Iowa Administrative Code

amount, and pursuant to the procedure, set forth in Iowa Code sections 507B.6, 507B.7, and 507B.8.

27.8(1) A health care insurer shall not prohibit a participating provider from or penalize a participating provider for discussing treatment options with covered persons, irrespective of the health care insurer’s position on the treatment options, or from advocating on behalf of …

this state by providing a system of rate, policy form, and operating standards for the transaction of credit life and credit accident and health insurance. Compliance with any disclosure requirements in this chapter shall not be deemed to be in compliance with the requirements se…

28.10(1) Each insurer doing insurance business in this state shall annually file with the insurance commissioner and the NAIC Support and Services Office a report of credit life and credit accident and health business written on a calendar-year basis. The report shall utilize the…

28.11(1) As used in this rule: “Earned premiums” means gross written premiums minus refunds on terminations, with this result adjusted for the change in unearned premium reserve. “Experience” means “earned premiums” and “incurred claims” during the experience period. “Experience …

28.12(1) Each insurer transacting credit insurance in this state shall be responsible for conducting a thorough periodic review of creditors, with respect to their credit insurance business, to ensure compliance with the insurance laws of this state and the rules promulgated by t…

connection with the sale or placement of credit insurance, or as an inducement, shall constitute unfair methods of competition and shall be subject to the unfair trade practices Acts of this state. 28.13(1) The offer or grant by an insurer to a creditor of any special advantage o…

28.14(1) Disclosure. When a premium or identifiable charge is payable by a debtor for credit insurance coverage offered by a creditor, at the time insurance is applied for, disclosures shall be made to the principal debtor and copies given and retained, in accordance with state a…

situation is held invalid, the invalidity shall not affect any other provision or application of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared severable.

28.16(1) This chapter shall take effect January 1, 1991. 28.16(2) Any deviations thought to be appropriate by an insurer as a result of promulgation of this chapter shall be filed in accordance with the provisions of rule 28.11(509) no later than January 1, 1991. 28.16(3) Certifi…

insurance, or individual policy may be returned to the creditor within 15 days of receipt of the policy or certificate for a full refund of premium paid, if after examination, the debtor(s) is not satisfied with the insurance for any reason. Notice of the 15-day free examination …

“Consumer credit transaction” shall mean the same as defined in Iowa Code section 537.1301. “Credit accident and health insurance” means insurance on a debtor or debtors to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor…

28.3(1) Multiple plans of insurance. If a creditor has available to the debtors more than one plan of credit life insurance or more than one plan of credit accident and health insurance, the debtors must be informed of all plans applicable to the credit transaction. All relevant …

28.4(1) Permissible forms. Credit life insurance and credit accident and health insurance shall be issued only in the following forms: a. Individual policies of life insurance issued to debtors on the term plan; b. Individual policies of accident and health insurance issued to de…

28.5(1) General standard. Under the credit insurance law, benefits provided by credit insurance policies must be reasonable in relation to the premium charged. This requirement is satisfied if the premium rate charged develops or may be reasonably expected to develop a loss ratio…

191—28.7(509) Credit life insurance rates. 28.7(1) Premium rate. Credit life insurance premium rates for the insured portion of an indebtedness repayable in equal monthly installments, where the insured portion of the indebtedness decreases uniformly by the amount of the monthly …

presumed to satisfy this general standard. 28.5(2) Nonstandard coverage. If any insurer files for approval of any form providing coverage more restrictive than that described in rules 191—28.7(509) and 191—28.8(509), the insurer shall demonstrate to the satisfaction of the insura…

considered that the debtor is charged a specific amount for insurance if an identifiable charge for insurance is disclosed in the credit or other instrument furnished the debtor which sets out the financial elements of the credit transactions, or if there is a differential in fin…

28.9(1) Refund formulas must be filed with and approved by the insurance commissioner prior to use. 28.9(2) In the event of termination, no charge for credit insurance may be made for the first 15 days of a loan month and a full month may be charged for 16 days or more of a loan …

“COBRA” means the federal Consolidated Omnibus Budget Reconciliation Act, 29 U.S.C. §1161, that may allow an employee or member to temporarily keep health coverage. “Continuation right” refers to the right under Iowa Code chapter 509B of an employee or member or the employee’s or…

29.2(1) An employer or group policyholder must provide written notice of the continuation right arising by virtue of termination of employment or membership, other than the notice required by Iowa Code section 509B.3(7), no later than ten days after termination. 29.2(2) The emplo…

29.3(1) A dependent child ceasing to be a dependent of its parent or legal guardian is not an event qualifying for a continuation right. 29.3(2) Loss of continuation rights under COBRA, chapter 509B, or any other state group health insurance continuation law, is not an event qual…

29.4(1) In the event an employee is eligible for a continuation right under Iowa Code chapter 509B and is also eligible for continuation of benefits from the employer under COBRA, an employer shall be deemed to comply with the requirements of chapter 509B if the employer offers t…

29.5(1) An insurer renewing an existing policy on or after July 1, 1987, shall provide a continuation right in its policy no later than the renewal date of the policy. 29.5(2) Policies issued or delivered on or after July 1, 1987, shall contain the continuation right as of the da…

the insurance division. [ARC 7731C, IAB 3/20/24, effective 4/24/24]

3.10(1) The presiding officer may consolidate contested case proceedings where (a) the matters at issue involve common parties or common questions of fact or law, (b) consolidation would expedite and simplify consideration of the issues involved, and (c) consolidation would not a…

3.12(1) Required service. Every pleading, motion, document, or other paper that is filed in a contested case proceeding and every discovery request or response in such a proceeding shall be served upon each of the parties of record to the proceeding, including the person designat…

3.13(1) Discovery permitted. Where statutory time limitations permit, discovery may be conducted as permitted by the Iowa Rules of Civil Procedure and these rules. Discovery shall be conducted in an expedited manner to prevent unnecessary delays to the hearing. 3.13(2) Scope of d…

3.14(1) A subpoena shall be issued by the presiding officer at a party’s request. a. A request for a subpoena must be in writing and submitted to the presiding officer or designated filing clerk by mail, email, or in-person delivery in accordance with the filing requirements of r…

3.15(1) No technical form for motions is required. However, prehearing motions must be in writing and must state the grounds for relief and relief sought. 3.15(2) Any party may file a written response to a motion within ten days after the motion is served, unless the time period …

3.16(1) A prehearing conference shall be scheduled not less than seven business days prior to the hearing date. The presiding officer shall give written notice of the prehearing conference to all parties. 3.16(2) Prehearing conferences may be conducted by telephone conference or …

the presiding officer. 3.17(1) An application for a continuance shall: a. Be made at the earliest possible time and no less than 14 days before the hearing except in case of unanticipated emergencies or consent of all parties, and b. State the specific reasons for the request. 3.…

prior to the hearing. [ARC 7731C, IAB 3/20/24, effective 4/24/24]

3.19(1) A motion for leave to intervene in a contested case proceeding shall state the grounds for the proposed intervention, including any statutory grounds, and the position and interest of the proposed intervenor. A proposed answer or petition in intervention shall be attached…

otherwise specifically defined by law or the context otherwise requires, the following definitions apply: “Contested case” means a proceeding defined by Iowa Code section 17A.2(5) and includes any matter defined as a no factual dispute contested case under Iowa Code section 17A.1…

3.20(1) The presiding officer presides at the hearing and may rule on motions, require briefs, issue a proposed decision, and issue such orders and rulings as will ensure orderly conduct of the proceedings. 3.20(2) The presiding officer shall conduct the hearing in the following …

3.21(1) The presiding officer shall rule on admissibility of evidence and may, where appropriate, take official notice of facts in accordance with applicable requirements of law. 3.21(2) Stipulation of facts is encouraged. The presiding officer may make a decision based on stipul…

3.22(1) If a party fails to appear or participate in a contested case proceeding after proper service of notice as provided in subrule 3.5(1), the presiding officer may, if no adjournment is granted, enter a default decision or proceed with the hearing and render a decision in th…

3.23(1) Unless required for the disposition of ex parte matters specifically, through communication either written, oral, or other forms authorized by statute, following issuance of the notice of hearing, there shall be no communication, directly or indirectly, between the presid…

provide a copy of the whole or any portion of the record at a reasonable cost. The cost of preparing a copy of the record or of transcribing the hearing record shall be paid by the requesting party. Parties who request that a hearing be recorded by certified shorthand reporters r…

[ARC 7731C, IAB 3/20/24, effective 4/24/24]

3.26(1) When the commissioner presides over the reception of evidence at the hearing, the commissioner’s decision is a final decision. 3.26(2) When the commissioner does not preside over the reception of evidence, the presiding officer shall make a proposed decision. The proposed…

proposed decision. 3.26(3) The presiding officer’s decision shall specify in bold print either that the decision is final or that the decision shall become final without further proceedings after the time provided in rule 191—3.27(17A). 3.26(4) Any administrative law judge servin…

3.28(1) Any party to a contested case proceeding may file an application for rehearing from a final order. 3.28(2) The application for rehearing shall state on whose behalf it is filed, the specific grounds for rehearing, and the relief sought. In addition, the application shall …

3.29(1) Petition requirements for stay of division action. a. Any party to a contested case proceeding may petition the commissioner for a stay of an order issued in that proceeding or for other temporary remedies, pending review by the division. The petition shall be filed with …

3.3(1) Time shall be computed as provided in Iowa Code section 4.1(34). 3.3(2) For good cause, the presiding officer may extend or shorten the time to take any action, except as precluded by statute. Except for good cause stated in the record, before extending or shortening the t…

exists as to a matter that would be a contested case if such a dispute of fact existed, the parties may present all relevant admissible evidence either by stipulation or otherwise as agreed by the parties, without necessity for the production of evidence at an evidentiary hearing…

3.31(1) To the extent necessary to prevent or avoid immediate danger to the public health, safety, or welfare, and consistent with the Constitution and other provisions of law, the division may issue a written order in compliance with Iowa Code section 17A.18A to suspend a licens…

taken without a prior hearing, the commissioner’s order shall be sent to the last-known address of the party by certified mail, return receipt requested, unless the party is a licensee, in which case the order shall be sent by restricted certified mail. The order shall include a …