Title XIII, COMMERCE (Ch. 505 - 554I)

1. A nonprofit corporation is established to be known as the Iowa small employer health reinsurance program. 2. A reinsuring carrier is subject to this program. 3. a. The program shall operate subject to the supervision and control of a board. Subject to the provisions of paragra…

The board shall study and report at least every three years to the commissioner on the effectiveness of this subchapter . The report shall analyze the effectiveness of the subchapter in promoting rate stability, product availability, and coverage affordability. The report may con…

1. The commissioner may suspend all or any part of section 513B.4 as to the premium rates applicable to one or more small employers for one or more rating periods upon a filing by the small employer carrier and a finding by the commissioner that the suspension is reasonable in li…

The commissioner shall develop, by rule, a uniform application form for use by small employers applying for new health insurance coverage under group health plans offered by small employer carriers. Small employer carriers shall be required to use the uniform application form not…

As used in this subchapter , 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 a small employer carrier is in compliance with the p…

This subchapter applies to a health benefit plan providing coverage to the employees of a small employer in this state if any of the following apply: 1. Any portion of the premium or benefits is paid by or on behalf of the small employer. 2. An eligible employee or dependent is r…

1. Premium rates for health benefit plans subject to this subchapter are subject to the following requirements: a. The index rate for a rating period for any class of business shall not exceed the index rate for any other class of business by more than twenty percent. b. For a cl…

A Taft-Hartley trust or a carrier with the written authorization of such a trust may make a written request to the commissioner for an exemption from the application of any provisions of section 513B.4 with respect to health insurance coverage provided to such a trust. The commis…

1. In order to encourage voluntary participation in wellness or disease management programs, a small employer carrier may offer premium credits or discounts to a small employer for the benefit of eligible employees of that small employer who participate in such a program. An empl…

1. Health insurance coverage subject to this chapter is renewable with respect to all eligible employees or their dependents, at the option of the small employer, except for one or more of the following reasons: a. The health insurance coverage sponsor fails to pay, or to make ti…

A small employer carrier shall make reasonable disclosure in solicitation and sales materials provided to small employers of all of the following: 1. The extent to which premium rates for a specific small employer are established or adjusted due to the claim experience, health st…

1. A small employer carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation which demonstrate that its rating methods and practices are based …

1. A carrier offering group health insurance coverage shall not establish rules for eligibility, including continued eligibility, of an individual to enroll under the terms of the coverage based on any of the following health status-related factors in relation to the individual o…