Text: H08604 Text: H08606 Text: H08600 - H08699 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend Senate File 2318, as amended, passed, and
1 2 reprinted by the Senate, as follows:
1 3 #1. Page 2, by striking lines 10 through 15 and
1 4 inserting the following:
1 5 "b. For the 2003 calendar year:
1 6 (1) One and three-fourths percent if the company
1 7 or association is described as any of the following:
1 8 (a) It is taxed under section 432.2.
1 9 (b) Its policies and contracts provide for third-
1 10 party payments or prepayments of health or medical
1 11 expenses which include coverage benefits for treatment
1 12 for neurobiological disorders and underlying co-
1 13 morbidity as provided in section 514C.21 and it meets
1 14 the requirements of subparagraph subdivision (d), (e),
1 15 or (f).
1 16 (c) Its commercial domicile is not in Iowa.
1 17 (d) Its commercial domicile is in Iowa and its
1 18 total premiums received in the previous calendar year
1 19 are less than ten million dollars and in the case of a
1 20 health insurance company or association it meets the
1 21 requirements of subparagraph subdivision (b).
1 22 (e) Its commercial domicile is in Iowa, its total
1 23 premiums received in the previous calendar year are at
1 24 least ten million dollars but not more than one
1 25 hundred million dollars, and it has purchased equity
1 26 interests in the Iowa fund of funds created pursuant
1 27 to section 15E.225 through the end of the previous
1 28 calendar year of at least five hundred thousand
1 29 dollars and in the case of a health insurance company
1 30 or association it meets the requirements of
1 31 subparagraph subdivision (b).
1 32 (f) Its commercial domicile is in Iowa, its total
1 33 premiums received in the previous calendar year are
1 34 more than one hundred million dollars, and it has
1 35 purchased equity interests in the Iowa fund of funds
1 36 through the end of the previous calendar year of at
1 37 least one million dollars and in the case of a health
1 38 insurance company or association it meets the
1 39 requirements of subparagraph subdivision (b).
1 40 (2) Two percent if the company or association does
1 41 not meet any of the descriptions in subparagraph (1).
1 42 c. For the 2004 calendar year:
1 43 (1) One and one-half percent if the company or
1 44 association is described as any of the following:
1 45 (a) It is taxed under section 432.2.
1 46 (b) Its policies and contracts provide for third-
1 47 party payments or prepayments of health or medical
1 48 expenses which include coverage benefits for treatment
1 49 for neurobiological disorders and underlying co-
1 50 morbidity as provided in section 514C.21 and it meets
2 1 the requirements of subparagraph subdivision (d), (e),
2 2 or (f).
2 3 (c) Its commercial domicile is not in Iowa.
2 4 (d) Its commercial domicile is in Iowa and its
2 5 total premiums received in the previous calendar year
2 6 are less than ten million dollars and in the case of a
2 7 health insurance company or association it meets the
2 8 requirements of subparagraph subdivision (b).
2 9 (e) Its commercial domicile is in Iowa, its total
2 10 premiums received in the previous calendar year are at
2 11 least ten million dollars but not more than one
2 12 hundred million dollars, and it has purchased equity
2 13 interests in the Iowa fund of funds through the end of
2 14 the previous calendar year of at least one million
2 15 dollars and in the case of a health insurance company
2 16 or association it meets the requirements of
2 17 subparagraph subdivision (b).
2 18 (f) Its commercial domicile is in Iowa, its total
2 19 premiums received in the previous calendar year are
2 20 more than one hundred million dollars, and it has
2 21 purchased equity interests in the Iowa fund of funds
2 22 through the end of the previous calendar year of at
2 23 least two million dollars and in the case of a health
2 24 insurance company or association it meets the
2 25 requirements of subparagraph subdivision (b).
2 26 (2) Two percent if the company or association does
2 27 not meet any of the descriptions in subparagraph (1).
2 28 d. For the 2005 calendar year:
2 29 (1) One and one-fourth percent if the company or
2 30 association is described as any of the following:
2 31 (a) It is taxed under section 432.2.
2 32 (b) Its policies and contracts provide for third-
2 33 party payments or prepayments of health or medical
2 34 expenses which include coverage benefits for treatment
2 35 for neurobiological disorders and underlying co-
2 36 morbidity as provided in section 514C.21 and it meets
2 37 the requirements of subparagraph subdivision (d), (e),
2 38 or (f).
2 39 (c) Its commercial domicile is not in Iowa.
2 40 (d) Its commercial domicile is in Iowa and its
2 41 total premiums received in the previous calendar year
2 42 are less than ten million dollars and in the case of a
2 43 health insurance company or association it meets the
2 44 requirements of subparagraph subdivision (b).
2 45 (e) Its commercial domicile is in Iowa, its total
2 46 premiums received in the previous calendar year are at
2 47 least ten million dollars but not more than one
2 48 hundred million dollars, and it has purchased equity
2 49 interests in the Iowa fund of funds through the end of
2 50 the previous calendar year of at least one million
3 1 five hundred thousand dollars and in the case of a
3 2 health insurance company or association it meets the
3 3 requirements of subparagraph subdivision (b).
3 4 (f) Its commercial domicile is in Iowa, its total
3 5 premiums received in the previous calendar year are
3 6 more than one hundred million dollars, and it has
3 7 purchased equity interests in the Iowa fund of funds
3 8 through the end of the previous calendar year of at
3 9 least three million dollars and in the case of a
3 10 health insurance company or association it meets the
3 11 requirements of subparagraph subdivision (b).
3 12 (2) Two percent if the company or association does
3 13 not meet any of the descriptions in subparagraph (1).
3 14 e. For the 2006 and subsequent calendar years:
3 15 (1) One percent if the company or association is
3 16 described as any of the following:
3 17 (a) It is taxed under section 432.2.
3 18 (b) Its policies and contracts provide for third-
3 19 party payments or prepayments of health or medical
3 20 expenses which include coverage benefits for treatment
3 21 for neurobiological disorders and underlying co-
3 22 morbidity as provided in section 514C.21 and it meets
3 23 the requirements of subparagraph subdivision (d), (e),
3 24 or (f).
3 25 (c) Its commercial domicile is not in Iowa.
3 26 (d) Its commercial domicile is in Iowa and its
3 27 total premiums received in the previous calendar year
3 28 are less than ten million dollars and in the case of a
3 29 health insurance company or association it meets the
3 30 requirements of subparagraph subdivision (b).
3 31 (e) Its commercial domicile is in Iowa, its total
3 32 premiums received in the previous calendar year are at
3 33 least ten million dollars but not more than one
3 34 hundred million dollars, and it has purchased equity
3 35 interests in the Iowa fund of funds through the end of
3 36 the previous calendar year of at least two million
3 37 dollars and in the case of a health insurance company
3 38 or association it meets the requirements of
3 39 subparagraph subdivision (b).
3 40 (f) Its commercial domicile is in Iowa, its total
3 41 premiums received in the previous calendar year are
3 42 more than one hundred million dollars, and it has
3 43 purchased equity interests in the Iowa fund of funds
3 44 through the end of the previous calendar year of at
3 45 least four million dollars and in the case of a health
3 46 insurance company or association it meets the
3 47 requirements of subparagraph subdivision (b).
3 48 (2) Two percent if the company or association does
3 49 not meet any of the descriptions in subparagraph (1)."
3 50 #2. By striking page 2, line 34 through page 3,
4 1 line 4 and inserting the following:
4 2 "b. For the 2004 calendar year:
4 3 (1) One and three-fourths percent if the company
4 4 or association is described as any of the following:
4 5 (a) Its commercial domicile is not in Iowa.
4 6 (b) Its commercial domicile is in Iowa and its
4 7 total premiums received in the previous calendar year
4 8 are less than ten million dollars.
4 9 (c) Its commercial domicile is in Iowa, its total
4 10 premiums received in the previous calendar year are at
4 11 least ten million dollars but not more than one
4 12 hundred million dollars, and it has purchased equity
4 13 interests in the Iowa fund of funds through the end of
4 14 the previous calendar year of at least five hundred
4 15 thousand dollars.
4 16 (d) Its commercial domicile is in Iowa, its total
4 17 premiums received in the previous calendar year are
4 18 more than one hundred million dollars, and it has
4 19 purchased equity interests in the Iowa fund of funds
4 20 through the end of the previous calendar year of at
4 21 least one million dollars.
4 22 (2) Two percent if the company or association does
4 23 not meet any of the descriptions in subparagraph (1).
4 24 c. For the 2005 calendar year:
4 25 (1) One and one-half percent if the company or
4 26 association is described as any of the following:
4 27 (a) Its commercial domicile is not in Iowa.
4 28 (b) Its commercial domicile is in Iowa and its
4 29 total premiums received in the previous calendar year
4 30 are less than ten million dollars.
4 31 (c) Its commercial domicile is in Iowa, its total
4 32 premiums received in the previous calendar year are at
4 33 least ten million dollars but not more than one
4 34 hundred million dollars, and it has purchased equity
4 35 interests in the Iowa fund of funds through the end of
4 36 the previous calendar year of at least one million
4 37 dollars.
4 38 (d) Its commercial domicile is in Iowa, its total
4 39 premiums received in the previous calendar year are
4 40 more than one hundred million dollars, and it has
4 41 purchased equity interests in the Iowa fund of funds
4 42 through the end of the previous calendar year of at
4 43 least two million dollars.
4 44 (2) Two percent if the company or association does
4 45 not meet any of the descriptions in subparagraph (1).
4 46 d. For the 2006 calendar year:
4 47 (1) One and one-fourth percent if the company or
4 48 association is described as any of the following:
4 49 (a) Its commercial domicile is not in Iowa.
4 50 (b) Its commercial domicile is in Iowa and its
5 1 total premiums received in the previous calendar year
5 2 are less than ten million dollars.
5 3 (c) Its commercial domicile is in Iowa, its total
5 4 premiums received in the previous calendar year are at
5 5 least ten million dollars but not more than one
5 6 hundred million dollars, and it has purchased equity
5 7 interests in the Iowa fund of funds through the end of
5 8 the previous calendar year of at least one million
5 9 five hundred thousand dollars.
5 10 (d) Its commercial domicile is in Iowa, its total
5 11 premiums received in the previous calendar year are
5 12 more than one hundred million dollars, and it has
5 13 purchased equity interests in the Iowa fund of funds
5 14 through the end of the previous calendar year of at
5 15 least three million dollars.
5 16 (2) Two percent if the company or association does
5 17 not meet any of the descriptions in subparagraph (1).
5 18 e. For the 2007 and subsequent calendar years:
5 19 (1) One percent if the company or association is
5 20 described as any of the following:
5 21 (a) Its commercial domicile is not in Iowa.
5 22 (b) Its commercial domicile is in Iowa and its
5 23 total premiums received in the previous calendar year
5 24 are less than ten million dollars.
5 25 (c) Its commercial domicile is in Iowa, its total
5 26 premiums received in the previous calendar year are at
5 27 least ten million dollars but not more than one
5 28 hundred million dollars, and it has purchased equity
5 29 interests in the Iowa fund of funds the end of the
5 30 previous calendar year of at least two million
5 31 dollars.
5 32 (d) Its commercial domicile is in Iowa, its total
5 33 premiums received in the previous calendar year are
5 34 more than one hundred million dollars, and it has
5 35 purchased equity interests in the Iowa fund of funds
5 36 through the end of the previous calendar year of at
5 37 least four million dollars.
5 38 (2) Two percent if the company or association does
5 39 not meet any of the descriptions in subparagraph (1)."
5 40 #3. Page 5, by inserting after line 16 the
5 41 following:
5 42 "Sec. . NEW SECTION. 514C.21 MANDATED
5 43 COVERAGE FOR NEUROBIOLOGICAL DISORDERS AND UNDERLYING
5 44 CO-MORBIDITY.
5 45 1. For purposes of this section, unless the
5 46 context otherwise requires:
5 47 a. "Co-morbidity" means the coexistence of
5 48 conditions or diagnosable disorders such as
5 49 neurobiological disorders and substance abuse. For
5 50 purposes of this section, "substance abuse" means a
6 1 pattern of pathological use of alcohol or a drug that
6 2 causes impairment in social or occupational
6 3 functioning, or that produces physiological dependency
6 4 evidenced by physical tolerance or by physical
6 5 symptoms when the alcohol or drug is withdrawn.
6 6 b. "Neurobiological disorder" means the following:
6 7 (1) Schizophrenia and other psychotic disorders.
6 8 (2) Affective disorders.
6 9 (3) Anxiety disorders.
6 10 (4) Pervasive developmental disorders.
6 11 (5) Attention deficit hyperactivity disorder and
6 12 related disorders.
6 13 (6) Disorders identified in childhood and
6 14 adolescence.
6 15 The commissioner, by rule, shall identify the
6 16 neurobiological disorders covered by this definition,
6 17 consistent with the guidelines provided in the most
6 18 recent edition of the American psychiatric
6 19 association's diagnostic and statistical manual of
6 20 mental disorders, as such definitions may be amended
6 21 from time to time. The commissioner may adopt the
6 22 definitions provided in the manual by reference.
6 23 c. "Rates, terms, and conditions" means any
6 24 lifetime or annual payment limits, deductibles,
6 25 copayments, coinsurance, and any other cost-sharing
6 26 requirements, out-of-pocket limits, visit limitations,
6 27 and any other financial component of benefits coverage
6 28 that affects the covered individual.
6 29 2. a. Notwithstanding the uniformity of treatment
6 30 requirements of section 514C.6, a policy, contract, or
6 31 plan providing for third-party payment or prepayment
6 32 of health or medical expenses shall provide coverage
6 33 benefits for treatment for neurobiological disorders
6 34 and underlying co-morbidity based on rates, terms, and
6 35 conditions that are no more restrictive than the
6 36 rates, terms, and conditions for coverage benefits
6 37 provided for other health or medical conditions under
6 38 the policy, contract, or plan.
6 39 b. Any restrictions or limitations with respect to
6 40 rates, terms, and conditions involving deductibles,
6 41 copayments, coinsurance, and any other cost-sharing
6 42 requirements shall be cumulative for coverage of
6 43 treatment for neurobiological disorders and underlying
6 44 co-morbidity and other health or medical conditions
6 45 under a policy, contract, or plan. A policy,
6 46 contract, or plan subject to this section shall not
6 47 impose an aggregate lifetime or annual limit on
6 48 treatment for neurobiological disorders and underlying
6 49 co-morbidity coverage benefits unless the policy,
6 50 contract, or plan imposes an aggregate lifetime or
7 1 annual limit on substantially all health or medical
7 2 coverage benefits. A policy, contract, or plan
7 3 subject to this section that imposes an aggregate
7 4 lifetime or annual limit on substantially all medical
7 5 and surgical coverage benefits shall not impose an
7 6 aggregate lifetime or annual limit on treatment for
7 7 neurobiological disorders and underlying co-morbidity
7 8 coverage benefits that is less than the aggregate
7 9 lifetime or annual limit imposed on substantially all
7 10 health or medical coverage benefits.
7 11 c. Coverage required under this section shall be
7 12 for the treatment of neurobiological disorders and
7 13 underlying co-morbidity, for services provided by a
7 14 health professional licensed under chapter 147A, 148,
7 15 150A, 152, 154B, 154C, or 154D, for services provided
7 16 in a hospital, clinic, office, community mental health
7 17 center, health care facility, outpatient treatment
7 18 facility, residential treatment facility, halfway
7 19 house, or similar facility for the provision of health
7 20 care services, and for services provided pursuant to
7 21 the comprehensive program for treatment for substance
7 22 abuse maintained by the department of public health
7 23 pursuant to section 125.12 in a hospital licensed
7 24 under chapter 135B or a facility licensed under
7 25 chapter 125.
7 26 3. This section applies to the following classes
7 27 of third-party payment provider policies, contracts,
7 28 or plans delivered, issued for delivery, continued, or
7 29 renewed in this state on or after January 1, 2003:
7 30 a. Individual or group accident and sickness
7 31 insurance providing coverage on an expense-incurred
7 32 basis.
7 33 b. An individual or group hospital or medical
7 34 service contract issued pursuant to chapter 509, 514,
7 35 or 514A.
7 36 c. A plan established pursuant to chapter 509A for
7 37 public employees.
7 38 d. An individual or group health maintenance
7 39 organization contract regulated under chapter 514B.
7 40 e. An individual or group Medicare supplemental
7 41 policy, unless coverage pursuant to such policy is
7 42 preempted by federal law.
7 43 f. Any other entity engaged in the business of
7 44 insurance, risk transfer, or risk retention, which is
7 45 subject to the jurisdiction of the commissioner.
7 46 g. An organized delivery system licensed by the
7 47 director of public health.
7 48 4. The commissioner shall adopt rules pursuant to
7 49 chapter 17A to administer this section."
7 50 #4. By renumbering, redesignating, and correcting
8 1 internal references as necessary.
8 2
8 3
8 4
8 5 SHOULTZ of Black Hawk
8 6
8 7
8 8
8 9 OSTERHAUS of Jackson
8 10 SF 2318.207 79
8 11 mg/sh
Text: H08604 Text: H08606 Text: H08600 - H08699 Text: H Index Bills and Amendments: General Index Bill History: General Index
© 2002 Cornell College and League of Women Voters of Iowa
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