Act 1179 of 2009 - Mandatory Offering for Coverage of Hearing Aids

Arkansas Insurance Department Mike Beebe Jay Bradford Governor Commissioner BULLETIN NO. 7A - 2009 TO: ALL LICENSED INSURERS, HEALTH MAINTENANCE ORGANIZATIONS (HMOs), FRATERNAL BENEFIT SOCIETIES, FARMERS’ MUTUAL AID ASSOCIATIONS OR COMPANIES, HOSPITAL MEDICAL SERVICE CORPORATIONS, NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS, PRODUCER AND COMPANY TRADE ASSOCIATIONS, AND OTHER INTERESTED PARTIES. FROM: ARKANSAS INSURANCE DEPARTMENT SUBJECT: ACT 1179 OF 2009- MANDATORY OFFERING FOR COVERAGE OF HEARING AIDS EFFECTIVE DATE: JANUARY 1, 2010 DATE: November 18, 2009 Bulletin 7A-2009 replaces Bulletin 7-2009 in its entirety. The Department is issuing this Bulletin to advise all insurance companies and other interested parties of the requirements set forth in Act 1179 of 2009. This Act requires all individual and group policies and certificates offered, issued or renewed in Arkansas on or after January 1, 2010, to offer coverage for hearing aids. The minimum amount of coverage that must be offered cannot be less than one thousand, four hundred dollars ($1,400) per ear for each three-year period. The benefit for hearing aids cannot be subject to any deductibles or copayment requirements. However, the benefit may be subject to co-insurance provisions. The hearing aid must be dispensed by an individual properly licensed by the State of Arkansas. This Act will apply to all insurance companies offering, issuing or renewing individual or group policies or certificates in Arkansas. This Act does not apply to hospital medical service corporations or health maintenance organizations. In addition, this Act is not applicable to Medicare supplement policies and certificates, individual limited benefit policies, qualified high deductible health plans, and long-term care policies and certificates. In regards to individual major medical policies, the mandatory offering will only apply to policies offered and sold after January 1, 2010. 1200 West Third Street, Little Rock, AR 72201-1904 · (501) 371-2600 · (501) 371-2618 fax · www.insurance.arkansas.gov Information (800) 282-9134 · Consumer Services (800) 852-5494 · Seniors (800) 224-6330 · Criminal Inv. (866) 660-0888 Though the Act specifically requires offering coverage for hearing aids only, the Commissioner understands the need for additional services and accessories related to the purchase and use of a hearing aid. Insurers at their option may include as a covered benefit these additional services and accessories. Any benefits paid for these services and accessories may be included in the maximum amount payable under the hearing aid benefit. Insurers are directed to furnish a copy of this Bulletin to their appointed producers in Arkansas. Questions concerning this Bulletin should be directed to the Arkansas Insurance Department Legal Division at 501-371-2820 or by e-mail to insurance.legal@arkansas.gov. it-1 V-(9 f = ADFO *, COMMISS ON' R DATE SAS INSURANCE D PARTMENT * ALL UNDERLINED LANGUAGE REPRESENTS THE CHANGES MADE TO THE ORIGINAL BULLETIN. Stricken language would be deleted from and underlined language would be added to the law as it existed prior to this session of the General Assembly. Act 1179 of the Regular Session State of Arkansas As Engrossed: H3/25/09 H3/30/09 A Bill Regular Session, 2009 HOUSE BILL 1930 By: Representative Adcock For An Act To Be Entitled AN ACT TO REQUIRE A HEALTH BENEFIT PLAN TO OFFER COVERAGE FOR HEARING AIDS IN AN AMOUNT OF NOT LESS THAN ONE THOUSAND FOUR HUNDRED DOLLARS ($1,400) PER EAR EVERY THREE (3) YEARS; AND FOR OTHER PURPOSES. Subtitle TO REQUIRE A HEALTH BENEFIT PLAN TO OFFER COVERAGE FOR HEARING AIDS IN AN AMOUNT OF NOT LESS THAN ONE THOUSAND FOUR HUNDRED DOLLARS ($1,400) PER EAR EVERY THREE (3) YEARS. BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: SECTION 1. Arkansas Code Title 23, Chapter 79 is amended to add an additional subchapter to read as follows: 23-79-1301. Definitions. As used in this subchapter: (1)(A) "Health benefit plan" means an individual, blanket, or group plan, policy, or contract for health care services issued or delivered by a health care insurer in this state. (B) "Health benefit plan" includes: (i) Indemnity and managed care plans; and (ii) Governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2009. 87th General Assembly As Engrossed: H3/25/09 H3/30/09 HB1930 1 (C) “Health benefit plan” does not include: 2 (i) Accidental injury insurance plans; 3 (ii) Dental insurance plans; 4 (iii) Vision insurance plans; 5 (iv) Specified disease insurance plans; 6 (v) Disability income plans; 7 (vi) Credit insurance plans; 8 (vii) Insurance coverage issued as a supplement to 9 liability insurance; 10 (viii) Medical payments under automobile or 11 homeowners' insurance plans; 12 (ix) Health benefit plans provided under Arkansas 13 Constitution, Article 5, Section 32, the Workers' Compensation Law, § 11-9- 14 101 et seq., and the Public Employee Workers' Compensation Act, § 21-5-601 et 15 seq.; 16 (x) Insurance under which benefits are payable with 17 or without regard to fault and the benefits that are statutorily required to 18 be contained in any liability policy or equivalent self-insurance; and 19 (xi) Plans that provide only indemnity for hospital 20 confinement; and 21 (2) “Hearing aid” means an instrument or device, including 22 repair and replacement parts, that: 23 (A) Is designed and offered for the purpose of aiding 24 persons with or compensating for impaired hearing; 25 (B) Is worn in or on the body; and 26 (C) Is generally not useful to a person in the absence of a 27 hearing impairment. 28 29 23-79-1302. Coverage for hearing aids required. 30 (a) A health benefit plan that is offered, issued, or renewed in this 31 state shall offer coverage for a hearing aid or hearing instrument sold on or 32 after January 1, 2010, by a professional licensed by the state to dispense a 33 hearing aid or hearing instrument. 34 (b) The coverage offered for hearing aids under this section: 35 (1) Shall not be for less than one thousand four hundred dollars 36 ($1,400) per ear for each three-year period; As Engrossed: H3/25/09 H3/30/09 HB1930 1 (2) Shall provide coverage of not less than one thousand four 2 hundred dollars ($1,400) per ear beginning on the first day of coverage; and 3 (3) Is not subject to policy deductibles or copayment 4 requirements. 5 6 23-79-1303. Rules. 7 The State Insurance Department shall develop and promulgate rules for 8 the implementation and administration of this subchapter. 9 10 /s/ Adcock 11 12 APPROVED: 4/7/2009 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36