§ 23-64-604 — [See Note] Guide license required

Arkansas § 23-64-604

• Jurisdiction: Arkansas
• Title: 23

Text

(a) (1) A person shall not act as a guide in this state through a health insurance marketplace unless licensed under this subchapter as an eligible entity. (2) A health insurer or an affiliate of a health insurer is not an eligible entity. (b) A contract awarded to a guide is contingent on a person's: (1) Being licensed under this subchapter; (2) Becoming licensed under this subchapter by September 30, 2013, or within ninety (90) days after the receipt of funding; or (3) Employing a licensee that meets the requirements in subdivision (b)(1) or subdivision (b)(2) of this section. (c) A guide shall: (1) Assist consumers in understanding the available qualified health plans offered through a health insurance marketplace, their differences, premium tax credits, cost-sharing provisions, and the public programs and their eligibility; (2) Provide enrollment information in a culturally and linguistically appropriate manner that meets the needs of the population being served by a health insurance marketplace in this state, including those individuals with limited English proficiency or who are protected under section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 and Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12131-12165 , as they existed on January 1, 2013; (3) Ensure that information is provided in a way that simplifies choices and considers the individual needs of consumers; (4) Maintain expertise in eligibility, enrollment, and public and private insurance specifications and conduct public education activities to raise awareness about the health insurance marketplace in this state; (5) Provide information and services in a fair, accurate, and impartial manner that acknowledges other health programs; (6) Increase awareness of insurance options in a way that does not stigmatize qualified health plans; (7) Facilitate enrollment in qualified health plans or coverage offered through a health insurance marketplace and with post-enrollment dispute resolution; (8) Provide referrals to an applicable office of health insurance consumer assistance or health insurance ombudsman established under section 2793 of the Public Health Service Act, 42 U.S.C. § 300gg et seq., as it existed on January 1, 2013, or any other appropriate state agency or agencies, for a consumer participating in enrollment with a grievance, complaint, or question regarding his or her health plan, coverage, or a determination under the plan or coverage; (9) Not receive any financial consideration directly or indirectly from a health insurer or stop-loss insurance company or qualified health plan; (10) Demonstrate that no conflict of interest exists in providing in-person assistance and the services as stated in 45 C.F.R. § 155.210 ; and (11) Provide resources or avenues for consumers to register complaints and grievances with a service provided through the health insurance marketplace.

Legislative History

Added by Act 2013, No. 1439,§ 1, eff. when (1) The United States Department of Health and Human Services or other responsible federal agency or federal official notifies the Governor, the Insurance Commissioner, or other responsible state agency or state official pursuant to the federal healthcare laws established by Pub. L. No. 111-148, as amended by Pub. L. No. 111-152, and any amendments thereto, or regulations or guidance issued under those federal statutes; or (2) A health insurance marketplace is initiated and is operable in this state..