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Little Rock Arkansas Form 1095 B: What You Should Know

Please call the Health Management Services (HMS) at if you have questions about or need additional information that was not included in the form. It may be a great first step to find your provider. 1095B and 1095A: Application Form Applies to all health insurance plans offered in Arkansas, including exchange coverage. Applies to health plans offered in the state of Arkansas under the Medicaid program, the Arkansas Family Planning Program and the Exchange. If an Arkansas Blue Cross or Blue Shield plan is not offered through this exchange, the form doesn't apply. Arkansas Health Connector — 1095 forms not used Arkansas Health Connector is an information and marketing portal for consumers to manage their health insurance benefits and enroll in plans with the state exchange. Statewide Coverage for Exchange-Mileage Plan Customers Health plans offered in the exchange will have the option to offer statewide coverage for their members. Statewide coverage is also available for the Health Choice Exchange customers. Statewide coverage of Exchange members will include coverage for certain essential health benefits without cost-sharing. This includes the following essential health benefits: (i) emergency services needed within a 30-day period, (ii) hospitalization for more than 30 days, (iii) maternity services and newborn care, (iv) mental health and substance abuse services, infertility and childbearing services, and treatments for vision and hearing loss, cancer treatment, and other medical conditions. Statewide health plan coverage may also include coverage for other items and services based on a person's unique health needs. Statewide Coverage for Individual Subscribers Health plans are required to offer Statewide coverage to individual subscribers. Some plans also may offer the option for “short term” coverage, where the subscriber may buy a plan for 90 days or less from the date of purchase. For details, please call 1095. A: Arkansas Health Exchange Individual and Family Coverage This form is only used for individuals and families who do not purchase coverage through the exchange or from a carrier. If you have more than one health plan in the exchange, you should file both forms for different family sizes. If you use your 1095A to compare and apply for coverage, you must complete additional information in the 1095A with the information for each health plan.

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