Availability of short-term health insurance in Arkansas

Yes. As of 2023, there were at least nine insurers offering short-term health insurance in Arkansas.

The average monthly premium for a short-term health insurance plan sold in Arkansas was $271.77 in 2022, according to data from IHC Specialty Benefits.

Because Arkansas doesn’t impose its own limits on short-term healthcare plan duration, the Trump administration’s regulations apply in Arkansas. Insurers are allowed to provide short-term health insurance in Arkansas with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.

But the Biden administration has proposed a new rule in 2023 that would limit these policies to initial terms of no more than three months, and total duration, including renewals, of no more than four months.

Prior to October 2, 2018, federal rules limited short-term health plans to three months in duration, and prohibited renewal. But the Trump administration relaxed those rules, and some of the insurers that offer short-term plans in Arkansas are allowing policy durations of up to 36 months.

Insurers can offer short-term plans with maximum durations that are below the limits allowed under federal regulations. For example, Blue Cross Blue Shield of Arkansas offers basic short-term plans that have a maximum plan duration of 88 days (this used to be the only short-term healthcare product that BCBSAR offered, but they have also begun selling “Complete” and “Complete Plus” plans that have available durations of up to 36 months).

As of 2023, there are several insurance companies that offer short-term health insurance policies in Arkansas:

• Allstate Health Solutions (National General)
• Arkansas Blue Cross and Blue Shield
• Companion Life
• Everest Reinsurance
• Golden Rule (UnitedHealthcare)
• The North River Insurance Company
• Pan-American Life Insurance Company
• QualChoice (QuicChoice)
• United States Fire Insurance Company

The plans offered by these insurers differ greatly from one company to another. And the sort of basic standardization that’s required of ACA-compliant plans does not apply to short-term plans. So carefully consider the benefits that each plan offers, and don’t assume that all companies will offer the same set of healthcare benefits, or that a particular service will be covered by all short-term health plans simply because it’s covered by some of them.

This list includes two insurers — Arkansas Blue Cross and Blue Shield, and QualChoice — that also offer ACA-compliant coverage through the marketplace in Arkansas (ie, Obamacare plans). In many states, there’s no overlap between the insurers that offer short-term coverage and the ones that offer ACA-compliant coverage, but that’s not the case in Arkansas.

Short-term health insurance in Arkansas can be purchased by residents who can meet the underwriting guidelines of insurers. For the most part, this means being under 65 years old (some insurers say 64 years) and in generally good health. There is also often a requirement that a person be at least six months old in order to enroll in a short-term policy.

Short-term medical insurance plans are generally less costly, in terms of monthly premiums, than ACA-compliant plans, assuming the person doesn’t qualify for premium subsidies that would offset some or all of the monthly premiums for an ACA-compliant plan. But short-term plans customarily exclude coverage for pre-existing conditions, so these plans are not suitable for someone in the Natural State who needs medical care for ongoing or pre-existing conditions.

Short-term health plans are also not required to cover the ACA’s essential health benefits; the most commonly excluded benefits are maternity care, prescription drugs, and mental health care, although various other benefits are often excluded as well. You’ll want to carefully read the details of any policy you’re considering, to make sure you know what’s covered and what isn’t.

If you need health insurance coverage in Arkansas and it’s outside of the annual open enrollment period for ACA-compliant plans (November 1 to January 15), start by checking your eligibility for a special enrollment period that you can use to enroll in an ACA-compliant major medical plan. A variety of qualifying life events can trigger a special enrollment period and allow you to buy a plan through the health insurance exchange in Arkansas.

The plans available through the exchange are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months. So if you’ll soon have coverage under another plan — maybe Medicare or a new employer’s plan — you’ll be able to cancel your marketplace plan when the new coverage takes effect. And if you’re eligible for a premium subsidy through the exchange, you can receive that even if you only need the coverage for a short time.

(Note that the premium subsidy is a tax credit that gets reconciled on your federal tax return based on your household income for the whole year; if your income is going to end up above the subsidy-eligible range due to a new job later in the year, you wouldn’t be eligible for the premium subsidy for the months prior to starting the new job, and would have to repay it on your tax return. But through at least the end of 2025, the American Rescue Plan and Inflation Reduction Act have made subsidies available to people with incomes well above the limits that applied in previous years.)

Be it in Fayetteville or Pine Bluff, there are times when a short-term health insurance plan might be the only realistic option, such as:

• If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
• You’ll soon be enrolled in Medicare, it’s outside of the annual open enrollment period for ACA-compliant coverage, and you don’t have access to any other coverage in the meantime.
• You’re newly employed and have enrolled in your new employer’s health plan, but have a waiting period before it takes effect (this can be up to three months).
• If you’re not eligible for Medicaid or a premium subsidy in the exchange, an ACA-compliant plan might be unaffordable, and the less costly monthly premiums for short-term plans might be a more realistic option.

Folks not eligible for premium subsidies include:

• Those earning too much money to qualify for a subsidy. Prior to the American Rescue Plan, this cap was set at 400% of the poverty level, but the American Rescue Plan made subsidies available at higher incomes, and the Inflation Reduction Act extended that through 2025.
• People who were previously caught by the ACA’s family glitch, and still aren’t eligible for a subsidy even with the family glitch fix in place.
• People whose immigration status prevents them from enrolling in a plan through the marketplace (premium subsidies are only available through the marketplace, and enrollees must have a valid lawfully present status in the US in order to enroll through the marketplace).

Arkansas defaults to the federal regulations in terms of the allowable duration of short-term health insurance policies, so insurers can offer plans with initial terms of up to a year, and total duration, including renewals, of up to three years. But the state conducts rate review for short-term plans to ensure that the rates are actuarially justified, and also requires short-term plans to include coverage for some state-mandated benefits.

The Arkansas Insurance Department allows short-term insurers to submit their initial rate filings and implement them without review, but rate changes after that are required to go through the state’s rate review process (short-term rate filings in SERFF indicate that Bulletin 14-2016 and Arkansas statute 23-79-109 are applicable to short-term plan rate filings).

Arkansas also requires short-term plans to cover some state-mandated benefits, but these are not the same as the ACA’s essential health benefits. Some examples of state-mandated medical benefits applicable to short-term health insurance plans are preventive healthcare for children, medical foods, gastric pacemakers, and treatment for loss or impairment of speech or hearing.

Arkansas insurance statute also indicates that sections 23-85-105 through 23-85-117 are applicable to all plans sold in the state, but those regulations largely pertain to things like billing, grace periods, and the processing of claims, rather than coverage of medical conditions.

The Arkansas Insurance Department issued a consumer alert in 2016, warning people about “high-pressure telemarketers” who were selling short-term health insurance in Arkansas over the phone and erroneously stating that the plans were ACA-compliant (short-term insurance is, by definition, not regulated by the ACA).

In November 2018, after the allowable duration for short-term coverage had been extended, the Arkansas Insurance Department issued another warning to consumers, noting that short-term plans are not compliant with the ACA, do not cover some of the ACA’s essential health benefits, do not cover pre-existing conditions, use medical underwriting to determine eligibility for coverage, and are limited to initial terms of under 12 months.