514C.6  Uniformity of treatment--employee welfare benefit plans.

1.  A statutory provision to mandate a health care coverage or service, or to mandate the offering of a health care coverage or service, applies to all state-regulated third- party payors and to employee welfare benefit plans described in 29 U.S.C. § 1001 et seq. However, if an employee welfare benefit plan subject to federal regulation is not subject to a substantially similar requirement, the statutory provision does not apply to a state-regulated third-party payor until the employee welfare benefit plans are subject to a substantially similar standard under federal regulations as determined by the commissioner.

2.  For purposes of this section unless the context otherwise requires, a third-party payor means:

a.  An accident and sickness insurer, subject to chapter 509 or 514A.

b.  A nonprofit health service corporation, subject to chapter 514.

c.  A health maintenance organization, subject to chapter 514B.

d.  Any other entity engaged in the business of insurance, risk transfer, or risk retention, which is subject to the jurisdiction of the commissioner.

Section History: Recent form

  91 Acts, ch 213, §20

Internal References

  Referred to in § 514C.7, 514C.11, 514C.12, 514C.18, 514C.19, 514C.20


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