Text: S05495 Text: S05497 Text: S05400 - S05499 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend the House amendment, S-5475, to Senate File
1 2 2318, as amended, passed, and reprinted by the Senate,
1 3 as follows:
1 4 #1. Page 1, by inserting after line 2 the
1 5 following:
1 6 "# . Page 2, by striking lines 10 through 15 and
1 7 inserting the following:
1 8 "b. For the 2003 calendar year:
1 9 (1) One and three-fourths percent if the company
1 10 or association is described as any of the following:
1 11 (a) It is taxed under section 432.2.
1 12 (b) Its policies and contracts provide for third-
1 13 party payments or prepayments of health or medical
1 14 expenses which include coverage benefits for treatment
1 15 for neurobiological disorders and underlying co-
1 16 morbidity as provided in section 514C.21 and it meets
1 17 the requirements of subparagraph subdivision (d), (e),
1 18 or (f).
1 19 (c) Its commercial domicile is not in Iowa.
1 20 (d) Its commercial domicile is in Iowa and its
1 21 total premiums received in the previous calendar year
1 22 are less than ten million dollars and in the case of a
1 23 health insurance company or association it meets the
1 24 requirements of subparagraph subdivision (b).
1 25 (e) Its commercial domicile is in Iowa, its total
1 26 premiums received in the previous calendar year are at
1 27 least ten million dollars but not more than one
1 28 hundred million dollars, and it has purchased equity
1 29 interests in the Iowa fund of funds created pursuant
1 30 to section 15E.225 through the end of the previous
1 31 calendar year of at least five hundred thousand
1 32 dollars and in the case of a health insurance company
1 33 or association it meets the requirements of
1 34 subparagraph subdivision (b).
1 35 (f) Its commercial domicile is in Iowa, its total
1 36 premiums received in the previous calendar year are
1 37 more than one hundred million dollars, and it has
1 38 purchased equity interests in the Iowa fund of funds
1 39 through the end of the previous calendar year of at
1 40 least one million dollars and in the case of a health
1 41 insurance company or association it meets the
1 42 requirements of subparagraph subdivision (b).
1 43 (2) Two percent if the company or association does
1 44 not meet any of the descriptions in subparagraph (1).
1 45 c. For the 2004 calendar year:
1 46 (1) One and one-half percent if the company or
1 47 association is described as any of the following:
1 48 (a) It is taxed under section 432.2.
1 49 (b) Its policies and contracts provide for third-
1 50 party payments or prepayments of health or medical
2 1 expenses which include coverage benefits for treatment
2 2 for neurobiological disorders and underlying co-
2 3 morbidity as provided in section 514C.21 and it meets
2 4 the requirements of subparagraph subdivision (d), (e),
2 5 or (f).
2 6 (c) Its commercial domicile is not in Iowa.
2 7 (d) Its commercial domicile is in Iowa and its
2 8 total premiums received in the previous calendar year
2 9 are less than ten million dollars and in the case of a
2 10 health insurance company or association it meets the
2 11 requirements of subparagraph subdivision (b).
2 12 (e) Its commercial domicile is in Iowa, its total
2 13 premiums received in the previous calendar year are at
2 14 least ten million dollars but not more than one
2 15 hundred million dollars, and it has purchased equity
2 16 interests in the Iowa fund of funds through the end of
2 17 the previous calendar year of at least one million
2 18 dollars and in the case of a health insurance company
2 19 or association it meets the requirements of
2 20 subparagraph subdivision (b).
2 21 (f) Its commercial domicile is in Iowa, its total
2 22 premiums received in the previous calendar year are
2 23 more than one hundred million dollars, and it has
2 24 purchased equity interests in the Iowa fund of funds
2 25 through the end of the previous calendar year of at
2 26 least two million dollars and in the case of a health
2 27 insurance company or association it meets the
2 28 requirements of subparagraph subdivision (b).
2 29 (2) Two percent if the company or association does
2 30 not meet any of the descriptions in subparagraph (1).
2 31 d. For the 2005 calendar year:
2 32 (1) One and one-fourth percent if the company or
2 33 association is described as any of the following:
2 34 (a) It is taxed under section 432.2.
2 35 (b) Its policies and contracts provide for third-
2 36 party payments or prepayments of health or medical
2 37 expenses which include coverage benefits for treatment
2 38 for neurobiological disorders and underlying co-
2 39 morbidity as provided in section 514C.21 and it meets
2 40 the requirements of subparagraph subdivision (d), (e),
2 41 or (f).
2 42 (c) Its commercial domicile is not in Iowa.
2 43 (d) Its commercial domicile is in Iowa and its
2 44 total premiums received in the previous calendar year
2 45 are less than ten million dollars and in the case of a
2 46 health insurance company or association it meets the
2 47 requirements of subparagraph subdivision (b).
2 48 (e) Its commercial domicile is in Iowa, its total
2 49 premiums received in the previous calendar year are at
2 50 least ten million dollars but not more than one
3 1 hundred million dollars, and it has purchased equity
3 2 interests in the Iowa fund of funds through the end of
3 3 the previous calendar year of at least one million
3 4 five hundred thousand dollars and in the case of a
3 5 health insurance company or association it meets the
3 6 requirements of subparagraph subdivision (b).
3 7 (f) Its commercial domicile is in Iowa, its total
3 8 premiums received in the previous calendar year are
3 9 more than one hundred million dollars, and it has
3 10 purchased equity interests in the Iowa fund of funds
3 11 through the end of the previous calendar year of at
3 12 least three million dollars and in the case of a
3 13 health insurance company or association it meets the
3 14 requirements of subparagraph subdivision (b).
3 15 (2) Two percent if the company or association does
3 16 not meet any of the descriptions in subparagraph (1).
3 17 e. For the 2006 and subsequent calendar years:
3 18 (1) One percent if the company or association is
3 19 described as any of the following:
3 20 (a) It is taxed under section 432.2.
3 21 (b) Its policies and contracts provide for third-
3 22 party payments or prepayments of health or medical
3 23 expenses which include coverage benefits for treatment
3 24 for neurobiological disorders and underlying co-
3 25 morbidity as provided in section 514C.21 and it meets
3 26 the requirements of subparagraph subdivision (d), (e),
3 27 or (f).
3 28 (c) Its commercial domicile is not in Iowa.
3 29 (d) Its commercial domicile is in Iowa and its
3 30 total premiums received in the previous calendar year
3 31 are less than ten million dollars and in the case of a
3 32 health insurance company or association it meets the
3 33 requirements of subparagraph subdivision (b).
3 34 (e) Its commercial domicile is in Iowa, its total
3 35 premiums received in the previous calendar year are at
3 36 least ten million dollars but not more than one
3 37 hundred million dollars, and it has purchased equity
3 38 interests in the Iowa fund of funds through the end of
3 39 the previous calendar year of at least two million
3 40 dollars and in the case of a health insurance company
3 41 or association it meets the requirements of
3 42 subparagraph subdivision (b).
3 43 (f) Its commercial domicile is in Iowa, its total
3 44 premiums received in the previous calendar year are
3 45 more than one hundred million dollars, and it has
3 46 purchased equity interests in the Iowa fund of funds
3 47 through the end of the previous calendar year of at
3 48 least four million dollars and in the case of a health
3 49 insurance company or association it meets the
3 50 requirements of subparagraph subdivision (b).
4 1 (2) Two percent if the company or association does
4 2 not meet any of the descriptions in subparagraph (1)."
4 3 # . By striking page 2, line 34 through page 3,
4 4 line 4 and inserting the following:
4 5 "b. For the 2004 calendar year:
4 6 (1) One and three-fourths percent if the company
4 7 or association is described as any of the following:
4 8 (a) Its commercial domicile is not in Iowa.
4 9 (b) Its commercial domicile is in Iowa and its
4 10 total premiums received in the previous calendar year
4 11 are less than ten million dollars.
4 12 (c) Its commercial domicile is in Iowa, its total
4 13 premiums received in the previous calendar year are at
4 14 least ten million dollars but not more than one
4 15 hundred million dollars, and it has purchased equity
4 16 interests in the Iowa fund of funds through the end of
4 17 the previous calendar year of at least five hundred
4 18 thousand dollars.
4 19 (d) Its commercial domicile is in Iowa, its total
4 20 premiums received in the previous calendar year are
4 21 more than one hundred million dollars, and it has
4 22 purchased equity interests in the Iowa fund of funds
4 23 through the end of the previous calendar year of at
4 24 least one million dollars.
4 25 (2) Two percent if the company or association does
4 26 not meet any of the descriptions in subparagraph (1).
4 27 c. For the 2005 calendar year:
4 28 (1) One and one-half percent if the company or
4 29 association is described as any of the following:
4 30 (a) Its commercial domicile is not in Iowa.
4 31 (b) Its commercial domicile is in Iowa and its
4 32 total premiums received in the previous calendar year
4 33 are less than ten million dollars.
4 34 (c) Its commercial domicile is in Iowa, its total
4 35 premiums received in the previous calendar year are at
4 36 least ten million dollars but not more than one
4 37 hundred million dollars, and it has purchased equity
4 38 interests in the Iowa fund of funds through the end of
4 39 the previous calendar year of at least one million
4 40 dollars.
4 41 (d) Its commercial domicile is in Iowa, its total
4 42 premiums received in the previous calendar year are
4 43 more than one hundred million dollars, and it has
4 44 purchased equity interests in the Iowa fund of funds
4 45 through the end of the previous calendar year of at
4 46 least two million dollars.
4 47 (2) Two percent if the company or association does
4 48 not meet any of the descriptions in subparagraph (1).
4 49 d. For the 2006 calendar year:
4 50 (1) One and one-fourth percent if the company or
5 1 association is described as any of the following:
5 2 (a) Its commercial domicile is not in Iowa.
5 3 (b) Its commercial domicile is in Iowa and its
5 4 total premiums received in the previous calendar year
5 5 are less than ten million dollars.
5 6 (c) Its commercial domicile is in Iowa, its total
5 7 premiums received in the previous calendar year are at
5 8 least ten million dollars but not more than one
5 9 hundred million dollars, and it has purchased equity
5 10 interests in the Iowa fund of funds through the end of
5 11 the previous calendar year of at least one million
5 12 five hundred thousand dollars.
5 13 (d) Its commercial domicile is in Iowa, its total
5 14 premiums received in the previous calendar year are
5 15 more than one hundred million dollars, and it has
5 16 purchased equity interests in the Iowa fund of funds
5 17 through the end of the previous calendar year of at
5 18 least three million dollars.
5 19 (2) Two percent if the company or association does
5 20 not meet any of the descriptions in subparagraph (1).
5 21 e. For the 2007 and subsequent calendar years:
5 22 (1) One percent if the company or association is
5 23 described as any of the following:
5 24 (a) Its commercial domicile is not in Iowa.
5 25 (b) Its commercial domicile is in Iowa and its
5 26 total premiums received in the previous calendar year
5 27 are less than ten million dollars.
5 28 (c) Its commercial domicile is in Iowa, its total
5 29 premiums received in the previous calendar year are at
5 30 least ten million dollars but not more than one
5 31 hundred million dollars, and it has purchased equity
5 32 interests in the Iowa fund of funds the end of the
5 33 previous calendar year of at least two million
5 34 dollars.
5 35 (d) Its commercial domicile is in Iowa, its total
5 36 premiums received in the previous calendar year are
5 37 more than one hundred million dollars, and it has
5 38 purchased equity interests in the Iowa fund of funds
5 39 through the end of the previous calendar year of at
5 40 least four million dollars.
5 41 (2) Two percent if the company or association does
5 42 not meet any of the descriptions in subparagraph
5 43 (1).""
5 44 #2. Page 1, by inserting after line 18 the
5 45 following:
5 46 "# . Page 5, by inserting after line 16 the
5 47 following:
5 48 "Sec. . NEW SECTION. 514C.21 MANDATED
5 49 COVERAGE FOR NEUROBIOLOGICAL DISORDERS AND UNDERLYING
5 50 CO-MORBIDITY.
6 1 1. For purposes of this section, unless the
6 2 context otherwise requires:
6 3 a. "Co-morbidity" means the coexistence of
6 4 conditions or diagnosable disorders such as
6 5 neurobiological disorders and substance abuse. For
6 6 purposes of this section, "substance abuse" means a
6 7 pattern of pathological use of alcohol or a drug that
6 8 causes impairment in social or occupational
6 9 functioning, or that produces physiological dependency
6 10 evidenced by physical tolerance or by physical
6 11 symptoms when the alcohol or drug is withdrawn.
6 12 b. "Neurobiological disorder" means the following:
6 13 (1) Schizophrenia and other psychotic disorders.
6 14 (2) Affective disorders.
6 15 (3) Anxiety disorders.
6 16 (4) Pervasive developmental disorders.
6 17 (5) Attention deficit hyperactivity disorder and
6 18 related disorders.
6 19 (6) Disorders identified in childhood and
6 20 adolescence.
6 21 The commissioner, by rule, shall identify the
6 22 neurobiological disorders covered by this definition,
6 23 consistent with the guidelines provided in the most
6 24 recent edition of the American psychiatric
6 25 association's diagnostic and statistical manual of
6 26 mental disorders, as such definitions may be amended
6 27 from time to time. The commissioner may adopt the
6 28 definitions provided in the manual by reference.
6 29 c. "Rates, terms, and conditions" means any
6 30 lifetime or annual payment limits, deductibles,
6 31 copayments, coinsurance, and any other cost-sharing
6 32 requirements, out-of-pocket limits, visit limitations,
6 33 and any other financial component of benefits coverage
6 34 that affects the covered individual.
6 35 2. a. Notwithstanding the uniformity of treatment
6 36 requirements of section 514C.6, a policy, contract, or
6 37 plan providing for third-party payment or prepayment
6 38 of health or medical expenses shall provide coverage
6 39 benefits for treatment for neurobiological disorders
6 40 and underlying co-morbidity based on rates, terms, and
6 41 conditions that are no more restrictive than the
6 42 rates, terms, and conditions for coverage benefits
6 43 provided for other health or medical conditions under
6 44 the policy, contract, or plan.
6 45 b. Any restrictions or limitations with respect to
6 46 rates, terms, and conditions involving deductibles,
6 47 copayments, coinsurance, and any other cost-sharing
6 48 requirements shall be cumulative for coverage of
6 49 treatment for neurobiological disorders and underlying
6 50 co-morbidity and other health or medical conditions
7 1 under a policy, contract, or plan. A policy,
7 2 contract, or plan subject to this section shall not
7 3 impose an aggregate lifetime or annual limit on
7 4 treatment for neurobiological disorders and underlying
7 5 co-morbidity coverage benefits unless the policy,
7 6 contract, or plan imposes an aggregate lifetime or
7 7 annual limit on substantially all health or medical
7 8 coverage benefits. A policy, contract, or plan
7 9 subject to this section that imposes an aggregate
7 10 lifetime or annual limit on substantially all medical
7 11 and surgical coverage benefits shall not impose an
7 12 aggregate lifetime or annual limit on treatment for
7 13 neurobiological disorders and underlying co-morbidity
7 14 coverage benefits that is less than the aggregate
7 15 lifetime or annual limit imposed on substantially all
7 16 health or medical coverage benefits.
7 17 c. Coverage required under this section shall be
7 18 for the treatment of neurobiological disorders and
7 19 underlying co-morbidity, for services provided by a
7 20 health professional licensed under chapter 147A, 148,
7 21 150A, 152, 154B, 154C, or 154D, for services provided
7 22 in a hospital, clinic, office, community mental health
7 23 center, health care facility, outpatient treatment
7 24 facility, residential treatment facility, halfway
7 25 house, or similar facility for the provision of health
7 26 care services, and for services provided pursuant to
7 27 the comprehensive program for treatment for substance
7 28 abuse maintained by the department of public health
7 29 pursuant to section 125.12 in a hospital licensed
7 30 under chapter 135B or a facility licensed under
7 31 chapter 125.
7 32 3. This section applies to the following classes
7 33 of third-party payment provider policies, contracts,
7 34 or plans delivered, issued for delivery, continued, or
7 35 renewed in this state on or after January 1, 2003:
7 36 a. Individual or group accident and sickness
7 37 insurance providing coverage on an expense-incurred
7 38 basis.
7 39 b. An individual or group hospital or medical
7 40 service contract issued pursuant to chapter 509, 514,
7 41 or 514A.
7 42 c. A plan established pursuant to chapter 509A for
7 43 public employees.
7 44 d. An individual or group health maintenance
7 45 organization contract regulated under chapter 514B.
7 46 e. An individual or group Medicare supplemental
7 47 policy, unless coverage pursuant to such policy is
7 48 preempted by federal law.
7 49 f. Any other entity engaged in the business of
7 50 insurance, risk transfer, or risk retention, which is
8 1 subject to the jurisdiction of the commissioner.
8 2 g. An organized delivery system licensed by the
8 3 director of public health.
8 4 4. The commissioner shall adopt rules pursuant to
8 5 chapter 17A to administer this section."
8 6 # . By renumbering, redesignating, and
8 7 correcting internal references as necessary."
8 8
8 9
8 10
8 11 THOMAS FIEGEN
8 12 MARK SHEARER
8 13 STEVEN D. HANSEN
8 14 AMANDA RAGAN
8 15 JOE BOLKCOM
8 16 MIKE CONNOLLY
8 17 BETTY A. SOUKUP
8 18 PATRICIA HARPER
8 19 BILL FINK
8 20 ROBERT E. DVORSKY
8 21 JOHNIE HAMMOND
8 22 MICHAEL E. GRONSTAL
8 23 JOHN P. KIBBIE
8 24 DENNIS H. BLACK
8 25 WALLY E. HORN
8 26 DICK L. DEARDEN
8 27 EUGENE S. FRAISE
8 28 MARY A. LUNDBY
8 29 SF 2318.208 79
8 30 mg/sh
Text: S05495 Text: S05497 Text: S05400 - S05499 Text: S Index Bills and Amendments: General Index Bill History: General Index
© 2002 Cornell College and League of Women Voters of Iowa
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