Text: HF00500 Text: HF00502 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. Section 96.3, Code 1997, is amended by adding
1 2 the following new subsection:
1 3 NEW SUBSECTION. 11. HEALTH INSURANCE COVERAGE. An
1 4 individual who qualifies for benefits as provided in
1 5 subsection 2 is also eligible for coverage as provided under
1 6 section 96.3A.
1 7 Sec. 2. NEW SECTION. 96.3A HEALTH INSURANCE COVERAGE FOR
1 8 UNEMPLOYED INDIVIDUALS.
1 9 1. A person who is totally unemployed under section 96.3,
1 10 subsection 2, is eligible for health insurance coverage
1 11 providing the same coverage as provided in a basic health
1 12 benefit plan, as defined in section 513B.2. The coverage
1 13 shall be provided at no expense to the unemployed person other
1 14 than for any applicable deductible or coinsurance amount.
1 15 2. Coverage provided under this section is subject to
1 16 sections 514E.5 and 514E.6.
1 17 3. a. Except as otherwise provided in paragraph "d", a
1 18 person is not eligible for coverage if the person, at the
1 19 effective date of coverage, has or will have coverage under
1 20 any insurance plan that has coverage nearly equivalent to the
1 21 coverage provided in this section. Only residents of this
1 22 state are eligible for coverage under this section. Coverage
1 23 provided under this section is in excess of, and shall not
1 24 duplicate, coverage under any other form of health insurance.
1 25 b. Coverage of a dependent unmarried person provided under
1 26 this section terminates when the person becomes nineteen years
1 27 of age or, if the person is enrolled full-time in an
1 28 accredited educational institution, terminates at twenty-five
1 29 years of age. Attainment of the limiting age does not operate
1 30 to terminate coverage when the person is and continues to be
1 31 both of the following:
1 32 (1) Incapable of self-sustaining employment by reason of
1 33 mental retardation or physical disability.
1 34 (2) Primarily dependent for support and maintenance upon
1 35 the person in whose name the coverage is provided.
2 1 Proof of incapacity and dependency must be furnished to the
2 2 carrier within one hundred twenty days of the person's
2 3 attainment of the limiting age, and subsequently as may be
2 4 required by the carrier, but not more frequently than annually
2 5 after the two-year period following the person's attainment of
2 6 the limiting age.
2 7 c. Coverage for a family member of the person in whose
2 8 name the contract is issued shall also provide, as to the
2 9 family member's coverage, that the health insurance benefits
2 10 applicable for children include the coverage required under
2 11 section 514C.1.
2 12 d. Coverage may be excluded during a period of six months
2 13 following the effective date of coverage as to a given covered
2 14 individual for preexisting conditions, as long as either of
2 15 the following exists:
2 16 (1) The condition has manifested itself within a period of
2 17 six months before the effective date of coverage in such a
2 18 manner as would cause an ordinarily prudent person to seek
2 19 diagnosis or treatment.
2 20 (2) Medical advice or treatment was recommended or
2 21 received within the period of six months immediately preceding
2 22 the effective date of coverage.
2 23 The preexisting condition exclusions shall be waived to the
2 24 extent to which similar exclusions have been satisfied under
2 25 any prior health insurance coverage which was terminated as a
2 26 result of the individual's unemployment, if the application
2 27 for coverage is made no later than thirty days following the
2 28 date the individual becomes eligible for benefits under this
2 29 chapter.
2 30 This paragraph does not prohibit preexisting conditions
2 31 coverage under this section that is more favorable to the
2 32 insured than that specified in this subsection.
2 33 If the coverage contains a waiting period for preexisting
2 34 conditions, an insured may retain any existing coverage the
2 35 person has under an insurance plan that has coverage nearly
3 1 equivalent to the coverage provided under this section for the
3 2 duration of the waiting period only.
3 3 e. An individual is not eligible for coverage under this
3 4 section if any of the following apply:
3 5 (1) The individual is at the time of application eligible
3 6 for medical assistance under chapter 249A.
3 7 (2) The individual has terminated coverage provided under
3 8 this section within the past twelve months.
3 9 (3) The individual is an inmate of a public institution or
3 10 is eligible for public programs for which medical care is
3 11 provided.
3 12 4. For each fiscal year beginning on or after July 1,
3 13 1997, the entire dollar amount of increase, as determined by
3 14 the commissioner of insurance and certified to the director of
3 15 the department of management, in taxes paid under chapter 432
3 16 on premiums and payments on individual and group accident and
3 17 health insurance policies and certificates and individual and
3 18 group subscriber contracts under chapter 514 shall be set
3 19 aside in a separate account within the general fund of the
3 20 state and is appropriated solely for the purposes of
3 21 implementing the health insurance coverage program under this
3 22 section and providing the coverage as established in this
3 23 section.
3 24 5. The director of the department of management, in
3 25 consultation with the commissioner of insurance, shall adopt
3 26 rules to administer this section.
3 27 Sec. 3. EFFECTIVE DATE. This Act takes effect July 1,
3 28 1998.
3 29 EXPLANATION
3 30 This bill establishes a program to provide health care
3 31 coverage to a person who qualifies for unemployment benefits
3 32 under chapter 96 as a totally unemployed individual. The
3 33 coverage to be the same as that coverage provided under a
3 34 basic health benefit plan under Code chapter 513B. The bill
3 35 is subject to some of the same exclusions and restrictions as
4 1 provided under Code chapter 514E, which establishes the Iowa
4 2 comprehensive health insurance association which offers health
4 3 care coverage to certain individuals otherwise unable to
4 4 procure such coverage. The bill provides that the increase in
4 5 the state's premium tax paid by nonprofit hospital and health
4 6 service corporations is to be diverted to a separate account
4 7 in the general fund of the state to fund the program.
4 8 This bill takes effect July 1, 1998.
4 9 LSB 2361YH 77
4 10 mj/jj/8
Text: HF00500 Text: HF00502 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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