23 CAR § 118-104 – Failure to provide required written notice of state-mandated health benefits

(a) Every health insurance purchasing group or health carrier contracted to provide the written notice under 23 CAR § 118-103 that fails, as a pattern or practice, to provide the written notice as required under 23 CAR § 118-103 shall be deemed to have committed a violation of the Trade Practices Act, Arkansas Code § 23-66-201 et seq., pursuant to Arkansas Code § 23-66-206(8).
(b) It shall be presumed that a health insurance group or health insurance purchasing group health carrier is not engaged in a trade practice violation under this section if the health insurance purchasing group or health insurance purchasing group health carrier:
1. (1) Has a reasonable procedure in place; and
2. (2) Regularly provides the written notices as required under 23 CAR § 118-103.
(c) Upon the failure to provide the written notice as required in 23 CAR § 118-103, the proposed eligible employee is deemed to have selected a health benefits plan subject to each applicable state-mandated health benefit or service that was not listed in the required written notice.
(d) The responsibility for payment for any health benefits or services that were required to be listed in the notice but were not so listed in the notice, and are therefore required to be covered under this section, shall be the responsibility of the small employer health purchasing group rather than the health insurance purchasing group health carrier.