AR| The Arkansas Insurance Department (AID) Bulletin No. 7-2025 outlines the certification requirements for Qualified Health Plans (QHPs), Stand-Alone Dental Plans (SADPs), and ACA-compliant off-Marketplace plans for Plan Year 2026. The bulletin provides detailed guidelines for state and federal compliance, timelines for submissions, and standards for essential health benefits, network adequacy, rate filings, and marketing practices. Issuers must adhere to Arkansas-specific regulations while ensuring alignment with federal ACA standards to participate in the Marketplace or offer off-Marketplace plans.
Key Points:
- Certification Requirements: QHPs and SADPs must meet state licensure, network adequacy, actuarial value standards, and essential health benefit guidelines. Issuers must submit applications through SERFF by specified deadlines.
- Network Adequacy & Service Areas: Issuers must ensure provider networks meet state and federal adequacy standards, including mental health and underserved population coverage. Service areas must align with Arkansas’s rating areas.
- Rate Filing & Marketing Compliance: Rates are subject to AID review for fairness and compliance, with strict public disclosure rules. Marketing materials must avoid discriminatory practices and meet state and federal laws.