Section 513C.1 – Short title.

513C.1 Short title. This chapter shall be known and may be cited as the “Individual Health Insurance Market Reform Act”. 95 Acts, ch 5, §3

Section 513C.10 – Iowa individual health benefit reinsurance association.

513C.10 Iowa individual health benefit reinsurance association. 1. The Iowa individual health benefit reinsurance association is established as a nonprofit corporation. a. All persons that provide health benefit plans in this state including insurers providing accident and sickness insurance under chapter 509, 514, or 514A, whether on an individual or group basis; fraternal benefit societies […]

Section 513C.11 – Self-funded employer-sponsored health benefit plan participation in reinsurance association.

513C.11 Self-funded employer-sponsored health benefit plan participation in reinsurance association. 1. A self-funded employer-sponsored health benefit plan qualified under the federal Employee Retirement Income Security Act of 1974 may voluntarily elect to participate in the Iowa individual health benefit reinsurance association established in section 513C.10 in accordance with the plan of operation and subject to […]

Section 513C.12 – Commissioner’s duties.

513C.12 Commissioner’s duties. The commissioner shall adopt rules administering this chapter. 97 Acts, ch 103, §41

Section 513C.2 – Purpose.

513C.2 Purpose. The purpose and intent of this chapter is to promote the availability of health insurance coverage to individuals regardless of their health status or claims experience, to prevent abusive rating practices, to require disclosure of rating practices to purchasers, to establish rules regarding the renewal of coverage, to establish limitations on the use […]

Section 513C.3 – Definitions.

513C.3 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Actuarial certification” means a written statement by a member of the American academy of actuaries or other individual acceptable to the commissioner that an individual carrier is in compliance with the provisions of section 513C.5 which is based upon the actuary’s or […]

Section 513C.4 – Applicability and scope.

513C.4 Applicability and scope. 1. Except as provided in subsection 2, for purposes of this chapter, carriers that are affiliated companies or that are eligible to file a consolidated tax return shall be treated as one carrier and any restrictions or limitations imposed by this chapter shall apply as if all individual health benefit plans […]

Section 513C.5 – Restrictions relating to premium rates.

513C.5 Restrictions relating to premium rates. 1. Premium rates for any block of individual health benefit plan business issued on or after January 1, 1996, or the date rules are adopted by the commissioner of insurance and become effective, whichever date is later, by a carrier subject to this chapter shall be limited to the […]

Section 513C.6 – Provisions on renewability of coverage.

513C.6 Provisions on renewability of coverage. 1. An individual health benefit plan subject to this chapter is renewable with respect to an eligible individual or dependents, at the option of the individual, except for one or more of the following reasons: a. The individual fails to pay, or to make timely payment of, premiums or […]

Section 513C.7 – Availability of coverage.

513C.7 Availability of coverage. 1. a. A carrier shall file with the commissioner, in a form and manner prescribed by the commissioner, the basic or standard health benefit plan. A basic or standard health benefit plan filed pursuant to this paragraph may be used by a carrier beginning thirty days after it is filed unless […]

Section 513C.8 – Health benefit plan standards.

513C.8 Health benefit plan standards. The board of directors of the Iowa comprehensive health insurance association, with the approval of the commissioner, shall adopt the form and level of coverage of the basic health benefit plan and the standard health benefit plan for the individual market which shall provide benefits substantially similar to the current […]

Section 513C.9 – Standards to assure fair marketing.

513C.9 Standards to assure fair marketing. 1. A carrier or an agent shall not do either of the following: a. Encourage or direct individuals to refrain from filing an application for coverage with the carrier because of the health status, claims experience, industry, occupation, or geographic location of the individuals. b. Encourage or direct individuals […]