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PAG LIN 1 1 SENATE FILE 2409 1 2 AN ACT 1 3 RELATING TO THE OPERATION AND REGULATION OF INSURANCE 1 4 COMPANIES, MUTUAL INSURANCE ASSOCIATIONS, BENEVOLENT 1 5 ASSOCIATIONS, HEALTH MAINTENANCE ORGANIZATIONS, AND 1 6 OTHER INSURANCE OR RISK-ASSUMING ENTITIES, INCLUDING 1 7 THE RIGHTS AND DUTIES OF SUCH ENTITIES AND THE POWERS 1 8 AND AUTHORITY OF THE INSURANCE COMMISSIONER AND PROVIDING 1 9 EFFECTIVE DATES. 1 10 1 11 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 1 12 1 13 Section 1. Section 87.4, unnumbered paragraph 2, Code 1 14 1999, is amended to read as follows: 1 15 A self-insurance association formed under this section and 1 16 an association comprised of cities or counties, or both, or 1 17 community colleges as defined in section 260C.2 or school 1 18 corporations, or both, or other political subdivisions, which 1 19 have entered into an agreement under chapter 28E for the 1 20 purpose of establishing a self-insured program for the payment 1 21 of workers' compensation benefits are exempt from taxation 1 22 under section 432.1. 1 23 Sec. 2. Section 87.4, unnumbered paragraph 4, Code 1999, 1 24 is amended to read as follows: 1 25 A self-insured program for the payment of workers' 1 26 compensation benefits established by an association comprised 1 27 of cities or counties, or both, or community colleges, as 1 28 defined in section 260C.2, or other political subdivisions, 1 29 which have entered into an agreement under chapter 28E, is not 1 30 insurance, and is not subject to regulation under chapters 505 1 31 through 523C. Membership in such an association together with 1 32 payment of premiums due relieves the member from obtaining 1 33 insurance as required in section 87.1. Such an association is 1 34 not required to submit its plan or program to the commissioner 1 35 of insurance for review and approval prior to its 2 1 implementation and is not subject to rules or rates adopted by 2 2 the commissioner relating to workers' compensation group self- 2 3 insurance programs. Such a program is deemed to be in 2 4 compliance with this chapter. 2 5 Sec. 3. Section 100A.1, Code 1999, is amended by adding 2 6 the following new paragraph: 2 7 NEW PARAGRAPH. j. The fraud bureau within the insurance 2 8 division of the department of commerce. 2 9 Sec. 4. Section 505.8, subsection 5, Code Supplement 1999, 2 10 is amended by striking the subsection. 2 11 Sec. 5. Section 505.8, Code Supplement 1999, is amended by 2 12 adding the following new subsection: 2 13 NEW SUBSECTION. 7. The commissioner shall adopt rules 2 14 protecting the privacy of information held by an insurer or an 2 15 agent consistent with the federal Gramm-Leach-Bliley Act, Pub. 2 16 L. No. 106-102. 2 17 Sec. 6. NEW SECTION. 505.23 HEARINGS. 2 18 If an evidentiary hearing is conducted in a proceeding 2 19 pursuant to sections 508B.7, 515G.7, 521A.3, or 521A.14, or in 2 20 a proceeding with respect to a merger or consolidation 2 21 pursuant to chapter 521, the proceeding is a contested case 2 22 subject to chapter 17A. 2 23 Sec. 7. Section 508.4, Code 1999, is amended to read as 2 24 follows: 2 25 508.4 APPROVAL OF AMENDMENTS. 2 26 All amendments tosuch articles and amendments hereafter2 27made tothe articles of incorporation of companies already 2 28 organized under the laws of this state shall be approved in 2 29 like manner. 2 30 A company shall file with the commissioner bylaws and 2 31 subsequent amendments to such bylaws within thirty days of the 2 32 adoption of such bylaws and amendments. 2 33 Sec. 8. Section 508B.3, unnumbered paragraph 1, Code 1999, 2 34 is amended to read as follows: 2 35 A plan of conversion shallnotbeunfair or inequitable3 1 fair and equitable to policyholders. A plan of conversion is 3 2not unfair or inequitablefair and equitable if it satisfies 3 3 the conditions of subsections 1, 2, or 3. The commissioner 3 4 may determinethatwhether any other plan proposed by a mutual 3 5 company isnot unfair or inequitablefair and equitable to its 3 6 policyholders. 3 7 Sec. 9. Section 508B.4, Code 1999, is amended to read as 3 8 follows: 3 9 508B.4 ELIGIBLE POLICYHOLDERS PARTICIPATION. 3 10 The policyholders who are entitled to notice of and to vote 3 11 upon approval of a plan of conversion and entitled to notice 3 12 of a public hearing are the policyholders whose policies or 3 13 contracts are in force on the date of adoption of the plan of 3 14 conversion. Each policyholder whose policy has been in force 3 15 for at least one year prior to the date is entitled to the 3 16 consideration, if any, provided for the policyholder in the 3 17 plan based on the policyholder's membership interest 3 18 determined pursuant to this chapter, but onlyto the extent3 19thatif the policyholder's membership interest arose from 3 20policies or contractsa policy or contract in force on the 3 21 effective date of the conversion andwhich were in forcesuch 3 22 membership interest has been held continuously for at least 3 23 one year prior to the date of adoption of the plan. For this 3 24 purpose, any changes in status of, or premiums in excess of 3 25 those required on the policies or contracts occurring or made 3 26 after the date one year prior to the date of adoption of the 3 27 plan shall be disregarded. 3 28 Sec. 10. Section 508B.7, Code 1999, is amended to read as 3 29 follows: 3 30 508B.7 REVIEW OF PLAN BY COMMISSIONER HEARING 3 31 AUTHORIZED APPROVAL. 3 32 The commissioner of insurance shall review the plan. The 3 33 commissioner shall approve the plan if the commissioner finds 3 34 the plan complies with all provisions of law, the plan isnot3 35unfair or inequitablefair and equitable to the mutual company 4 1 and its policyholders, and that the reorganized company will 4 2 have the amount of capital and surplus deemed by the 4 3 commissioner to be reasonably necessary for its future 4 4 solvency. The commissioner may order a hearing on the 4 5 fairness and equity of the terms of the plan after giving 4 6 written notice of the hearing to the mutual company, its 4 7 policyholders, and other interested persons, all of whom have 4 8 the right to appear at the hearing. Costs incurred in 4 9 connection with the notice shall be paid by the company. 4 10 Sec. 11. Section 508B.9, unnumbered paragraph 1, Code 4 11 1999, is amended to read as follows: 4 12 When the commissioner and the policyholders approve the 4 13 conversion plan as provided in this chapter, the commissioner 4 14 shall issue a new certificate of authority to the reorganized 4 15 company effective on the effective datespecifiedof the 4 16 conversion as provided in the plan. The reorganized company 4 17 is a continuation of the mutual life insurance company and the 4 18 conversion shall not annul or modify any of the mutual 4 19 company's existing suits, contracts, or liabilities except as 4 20 provided in the approved conversion plan. All rights, 4 21 franchises, and interests of the mutual company in and to 4 22 property, assets, and other interests shall be transferred to 4 23 and shall vest in the reorganized company and the reorganized 4 24 company shall assume all obligations and liabilities of the 4 25 mutual company. 4 26 Sec. 12. Section 508B.14, unnumbered paragraph 2, Code 4 27 Supplement 1999, is amended to read as follows: 4 28 An action challenging the validity of a conversion plan, or 4 29 any part of a conversion plan, shall not be commenced more 4 30 thanone hundred eightythirty days following the date of 4 31 approval by the commissioner, unless an application for 4 32 rehearing is filed pursuant to section 17A.16, subsection 2. 4 33 If an application for rehearing is filed, then such action 4 34 must be filed within thirty days after that application is 4 35 denied or deemed denied or, if the application is granted, 5 1 within thirty days after the issuance of the commissioner's 5 2 final decision on rehearing. 5 3 Sec. 13. Section 508C.3, subsection 3, Code 1999, is 5 4 amended by adding the following new paragraphs: 5 5 NEW PARAGRAPH. j. An obligation that does not arise under 5 6 the express written terms of a covered policy. 5 7 NEW PARAGRAPH. k. A contractual agreement that 5 8 establishes a member insurer's obligations to provide a book 5 9 value accounting guaranty for defined contribution benefit 5 10 plan participants by reference to a portfolio of assets that 5 11 is owned by the benefit plan or its trustee, which in each 5 12 case is not an affiliate of the member insurer. 5 13 NEW PARAGRAPH. l. A portion of a covered policy to the 5 14 extent it provides for interest or other change in value to be 5 15 determined by the use of an index or other external reference 5 16 stated in the covered policy, but which has not been credited 5 17 to the covered policy, or as to which the covered policy 5 18 owner's rights are subject to forfeiture, as of the date the 5 19 member insurer becomes an impaired or insolvent insurer under 5 20 this chapter, whichever is earlier. If a covered policy's 5 21 interest or change in value is credited less frequently than 5 22 annually, then for purposes of determining the values that 5 23 have been credited and are not subject to forfeiture under the 5 24 covered policy, the interest or change in value determined by 5 25 using the procedures defined in the covered policy will be 5 26 credited as if the contractual date of crediting interest or 5 27 changing values was the date of impairment or insolvency, 5 28 whichever is earlier, and will not be subject to forfeiture. 5 29 Sec. 14. Section 508C.9, subsection 5, paragraph a, Code 5 30 1999, is amended to read as follows: 5 31 a. The total of all assessments upon a member insurer for 5 32 each account shall not in any one calendar year exceed two 5 33 percent of the average of the insurer's premiums received in 5 34 this state during the three most recent calendar years for 5 35 which information is available, preceding the year in which 6 1 the insurer becomes impaired or insolvent, on the policies 6 2 related to that account. However, if two or more assessments 6 3 are authorized in one calendar year with respect to insurers 6 4 that become impaired or insolvent in different calendar years, 6 5 the average annual premiums for purposes of the aggregate 6 6 assessment percentage limitation of this paragraph shall be 6 7 equal, and limited, to the higher of the three-year average 6 8 annual premiums for the applicable account as calculated 6 9 pursuant to this section. If the maximum assessment for an 6 10 account, together with the other assets of the association in 6 11 the account, does not provide in any one year in the account 6 12 an amount sufficient to carry out the responsibilities of the 6 13 association, the necessary additional funds shall be assessed 6 14 for the account in succeeding years as soon as permitted by 6 15 this chapter. 6 16 Sec. 15. Section 511.8, subsection 5, paragraph b, 6 17 unnumbered paragraph 1, Code 1999, is amended to read as 6 18 follows: 6 19 If adjustment, income or other contingent interest 6 20 obligations, the net earnings of the issuing, assuming or 6 21 guaranteeing corporation available for its fixed charges for a 6 22 period of five fiscal years next preceding the date of 6 23 acquisition of the obligations by such insurance company shall 6 24 have averaged per year not less than one and one-half times 6 25 such average annual fixed charges of the issuing, assuming or 6 26 guaranteeing corporation and its average annual maximum 6 27 contingent interest applicable to such period and, during at 6 28 least one of the last two years of such period, its net 6 29 earnings shall have been not less than one and one-half times 6 30 the sum of its fixed charges and maximum contingent interest 6 31 for such year, or if, at the date of acquisition, the 6 32 obligations are adequately secure and have investment 6 33 qualities and characteristics and speculative elements are not 6 34 predominant. 6 35 Sec. 16. Section 511.8, subsection 5, paragraph b, 7 1 unnumbered paragraph 4, Code 1999, is amended to read as 7 2 follows: 7 3 The term "corporation" as used in this chapter includes a 7 4 joint stock association, a limited liability company, a 7 5 partnership, or a trust. 7 6 Sec. 17. Section 511.8, subsection 17, paragraph b, Code 7 7 1999, is amended by striking the paragraph. 7 8 Sec. 18. Section 511.8, Code 1999, is amended by adding 7 9 the following new subsection: 7 10 NEW SUBSECTION. 22. FINANCIAL INSTRUMENTS USED IN HEDGING 7 11 TRANSACTIONS. 7 12 a. As used in this subsection, unless the context 7 13 otherwise requires: 7 14 (1) "Financial instrument" means an agreement, option, 7 15 instrument, or any series or combination agreement, option, or 7 16 instrument that provides for either of the following: 7 17 (a) To make or take delivery of, or assume or relinquish, 7 18 a specified amount of one or more underlying interests, or to 7 19 make a cash settlement in lieu of such delivery or 7 20 relinquishment. 7 21 (b) Which has a price, performance, value, or cash flow 7 22 based primarily upon the actual or expected price, level, 7 23 performance, value, or cash flow of one or more underlying 7 24 interests. 7 25 (2) "Financial instrument transaction" means a transaction 7 26 involving the use of one or more financial instruments. 7 27 (3) "Hedging transaction" means a financial instrument 7 28 transaction which is entered into and maintained to reduce 7 29 either of the following: 7 30 (a) The risk of a change in the value, yield, price, cash 7 31 flow, or quality of assets or liabilities which the domestic 7 32 insurer has acquired and maintains as qualified assets in its 7 33 legal reserve deposit or which liabilities the domestic 7 34 insurer has incurred and form the basis for calculation of its 7 35 legal reserve. 8 1 (b) The currency exchange-rate risk or the degree of 8 2 exposure as to assets or liabilities which the domestic 8 3 insurer has acquired or incurred. 8 4 b. Financial instruments used in hedging transactions must 8 5 meet the qualifications established in subsection 5 for bonds 8 6 or other evidences of indebtedness issued, assumed, or 8 7 guaranteed by a corporation incorporated under the laws of the 8 8 United States or Canada, or the qualifications established in 8 9 subsection 19 for bonds or other evidences of indebtedness 8 10 issued, assumed, or guaranteed by a corporation incorporated 8 11 under the laws of a foreign government other than Canada. 8 12 c. Investments in financial instruments used in hedging 8 13 transactions are not eligible in excess of two percent of the 8 14 legal reserve in the financial instruments of any one 8 15 corporation, less any securities of that corporation owned by 8 16 the company or association and in which its legal reserve is 8 17 invested, except insofar as the financial instruments are 8 18 collateralized by cash or United States government obligations 8 19 as authorized by subsection 1 deposited with a custodian bank 8 20 as defined in subsection 21, and held under a written 8 21 agreement with the custodian bank that complies with 8 22 subsection 21 and provides for the proceeds of the collateral, 8 23 subject to the terms and conditions of the applicable 8 24 collateral or other credit support agreement, to be remitted 8 25 to the legal reserve deposit of the company or association and 8 26 to vest in the state in accordance with section 508.18 8 27 whenever proceedings under that section are instituted. 8 28 d. Investments in financial instruments used in hedging 8 29 transactions are not eligible in excess of ten percent of the 8 30 legal reserve, except insofar as the financial instruments are 8 31 collateralized by cash or United States government obligations 8 32 as authorized by subsection 1 deposited with a custodian bank 8 33 as defined in subsection 21, and held under a written 8 34 agreement with the custodian bank that complies with 8 35 subsection 21 and provides for the proceeds of the collateral, 9 1 subject to the terms and conditions of the applicable 9 2 collateral or other credit support agreement, to be remitted 9 3 to the legal reserve deposit of the company or association and 9 4 to vest in the state in accordance with section 508.18 9 5 whenever proceedings under this section are instituted. 9 6 e. Investments in financial instruments of foreign 9 7 governments or foreign corporate obligations, other than 9 8 Canada, used in hedging transactions are not eligible in 9 9 excess of ten percent of the legal reserve, less any foreign 9 10 investment authorized by subsection 19 owned by the company or 9 11 association and in which its legal reserve is invested, except 9 12 insofar as the financial instruments are collateralized by 9 13 cash or United States government obligations as authorized by 9 14 subsection 1 deposited with a custodian bank as defined in 9 15 subsection 21, and held under a written agreement with the 9 16 custodian bank that complies with subsection 21 and provides 9 17 for the proceeds of the collateral, subject to the terms and 9 18 conditions of the applicable collateral or other credit 9 19 support agreement, to be remitted to the legal reserve deposit 9 20 of the company or association and to vest in the state in 9 21 accordance with section 508.18 whenever proceedings under that 9 22 section are instituted. 9 23 f. Prior to engaging in hedging transactions under this 9 24 subsection, a domestic insurer shall develop and adequately 9 25 document policies and procedures regarding hedging transaction 9 26 strategies and objectives. Such policies and procedures shall 9 27 address authorized hedging transactions, limitations, internal 9 28 controls, documentation, and authorization and approval 9 29 procedures. Such policies and procedures shall also provide 9 30 for review of hedging transactions by the domestic insurer's 9 31 board of directors or the board of directors' designee. 9 32 g. A domestic insurer shall be able to demonstrate to the 9 33 commissioner the intended hedging characteristics of hedging 9 34 transactions under this subsection and the ongoing 9 35 effectiveness of each hedging transaction or combination of 10 1 hedging transactions. 10 2 h. Financial instruments used in hedging transactions 10 3 shall only be eligible in accordance with this subsection 10 4 after the commissioner has adopted rules pursuant to chapter 10 5 17A regulating hedging transactions under this subsection. 10 6 Sec. 19. NEW SECTION. 512A.10 AMENDMENTS TO ARTICLES AND 10 7 BYLAWS. 10 8 1. An organization shall present to the commissioner of 10 9 insurance for approval its articles of incorporation and any 10 10 subsequent amendment. The commissioner shall submit the 10 11 articles of incorporation and any subsequent amendment to the 10 12 attorney general for examination, and if found by the attorney 10 13 general to be in accordance with this chapter, and the 10 14 constitution and laws of the state, the attorney general shall 10 15 certify such fact on the articles of incorporation or 10 16 amendment and return the articles or amendment to the 10 17 commissioner. Articles of incorporation or an amendment to 10 18 the articles shall not be approved by the commissioner or 10 19 recorded unless certified by the attorney general. 10 20 2. The directors of a benevolent association shall have 10 21 the authority to enact such bylaws and regulations not 10 22 inconsistent with law as they consider necessary for the 10 23 regulation and conduct of the business. A change in the 10 24 bylaws shall not limit coverage under existing certificates. 10 25 A benevolent association shall file with the commissioner 10 26 bylaws and amendments to the bylaws within thirty days of 10 27 adoption of such bylaws or amendments. 10 28 Sec. 20. Section 513B.2, subsections 2, 13, and 15, Code 10 29 1999, are amended to read as follows: 10 30 2. "Base premium rate" means, for each class of business 10 31 as to a rating period, the lowest premium rate charged or 10 32 which could have been charged under a rating system for that 10 33 class of business, by the small employer carrier to small 10 34 employerswith similar case characteristicsfor health 10 35 insurance plans with the same or similar coverage. 11 1 13. "Index rate" means for each class of business for 11 2 small employerswith similar case characteristicsthe average 11 3 of the applicable base premium rate and the corresponding 11 4 highest premium rate. 11 5 15. "New business premium rate" means, for each class of 11 6 business as to a rating period, the lowest premium rate 11 7 charged or offered by the small employer carrier to small 11 8 employerswith similar case characteristicsfor newly issued 11 9 health insurance coverages with the same or similar coverage. 11 10 Sec. 21. Section 513C.10, subsection 6, Code 1999, is 11 11 amended to read as follows: 11 12 6. Rates for basic and standard coverages as provided in 11 13 this chapter shall be determined by each carrier or organized 11 14 delivery system as theaverage ofproduct of a basic and 11 15 standard factor and the lowest rate available for issuance by 11 16 that carrier or organized delivery system adjusted for rating 11 17 characteristics and benefitsand the maximum rate allowable by11 18law after adjustments for rate characteristics and benefits. 11 19 Basic and standard factors shall be established annually by 11 20 the Iowa individual health benefit reinsurance association 11 21 board with the approval of the commissioner. Multiple basic 11 22 and standard factors for a distinct grouping of basic and 11 23 standard policies, may be established. A basic and standard 11 24 factor is limited to a minimum value defined as the ratio of 11 25 the average of the lowest rate available for issuance and the 11 26 maximum rate allowable by law divided by the lowest rate 11 27 available for issuance. A basic and standard factor is 11 28 limited to a maximum value defined as the ratio of the maximum 11 29 rate allowable by law divided by the lowest rate available for 11 30 issuance. The maximum rate allowable by law and the lowest 11 31 rate available for issuance is determined based on the rate 11 32 restrictions under this chapter. However, to maintain 11 33 assessable loss assessments at or below one percent of total 11 34 health insurance premiums or payments as determined in 11 35 accordance with subsection 10, the Iowa individual health 12 1 benefit reinsurance association board with the approval of the 12 2 commissioner may increase the value for any basic and standard 12 3 factor greater than the maximum value and with the approval of 12 4 the commissioner may increase cost sharing provisions 12 5 including, but not limited to, basic and standard plan 12 6 deductibles, coinsurance, or copayments. 12 7 Sec. 22. Section 514.3, Code 1999, is amended to read as 12 8 follows: 12 9 514.3 APPROVAL BY COMMISSIONER. 12 10 The articles of incorporation, and any subsequent 12 11 amendments, ofsucha corporation shall have endorsedthereon12 12 on or annexedtheretoto the approval of the commissioner of 12 13 insurance before the same shall be filed for record. A 12 14 corporation shall file with the commissioner bylaws and 12 15 subsequent amendments to the bylaws within thirty days of the 12 16 adoption of the bylaws and amendments. 12 17 Sec. 23. Section 514.4, unnumbered paragraph 7, Code 1999, 12 18 is amended by striking the unnumbered paragraph. 12 19 Sec. 24. NEW SECTION. 514B.3A APPROVAL BY COMMISSIONER 12 20 AND ATTORNEY GENERAL. 12 21 The articles of incorporation, and any subsequent 12 22 amendment, of a corporation shall have endorsed on or annexed 12 23 to such articles or amendment the approval of the commissioner 12 24 of insurance and the attorney general before filing for 12 25 record. A corporation shall file with the commissioner bylaws 12 26 and subsequent amendments to the bylaws within thirty days of 12 27 the adoption of the bylaws and amendments. 12 28 Sec. 25. Section 514B.24, unnumbered paragraph 1, Code 12 29 1999, is amended to read as follows: 12 30 The commissioner shall make an examination of the affairs 12 31 ofanya health maintenance organization and its providers as 12 32 often as the commissioner deems necessary for the protection 12 33 of the interests of the people of this state, but not less 12 34 frequently than once everythreefive years. 12 35 Sec. 26. NEW SECTION. 514B.25A INSOLVENCY PROTECTION 13 1 ASSESSMENT. 13 2 1. Upon a health maintenance organization or organized 13 3 delivery system authorized to do business in this state and 13 4 licensed by the director of public health being declared 13 5 insolvent by the district court, the commissioner may levy an 13 6 assessment on each health maintenance organization or 13 7 organized delivery system doing business in this state and 13 8 licensed by the director of public health, as applicable, to 13 9 pay claims for uncovered expenditures for enrollees. The 13 10 commissioner shall not assess an amount in any one calendar 13 11 year which is more than two percent of the aggregate premium 13 12 written by each health maintenance organization or organized 13 13 delivery system. 13 14 2. The commissioner may use funds obtained through an 13 15 assessment under subsection 1 to pay claims for uncovered 13 16 expenditures for enrollees of an insolvent health maintenance 13 17 organization or organized delivery system and administrative 13 18 costs. The commissioner, by rule, may prescribe the time, 13 19 manner, and form for filing claims under this section. The 13 20 commissioner may require claims to be allowed by an ancillary 13 21 receiver or the domestic receiver or liquidator. 13 22 3. a. A receiver or liquidator of an insolvent health 13 23 maintenance organization or organized delivery system shall 13 24 allow a claim in the proceeding in an amount equal to 13 25 uncovered expenditures and administrative costs paid under 13 26 this section. 13 27 b. A person receiving benefits under this section for 13 28 uncovered expenditures is deemed to have assigned the rights 13 29 under the covered health care plan certificates to the 13 30 commissioner to the extent of the benefits received. The 13 31 commissioner may require an assignment of such rights by a 13 32 payee, enrollee, or beneficiary, to the commissioner as a 13 33 condition precedent to the receipt of such benefits. The 13 34 commissioner is subrogated to these rights against the assets 13 35 of the insolvent health maintenance organization or organized 14 1 delivery system that are held by a receiver or liquidator of a 14 2 foreign jurisdiction. 14 3 c. The assigned subrogation rights of the commissioner and 14 4 allowed claims under this subsection have the same priority 14 5 against the assets of the insolvent health maintenance 14 6 organization or organized delivery system as those claims of 14 7 persons entitled to receive benefits under this section or for 14 8 similar expenses in the receivership or liquidation. 14 9 4. If funds assessed under subsection 1 are unused 14 10 following the completion of the liquidation of an insolvent 14 11 health maintenance organization or organized delivery system, 14 12 the commissioner shall distribute the remaining amounts, if 14 13 such amounts are not de minimis, to the health maintenance 14 14 organizations or organized delivery systems that were 14 15 assessed. 14 16 5. The aggregate coverage of uncovered expenditures under 14 17 this section shall not exceed three hundred thousand dollars 14 18 with respect to one individual. Continuation of coverage 14 19 shall cease after the lesser of one year after the health 14 20 maintenance organization or organized delivery system is 14 21 terminated by insolvency or the remaining term of the 14 22 contract. The commissioner may provide continuation of 14 23 coverage on a reasonable basis, including, but not limited to, 14 24 continuation of the health maintenance organization or 14 25 organized delivery system contract or substitution of 14 26 indemnity coverage in a form as determined by the 14 27 commissioner. 14 28 6. The commissioner may waive an assessment of a health 14 29 maintenance organization or organized delivery system if such 14 30 organization or system is impaired financially or would be 14 31 impaired financially as a result of such assessment. A health 14 32 maintenance organization or organized delivery system that 14 33 fails to pay an assessment within thirty days after notice of 14 34 the assessment is subject to a civil forfeiture of not more 14 35 than one thousand dollars for each day the failure continues, 15 1 and suspension or revocation of its certificate of authority. 15 2 An action taken by the commissioner to enforce an assessment 15 3 under this section may be appealed by the health maintenance 15 4 organization or organized delivery system pursuant to chapter 15 5 17A. 15 6 Sec. 27. Section 515.2, Code 1999, is amended to read as 15 7 follows: 15 8 515.2 ARTICLES APPROVAL. 15 9 Each such organization shall present to the commissioner of 15 10 insurance its articles of incorporation, which shall show its 15 11 name, objects, location of its principal place of business, 15 12 and amount of its capital stock, who shall submit it to the 15 13 attorney general for examination, and if found by the attorney 15 14 general to be in accordance with the provisions of this title, 15 15 the laws of the United States, and the Constitution and laws 15 16 of the state, the attorney general shall certify such fact 15 17 thereon and return the same to said commissioner, and no 15 18 articles shall be approved by the commissioner or recorded 15 19 unless accompanied with such certificate. A company shall 15 20 file with the commissioner bylaws and subsequent amendments to 15 21 the bylaws within thirty days of the adoption of the bylaws 15 22 and amendments. 15 23 Sec. 28. Section 515.46, Code 1999, is amended to read as 15 24 follows: 15 25 515.46 FORFEITURE OF CERTIFICATE OF AUTHORITY. 15 26 Any dividend made contrary to the provisions ofsections15 27 section 515.44and 515.45or rules adopted by the commissioner 15 28 shall subject the company making it to forfeiture of its 15 29 certificate of authority. 15 30 Sec. 29. Section 515.71, unnumbered paragraph 1, Code 15 31 1999, is amended to read as follows: 15 32 Every alien insurer authorized to transact business in this 15 33 state shall at all times maintain a deposit with the 15 34 commissioner of insurance in cash or in securities in which 15 35 insurance companies are authorized to invest, of a sum equal 16 1 to the greater of the reserve on all policies covering risks 16 2 located in this state or one million dollars. The securities 16 3 shall be approved, and the amount of the deposit shall be 16 4 determined, by the commissionerin accordance with section16 5515.47. The commissioner, in the commissioner's discretion, 16 6 may permit the withdrawal of interest earnings. 16 7 Sec. 30. Section 515B.2, subsection 5, Code 1999, is 16 8 amended to read as follows: 16 9 5. "Insurer" means an insurer licensed to transact 16 10 insurance business in this state under either chapter 515 or 16 11 chapter 520, either at the time the policy was issued or when 16 12 the insured event occurred. It does not include county or 16 13 state mutualassessmentinsurance associations licensed under 16 14 chapter 518 or chapter 518A, or fraternal beneficiary 16 15 societies, orders, or associations licensed under chapter 16 16 512B, or corporations operating nonprofit service plans under 16 17 chapter 514, or life insurance companies or life, accident, or 16 18 health associations licensed under chapter 508, or those 16 19 professions under chapter 519. 16 20 Sec. 31. Section 515C.3, Code 1999, is amended to read as 16 21 follows: 16 22 515C.3 BASES FOR COMPUTATIONS. 16 23 The unearned premium reserve shall be computedin16 24accordance with section 515.47, except that all premiums on16 25risks written for one year or less must be reserved on a16 26monthly pro rata basis, and the reserve for those policies16 27covering a risk period of more than five years shall be16 28computed in accordance with formulae filed by the insurer and16 29approvedpursuant to rules adopted by the commissioner of 16 30 insurance. 16 31 Sec. 32. Section 515F.3, subsection 6, Code 1999, is 16 32 amended to read as follows: 16 33 6. Insurance written by a county mutualassessment16 34 insurance association as provided in chapter 518A. 16 35 Sec. 33. Section 515G.7, Code 1999, is amended to read as 17 1 follows: 17 2 515G.7 REVIEW OF PLAN BY COMMISSIONER HEARING 17 3 AUTHORIZED APPROVAL. 17 4 The commissioner of insurance shall review the plan. The 17 5 commissioner shall approve the plan if the commissioner finds 17 6 the plan complies with all provisions of law, the plan isnot17 7unfair or inequitablefair and equitable to the mutual insurer 17 8 and its policyholders, and that the reorganized company will 17 9 have the amount of capital and surplus deemed by the 17 10 commissioner to be reasonably necessary for its future 17 11 solvency. The commissioner may order a hearing on the 17 12 fairness and equity of the terms of the plan after giving 17 13 written notice of the hearing to the mutual insurer, and its 17 14 policyholders, all of whom have the right to appear at the 17 15 hearing. 17 16 Sec. 34. Section 515G.14, unnumbered paragraph 1, Code 17 17 1999, is amended to read as follows: 17 18 An action challenging the validity of a conversion plan, or 17 19 any part of a conversion plan, shall not be commenced more 17 20 than thirty days following the date of approval by the 17 21 commissioner, unless an application for rehearing is filed 17 22 pursuant to section 17A.16, subsection 2. If an application 17 23 for rehearing is filed, then such action must be filed within 17 24 thirty days after that application is denied or deemed denied 17 25 or, if the application is granted, within thirty days after 17 26 the issuance of the commissioner's final decision on 17 27 rehearing. 17 28 Sec. 35. Section 518.7, Code 1999, is amended to read as 17 29 follows: 17 30 518.7 OFFICERS AND DIRECTORS ELECTION. 17 31 Officers or directors shall be elected in the manner and 17 32 for the length of time prescribed in the articles of 17 33 incorporation. The same person shall not simultaneously hold 17 34 the offices of president and secretary. A director shall be a 17 35 member of the association. 18 1 Sec. 36. Section 518.8, Code 1999, is amended to read as 18 2 follows: 18 3 518.8 BYLAWS. 18 4 The directors of the association shall have the authority 18 5 to enact such bylaws and regulations not inconsistent with law 18 6 as they consider necessary for the regulation and conduct of 18 7 the business. No change in the bylaws shall have the effect 18 8 of limiting coverage under existing policies of insurance. An 18 9 association shall file with the commissioner bylaws and 18 10 subsequent amendments to the bylaws within thirty days of the 18 11 adoption of the bylaws and amendments. 18 12 Sec. 37. NEW SECTION. 518.13A ASSESSMENTS PROHIBITED. 18 13 An association doing business under this chapter shall not 18 14 levy an assessment on any member of the association. 18 15 Sec. 38. Section 518.17, Code Supplement 1999, is amended 18 16 to read as follows: 18 17 518.17 REINSURANCE. 18 18 A county mutual insurance association may reinsure a part 18 19 or all of itsriskscoverages written pursuant to this chapter 18 20 withanyan association operating underthe provisions ofthis 18 21 chapter, or with any other association or company licensed in 18 22 this state and authorized to write the kinds of insurance 18 23 enumerated in section 518.11. 18 24 Reinsurance sufficient to protect the financial stability 18 25 of the state mutual association is also required. Reinsurance 18 26 coverage obtained by a county mutual insurance association 18 27 shall not expose the association toa losslosses from 18 28 coverages written pursuant to this chapter of more than 18 29 fifteen percent from surplus in any calendar year. The 18 30 commissioner of insurance may require additional reinsurance 18 31 if necessary to protect the policyholders of the association. 18 32 Sec. 39. Section 518.23, Code 1999, is amended to read as 18 33 follows: 18 34 518.23 CANCELLATION OF POLICIES. 18 35 1. CANCELLATION BY INSURED.AnyA policy shall be 19 1 canceled at any time at the request of the insured upon the 19 2 return of the policy to the home office of the association, 19 3 and the payment of all premium charges against such policy; or19 4by the association by giving five days' notice of such19 5cancellation.Such service19 6 2. CANCELLATION BY ASSOCIATION. 19 7 a. Except as provided in paragraph "b", notice of 19 8 cancellation is not effective unless mailed or delivered by 19 9 the association to the named insured at least twenty days 19 10 before the effective date of cancellation. 19 11 b. Notice of cancellation resulting from nonpayment of a 19 12 premium or installment provided for in the policy, or provided 19 13 for in a note or contract for the payment of such premium or 19 14 installment, is not effective unless mailed or delivered by 19 15 the association to the named insured at least ten days prior 19 16 to the date of cancellation. 19 17 c. If a notice of cancellation under paragraph "a" or "b" 19 18 fails to include the reason for such cancellation, the 19 19 association, upon receipt of a timely request by the named 19 20 insured, shall provide in writing the reason for the 19 21 cancellation. 19 22 3. NONRENEWAL BY ASSOCIATION. A notice of intention not 19 23 to renew is not effective unless mailed or delivered by the 19 24 insurer to the named insured at least thirty days prior to the 19 25 expiration date of the policy. If the reason does not 19 26 accompany the notice of nonrenewal, the association, upon 19 27 receipt of a timely request by the named insured, shall 19 28 provide the reason for the nonrenewal in writing. 19 29 4. NOTICE. Service of notice under subsection 2 or 3 may 19 30 be made in person, or by mailing such notice by certified mail 19 31 deposited in the post office and directed to the insured at 19 32 the insured's post office address as given in or upon the 19 33 policy, or to such other address as the insured shall have 19 34 given to the association in writing. A post office department 19 35 receipt of certified or registered mail shall be deemed proof 20 1 of receipt of such notice. If in either case the cash 20 2 paymentsshallexceed the amount properly chargeable, the 20 3 excesswillshall be refunded to the insured upon the 20 4 surrender of the policy to the association at its home office. 20 5 Sec. 40. Section 518A.6, Code 1999, is amended to read as 20 6 follows: 20 7 518A.6 OFFICERS ELECTION. 20 8 Officers or directors shall be elected in the manner and 20 9 for the length of time prescribed in the articles of 20 10 incorporation or bylaws. The same person shall not 20 11 simultaneously hold the offices of president and secretary. A 20 12 director shall be a member of the association. 20 13 Sec. 41. NEW SECTION. 518A.6A BYLAWS. 20 14 The directors of the association may enact the bylaws and 20 15 regulations not inconsistent with law as they consider 20 16 necessary for the regulation and conduct of the business. A 20 17 change in the bylaws shall not limit coverage under existing 20 18 policies of insurance. An association shall file with the 20 19 commissioner bylaws and amendments to bylaws within thirty 20 20 days of adoption. 20 21 Sec. 42. Section 518A.7, Code 1999, is amended to read as 20 22 follows: 20 23 518A.7 POLICIES ISSUANCE CONDITIONS. 20 24NoA state mutualassessmentinsurance association shall 20 25 not issue policies until at least one hundred twenty-five 20 26 applications have been received in any class as shown by 20 27 section 518A.1, representing the following amount of 20 28 insurance: Classes one, two, three, and five, two hundred 20 29 fifty thousand dollars each; class four, one hundred thousand 20 30 dollars, andno county mutual assessment association shall20 31issue policies until applications for insurance to the amount20 32of fifty thousand dollars representing at least fifty20 33applicants have been received, and noan application for 20 34 insurance during the period of organization shall not exceed 20 35 two percent of the amount required for organization, or after 21 1 one year of organization, one percent of the total insurance 21 2 in force, any reinsurance taking effect simultaneously with 21 3 the policy being deducted in determining such maximum single 21 4 risk. 21 5 Sec. 43. Section 518A.9, Code 1999, is amended by striking 21 6 the section and inserting in lieu thereof the following: 21 7 518A.9 PREMIUM CHARGES. 21 8 An association, by action of its board of directors, may 21 9 establish premium charges for the purpose of payment of losses 21 10 and expenses and for the establishment or maintenance of a 21 11 reserve fund. 21 12 A policy shall stand suspended if any default is made in 21 13 the payment of any premium on or before the date specified in 21 14 a written notice requiring the payment of such premium and 21 15 mailed to the insured and directed to the insured's last known 21 16 address not less than thirty days prior to such suspension 21 17 date. The notice shall specify the amount and due date of the 21 18 premium. The association is not liable for any loss occurring 21 19 during such period of suspension. 21 20 Sec. 44. NEW SECTION. 518A.9A ASSESSMENTS PROHIBITED. 21 21 An association doing business under this chapter shall not 21 22 levy an assessment on any member of the association. 21 23 Sec. 45. Section 518A.12, subsection 1, paragraphs a and 21 24 c, Code 1999, are amended to read as follows: 21 25 a. This section applies to the investments of state mutual 21 26casualty assessmentinsurance associations. 21 27 c. Financial terms relating to state mutualcasualty21 28assessmentinsurance associations have the meanings assigned 21 29 to them under statutory accounting methods. Financial terms 21 30 relating to companies other than state mutualcasualty21 31assessmentinsurance associations have the meanings assigned 21 32 to them under generally accepted accounting principles. 21 33 Sec. 46. Section 518A.18, Code 1999, is amended to read as 21 34 follows: 21 35 518A.18 ANNUAL REPORT. 22 1 An association doing business under this chaptershall, on 22 2 or before March 1 of each year,report to the commissioner of22 3insurance the facts required of domestic insurance companies22 4organizing under chapter 515, which are applicable to this22 5chapter. These reportsshall prepare under oath and file with 22 6 the commissioner of insurance an accurate and complete 22 7 statement of the condition of the association as of the last 22 8 day of the preceding calendar year. The statement shall 22 9 conform to the annual statement blank prepared pursuant to 22 10 instructions prescribed by the commissioner. All financial 22 11 information reflected in the annual report shall be kept and 22 12 prepared pursuant to accounting practices and procedures 22 13 prescribed by the commissioner. Statements filed with the 22 14 commissioner pursuant to this section shall be tabulated and 22 15 published by the commissioner of insurance in the annual 22 16 report of insurance. 22 17 Sec. 47. Section 518A.29, Code 1999, is amended by 22 18 striking the section and inserting in lieu thereof the 22 19 following: 22 20 518A.29 CANCELLATION BY ASSOCIATION NOTICE. 22 21 1. CANCELLATION BY INSURED. A policy shall be canceled at 22 22 any time at the request of the insured upon the return of the 22 23 policy to the home office of the association and the payment 22 24 of all premium charges against such policy. 22 25 2. CANCELLATION BY ASSOCIATION. 22 26 a. Except as provided in paragraph "b", notice of 22 27 cancellation is not effective unless mailed or delivered by 22 28 the association to the named insured at least twenty days 22 29 before the effective date of cancellation. 22 30 b. Notice of cancellation resulting from nonpayment of a 22 31 premium or installment provided for in the policy, or provided 22 32 for in a note or contract for the payment of such premium or 22 33 installment, is not effective unless mailed or delivered by 22 34 the association to the named insured at least ten days prior 22 35 to the date of cancellation. 23 1 c. If a notice of cancellation under paragraph "a" or "b" 23 2 fails to include the reason for such cancellation, the 23 3 association, upon receipt of a timely request by the named 23 4 insured, shall provide the reason for the cancellation in 23 5 writing. 23 6 3. NONRENEWAL BY ASSOCIATION. A notice of intention not 23 7 to renew is not effective unless mailed or delivered by the 23 8 insurer to the named insured at least thirty days prior to the 23 9 expiration date of the policy. If the reason does not 23 10 accompany the notice of nonrenewal, the association, upon 23 11 receipt of a timely request by the named insured, shall 23 12 provide in writing the reason for the nonrenewal. 23 13 4. NOTICE. Service of notice under subsection 2 or 3 may 23 14 be made in person, or by mailing such notice by certified mail 23 15 deposited in the post office and directed to the insured at 23 16 the insured's post office address as given in or upon the 23 17 policy, or to such other address as the insured shall have 23 18 given to the association in writing. A post office department 23 19 receipt of certified or registered mail shall be deemed proof 23 20 of receipt of such notice. If in either case the cash 23 21 payments exceed the amount properly chargeable, the excess 23 22 shall be refunded upon the surrender of the policy to the 23 23 association at its home office. 23 24 Sec. 48. Section 518A.35, Code 1999, is amended to read as 23 25 follows: 23 26 518A.35 ANNUAL TAX. 23 27EveryA state mutual insurance association doing business 23 28 under this chapter shall on or before the first day of March, 23 29 each year, pay to the director of the department of revenue 23 30 and finance, or a depository designated by the director, a sum 23 31 equivalent to two percent of the gross receipts from premiums,23 32assessments,and fees, and promissory obligationsfor business 23 33 done within the state, including all insurance upon property 23 34 situated in the state without including or deducting any 23 35 amounts received or paid for reinsuranceexcept that any. 24 1 However, a company reinsuring windstorm or hail risks written 24 2 by county mutual associationsshall beis required to pay a 24 3 two percent tax on the gross amount of reinsurance premiums 24 4 received upon such risks, but after deducting the amount 24 5 returned upon canceled policies and rejected applications 24 6 covering property situated within the state, and dividends 24 7 returned to policyholders on property situated within the 24 8 state. 24 9 Sec. 49. Section 518A.44, Code Supplement 1999, is amended 24 10 to read as follows: 24 11 518A.44 REINSURANCE. 24 12 A state mutual insurance association may reinsure a part or 24 13 all of itsriskscoverages written pursuant to this chapter 24 14 withanyan association operating underthe provisions ofthis 24 15 chapter, or with any other association or company licensed in 24 16 this state and authorized to write the kinds of insurance 24 17 enumerated in section 518A.1. 24 18 Reinsurance sufficient to protect the financial stability 24 19 of the state mutual insurance association is required. 24 20 Reinsurance coverage obtained by an association shall not 24 21 expose the association toa losslosses from coverages written 24 22 pursuant to this chapter of more than fifteen percent from 24 23 surplus in any calendar year. The commissioner of insurance 24 24 may require additional reinsurance if necessary to protect the 24 25 policyholders of the association. 24 26 Sec. 50. Section 518A.52, Code 1999, is amended to read as 24 27 follows: 24 28 518A.52 FORM APPROVAL. 24 29 The form of all policies, applications, agreements, and 24 30 endorsements modifying the provisions of policies, and all 24 31 permits and riders used in this state, issued or proposed to 24 32 be issued by a state mutualcasualty assessmentinsurance 24 33 association doing business in this state underthe provisions24 34ofthis chapter, shall first be examined and approved by the 24 35 commissioner of insurance. 25 1 Sec. 51. Section 518A.53, Code 1999, is amended to read as 25 2 follows: 25 3 518A.53 FAILURE TO FILE COPY. 25 4 Upon the failure of a state mutualcasualty assessment25 5 insurance association to file a copy of its forms of policies 25 6 or contracts pursuant to section 518A.52, the commissioner of 25 7 insurance may suspend its authority to transact business 25 8 within the state until such forms of policies or contracts 25 9 have been filed and approved. 25 10 Sec. 52. Section 518A.54, Code 1999, is amended to read as 25 11 follows: 25 12 518A.54 DISAPPROVAL OF FILINGS. 25 13 If the commissioner finds that a filing does not meet the 25 14 requirements of this chapter, written notice of disapproval 25 15 shall be sent to the state mutualcasualty assessment25 16 insurance association specifying in what respect the filing 25 17 fails to meet the requirements of this chapter and stating 25 18 that the filing is not effective. If a filing is disapproved 25 19 by the commissioner, the association may request a hearing on 25 20 the disapproval within thirty days. The association bears the 25 21 burden of proving compliance with the standards established by 25 22 this chapter. 25 23 If, at any time after a form has been approved, the 25 24 commissioner finds that the form no longer meets the 25 25 requirements of this chapter, the commissioner may order the 25 26 discontinuance of the use of the form. The order of 25 27 discontinuance shall be in writing and may be issued only 25 28 after a hearing with at least ten days' prior notice to all 25 29 state mutualcasualty assessmentinsurance associations 25 30 affected by the order. The order shall state the grounds upon 25 31 which the order is based and when the order of discontinuance 25 32 is effective. 25 33 Sec. 53. Section 518A.55, Code 1999, is amended to read as 25 34 follows: 25 35 518A.55 CERTIFICATE SUSPENSION. 26 1 The commissioner of insurance may suspend a state mutual 26 2casualty assessmentinsurance association's certificate of 26 3 authority to do business if the association neglects or fails 26 4 to comply with this chapter. 26 5 Sec. 54. Section 519.10, Code 1999, is amended to read as 26 6 follows: 26 7 519.10 POWERS OF COMMISSIONER. 26 8 The commissioner of insurance shall have and exercise the 26 9 same control over such corporations as the commissioner now 26 10 has over state mutualassessmentinsurance associations 26 11 organized and doing business under chapter 518A. 26 12 Sec. 55. Section 519.11, Code Supplement 1999, is amended 26 13 to read as follows: 26 14 519.11 LIABILITY TO ASSESSMENTS. 26 15 The provisions as to maximum liability of members to 26 16 assessments when assets are insufficient and to assessments 26 17 when the corporation is insolvent, found insectionssection 26 18 518A.9and 518A.14, shall apply to all mutual insurance 26 19 corporations organized under this chapter. 26 20 Sec. 56. Section 521E.1, subsection 4, paragraph e, Code 26 21 1999, is amended to read as follows: 26 22 e. A state mutualcasualty assessmentinsurance 26 23 association organized under chapter 518A. 26 24 Sec. 57. Section 522.3, unnumbered paragraph 3, Code 1999, 26 25 is amended by striking the unnumbered paragraph. 26 26 Sec. 58. Section 573.3, Code 1999, is amended by adding 26 27 the following new unnumbered paragraph: 26 28 NEW UNNUMBERED PARAGRAPH. A public corporation, with 26 29 respect to a public improvement which is or has been 26 30 competitively bid or negotiated, shall not require a 26 31 contractor to procure a bond, as required under section 573.2, 26 32 from a particular insurance or surety company, agent, or 26 33 broker. 26 34 Sec. 59. Sections 515.45, 515.47, 518A.11, 518A.14, 26 35 518A.15, 518A.30, 518A.31, and 518A.32, Code 1999, are 27 1 repealed. 27 2 Sec. 60. EFFECTIVE DATES. 27 3 1. Section 8 of this Act, which amends section 508B.3, and 27 4 section 10 of this Act, which amends section 508B.7, being 27 5 deemed of immediate importance, take effect upon enactment. 27 6 2. Section 17 of this Act, which amends section 511.8 by 27 7 striking subsection 17, paragraph "b", section 28 of this Act, 27 8 which amends section 515.46, section 29 of this Act, which 27 9 amends section 515.71, and section 31 of this Act, which 27 10 amends section 515C.3, and the repeal of sections 515.45 and 27 11 515.47, take effect on January 1, 2001. 27 12 27 13 27 14 27 15 MARY E. KRAMER 27 16 President of the Senate 27 17 27 18 27 19 27 20 BRENT SIEGRIST 27 21 Speaker of the House 27 22 27 23 I hereby certify that this bill originated in the Senate and 27 24 is known as Senate File 2409, Seventy-eighth General Assembly. 27 25 27 26 27 27 27 28 MICHAEL E. MARSHALL 27 29 Secretary of the Senate 27 30 Approved , 2000 27 31 27 32 27 33 27 34 THOMAS J. VILSACK 27 35 Governor
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