Bill > HB1295

This bill creates the Healthcare Cost-Sharing Collections Act, which establishes new regulations for healthcare insurers in Arkansas. The bill comprehensively defines key terms like "healthcare insurer," "health benefit plan," and "cost sharing," and mandates that healthcare insurers have sole responsibility for collecting cost-sharing amounts from enrollees. Insurers are prohibited from withholding cost-sharing amounts from healthcare provider payments, requiring providers to offer additional discounts, or denying/delaying payments due to cost-sharing collection issues. The bill requires healthcare insurers to file detailed annual financial reports with the Insurance Commissioner, including information about premiums, claims, and expenses. Insurers are also restricted from increasing cost sharing, premiums, or fees except under specific financial conditions, such as having a medical loss ratio of 90% or higher. The legislation provides enrollees with a private right of action to sue insurers for overcharges, potentially recovering double the overcharged amount plus legal costs. Violations of the act are considered deceptive acts under existing trade practices law, and the State Insurance Department is tasked with enforcement. The bill aims to increase transparency, protect enrollees, and regulate healthcare insurance practices in Arkansas.

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https://arkleg.state.ar.us/Bills/Detail?id=hb1295&ddBienniumSession=2025%2F2025R