Health Insurance in Arkansas

Health Insurance in Arkansas

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 (5expect 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 (5including 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 (5Section 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
https://1-urlm.co/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
https://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
(5800) 457-4454, (5501) 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.