§ 23-60-104 — Exceptions - Burial associations - Healthcare sharing ministries - Direct healthcare agreements - Definitions

Arkansas § 23-60-104

• Jurisdiction: Arkansas
• Title: 23

Text

(a) The Arkansas Insurance Code and rules promulgated by the Insurance Commissioner under the Arkansas Insurance Code do not apply to a: (1) Burial association governed by §§ 23-78-101 - 23-78-119 and 23-78-121 - 23-78-125 ; (2) Direct healthcare agreement; (3) Healthcare sharing ministry; or (4) (A) Nonprofit agricultural membership organization. (B) Any risk arising out of a contract for coverage for healthcare services between a member of a nonprofit agricultural membership organization and a nonprofit agricultural membership organization, or its affiliate, may be reinsured by an insurer that is authorized to transact insurance in this state. (C) A nonprofit agricultural membership organization shall pay a levy of the insurance premium tax to the same extent as a domestic insurer under § 26-57-604 . (b) As used in this section: (1) (A) "Direct healthcare agreement" means a written agreement that: (i) Is between a licensed healthcare provider and a patient or the patient's legal representative; (ii) (a) Allows either party to terminate the agreement in writing, without penalty or payment of a termination fee, at any time or after notice as specified in the agreement. (b) The notice of termination described in subdivision (b)(1)(A)(ii) (a) of this section shall not exceed sixty (60) days; (iii) Describes the healthcare services to be provided in exchange for payment of a periodic fee; (iv) Specifies the periodic fee required and any additional fees that may be charged; (v) May allow the periodic fee and any additional fees to be paid by a third party; (vi) Prohibits the healthcare provider from charging or receiving additional compensation for healthcare services included in the periodic fee; and (vii) Conspicuously and prominently states that the agreement is not health insurance and does not meet any individual health insurance mandate that may be required by federal law. (B) A direct healthcare agreement shall provide a written disclaimer on or accompanying an application distributed by or on behalf of an entity offering a direct healthcare agreement that reads, in substance: "Notice: A direct healthcare agreement is not an insurance policy, and the select medical services as specified under a direct healthcare agreement may not constitute the minimum essential health benefits under federal healthcare laws established by Pub. L. No. 111-148, as amended by Pub. L. No. 111-152, and any amendments to, or regulations or guidance issued under, those statutes existing on January 1, 2017. You may be responsible for any payment for medical services not covered by health insurance under your insurer's statement of benefits policy." (C) "Direct healthcare agreement" does not mean a health benefit plan or a health maintenance organization as defined in § 23-76-102 ; (2) "Healthcare sharing ministry" means a faith-based, nonprofit organization that: (A) Is tax-exempt under the Internal Revenue Code of 1986; (B) Limits participation to those who are of a similar faith; (C) Facilitates an arrangement to match participants who have financial or medical needs to participants with the present ability to assist those with financial or medical needs according to criteria established by the healthcare sharing ministry; (D) Provides for the financial or medical needs of a participant through contributions from one (1) participant to another; (E) Establishes contribution amounts for participants with no guarantee of return, assumption of risk, or promise to pay qualified medical needs of the participant or of the medical provider performing the service or services for the participant; (F) Provides a written monthly statement to its participants that lists: (i) The total dollar amount of qualified needs submitted to the healthcare sharing ministry; and (ii) The amount of contribution established for its participants; (G) Provides a written disclaimer on or accompanying an application and guideline material distributed by or on behalf of the healthcare sharing ministry that reads, in substance: "Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor plan of operation is an insurance policy. If anyone chooses to assist you with your medical bills, it will be totally voluntary because participants are not compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive a payment for medical expenses or if this organization continues to operate, you are always personally responsible for the payment of your own medical bills."; (H) Transfers or distributes contribution amounts from one (1) participant to match the qualified medical needs of another participant to whom neither the organization nor the sending participant has an obligation or commitment to pay for any qualified medical needs with its own funds; and (I) Provides an identification card to each participant that includes an indication that the participant is a member of a healthcare sharing ministry; and (3) "Nonprofit agricultural membership organization" means an organization that: (A) Is incorporated under the laws of this state; (B) Has a physical presence in every county of this state; (C) Has a purpose of promoting the interests of farmers or their affiliates in this state; (D) Provides coverage for healthcare services for members and their families pursuant to contracts between members and the organization or its affiliates; and (E) (i) Has a designated individual who, in consultation with the State Insurance Department, operates as an ombudsman to address concerns from insured members regarding the insurance policy. (ii) If a complaint is received by the department from insured members of the nonprofit agricultural membership organization, then the department shall forward the complaints to the designated individual operating as the nonprofit agricultural membership organization's ombudsman under subdivision (b)(3)(E)(i) of this section.

Legislative History

Amended by Act 2023, No. 626,§ 2, eff. 8/1/2023. Amended by Act 2023, No. 626,§ 1, eff. 8/1/2023. Amended by Act 2023, No. 500,§ 1, eff. 8/1/2023. Amended by Act 2021, No. 381,§ 1, eff. 7/28/2021. Amended by Act 2017, No. 1020,§ 1, eff. 8/1/2017. Amended by Act 2015, No. 101,§ 1, eff. 7/22/2015. Amended by Act 2013, No. 1163,§ 1, eff. 8/16/2013. Acts 1959, No. 148, § 12; A.S.A. 1947, § 66-2012.