Text: HF00732 Text: HF00734 Text: HF00700 - HF00799 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 HOUSE FILE 733 1 2 1 3 AN ACT 1 4 RELATING TO THE IOWA INDIVIDUAL HEALTH BENEFIT REINSURANCE 1 5 ASSOCIATION AND THE IOWA COMPREHENSIVE HEALTH INSURANCE 1 6 ASSOCIATION, BY CHANGING THE BOARD OF DIRECTORS, MEMBERSHIP, 1 7 AND ASSESSMENT RELATED TO THE ASSOCIATIONS, AND MAKING CHANGES 1 8 RELATED TO ADJUSTMENTS IN THE COVERAGE OF BASIC AND STANDARD 1 9 HEALTH BENEFIT PLANS. 1 10 1 11 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 1 12 1 13 Section 1. Section 513B.14, subsection 1, Code 2001, is 1 14 amended to read as follows: 1 15 1. The commissioner shall adopt by rule the form and level 1 16 of coverage of the basic health benefit plan and the standard 1 17 health benefit plan to be made available by a small employer 1 18 carrier pursuant to section 513B.10, but which shall be 1 19 appropriately adjusted at least every three years to reflect 1 20 the current state of the small group market. The 1 21 commissioner's rules shall include the benefit levels, cost- 1 22 sharing levels, exclusions, and limitations for the basic 1 23 health benefit plan and the standard health benefit plan, and 1 24 shall define for purposes of this subchapter, a basic health 1 25 benefit plan and a standard health benefit plan which contain 1 26 benefit and cost-sharing levels that are consistent with the 1 27 basic method of operation and the benefit plans of health 1 28 maintenance organizations, including any restrictions imposed 1 29 by federal law. 1 30 Sec. 2. Section 513C.5, subsection 2, Code 2001, is 1 31 amended to read as follows: 1 32 2. Notwithstanding subsection 1, the commissioner, with 1 33 the concurrence of the board of the Iowa individual health 1 34 benefit reinsurance association establishedin section 513C.101 35 under chapter 514E, may by order reduce or eliminate the 2 1 allowed rating bands provided under subsection 1, paragraphs 2 2 "a", "b", "c", and "e", or otherwise limit or eliminate the 2 3 use of experience rating.The commissioner shall also develop2 4a recommendation for the elimination of age as a rating2 5characteristic, and shall submit such recommendation by2 6January 8, 1996.2 7 Sec. 3. Section 513C.8, Code 2001, is amended to read as 2 8 follows: 2 9 513C.8 HEALTH BENEFIT PLAN STANDARDS. 2 10 The commissioner shall adopt by rule the form and level of 2 11 coverage of the basic health benefit plan and the standard 2 12 health benefit plan for the individual market which shall 2 13 provide benefits substantially similar to those as provided 2 14 for under chapter 513B with respect to small group coverage, 2 15 but which shall be appropriately adjusted at least every three 2 16 years to reflect the current state of the individual market. 2 17 Sec. 4. Section 513C.10, subsection 1, Code 2001, is 2 18 amended to read as follows: 2 19 1.A nonprofit corporation is established to be known as2 20theThe Iowa individual health benefit reinsurance association 2 21 is established as a nonprofit corporation. 2 22 a. All persons that provide health benefit plans in this 2 23 state including insurers providing accident and sickness 2 24 insurance under chapter 509, 514, or 514A; fraternal benefit 2 25 societies providing hospital, medical, or nursing benefits 2 26 under chapter 512B; and health maintenance organizations, 2 27 organized delivery systems, and all other entities providing 2 28 health insurance or health benefits subject to state insurance 2 29 regulation shall be members of the association. 2 30 b. The association shall be incorporated under chapter 2 31 504A, shall operate under a plan of operation established and 2 32 approved pursuant to chapter 504A, and shall exercise its 2 33 powers throughathe board of directors established underthis2 34sectionchapter 514E. 2 35 Sec. 5. Section 513C.10, subsections 2 through 5, Code 3 1 2001, are amended by striking the subsections. 3 2 Sec. 6. Section 513C.10, subsection 6, Code 2001, is 3 3 amended to read as follows: 3 4 6. Rates for basic and standard coverages as provided in 3 5 this chapter shall be determined by each carrier or organized 3 6 delivery system as the product of a basic and standard factor 3 7 and the lowest rate available for issuance by that carrier or 3 8 organized delivery system adjusted for rating characteristics 3 9 and benefits. Basic and standard factors shall be established 3 10 annually by the Iowa individual health benefit reinsurance 3 11 association board with the approval of the commissioner. 3 12 Multiple basic and standard factors for a distinct grouping of 3 13 basic and standard policies may be established. A basic and 3 14 standard factor is limited to a minimum value defined as the 3 15 ratio of the average of the lowest rate available for issuance 3 16 and the maximum rate allowable by law divided by the lowest 3 17 rate available for issuance. A basic and standard factor is 3 18 limited to a maximum value defined as the ratio of the maximum 3 19 rate allowable by law divided by the lowest rate available for 3 20 issuance. The maximum rate allowable by law and the lowest 3 21 rate available for issuance is determined based on the rate 3 22 restrictions under this chapter. For policies written after 3 23 January 1, 2002, rates for the basic and standard coverages as 3 24 provided in this chapter shall be calculated using the basic 3 25 and standard factors and shall be no lower than the maximum 3 26 rate allowable by law. However, to maintain assessable loss 3 27 assessments at or below one percent of total health insurance 3 28 premiums or payments as determined in accordance with 3 29 subsection 10, the Iowa individual health benefit reinsurance 3 30 association board with the approval of the commissioner may 3 31 increase the value for any basic and standard factor greater 3 32 than the maximum valueand. 3 33 The Iowa individual health benefit reinsurance association 3 34 may, with the approval of the commissioner,mayincrease cost 3 35 sharing provisions including, but not limited to, basic and 4 1 standard plan deductibles, coinsurance, or copayments. 4 2 Sec. 7. Section 514E.2, subsections 1 and 2, Code 2001, 4 3 are amended to read as follows: 4 4 1.There is established a nonprofit corporation known as4 5theThe Iowa comprehensive health insurance associationwhich4 6 is established as a nonprofit corporation. The association 4 7 shall assure that health insurance, as limited by sections 4 8 514E.4 and 514E.5, is made available to each eligible Iowa 4 9 resident and each federally eligible individual applying to 4 10 the association for coverage. The association shall also be 4 11 responsible for administering the Iowa individual health 4 12 benefit reinsurance association pursuant to all of the terms 4 13 and conditions contained in chapter 513C. 4 14 a. All carriers as defined in section 514E.1, subsection 4 15 3, and all organized delivery systems licensed by the director 4 16 of public health providing health insurance or health care 4 17 services in Iowa shall be members of the association. 4 18 b. The association shall operate under a plan of operation 4 19 established and approved under subsection 3 and shall exercise 4 20 its powers through a board of directors established under this 4 21 section. 4 22 2. The board of directors of the association shall consist 4 23of fourof all of the following: 4 24 a. Two members who shall be representatives of the two 4 25 largest domestic carriers of individual health insurance in 4 26 the state as of the calendar year ending December 31, 2000, 4 27 based on earned premium standards. 4 28 b. Three members who shall be representatives of the three 4 29 largest carriers of health insurance in the state, based on 4 30 earned premium standards, excluding Medicare supplement 4 31 coverage premiums, that are not otherwise represented. 4 32 c. Two members selected by the members of the association, 4 33twoone of whom shall berepresentatives from corporationsa 4 34 representative from a corporation operating pursuant to 4 35 chapter 514 on July 1, 1989, or anysuccessorssuccessor in 5 1 interest, andtwoone of whom shall berepresentatives ofa 5 2 representative of an organized deliverysystems or insurers5 3 system or an insurer providing coverage pursuant to chapter 5 4 509 or 514A; four. 5 5 d. Four public members selected by the governor; the. 5 6 e. The commissioner or the commissioner's designee from 5 7 the division of insurance; and two. 5 8 f. Two members of the general assembly, one of whom shall 5 9 be appointed by the speaker of the house and one of whom shall 5 10 be appointed by the president of the senate, after 5 11 consultation with the majority leader and the minority leader 5 12 of the senate, who shall be ex officio,andnonvoting members. 5 13 PARAGRAPH DIVIDED. The composition of the board of 5 14 directors shall be in compliance with sections 69.16 and 5 15 69.16A. The governor's appointees shall be chosen from a 5 16 broad cross-section of the residents of this state. 5 17 Members of the board may be reimbursed from the moneys of 5 18 the association for expenses incurred by them as members, but 5 19 shall not be otherwise compensated by the association for 5 20 their services. 5 21 5 22 5 23 5 24 BRENT SIEGRIST 5 25 Speaker of the House 5 26 5 27 5 28 5 29 MARY E. KRAMER 5 30 President of the Senate 5 31 5 32 I hereby certify that this bill originated in the House and 5 33 is known as House File 733, Seventy-ninth General Assembly. 5 34 5 35 6 1 6 2 MARGARET THOMSON 6 3 Chief Clerk of the House 6 4 Approved , 2001 6 5 6 6 6 7 6 8 THOMAS J. VILSACK 6 9 Governor
Text: HF00732 Text: HF00734 Text: HF00700 - HF00799 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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