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Arkansas Health Insurance

Health insurance is one type of insurance which you cannot afford to ignore. Indeed, purchasing suitable health insurance coverage for your family is costly, but it also requires a good evaluation of all potential risks and its impact on your financial health. In the U.S., more than 47 million people are uninsured and working families constitute a major part of this uninsured population. With the rising health care costs, many of these families usually decide to do without having proper health coverage, unaware of the consequences of huge medical bills of an unforeseen event. For those families who are not covered under their employers’ group plan, many states provide low-cost health insurance programs to them.

In 2008, Arkansas was ranked as the 43rd healthiest state to live in, climbing five spots from its 2007 ranking, according to the America's Health Rankings. The state witnessed a remarkable improvement in its health score due to the decrease in the prevalence of smoking as well as in the percentage of children in poverty, and a moderate public health funding. The state of Arkansas, having the population of more than two million citizens, has both private-market and public health insurance alternatives. The private-market health insurance comprises of numerous types of health plans including family, medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide inexpensive health coverage to the uninsurable residents of Arkansas who meet specific eligibility requirements such as age, income and tobacco consumption.

The Alaska Insurance Department is responsible for regulating all types of insurance sold in the state of Alaska including health insurance policies offered by private-market health insurers or public health coverage programs. However, approximately 17.5% of the population remains uninsured, which is the biggest health concern for the Arkansas government. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, approximately 29.5% of Arkansas citizens continue to survive without any kind of health insurance and under the above 200% FPL category.

Choosing a health plan for your family can be intimidating and confusing. Therefore, your best interests lie in consulting with a licensed health insurance agent/broker to avail the appropriate health insurance alternatives.

Individual/Family Health Insurance

Below is the guidelines for applying for and obtaining individual health insurance in the state of Arkansas. These regulations apply to all insurance companies offering individual or family health insurance in Arkansas:


Medical Underwriting

Yes

Pre-Existing Condition Exclusion Period

No Limit

Look Back Period

60 months

Look Back Standard

Prudent person standard

Mandatory Benefits

Cancer screening for women, breast cancer screening, minimum IP mastectomy stay of 48 hours, reconstructive surgery after mastectomy, infertility diagnosis and treatment (expect in vitro fertilization), direct access to OB/GYNs, depression parity, eating disorder parity

Market Rate Restrictions

None

Guaranteed Issue Options

None

Small Group Health Insurance

Below is the guidelines for small group health insurance in the state of Arkansas. These regulations apply to all insurance companies offering small group health insurance in Arkansas:


Small Group Size

2-50 (including owner)

Employee Qualifications

  • Two employees must work for at least 6 months out of the year, and work 20 hours per week for coverage.
  • Most small group carriers also require 75% employee participation and accept employees who sign a waiver indicating other coverage as counting towards the 75%

Guaranteed Issue

Yes

Premium Rating Factors

Rate bands

Rate Adjustment Factors

25%

Look-Back Period

6 months

Pre-existing condition exclusionary period

12 months

Mandatory Benefits

Same as individual

State Cobra Variations for Small Groups

Below are the COBRA guidelines for small groups in the state of Arkansas. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:


Mini-Cobra Option

Yes

Eligible Group Sizes

2 to 19

Extension of Benefits Period - Standard

120 days

Extension of Benefits Period - Disabled

120 days

Maximum Premium Increase

100%

State Legislation Reference

Arkansas Code of 1987 – Title 23, Chapter 86 (Section 23-86-114, 23-86-115, 23-86-116)

Additional Notes

  • Continuation of benefits to individuals and qualified dependents that have been insured under the policy for at least 3 months prior to date of termination
  • Continuation of coverage must be requested by individual within 10 days after termination of employment.

State Sponsored Health Insurance Programs

There are several state sponsored health insurance programs in the State of Arkansas to assist those without insurance in obtaining adequate coverage.

High-Risk Pools

Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of Arkansas is summarized in the chart below:


Plan Name

Arkansas Comprehensive Health Insurance Pool

Website

http://www.chiparkansas.org/

Phone Number

800-285-6477

HIPPA Eligibility Required?

Yes

Available Carriers

Arkansas Blue Cross Blue Shield, BlueAdvantage Administrators of Arkansas

Pre-Existing Condition Waiting Period

6 months

Enrollment Periods

Open to new enrollment

Premium Limits

No more than 150% of the standard risk

Lifetime Maximum Benefit

$1 million

Special Notes

Exclusively available for people who have lost their group health insurance and have exhausted or have no COBRA option available

Children’s Health Insurance Program

Through shared funding from the federal government, the State of Arkansas provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:


Program Name

ARKids First

Website

http://www.arkidsfirst.com/home.htm

Phone Number

888-474-8275

Apply Online

Yes

Age Limits

Under 19

Insurance Carrier

NA

Length of Coverage

Periodic review of eligibility

Other Eligibility Requirements

  • Children who do not have employer-sponsored or group health insurance and have not had insurance for 6 months.
  • If you have lost insurance involuntarily, your children may be eligible for insurance immediately

Pre-Existing Condition Exclusions

None

Cost

$0-$10 with the exceptions of durable medical equipment and inpatient hospital care, which both require a 20 percent coinsurance payment for ARKids B

Medicaid

Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Arkansas:


Governing Agency

Arkansas Medicaid

Website

https://www.medicaid.state.ar.us/

Phone Number

(800) 457-4454, (501) 376-2211

Residency Requirements

Arkansas residents, U.S. citizens, legal alien

Federal Poverty Line Income Limits

Pregnant women & children ages 0-19: 200% FPL
Supplemental Security Income Recipients: 74% FPL
Parents-15% FPL

Additional Resources

Arkansas Health Care Options Matrix™ Guide

Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Arkansas’s public and private health care choices for individuals and groups with various demographic profiles.

Family Health Insurance Guide by HealthInsuranceFinders.com

The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.

Arkansas: At-A-Glance

Provides exclusive health data of Arkansas. Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.


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