A. Inpatient hospitalization coverage of fifteen (15) days per year. Inpatient hospitalization shall be defined in the policy no more strictly than those services rendered to an insured who is confined in a Hospital as a registered bed patient and which includes room and board in a semiprivate room, special care ward or, when medically necessary, a private room and all medically necessary examinations, laboratory procedures or tests, any other tests, procedures, or treatment deemed appropriate by the treating physician, as well as coverage for medicine, supplies and equipment charges incurred during the inpatient hospitalization;

B. Two (2) office or clinic visits per year for Primary and Preventative Care, including outpatient surgery or other treatment or therapy rendered on an outpatient basis. The insured may be required to pay a copayment as specified in Section 4(D) for such treatment.

C. An annual deductible for inpatient hospitalization and outpatient surgery of Five Hundred Dollars ($500.00) per year per covered person. The maximum annual deductible for family coverage is One Thousand Dollars ($1,000.00).

D. Insured copayment provision of no more than thirty percent (30Z) of the actual covered charge up to Five Thousand Dollars ($5,000). No copayment shall be required of an insured for covered charges exceeding Five Thousand Dollars ($5,000) up to the annual maximum benefit provided in the policy;

E. The annual maximum benefit provided shall be no less than $100,000 per policy or certificate of enrollment. The lifetime maximum benefit provided shall be no less than $250,000 per policy or certificate of enrollment;

F. Provisions for a maximum differential of no more than twentyfive (25Z) percent for services rendered by a nonpreferred provider for plans incorporating preferred provider arrangements as a part of a managed cost program. This subsection shall apply to all benefits offered pursuant to this Rule and Regulation;

G. A waiting period for coverage of preexisting conditions of no more than six (6) months from the effective date of coverage;

H. All group policies issued pursuant to this Rule and Regulation shall contain those provisions required by Arkansas Code Annotated §§ 23-86-108(7)(A), 23-86-114, 23-86-115, and 23-86-116, except that no minimum basic benefit policy shall be required to comply with § 23-86-108(7)(A) unless replacing another minimum basic benefit policy approved by the Commissioner pursuant to this Rule and Regulation and Act 238 of 1991; and

I. Every policy issued pursuant to this chapter which covers the insured and members of the insured's family shall include coverage for newborn infant children of the insured from the moment of birth, and for adopted minors from the date of the interlocutory decree of adoption; provided, the insurer may require that the insured give notice to his insurer of any newborn children within ninety (90) days following the birth of such newborn infant and of any adopted child within sixty (60) days of the date the insured has filed a petition to adopt. The coverage of newborn children or adopted children shall not be less than the same as is provided for other members of the insured's family.