State Mandated Benefits

AID * * ARKANSAS INSURANCE DEPARTMENT Hugh McDonald SECRETARY OF COMMERCE Jimmy Harris COMMISSIONER ARKANSAS INSURANCE DEPARTMENT Bulletin No. 7-2026 To: All Licensed Healthcare Insurers Covering Primary Care Benefits From: Arkansas Insurance Department Date: May 12, 2026 Subject: State Mandated Benefits The Commissioner directs health carriers planning to participate in the Arkansas Health Insurance Marketplace ("Exchange") to file plans that include only essential health benefits ("EHB"), as defined by Section 1302(b) of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat 119 (2010), and benefits required by state action on or before December 31, 2011. These EHB-only plans must include the notice required by Ark. Code Ann. § 23-79-803(c). Health carriers intending to offer plans that include all state-mandated benefits shall file such plans for sale exclusively in the off-Exchange market. The Centers for Medicare and Medicaid Services ("CMS") issued a proposed rule on February 11, 2026, the "Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program" (NBPP), 91 FR 6292. The proposed rule would require states to defray the cost of any benefit mandated by state action after December 31, 2011, even if that benefit is included in the state's benchmark plan. Arkansas last updated its benchmark plan in 2017. As a result, certain benefits currently reflected in the benchmark plan would be considered "in addition to EHB" and would require defrayal by the State of Arkansas. The Commissioner's instructions align with the "Arkansas. Health and Opportunity for Me Act of 2021," which requires "individual qualified health insurance plans" to provide only essential health benefits. Ark. Code Ann. § 23-61-1003(15). Furthermore Ark. Code Ann. § 23-79-803(b) allows issuers to offer an individual health benefit plan that does not include all state mandated benefits. immy Co Ar arr s er nsas Insurance Department