Definitions

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As used in this subchapter:

  1. (1) “Health benefits plan” means any individual, blanket, or group plan, policy, or contract for healthcare services, issued or delivered by a healthcare insurer, health maintenance organization, or hospital and medical service corporation, excluding plans, policies, or contracts providing healthcare benefits or healthcare services pursuant to Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., the Public Employee Workers' Compensation Act, § 21-5-601 et seq., and the no-fault medical and hospital benefit requirements under § 23-89-202; and

  2. (2)

    1. (A)

      1. (i) “State-mandated health benefits” means coverages for healthcare services or benefits required by state law or state rules, requiring the reimbursement or utilization related to a specific health illness, injury, or condition of the covered person or inclusion of a specific category of licensed healthcare practitioner to be provided to the covered person in a health benefits plan for a health-related condition of a covered person.

      2. (ii) However, for the purposes of the options provided by this subchapter, state-mandated health benefits that may be excluded, in whole or in part, shall not include any healthcare services or benefits that were mandated by Acts 1971, No. 34.

    2. (B) “State-mandated health benefits” does not mean standard provisions or rights required to be present in a health benefit plan pursuant to state law or rules unrelated to a specific health illness, injury, or condition of the insured, including, but not limited to, those related to continuation of benefits in § 23-86-114, or entitlement to a conversion policy under § 23-86-115.


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