The bill amends Arkansas Code 23-86-119 to enhance disclosure requirements for insurers regarding policyholder information. Specifically, it raises the threshold for policyholders eligible for detailed reporting from twenty-five to fifty insured employees under a comprehensive group health insurance policy. Insurers are now required to provide monthly reports that include a variety of data such as medical and pharmacy claims on a paid basis, premiums paid, and the total number of enrolled members, including dependents. Additionally, a high-cost claimant report must be provided for any enrolled member with claims exceeding ten thousand dollars, detailing their current coverage status and claims information.
The bill stipulates that these reports must be delivered to the policyholder within thirty days of their request and can be requested no more frequently than quarterly. It also clarifies that insurers are not obligated to disclose confidential information and defines "enrolled member" to include insured employees, subscribers, and certificate holders. Furthermore, the bill ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) by prohibiting the disclosure of any claims information that could reveal the identity of an enrolled member.