§ 23-96-107 — Coverage

Arkansas § 23-96-107

• Jurisdiction: Arkansas
• Title: 23

Text

(a) This chapter shall provide coverage for the policies and contracts specified in subsection (b) of this section to: (1) Persons who, regardless of where they reside, except for nonresident certificate holders under group policies or contracts, are the beneficiaries, assignees, or payees, including healthcare providers rendering services covered under health insurance policies or certificates of the persons covered under subdivision (a)(2) of this section; (2) Persons who are owners of or certificate holders or enrollees under such policies or contracts, other than unallocated annuity contracts and structured settlement annuities, and in each case who: (A) Are residents; or (B) Are not residents, but only under all of the following conditions: (i) The member insurer that issued the policies or contracts is domiciled in this state; (ii) The states in which the persons reside have associations similar to the Arkansas Life and Health Insurance Guaranty Association created by this chapter; and (iii) The persons are not eligible for coverage by an association in any other state because the insurer or the health maintenance organization was not licensed in the state at the time specified in the state's guaranty association law; (3) For unallocated annuity contracts specified in subsection (b) of this section, subdivisions (a)(1) and (2) of this section shall not apply, and except as provided in subdivisions (a)(5) and (6) of this section, this chapter shall provide coverage to: (A) Persons who are the owners of the unallocated annuity contracts if the unallocated annuity contracts are issued to or in connection with a specific benefit plan whose plan sponsor has its principal place of business in this state; and (B) Persons who are owners of unallocated annuity contracts issued to or in connection with government lotteries if the owners are residents; (4) For structured settlement annuities specified in subsection (b) of this section, subdivisions (a)(1) and (2) of this section shall not apply, and except as provided in subdivisions (a)(5) and (6) of this section, this chapter shall provide coverage to a person who is a payee under a structured settlement annuity, or beneficiary of a payee if the payee is deceased, if the payee: (A) Is a resident, regardless of where the contract owner resides; or (B) Is not a resident, but only under the following conditions: (i) The contract owner of the structured settlement annuity: (a) Is a resident; or (b) Is not a resident, but the insurer that issued the structured settlement annuity is domiciled in this state; (ii) The state in which the contract owner resides has an association similar to the Arkansas Life and Health Insurance Guaranty Association created by this chapter; and (iii) Neither the payee, or beneficiary, nor the contract owner is eligible for coverage by the association of the state in which the payee or contract owner resides; (5) This chapter shall not provide coverage for: (A) A person who is a payee, or beneficiary, of a contract owner resident of this state, if the payee, or beneficiary, is afforded any coverage by the association of another state; (B) A person covered in subdivision (a)(3) of this section if any coverage is provided by the association of another state to the person; or (C) A person who acquires rights to receive payments through a structured settlement factoring transaction as defined in 26 U.S.C. § 5891(c)(3)(A) , regardless of whether or not the structured settlement factoring transaction occurred before or after the section became effective; (6) (A) This chapter is intended to provide coverage to a person who is a resident of this state and, in special circumstances, to a nonresident. (B) In order to avoid duplicate coverage, if a person who would otherwise receive coverage under this chapter is provided coverage under the laws of any other state, the person shall not be provided coverage under this chapter. (C) In determining the application of the provision of this subdivision (a)(6) in situations in which a person could be covered by the association of more than one (1) state, whether as an owner, payee, enrollee, beneficiary, or assignee, this chapter shall be construed in conjunction with other state laws to result in coverage by only one (1) association. (b) (1) This chapter shall provide coverage to the persons specified in subsection (a) of this section for policies or contracts of direct, nongroup life insurance, health insurance that, for the purposes of this chapter, includes health maintenance organization subscriber contracts and certificates, or annuities for certificates under direct group policies and contracts, and for supplemental contracts to any of these, and for unallocated annuity contracts, in each case issued by member insurers, except as limited by this chapter. (2) Annuity contracts and certificates under group annuity contracts include without limitation: (A) Guaranteed investment contracts; (B) Deposit administration contracts; (C) Unallocated funding agreements; (D) Allocated funding agreements; (E) Structured settlement annuities; (F) Annuities issued to or in connection with government lotteries; and (G) Any immediate or deferred annuity contracts. (c) (1) A member insurer or agent shall not deliver a policy or contract described in subsection (b) of this section and excluded under § 23-96-106(a)(1) from coverage under this chapter unless the member insurer or agent, before or at the time of delivery, gives the policy holder or contract holder a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the Arkansas Life and Health Insurance Guaranty Association. (2) The Insurance Commissioner shall by rule specify the form and content of the notice.

Legislative History

Amended by Act 2019, No. 520,§ 2, eff. 7/24/2019. Amended by Act 2013, No. 456,§ 3, eff. 8/16/2013. Acts 1989, No. 444, §§ 3, 19; 1997, No. 950, § 1; 2001, No. 1603, §§ 53, 54.