Iowa Administrative Code

thereby setting forth those requirements deemed appropriate by the commissioner for the general provision of coverage for benefits for postdelivery care.

health insurance, individual or group hospital or health care service contracts issued pursuant to Iowa Code chapter 509, 509A, 514, or 514A, and individual or group health maintenance organization contracts issued and regulated under chapter 514B, which are delivered, amended, o…

providing maternity benefits, which are not limited to complications of pregnancy, or newborn care benefits, shall not terminate inpatient benefits or require discharge of a mother or the newborn from a hospital following delivery earlier than determined to be medically appropria…

85.1(1) The purpose of these rules is to set out the requirements, procedures and fees relating to the qualification, licensure, training, continuing education and regulation of navigators. 85.1(2) These rules are established based upon the authority provided in Iowa Code section…

85.10(1) Individual navigators shall complete a minimum of 32 credits of initial training in courses approved by the commissioner. Initial training must include a minimum of 2 credits of Iowa-specific training on Medicaid and healthy and well kids in Iowa program training, as wel…

85.11(1) Prior to each renewal term, individual navigators must complete a minimum of 36 continuing education credits for each continuing education term in courses approved by the commissioner on subjects relevant to navigators, including health insurance, tax credits, tax penalt…

85.12(1) The commissioner will enter into a contractual relationship with an outside testing service to provide the licensing examinations for individual navigators. 85.12(2) The outside testing service will administer all examinations for applicants. 85.12(3) The testing service…

85.13(1) Fees may be paid by check or credit card. 85.13(2) The fee for issuance or renewal of a navigator license is $20 for three years. 85.13(3) The fee for reinstatement of a navigator license is a total of the renewal fee plus $100. 85.13(4) The division may charge a reasona…

85.14(1) Prior to the issuance by the division of a license as a navigator and for the duration of the license, including any renewal thereof, a navigator shall secure and maintain evidence of financial responsibility in the form of a surety bond or other alternative financial re…

85.15(1) Navigators shall comply with all federal and state statutes, regulations, and rules affecting insurance and navigators. 85.15(2) Navigators shall comply with any inquiries or requests submitted by the commissioner. Navigators shall respond to requests by the commissioner…

circumstance is held invalid by a court of competent jurisdiction or by federal law, the invalidity does not affect other provisions or applications of the chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapte…

“ACA” means, collectively, the Patient Protection and Affordable Care Act (Pub. L. 111-148) and Health Care and Education Reconciliation Act (Pub. L. 111-152). “Applicant” means an individual or entity applying or intending to apply for a navigator license. “Business entity” mean…

person has been issued an Iowa navigator license. 85.3(1) To be licensed as a navigator, a person must satisfy the following requirements: a. Be at least 18 years of age; b. Demonstrate compliance with the initial training and certification requirements set forth in rule 191—85.1…

85.4(1) A person that meets the requirements of this chapter and of Iowa Code sections 522D.4 and 522D.5, unless otherwise denied licensure pursuant to Iowa Code section 522D.7, shall be issued a navigator license. A navigator license shall be valid for three years. A navigator l…

the expiration date of the license. Failure to apply to renew a license and pay appropriate fees prior to the expiration date of the license will result in expiration of the license. [ARC 0981C, IAB 8/21/13, effective 9/25/13]

85.6(1) A navigator may reinstate an expired license up to 12 months after the license expiration date by proving that during the continuing education term the navigator met the continuing education requirements of this chapter and by paying a reinstatement fee and license renewa…

forfeiture in connection with disciplinary matters; and forfeiture in lieu of compliance. 85.7(1) The term “reinstatement” as used in this rule means the reinstatement of a suspended license. The term “reissuance” as used in this rule means the issuance of a new license following…

85.8(1) If a navigator changes the navigator’s legal name, the navigator must file written notification with the division within 30 days of the name change. The notification must include the navigator’s previous name and new name. 85.8(2) If a navigator changes the navigator’s ad…

85.9(1) A business entity that has been appointed as a navigator shall obtain a navigator license. 85.9(2) Navigator entities shall be exempt from the requirements of training, examination, and continuing education. All individual navigators that are hired, retained, recruited, e…

90.1(1) This chapter governs the treatment of nonpublic personal financial information and nonpublic personal health information about individuals by all licensees of the insurance division. 90.1(2) This chapter also applies to nonpublic personal financial information and nonpubl…

90.10(1) In the event a licensee receives nonpublic personal financial information from a nonaffiliated financial institution under an exception to rules 191—90.13(505) and 191—90.14(505), the licensee’s disclosure and use of that information is limited as follows: a. The license…

90.11(1) A licensee shall not directly or through an affiliate disclose, other than to a consumer reporting agency, a policy number or similar form of access number or access code for a consumer’s policy or transaction account to any nonaffiliated third party for use in telemarke…

with another financial institution, the licensee satisfies the disclosure requirement of paragraph 90.5(1)“e” if it does the following: a. Lists the categories of nonpublic personal financial information it discloses using the same categories and examples the licensee used to mee…

financial information for processing and servicing transactions. 90.13(1) The requirements for initial notice in paragraph 90.3(1)“b,” for the opt out in rules 191— 90.6(505) and 191—90.9(505), and for service providers and joint marketing in rule 191—90.12(505) do not apply if t…

personal financial information. 90.14(1) The requirements for initial notice to consumers in paragraph 90.3(1)“b,” for the opt out in rules 191—90.6(505) and 191—90.9(505), and for service providers and joint marketing in rule 191— 90.12(505) do not apply when a licensee disclose…

comply with the above requirements if the licensee uses text or visual cues to encourage scrolling down the page if necessary to view the entire notice and ensure that other elements on the website such as text, graphics, hyperlinks or sound do not distract attention from the not…

90.16(1) A licensee is not subject to the notice and opt-out requirements for nonpublic personal financial information if: a. The licensee is an employee, agent or other representative of another licensee; and b. The other licensee otherwise complies with, and provides the notice…

90.17(1) A licensee shall not disclose nonpublic personal health information about a consumer or customer unless an authorization is obtained from the consumer or customer whose nonpublic personal health information is sought to be disclosed. 90.17(2) Nothing in this rule shall p…

90.18(1) A valid authorization to disclose nonpublic personal health information pursuant to the health information rules as required under subrule 90.17(1) shall be in written or electronic form and shall contain all of the following: a. The identity of the consumer or customer …

form may be delivered to a consumer or a customer as part of an opt-out notice pursuant to rule 191— 90.8(505), provided that the request and the authorization form are clear and conspicuous. An authorization form is not required to be delivered to the consumer or customer or inc…

“Affiliate” means any company that controls, is controlled by or is under common control with another company. “Clear and conspicuous” means that a notice is reasonably understandable and designed to call attention to the nature and significance of the information in the notice. …

Health Insurance Portability and Accountability Act privacy rules promulgated by the U.S. Department of Health and Human Services, if a licensee complies with all requirements of the federal rules except for their effective date provision, the licensee shall not be subject to the…

supersede existing state law related to medical records, health or insurance information privacy. [ARC 7741C, IAB 3/20/24, effective 4/24/24]

modify, limit or supersede the operations of the federal Fair Credit Reporting Act, and no inference shall be drawn on the basis of the provisions of these rules regarding whether information is transaction or experience information under Section 603 of that Act. [ARC 7741C, IAB …

customer because that consumer or customer has opted out from the disclosure of the consumer’s or customer’s nonpublic personal financial information pursuant to the provisions of this chapter. [ARC 7741C, IAB 3/20/24, effective 4/24/24]

person or circumstance is held invalid by a court, the remainder of the rules or the applicability of the provision to other persons or circumstances shall not be affected. [ARC 7741C, IAB 3/20/24, effective 4/24/24]

shall be found to have committed a violation of Iowa Code section 507B.4 in addition to any other penalties provided by the laws of this state. [ARC 7741C, IAB 3/20/24, effective 4/24/24]

90.26(1) These rules became effective November 13, 2000. However, in order to provide sufficient time for licensees to establish policies and systems to comply with the requirements of these rules, the commissioner extends the time for compliance until July 1, 2001. 90.26(2) A li…

DIVISION III SAFEGUARDING CUSTOMER INFORMATION

90.3(1) A licensee shall provide a clear and conspicuous notice that accurately reflects its privacy policies and practices to the following persons and at the following times: a. An individual who becomes the licensee’s customer, not later than when the licensee establishes a cu…

90.37(1) Each licensee shall implement a comprehensive written information security program that includes administrative, technical and physical safeguards for the protection of customer information. The administrative, technical and physical safeguards included in the informatio…

procedures that follow are examples of methods a licensee may use to implement the requirements of rule 191—90.37(505) to assess, manage and control risks of disclosure: 1. Identify reasonably foreseeable internal or external threats that could result in unauthorized disclosure, …

be subject to the penalties imposed under Iowa Code chapter 507B in addition to any other penalties provided by the laws of this state. [ARC 7741C, IAB 3/20/24, effective 4/24/24]

90.4(1) A licensee shall provide a clear and conspicuous notice to customers that accurately reflects its privacy policies and practices not less than annually during the continuation of the customer relationship. “Annually” means at least once in any period of 12 consecutive mon…

program, including appropriate policies and systems, by June 30, 2003. [ARC 7741C, IAB 3/20/24, effective 4/24/24] These rules are intended to implement Iowa Code section 505.8(6) and P.L. 106-102. APPENDIX A SAMPLE CLAUSES Licensees, including a group of financial holding compan…

90.5(1) The initial annual and revised privacy notices that a licensee provides under rules 191— 90.3(505), 191—90.4(505) and 191—90.7(505) shall include each of the following items of information in addition to any other information the licensee wants to provide and that apply t…

90.6(1) A licensee required to provide an opt-out notice under subrule 90.9(1) shall provide a clear and conspicuous notice to each of its consumers that accurately explains the right to opt out under that rule. The notice shall state the following: a. The licensee discloses or r…