Title 23, Public Utilities and Regulated Industries

(a) In lieu of suspension or revocation of a certificate of authority under § 23-76-123, the Insurance Commissioner may levy an administration penalty in an amount not less than two hundred fifty dollars ($250), nor more than two thousand five hundred dollars ($2,500), if reasona…

No person shall perform any of the services or procedures or sell or dispense any goods or devices in the field of the healing arts for which a license is required under the laws of the State of Arkansas unless the person holds a valid license authorizing him or her to perform th…

(a) (1) Any person that meets the requirements of § 23-76-102(9) may apply to the Insurance Commissioner for and obtain a certificate of authority to establish and operate a health maintenance organization.(2) No person shall establish or operate a health maintenance organization…

(a) Upon receipt of an application for issuance of a certificate of authority, the Insurance Commissioner shall determine whether the applicant furnishes or proposes to furnish adequate and accessible healthcare services for its healthcare plans subject to the requirements or rul…

(a) The powers of a health maintenance organization include, but are not limited to, the following:(1) The purchase, lease, construction, renovation, operation, or maintenance of hospitals, medical facilities, or both, and their ancillary equipment, and the property as may reason…

(a) The advisory board of any health maintenance organization shall include at least one (1) physician, one (1) dentist, one (1) pharmacist, one (1) nurse, one (1) consumer, and one (1) enrollee. (b) The advisory board shall establish a mechanism to afford the enrollees an opport…

(a) Any director, officer, or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of the health maintenance organization shall be responsible for the funds in a fiduciary relationship to the enrollees.…

(a) (1) (A) Every enrollee residing in this state is entitled to evidence of coverage under a healthcare plan.(B) If the enrollee obtains coverage under a healthcare plan through an insurance policy or a contract issued by a hospital and medical service corporation, whether by op…

(a) A health maintenance organization shall annually on or before March 1 file a report verified by at least two (2) principal officers with the Insurance Commissioner covering the preceding calendar year. (b) (1) The report shall be on forms prescribed by the commissioner.(2) Fo…

(a) A health maintenance organization shall make available to its subscribers a list of providers upon enrollment and re-enrollment. (b) Every health maintenance organization shall provide within thirty (30) days to its subscribers a notice of any material change in the operation…

(a) (1) After a health maintenance organization has been in operation twenty-four (24) months, it shall have an annual open enrollment period of at least one (1) month during which it accepts enrollees up to the limits of its capacity, as determined by the health maintenance orga…

(a) (1) Every health maintenance organization shall establish and maintain a complaint system that has been approved by the Insurance Commissioner to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning healthcare services.(2) E…

With the exception of investments made in accordance with § 23-76-109(a)(1) and (2) and § 23-76-109(b), the investable funds of a health maintenance organization shall be invested only in securities or other investments permitted by the laws of this state for the investment of as…

(a) No health maintenance organization, or representative thereof, may knowingly cause or knowingly permit the use of advertising that is untrue or misleading, solicitation that is untrue or misleading, or any form of evidence of coverage that is deceptive. For purposes of this c…

(a) After notice and hearing, the Insurance Commissioner may promulgate such reasonable rules as are necessary to provide for the licensing of agents. (b) “Agent” means a person directly or indirectly associated with a healthcare plan who engages in solicitation or enrollment.

(a) An insurance company licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may either directly, or through a subsidiary or affiliate, organize and operate a health maintenance organization under the provisions of this ch…

(a) The Insurance Commissioner may make an examination of the affairs of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every five (5) years. (b…

(a) The Insurance Commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if the commissioner finds that any of the following conditions exist:(1) The health maintenance organization is operating in contravent…

(a) Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the Insurance Commissioner pursuant to the law …

(a) After notice and hearing, the Insurance Commissioner may promulgate reasonable rules, not inconsistent with existing statutes of this state, as are necessary or proper to carry out the provisions of this chapter. (b) The rules shall be subject to review in accordance with § 2…

(a) (1) If the Insurance Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority exist, the commissioner shall:(A) Notify the health maintenance organization in writing of the grounds for suspension or revocation of the certif…

(1) A health maintenance organization subject to this chapter shall pay to the State Insurance Department Trust Fund as special revenues the following fees:(1) For filing and reviewing all documents necessary for issuance of an original certificate of authority, one thousand doll…

All applications, filings, and reports required under this chapter shall be treated as public documents.

(a) Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from the person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the exten…

(a) The Insurance Commissioner may contract with qualified persons to make recommendations concerning the adequacy, network adequacy, or accessibility of healthcare services under a healthcare plan furnished or proposed to be furnished by a health maintenance organization. (b) Th…

(a) (1) (A) (i) Each health maintenance organization shall pay a tax on the premiums for coverages provided during the calendar year.(ii) The tax shall be paid on an annual basis and on a quarterly estimate basis as prescribed by the Insurance Commissioner and reconciled at the t…

(1) If a health maintenance organization requires the selection or assignment of a primary care physician, the health maintenance organization shall provide an enrollee who is a student enrolled at a postsecondary institution one (1) of the following options:(1) To select two (2)…