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| Important Facts |  Individual Health Insurance Regulations
Your current and previous health status and history influence strongly your eligibility to obtain individual health insurance in Arkansas. Health insurance providers are permitted to accept or decline an individual for coverage, they believe that assuming the health care costs for an individual would pose a risk on their claims ratios. For their members, the insurance companies are permitted to look back 60 months at medical records to determine if any claim classifies as a pre-existing medical condition, in which case they may be able to deny payment of claim. Insurance providers may accept you for coverage, but place an elimination rider on the policy that exempts them from paying claims on the disclosed pre-existing medical condition. Besides, they are also permitted to exclude any pre-existing medical condition for 24 months, regardless if the insured member has had prior health insurance or not.
Small Group Health Insurance Regulations
Arkansas law determines a small group as any employer with 2-50 employees. Insurance providers offering a small group product are required to accept any qualified group for coverage, regardless of the health status of any employee participating in that group. New group health insurance applications contain health questions and these answers may affect the rate that the insurance company charges the employer. The maximum rate adjustment factor is 25% over the standard rate that is published and approved by the Arkansas Department of Insurance. Federal HIPAA regulations defined the insurance company can exclude paying benefits on pre-existing medical conditions for up to 12 months for new members without prior health insurance coverage. Your company must have at least 2 employees that are working at least 20 hours per week for that business to qualify for small group coverage.
Arkansas COBRA and Continuation Coverage
If a group with 20 or more employees, it must follow federal COBRA regulations which state that a departing employee is entitled to remain on the group health plan for a period of 18 months, provided that group health plan remains in existence. As a COBRA recipient you will be responsible for paying the insurance premium, which may not exceed 2% of the amount that the employer was paying for his coverage. In addition, Arkansas also has a mini-COBRA that applies to qualified employers with less than 20 employees. This law states that continuation of coverage under the group health plan must be made available to individuals for 120 days, if that individual was insured under the group plan for at least 3 months. The individual may receive an option for a conversion policy, once the 4 months of mini-COBRA coverage expires. Also, Arkansas offers a state sponsored program for individuals that have lost their COBRA coverage and are not eligible for individual coverage.
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