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Medicaid to children born after September 30, 1982, and prior to October 1, 1983, whose familyincome was at or below 100 percent of FPL. In 2001, an amendment to the program wasapproved allowing Arkansas to establish a separate child health program, which essentiallycovered the children from 150 to 200 percent of FPL already served under the ARkids BMedicaid waiver expansion program. The application form, ID card, and benefit packageremained the same for the ARkids B expansion program.Private Insurance RegulationArkansas has a.7.0 percent HMO penetration rate. Regarding small-group market reforms(applies to groups of 2-50), Arkansas does not apply community rating, limits pre-existingcondition exclusions (to 12 months exclusion and 6 months look-back time), and mandatesguaranteed issue and guaranteed renewability. Regarding individual insurance market reforms,Arkansas does not apply community rating, does not limit pre-existing condition exclusions, andmandates guaranteed issue and guaranteed renewability. Arkansas has a high risk pool fundedby premiums and assessments on insurers. High risk pool rates are capped at 200 percent ofthe rate that would be charged in the private insurance market for a healthy individual of thesame age. There is no annual limit, but a life-time maximum of $1 million. There is noenrollment cap, but a waiting period of six months. The state mandates that patients haveaccess to an external review board for filing complaints against their health plans, andmandates mental health parity of benefits. Arkansas has a state COBRA expansion program,up to 120 days, for small firms. 298Incentives for Small GroupsIn 2001, the Arkansas General Assembly passed several health reforms targeting access forindividuals. The reforms included scaled-down insurance policies (exemption from statemandatedcoverage benefits), small-employer purchasing groups, and a demonstration projectallowing communities to self-insure to provide coverage. 299Medicaid and SCHIP InitiativesIn Arkansas, 69.4 percent of Medicaid beneficiaries are enrolled in managed care, as comparedto 60.2 for the U.S. as a whole. Arkansas has a family planning waiver that extends familyplanning services to women up to 200 percent FPL. 300 Arkansas has used Section 1931 toexpand Medicaid coverage by increasing income disregards; the state may disregard a family’sfirst $120 in monthly earnings and one-third of the remaining monthly earnings beforecalculating if families’ incomes are below the eligibility level to qualify for Medicaid. 301Other current comprehensive state health reform 1915 and 1115 waivers:• ConnectCare: 1915(b) — managed care through a PCCM model for children’sMedicaid.• ARkids B: an 1115 Waiver originally approved in 1997, which expands Medicaidcoverage for kids through age 18 up to 200 percent FPL.• Tefra: an 1115 waiver which provides Medicaid coverage for disabled children (SSIdefinition) whose parental income is less than the long-term care income limit; child’sasset limit must be below $2000.• Family Planning Waiver: (since 1995) providing Medicaid coverage to women ages 14to 44 years, now up to 200 percent FPL.• Ticket to Work Medicaid Buy-In: for low-income (up to 250 percent FPL) disabled adultsintending to remain in the workforce. 302C-18