§ 23-61-1008. Insurance standards for employer health insurance coverage.

AR Code § 23-61-1008 (2018) (N/A)
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(a) A program participant shall enroll in employer health insurance coverage if:

(1) The employer of the program participant elects to participate;

(2) Except as authorized under subsection (c) of this section, the employer health insurance coverage is a small group plan that provides essential health benefits as defined by 45 C.F.R. § 156.110, as it existed on January 1, 2016, and has no less than a seventy percent (70%) actuarial value;

(3) The employer health insurance coverage is deemed cost-effective; and

(4) The employer and health insurer providing the employer health insurance coverage are willing to meet the reporting obligations under § 23-61-1004(g)(2).

(b) The Department of Human Services may pay premiums and supplemental cost sharing reductions for employer health insurance coverage meeting the standards in subsection (a) of this section.

(c) The Department of Human Services, in coordination with the State Insurance Department and the Arkansas Health Insurance Marketplace, shall explore and seek any necessary waivers or other authority necessary to:

(1) Offer incentives for employers of program participants who enroll in employer health insurance coverage; and

(2) Expand opportunities for eligible individuals to obtain employer health insurance coverage providing coverage through:

(A) The fully insured large group insurance market; or

(B) Employers with self-funded insurance plans.

(d) The Department of Human Services, in coordination with the State Insurance Department and the Arkansas Health Insurance Marketplace, shall develop methods to ensure the continuation of health insurance coverage for a program participant with employer health insurance coverage if the program participant:

(1) Loses employment with an employer who is offering the employer health insurance coverage; or

(2) Switches employment to a different employer who does not offer employer health insurance coverage that meets the standards in subsection (a) of this section.

(e) This subchapter does not:

(1) Modify the authority of the Department of Human Services to enroll eligible individuals who are not program participants in employer health insurance coverage where cost-effective;

(2) Preclude the state from exploring the expanded utility and functionality of the state-administered small business health options program created by the Arkansas Health Insurance Marketplace Act, § 23-61-801 et seq.; or

(3) Exempt any plans offered in the small group insurance market, large group insurance market, or individual insurance market from complying with state and federal requirements regarding medical loss ratio.

(f) On or before January 1, 2017, the State Insurance Department, the Department of Human Services, and other necessary state agencies may implement the applicable provisions of this section through certification requirements or rule, or both.

(g)

(1) This section shall expire on December 31, 2017.

(2) The Arkansas Code Revision Commission shall remove this section from the Arkansas Code after December 31, 2017.