§ 23-79-506 — Powers

Arkansas § 23-79-506

• Jurisdiction: Arkansas
• Title: 23

Text

(a) (1) The Arkansas Comprehensive Health Insurance Pool shall have the general powers and authority granted under the laws of the State of Arkansas to health insurers and, in addition thereto, the specific authority to: (A) Enter into contracts as are necessary or proper to carry out the provisions and purposes of this subchapter; (B) Sue or be sued, including taking any legal actions necessary or proper; (C) Take such legal action as necessary, including without limitation: (i) Avoiding the payment of improper claims against the pool or the coverage provided by or through the pool; (ii) Recovering any amounts erroneously or improperly paid by the pool; (iii) Recovering any amounts paid by the pool as a result of mistake of fact or law; (iv) Recovering other amounts due the pool; or (v) Coordinating legal action with the Insurance Commissioner to enforce the provisions of this subchapter; (D) (i) Establish and modify from time to time as appropriate, rates, rate schedules, rate adjustments, expense allowances, agent referral fees, claim reserve formulas, deductibles, copayments, coinsurance, and any other actuarial function appropriate to the operation of the pool. (ii) Rates and rate schedules may be adjusted for appropriate factors such as age, sex, and geographical variation in claim costs and shall take into consideration appropriate factors in accordance with established actuarial and underwriting practices; (E) Issue policies of insurance in accordance with the requirements of this subchapter. All policy forms shall be subject to the approval of the commissioner; (F) Authorize the plan administrator to prepare and distribute certificate of eligibility forms and enrollment instruction forms to agents and to the general public; (G) Provide and employ cost-containment measures and requirements, including without limitation preadmission screening, second surgical opinion, concurrent utilization review, and individual case management for the purposes of making the plan more cost effective; (H) Design, utilize, contract, or otherwise arrange the delivery of cost-effective healthcare services, including establishing or contracting directly or through the plan administrator with preferred provider organizations, health maintenance organizations, physician hospital organizations, or other limited network provider arrangements; (I) Borrow money to effect the purposes of the pool. Any notes or other evidence of indebtedness of the pool not in default shall be legal investments for insurers and may be carried as admitted assets; (J) Pledge, assign, and grant a security interest in any of the assessments authorized by this subchapter or other assets of the pool in order to secure any notes or other evidences of indebtedness of the pool; (K) Provide reinsurance of risks incurred by the pool; (L) Provide additional types of plans to provide optional coverages, including Medicare supplement health insurance and health savings accounts that comply with applicable federal law as in effect January 1, 2005; (M) Enter into reciprocal agreements with other comparable state plans in order to provide coverage for persons who move between states and are covered by such other states' plans; and (N) Establish lifetime maximum benefits under § 23-79-510(a)(2)(W) for any person covered by a plan. (2) In addition to the other powers granted by the Arkansas Insurance Code, the commissioner may impose, after notice and hearing in accordance with the provisions of the Arkansas Insurance Code, a monetary penalty upon any insurer or suspend or revoke the certificate of authority to transact insurance in the State of Arkansas of any insurer that fails to pay an assessment or otherwise file any report or furnish information required to be filed with the Board of Directors of the Arkansas Comprehensive Health Insurance Pool pursuant to the board's direction that the board believes is necessary in order for the board to perform its duties under this subchapter. (b) All outstanding contracts executed by the Board of Directors of the State Comprehensive Health Insurance Pool created by Acts 1995, No. 1339, shall be deemed continuing obligations of the board created by this subchapter. (c) As provided for in § 23-79-502 , any health insurance benefit not provided for in this subchapter shall be deemed to be in conflict with and therefore inapplicable to the provisions of this subchapter.

Legislative History

Acts 1997, No. 292, § 6; 1999, No. 1356, § 2; 2005, No. 2292, § 1; 2009, No. 726, § 40.