HSB 581 (LSB 5801YC (4) 88)

HOUSE FILE _____ 

BY  (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON LUNDGREN)

A BILL FOR

An Act relating to reenrollment following a member’s termination from the Iowa health and wellness plan or the dental wellness plan.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 249N.7, Code 2020, is amended to read as follows:
   249N.7  Member financial participation —— reenrollment administrative fee for Iowa health and wellness plan and dental wellness plan.
   1.  Membership in the Iowa health and wellness plan shall require payment of monthly contributions for members whose household income is at or above fifty percent of the federal poverty level. Members shall be subject to copayment amounts applicable only to nonemergency use of a hospital emergency department. Total member cost-sharing, annually, shall align with the cost-sharing limitations requirements for the American health benefits exchanges under the Affordable Care Act. Contributions and copayment amounts shall be established by rule of the department.
   2.  Contributions shall be waived for a member during the initial year of membership. If a member completes all required preventive care services and wellness activities as specified by rule of the department during the initial year of membership, contributions shall be waived during the subsequent year of membership and each year thereafter until such time as the member fails to complete required preventive care services and wellness activities specified during the prior annual membership period.
   3.  Membership in the Iowa health and wellness plan and the dental wellness plan shall require that a member who does not complete required healthy behaviors and is not otherwise exempt from payment of a monthly contribution, and whose eligibility is terminated due to nonpayment of monthly contributions, in addition to any other requirements for reenrollment, shall be subject to payment of an administrative fee as established by rule of the department upon the member’s application for reenrollment in either plan.
    Sec. 2.  IOWA HEALTH AND WELLNESS PLAN —— DENTAL WELLNESS PLAN —— TERMINATION —— REENROLLMENT FEE.  Subject to any necessary federal approval, the department of human services shall adopt rules pursuant to chapter 17A to require that an Iowa health and wellness plan member or a dental wellness plan member who does not complete required healthy behaviors and is not otherwise exempt from payment of a monthly contribution, and whose eligibility is terminated due to nonpayment of monthly contributions, in addition to any other requirements for reenrollment, shall be subject to payment of an administrative fee as established by rule of the department upon the member’s application for reenrollment in either plan.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill provides that membership in the Iowa health and wellness plan or the dental wellness plan shall require that an Iowa health and wellness plan member or a dental wellness plan member who does not complete required healthy behaviors and is not otherwise exempt from payment of a monthly contribution, and whose eligibility is terminated due to nonpayment of monthly contributions, in addition to any other requirements for reenrollment, shall be subject to payment of an administrative fee as established by rule of the department upon the member’s application for reenrollment in either plan. The bill directs the department of human services to adopt administrative rules in accordance with the bill, subject to federal approval.