Iowa Administrative Code

All LSOs shall include in contracts and evidence of coverage forms a statement disclosing the existence of any prescription drug formularies. Upon request, all LSOs offering policies under this chapter that include a prescription drug formulary shall inform policyholders, and pro…

Except for groups which maintain a cafeteria plan pursuant to Section 125 of the Internal Revenue Code (28 U.S.C.A. § 125), an enrollee may, if evidence of coverage is not satisfactory for any reason, return evidence of coverage within ten days of receipt of same and receive full…

An LSO shall have a basic written organizational document setting forth its scheme of organization and establishing a governing body appropriate to its form of organization. The governing body shall be responsible for matters of policy and operation. The LSO shall develop bylaws …

Each LSO shall: 41.5(1) Advise the insurance division annually of the ratio of full-time providers and ancillary health personnel to enrollees to ensure an adequate network. Changes in the provider ratios shall be immediately reported together with action taken to correct any def…

No name other than that certified by the division may be used. The name of the LSO may not be changed without prior approval of the division.

Each LSO which desires to transfer ownership of more than 10 percent of the stock or ownership interest in the LSO shall not do so without first submitting a proposed plan to the division for review and approval or disapproval.

41.8(1) Each LSO shall provide in its bylaws for a system to resolve and record complaints. 41.8(2) The complaint system shall provide for the resolution of the following kinds of complaints and the recording of the information required to be reported to the commissioner. a. Comp…

41.9(1) Membership of an enrollee in an LSO may be terminated by the LSO for the following reasons and no other: a. Nonpayment of charges when due. b. Termination of the conditions, other than a change in the health of the enrollee, under which the enrollee became eligible to be …

The purpose of this rule is to permit life insurance policies to provide the same cash surrender values and paid-up nonforfeiture benefits to both men and women. No change in minimum valuation standards is implied by this rule.

For purposes of this chapter, the following definitions shall apply: “1980 CSO Table, with or without Ten-Year Select Mortality Factors” means that mortality table, consisting of separate rates of mortality for male and female lives, developed by the Society of Actuaries Committe…

For any policy of insurance on the life of either a male or female insured delivered or issued for delivery in this state after the operative date of Iowa Code section 508.37, an insurer may: 42.3(1) Substitute a mortality table which is a blend of the 1980 CSO Table (M) and the …

It shall not be a violation of Iowa Code section 507B.4(7) for an insurer to issue the same kind of policy of life insurance on both a sex-distinct and sex-neutral basis.

If any provision of this rule or its application to any person or circumstance is for any reason held to be invalid, the remainder of the rule and the application of such provision to other persons or circumstances shall not be affected. 191—42.6(508) 2001 CSO Mortality Table. Th…

2012 IAM Period Table Female, Age Nearest Birthday AGE 1000 · qx2012 AGE 1000 · qx2012 AGE 1000 · qx2012 AGE 1000 · qx2012 0 1.621 30 0.300 60 3.460 90 88.377 1 0.405 31 0.321 61 3.916 91 97.491 2 0.259 32 0.338 62 4.409 92 107.269 3 0.179 33 0.351 63 4.933 93 118.201 4 0.137 34 …

2012 IAM Period Table Male, Age Nearest Birthday AGE 1000 · qx2012 AGE 1000 · qx2012 AGE 1000 · qx2012 AGE 1000 · qx2012 0 1.605 30 0.741 60 5.096 90 109.993 1 0.401 31 0.751 61 5.614 91 123.119 2 0.275 32 0.754 62 6.169 92 137.168 3 0.229 33 0.756 63 6.759 93 152.171 4 0.174 34 …

Projection Scale G2 Female, Age Nearest Birthday AGE G2x AGE G2x AGE G2x AGE G2x 0 0.010 30 0.010 60 0.013 90 0.006 1 0.010 31 0.010 61 0.013 91 0.006 2 0.010 32 0.010 62 0.013 92 0.005 3 0.010 33 0.010 63 0.013 93 0.005 4 0.010 34 0.010 64 0.013 94 0.004 5 0.010 35 0.010 65 0.01…

Projection Scale G2 Male, Age Nearest Birthday AGE G2x AGE G2x AGE G2x AGE G2x 0 0.010 30 0.010 60 0.015 90 0.007 1 0.010 31 0.010 61 0.015 91 0.007 2 0.010 32 0.010 62 0.015 92 0.006 3 0.010 33 0.010 63 0.015 93 0.005 4 0.010 34 0.010 64 0.015 94 0.005 5 0.010 35 0.010 65 0.015 …

The purpose of this chapter is to recognize the following mortality tables for use in determining the minimum standard of valuation for annuity and pure endowment contracts: the 1983 Table “a” and 1983 Group Annuity Mortality (1983 GAM) Table, the Annuity 2000 Mortality Table, th…

For purposes of this chapter, the following definitions shall apply: “1983 GAM Table” means that mortality table developed by the Society of Actuaries Committee on Annuities and adopted as a recognized mortality table for annuities in December 1983 by the National Association of …

43.3(1) Except as provided in subrules 43.3(2) and 43.3(3), the 1983 Table “a” is recognized and approved as an individual annuity mortality table for valuation and, at the option of the company, may be used for purposes of determining the minimum standard of valuation for any in…

43.4(1) Except as provided in subrules 43.4(2) and 43.4(3), the 1983 GAM Table, the 1983 Table “a” and the 1994 GAR Table are recognized and approved as group annuity mortality tables for valuation and, at the option of the company, any one table may be used for purposes of valua…

In using the 1994 GAR Table, the mortality rate for a person aged x in year (1994 + n) is calculated as follows: qx 1994+n = qx1994 (1 - AAx ) n where the qx1994 and AAxs are as specified in the 1994 GAR Table.

In using the 2012 IAR Mortality Table, the mortality rate for a person age x in year (2012 + n) is calculated as follows: qx2012+n = qx2012 (1 - G2x)n The resulting qx2012+n shall be rounded to three decimal places per 1,000, e.g., 0.741 deaths per 1,000. Also, the rounding shall…

If any provision of this rule or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of the rule and the application of such provision to other persons or circumstances shall not be affected thereby. [ARC 1110C, IAB 10/16/13,…

The purpose of the rule is to permit the use of mortality tables that reflect differences in mortality between smokers and nonsmokers in determining minimum reserve liabilities and minimum cash surrender values and amounts of paid-up nonforfeiture benefits for plans of insurance …

“1980 CSO Table, with or without Ten-Year Select Mortality Factor” means that mortality table, consisting of separate rates of mortality for male and female lives, developed by the Society of Actuaries Committee to Recommend New Mortality Tables for Valuation of Standard Individu…

44.3(1) In determining minimum reserve liabilities and minimum cash surrender values and amounts of paid-up nonforfeiture benefits for any policy of insurance delivered or issued for delivery in this state after the operative date of Iowa Code section 508.37(7)“k” for that policy…

For each plan of insurance with separate rates for smokers and nonsmokers an insurer may: 1. Use composite mortality tables to determine minimum reserve liabilities and minimum cash surrender values and amounts of paid-up nonforfeiture benefits, 2. Use smoker and nonsmoker mortal…

If any provision of this chapter or the application of this chapter to any person or circumstance is for any reason held to be invalid, the remainder of this chapter and the application of the remaining provisions to other persons or circumstances shall not be affected. 191—44.6(…

The purpose of these rules is to set forth rules and procedural requirements which the commissioner deems necessary to carry out the provisions of Iowa Code chapter 521A. The information called for by these rules is hereby declared to be necessary and appropriate in the public in…

45.10(1) Requests for approval of extraordinary dividends or any other extraordinary distribution to shareholders shall include the following: a. The date established for payment of the dividend; b. The amount of the proposed dividend; c. A statement as to whether the dividend is…

The ultimate controlling person of an insurer required to file an enterprise risk report pursuant to Iowa Code section 521A.4(12) shall furnish the required information on Form F, hereby made a part of these rules. [ARC 1844C, IAB 2/4/15, effective 1/14/15]

In addition to the information expressly required to be included in Form A, Form B, Form C, Form D, and Form F, the commissioner may request such further material information, if any, as may be necessary to make the information contained therein not misleading. The person filing …

In addition to the definitions in Iowa Code section 521A.1 and 191—1.1(502,505), the following rules apply to this chapter, unless otherwise required by the context: “Executive officer” means any individual charged with active management and control in an executive capacity (incl…

The authority to invest in subsidiaries under Iowa Code section 521A.2(3) is in addition to any authority to invest in subsidiaries which may be contained in any other provision of the insurance code. An investment by a subsidiary under Iowa Code section 521A.2(3)“c” may cause th…

Any person required to file a statement pursuant to Iowa Code section 521A.3 entitled “Acquisition of control of or merger with domestic insurer,” shall furnish all the information requested on Form A hereto annexed and hereby made a part of these rules. 45.4(1) If the person bei…

45.5(1) Annual registration. Any insured required to file an annual registration statement pursuant to Iowa Code section 521A.4 shall furnish all the information required on Form B hereto annexed and hereby made a part of these rules. 45.5(2) Amendment to Form B. An amendment to …

Any authorized insurer may file a registration statement on behalf of any affiliated insurer or insurers which are required to register under section 521A.4. A registration statement may include information regarding any insurer in the insurance holding company system even if suc…

A foreign or alien insurer otherwise subject to Iowa Code section 521A.4, shall not be required to register pursuant to that section if it is admitted in the domiciliary state of the principal insurer (as that term is defined in 45.6(1)) and in said state if subject to disclosure…

A disclaimer of affiliation or a request for termination of registration claiming that a person does not, or will not upon the taking of some proposed action, control another person (hereinafter referred to as the “subject”) shall contain the following information: 45.8(1) The nu…

45.9(1) An insurer required to give notice of a proposed transaction pursuant to Iowa Code section 521A.5 shall furnish the required information on Form D, hereby made a part of these rules. 45.9(2) Agreements for cost-sharing services and management services shall, at a minimum …

This chapter is intended to implement the provisions of Iowa Code section 521A.14 to provide for: 46.1(1) The formation of a mutual insurance holding company through an application process subject to regulation by the division. A domestic mutual insurance company may reorganize b…

46.10(1) No stock offering by a mutual insurance holding company, an insurance company subsidiary of a mutual insurance holding company, an intermediate holding company subsidiary of a mutual insurance holding company, or an insurance company subsidiary of an intermediate holding…

46.11(1) A mutual insurance holding company, and its subsidiaries and affiliates, shall be subject to all provisions of Iowa Code chapter 521A, “Insurance Holding Company Systems.” In addition to the provisions of that chapter, all material transactions, as that term is defined i…

46.12(1) Any director or officer of a mutual insurance holding company, its subsidiary or affiliate, who acquires directly or indirectly the beneficial ownership of any security issued by any member of the mutual insurance holding company system shall, within 15 days following th…

In addition to the definitions in 191—1.1(502,505), the following definitions apply to this chapter: “Affiliated person” of another person means: 1. Any person directly or indirectly owning, controlling, or holding with power to vote, 5 percent or more of the outstanding voting s…

46.3(1) An application shall be designated as either: a. A limited application, or b. A standard application. The filing of a limited application shall not preclude the subsequent filing of an application for approval of an initial sale of stock as provided in rule 46.9(521A). 46…