall report the following information for every individual resident of this state for which the issuer has in force more than one (1) Medicare supplement policy or certificate: (1) …

23 CAR § 89-125. Prohibition against preexisting conditions, waiting periods, elimination periods, and probationary periods in replacement policies or certificates. (a) If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate, the …

23 CAR § 89-126. Prohibition against use of genetic information and requests for genetic testing. (a) This section applies to all policies with policy years beginning on or after May 21, 2009. (b) An issuer of a Medicare supplement policy or certificate: (1) Shall not deny or con…

23 CAR § 89-127. Availability of Medicare supplement benefit plans to applicants with a disability. (a) No later than July 1, 2018, at least one (1) of the ten (10) standardized Medicare supplement plans currently available from an issuer shall be made available to all applicants…

23 CAR § 90-101. Purpose. The purpose of this part is to implement Arkansas Statutes § 66-3005(7) so as to prevent unfair discrimination in life insurance, annuities, and disability insurance on the basis of physical impairment or mental impairment.

23 CAR § 90-102. Unfairly discriminatory acts or practices. The following are hereby identified as acts or practices in life insurance, annuities, and disability insurance that constitute unfair discrimination between individuals of the same class: refusing to insure, refusing to…

23 CAR § 90-103. Effective date and applicability. This part shall be effective August 1, 1987, and shall be applicable to all life insurance, annuities, and disability policies delivered or issued for delivery in this state on or after such date, and to all existing group contra…

23 CAR § 91-101. Purpose. The purpose of this part is to: (1) Define funeral expense insurance as required by Arkansas Code § 23-64-202(c)(7)(B); and (2) Set out the general requirements that must be met in selling this form of life insurance.…

23 CAR § 91-102. Definitions. As used in this part: (1) “Funeral expense insurance” means that form of life insurance as defined in Arkansas Code § 23-62-102, which provides benefits for expenses incurred in connection with the death of the insured and which does not exceed twent…

23 CAR § 91-103. General requirements. (a) No insurer doing business in this state shall: (1) Write life insurance wherein the proceeds of the policy after death are payable other than in cash; or (2) Write a policy that shall in any way, directly or indirectly, undertake to limi…

23 CAR § 92-101. Purpose. The purpose of this part is to implement Arkansas Code § 23-86-115, so as to provide minimum standards for policies, certificates, or contracts, hereinafter referred to as "the converted policy", issued pursuant to a conversion privilege under a policy o…

23 CAR § 92-102. Scope. This part shall apply to all of the converted policies and certificates delivered or issued for delivery on or after the effective date hereof and should be read in addition to and supplementary to Arkansas Code § 23-86-115.

23 CAR § 92-103. Definitions. No converted policy delivered or issued to be delivered in this state shall contain definitions that do not comply with 23 CAR § 86-104, which is hereby incorporated by reference.

23 CAR § 92-104. Time limit. Written application for the converted policy shall be made and the first premium paid to the insurer not later than thirty (30) days after such termination.

23 CAR § 92-105. Evidence of insurability. The converted policy shall be issued without evidence of insurability.

23 CAR § 92-106. Effective date of coverage. The effective date of the converted policy shall be the day following the termination of insurance under the group policy.

23 CAR § 92-107. Scope of coverage. (a) The converted policy shall cover the employee or member and his or her dependents who were covered by the group policy on the date of termination of insurance. (b) At the option of the insurer, a separate converted policy may be issued to c…

23 CAR § 92-108. Optional coverage. (a) The insurer shall not be required to issue a converted policy covering any person if such person is or could be covered by Medicare (Title XVIII of the United States Social Security Act as added by the Social Security Amendments of 1965 or …

23 CAR § 92-109. Information requested by insurer. (a) A converted policy may include a provision whereby the insurer may request information in advance of any premium due date of such policy of any person covered thereunder as to whether: (1) He or she is covered for similar ben…

23 CAR § 92-110. Benefits offered. (a) An insurer shall not be required to issue a converted policy that provides benefits in excess of those provided under the group policy from which conversion is made. (b) The converted policy may contain any exclusion, reduction, or limitatio…

23 CAR § 92-111. Preexisting condition. (a)(1)The converted policy shall not exclude a preexisting condition not excluded by the group policy. (2) However, the converted policy may provide that any hospital, surgical, or medical benefits payable thereunder may be reduced by the a…

23 CAR § 92-112. Optional coverage — Hospitalization or surgical expense. (a) Subject to the provisions and conditions of this part, if the group insurance policy from which conversion is made insures the employee or member for basic hospital or surgical expense insurance, the em…

23 CAR § 92-113. Optional coverage — Major medical. Subject to the provisions and conditions of this part, if the group insurance policy from which conversion is made insures the employee or member for major medical expense insurance, the employee or member shall be entitled to o…

23 CAR § 92-114. Benefit plans under 23 CAR §§ 92-112 and 92-113. (a)(1) The conversion policy shall, if the group insurance policy insures that employee or member for basic hospital or surgical expenses insurance, make available the plans of benefits as set forth in 23 CAR §§ 92…

23 CAR § 92-115. Alternate plans. The insurer may, at its option, also offer alternative plans with benefits in excess of those required by this part.

23 CAR § 92-116. Coverage of retirement. In the event coverage would be continued under the group policy on an employee following his or her retirement prior to the time he or she is or could be covered by Medicare, he or she may elect, in lieu of such continuation of group insur…

23 CAR § 92-117. Coordination of benefits due to Medicare. The converted policy may provide for coordination of benefits provided under: (1) Medicare (Title XVIII of the United States Social Security Act as added by the Social Security Amendments of 1965 or as later amended or su…

23 CAR § 92-118. Conversion privilege allowed. Subject to the conditions set forth above, the conversion privilege shall also be available: (1) To the surviving spouse, if any, at the death of the employee or member, with respect to the spouse and such children whose coverage und…

23 CAR § 92-119. Benefit levels. If the benefit levels required in 23 CAR § 92-112 exceed the benefit levels provided under the group policy, the conversion policy may offer benefits that are substantially similar to those provided under the group policy in lieu of those required…

23 CAR § 92-120. Group in lieu of individual coverage. (a) Nothing contained herein shall be construed to prevent the insurer from providing group coverage rather than the issuance of a converted individual policy. (b)(1) Any certificate of insurance issued pursuant to this part …

23 CAR § 92-121. Conversion premium. (a)(1) The initial premium for the converted policy for the first twelve (12) months and subsequent renewal premiums shall be determined in accordance with premium rates applicable to: (A) Individually underwritten standard risks; (B) The age …

23 CAR § 93-101. Definitions. As used in this part: (1) "Affiliate" of an insurer means any: (A) Person directly or indirectly controlling, controlled by, or under common control with such insurer; (B) Person who regularly furnishes investment advice to such insurer with respect …