HUMAN SERVICES DEPARTMENT[441] (Cont'd)

Filed, PROMISE JOBS, 93.114(15), 94.10
ARC 8291A 561
Filed, Child support enforcement, 98.24, 98.37,
98.45 ARC 8292A 562
Filed, Child day care, 109.6(5), 110.27, 110.35
ARC 8293A 564
Filed, Purchase of service reimbursement rates,
150.3(5), 150.22(7) ARC 8294A 565
Filed, Funding for empowerment areas, ch 169
ARC 8295A 566
Filed, Child care assistance--waiting list, 170.2(3)
ARC 8296A 568
INSURANCE DIVISION[191]
COMMERCE DEPARTMENT[181]"umbrella"
Filed Emergency, Medicare supplement
insurance, 37.3, 37.8(5), 37.15(3), 37.24,
Appendix C ARC 8298A 521
NATURAL RESOURCE COMMISSION[571]
NATURAL RESOURCES DEPARTMENT[561]"umbrella"
Notice, No-wake zones at Sabula, 40.34
ARC 8325A 503
Filed Emergency After Notice, Local
recreation infrastructure grants program,
ch 29 ARC 8323A 540
Filed Emergency After Notice, State and local
cooperative lake rehabilitation, 30.14
ARC 8324A 542
Filed, State parks and recreation areas, 61.2 to
61.6, 61.22(16) ARC 8322A 569
Filed Emergency After Notice, Waterfowl and
coot hunting seasons, 91.1 to 91.6
ARC 8326A 543
PROFESSIONAL LICENSURE DIVISION[645]
PUBLIC HEALTH DEPARTMENT[641]"umbrella"
Filed, Marital and family therapists and mental
health counselors, 30.1 to 30.6, 30.8 to 30.10,
31.1(3), 31.4(1), 31.8(4) ARC 8321A 571
Filed, Mortuary science examiners, 100.9(1),
100.10(3), 100.11, 101.1 to 101.7, 101.98,
101.101 to 101.103, 101.200, 101.212 to
101.215 ARC 8297A 571
PUBLIC FUNDS--AVAILABILITY
Public Health Department[641]
PRIMECARRE 494
PUBLIC HEALTH DEPARTMENT[641]
Notice of Public Funds Availability 494
Notice, Renovation, remodeling, and
repainting--lead hazard notification process,
69.1 to 69.9 ARC 8318A 504
Notice, Lead professional certification, 70.2,
70.4 to 70.9 ARC 8319A 506
Notice, Domestic abuse death review team,
ch 91 ARC 8317A 508
PUBLIC HEARINGS
Summarized list 486
RACING AND GAMING COMMISSION[491]
INSPECTIONS AND APPEALS DEPARTMENT[481]"umbrella"
Notice, General, 1.6(4), 3.11(3), 5.1(5),
5.16(21), 13.13 to 13.26, 20.22(3), 26.19(5)
ARC 8320A 510
REVENUE AND FINANCE DEPARTMENT[701]
Notice, Sales and use tax, 17.30, 18.24, 18.25,
18.34, 18.49, 18.58(1), 18.59, 20.7, 32.4
ARC 8308A 512
Notice, Local option school infrastructure sales
and service tax, ch 108 ARC 8309A 515
Filed, Federal tax on S corporation income;
credit for taxes paid to another state, 50.5,
50.7 ARC 8307A 575
USURY
Notice 518
VETERINARY MEDICINE BOARD[811]
Notice, Release of information to college
student aid commission; application for
licensure; examination, 5.18, 6.1, 6.2, 6.4
to 6.6, 6.8, 7.1, 9.1, 9.2(4), 9.3, 10.1,
10.4(24) ARC 8316A 518
WORKFORCE DEVELOPMENT BOARD/
SERVICES DIVISION[877]
WORKFORCE DEVELOPMENT DEPARTMENT[871]"umbrella"
Filed, Coordinating service provider, ch 4
ARC 8299A 576
Filed, Youth affairs, 10.1 to 10.5 ARC 8300A 578
Filed, Work force investment program,
11.3 to 11.10 ARC 8301A 581
Filed, Welfare-to-work program, ch 14
ARC 8302A 582
Filed, Strategic workforce development fund,
ch 15 ARC 8303A 585

PLEASE NOTE:
Rules will not be accepted after 12 o'clock noon on the Friday filing deadline days unless prior approval has been received from the Administrative Rules Coordinator's office.
If the filing deadline falls on a legal holiday, submissions made on the following Monday will be accepted.

CITATION of Administrative Rules

The Iowa Administrative Code shall be cited as (agency identification number) IAC
(chapter, rule, subrule, lettered paragraph, or numbered subparagraph).

441 IAC 79 (Chapter)

441 IAC 79.1(249A) (Rule)

441 IAC 79.1(1) (Subrule)

441 IAC 79.1(1)"a" (Paragraph)

441 IAC 79.1(1)"a"(1) (Subparagraph)

The Iowa Administrative Bulletin shall be cited as IAB (volume), (number), (publication
date), (page number), (ARC number).

IAB Vol. XII, No. 23 (5/16/90) p. 2050, ARC 872A

ITEM 2. Amend rule 261--21.2(15) as follows:
261--21.2(15) Structure. The division consists of two bureaus and the rural development program.
21.2(1) Bureau of community financing facilities and services. The bureau of community financing facilities and services is responsible for the following federal programs: Community Development Block Grant Nonentitlement Program (CDBG); Home Investment Partnership Program (HOME); Public Facilities Set-Aside (PFSA); and Emergency Shelter Grants Program (ESGP) as well as the state-funded Homeless Shelter Operating Grants (HSOG) and the Local Housing Assistance Program (LHAP). The bureau administers available federal funds for housing through the housing fund and is also responsible for developing a consolidated state plan for infrastructure and housing.
21.2(2) Bureau of community assistance planning and development. The bureau assists communities through training, grants and technical assistance to address industrial, commercial and community development issues. The programs include community outreach, the Iowa community betterment program, and main street. The city development board, which deals with corporate boundary changes, and the Iowa rural development council is are also staffed by this bureau.
21.2(3) Rural development. This program provides This bureau also promotes technical assistance and grants to rural communities and clusters of rural communities to help them address community and economic development initiatives including industrial, commercial, housing, leadership, local government, and tourism challenges. The programs include the rural enterprise fund, governmental services sharing program, rural leadership, and rural action.
ITEM 3. Amend rule 261--50.2(15) as follows:
261--50.2(15) Structure. The division is divided into three segments: the marketing and business expansion bureau, bureau of business finance, and the small business resource office.
50.2(1) Marketing and business expansion bureau. The bureau has two sections: marketing and promotion and business expansion. It also includes the department's procurement outreach office.
a. The marketing and promotion section is responsible for promoting Iowa as a location for business site expansion. The section is responsible for implementation of the bureau's five-year marketing plan which includes marketing strategies for advertising, public relations, direct mail, trade shows, conference/seminars, and other programs aimed at recruiting new businesses and encouraging existing businesses to expand in the state.
b. The business expansion section works one-on-one with business expansion clients to identify sites, buildings and communities which meet the client's location or expansion criteria. Once communities have been identified, IDED's site location managers work with the communities to prepare customized proposals for the client.
c. Procurement outreach office. This office is responsible for identifying federal procurement opportunities for Iowa businesses.
50.2(2) Bureau of business finance. The bureau provides financial assistance to businesses expanding in the state of Iowa, as well as to new business start-ups and business relocations to the state. The bureau administers the community economic betterment account (CEBA) which provides financial assistance to businesses and industries that require assistance in order to create new job opportunities or retain existing jobs which are in jeopardy. Other financial assistance programs administered by the bureau include the economic development set-aside (EDSA) program which is designed to encourage economic growth by providing financial assistance to businesses in communities of less than 50,000 in population and is aimed at providing employment opportunities for individuals from low- and moderate-income households; the value-added agricultural products and proc-esses financial assistance program (VAAPFAP); the self-employment loan program (SELP) which is designed to encourage self-employment for disadvantaged individuals; and the targeted small business financial assistance program (TSBFAP) which fosters the entrepreneurial spirit of women and minority owners by assisting with start-ups or expansions.
50.2(3) Small business resource office (SBRO). The SBRO's mission is to facilitate the growth of emerging small businesses in the state by providing entrepreneurial assistance, networking opportunities, and education programs. The SBRO is also responsible for identifying federal procurement opportunities for Iowa businesses. The SBRO's activities focus on the following three issues of concern to small business: procurement and marketing development, regulatory assistance, and entrepreneurial services. The SBRO is organized as follows:
a. Small business forums program. This program is the core of the SBRO's small business activities in entrepreneurial development and education. The forums program organizes quarterly entrepreneurial education round tables at multiple sites throughout Iowa, develops education programs for emerging small businesses, and forms entrepreneurial networking groups.
b. Small business advocacy program. The advocate works with small businesses both on a case managed basis and as a referral service. The program identifies small business service providers including sources of financial assistance for emerging businesses, regulatory information including licensing and permits, management assistance sources, and other small business service providers.
c. Management assistance program. The management assistance program is responsible for identifying and developing networks of sources of managerial talent including establishing an entrepreneurial mentor program utilizing middle management volunteers, members of SCORE and other retired management executives, and other successful entrepreneurs.
d. Targeted small business program. This program promotes the growth and development of small businesses owned and operated by minorities and women. It works with state purchasing officials to increase the number of contracts awarded to targeted small businesses (TSBs), and it identifies procurement opportunities for TSBs in both public and private sectors.
a. Procurement and marketing development team. The procurement and marketing development team includes the Iowa procurement outreach center and the targeted small business marketing programs.
b. Regulatory assistance team. The regulatory assistance team focuses on providing key business, licensing and regulatory information for the management of small businesses.
c. Entrepreneurial services team. The entrepreneurial services team includes small business case management and the operation of the venture network of Iowa.
ITEM 4. Amend rule 261--53.2(15), Definitions, by striking the definition of "Community builder program" and adding the definition of "Comprehensive community and economic development plan" as follows:
"Community builder program" means the community builder program as defined in 261--Chapter 80.
"Comprehensive community and economic development plan" means a plan that meets the requirements of 261-- Chapter 80.
ITEM 5. Amend paragraph 53.8(3)"d" as follows:
d. Certified community builder community. Maximum--10 points. A community will receive 10 points upon completion and subsequent certification by the department of a plan in accordance with 261--Chapter 80. Comprehensive community and economic development plan. Maximum--10 points. A community submitting a comprehensive community and economic development plan meeting the requirements of 261--Chapter 80 will receive 10 points.
ITEM 6. Amend paragraph 53.9(4)"c" as follows:
c. Certified community builder community (as defined in 53.8(3)"c"). Comprehensive community and economic development plan (as defined in 53.8(3)"d"). Maximum--10 points;
ITEM 7. Amend subrule 53.14(1) as follows:
53.14(1) The committee may approve negotiated settlements or the discontinuance of collection efforts by IDED if it determines that any of the following conditions exist:
a. The cost of collection would exceed the amount that would be recovered.
b. The claim is not legally feasible, e.g., the claim cannot be substantiated by the evidence, a statute of limitations has run, there is little likelihood of prevailing in a legal proceeding, the claim has been discharged in bankruptcy.
c. The claim has been referred to the Iowa attorney general's office for disposition.
c d. Other conditions exist that would not allow the recovery of funds.
ITEM 8. Amend 261--Chapter 80 by rescinding Division I, title, and rules 261--80.1(15) through 261-- 80.12(15) and adopting in lieu thereof the following:

The combined actual enrollment for the county, for purposes of this tax, shall be determined for each county imposing the tax under this rule by the Iowa department of management based on the actual enrollment figures reported by October 1 of each year to the department of management by the department of education pursuant to Iowa Code section 257.6(1). Enrollment figures to be used for the purpose of this formula are the enrollment figures reported by the department of education for the year preceding the favorable vote by a county to implement the local option school infrastructure sales and service tax.
EXAMPLE: In November of 1998, Polk County holds a valid election that results in a favorable vote to impose the local option school infrastructure tax. To determine the proper ratio of funds to be distributed to the multiple school districts located in Polk County, the enrollment figures reported by the department of education to the department of management by October of 1997 must be obtained to compute the formula as set forth.
For additional information regarding the formula for tax revenues to be distributed to the school districts, see the department of education's rules regarding this tax under 281-- Chapter 96, Iowa Administrative Code.
This rule is intended to implement 1998 Iowa Acts, House File 2282, section 3.

Medicare supplement insurance can be sold in only ten standardized plans plus two high deductible plans. The chart shows the benefits in each plan. Every company must make available Plan "A." Some plans may not be available in Iowa.
Basic Benefits: Included in All Plans.
Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses: Part B coinsurance (generally 20% of Medicare-approved expenses).
Blood: First three pints of blood each year.

*Plans F and J also have an option called a high deductible plan F and a high deductible plan J. These high deductible plans pay the same or offer the same benefits as Plans F and J after one has paid a calendar year [$1500] deductible. Benefits from high deductible plans F and J will not begin until out-of-pocket expenses are [$1500]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include, in Plan J, the plan's separate prescription drug deductible or, in Plans F and J, the plan's separate foreign travel emergency deductible.

*Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.
Adopt new Plan F or High Deductible Plan F as follows:

Adopt new Plan J or High Deductible Plan J as follows:

*** Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.
ITEM 4. Amend 191--Chapter 37 by adopting the following new rule:
191--37.24(514D) Guaranteed issue for eligible persons.
37.24(1) Eligible persons are those individuals described in subrule 37.24(2) who apply to enroll under the policy not later than 63 days after the date of the termination of enrollment described in subrule 37.24(2), and who submit evidence of the date of termination or disenrollment with the application for a Medicare supplement policy.
With respect to eligible persons, an issuer shall not deny or condition the issuance or effectiveness of a Medicare supplement policy described in subrule 37.24(3) that is offered and is available for issuance to new enrollees by the issuer, shall not discriminate in the pricing of such a Medicare supplement policy because of health status, claims experience, receipt of health care, or medical condition, and shall not impose an exclusion of benefits based on a preexisting condition under such a Medicare supplement policy.
37.24(2) An eligible person is an individual described in any of the following paragraphs:
a. The individual is enrolled under an employee welfare benefit plan that provides health benefits that supplement the benefits under Medicare; and the plan terminates, or the plan ceases to provide some or all such supplemental health benefits to the individual;
b. The individual is enrolled with a Medicare+Choice organization under a Medicare+Choice plan under Part C of Medicare, and there are circumstances permitting discontinuance of the individual's election of the plan under the first sentence of Section 1851(e)(4) of the federal Social Security Act, which consists of the following:
"Effective as of January 1, 2002, an individual may discontinue an election of a Medicare+Choice plan offered by a Medicare+Choice organization other than during an annual, coordinated election period [under Medicare] and make a new election under this section if:
"(1) The organization's or plan's certification [under this part] has been terminated or the organization has terminated or otherwise discontinued providing the plan in the area in which the individual resides;
"(2) The individual is no longer eligible to elect the plan because of a change in the individual's place of residence or other change in circumstances specified by the Secretary, but not including termination of the individual's enrollment on the basis described in Section 1851(g)(3)(B) of the federal Social Security Act (where the individual has not paid premiums on a timely basis or has engaged in disruptive behavior as specified in standards under Section 1856), or the plan is terminated for all individuals within a residence area;
"(3) The individual demonstrates, in accordance with guidelines established by the Secretary, that:
"1. The organization offering the plan substantially violated a material provision of the organization's contract under this part in relation to the individual, including the failure to provide an enrollee on a timely basis medically necessary care for which benefits are available under the plan or the failure to provide such covered care in accordance with applicable quality standards; or
"2. The organization, or agent or other entity acting on the organization's behalf, materially misrepresented the plan's provisions in marketing the plan to the individual; or
"(4) The individual meets such other exceptional conditions as the Secretary may provide."
c. The individual is enrolled with:
(1) An eligible organization under a contract under Section 1876 (Medicare risk or cost); or
(2) A similar organization operating under demonstration project authority, effective for periods before April 1, 1999; or
(3) An organization under an agreement under Section 1833(a)(1)(A) (Health care prepayment plan); or
(4) An organization under a Medicare Select policy; and
(5) The enrollment ceases under the same circumstances that would permit discontinuance of an individual's election of coverage under the first sentence of Section 1851(3)(4) of the federal Social Security Act as delineated above in paragraph 37.24(2)"b."
d. The individual is enrolled under a Medicare supplement policy and the enrollment ceases because:
(1) Of the insolvency of the issuer or bankruptcy of the nonissuer organization; or
Of other involuntary termination of coverage or enrollment under the policy;
(2) The issuer of the policy substantially violated a material provision of the policy; or
(3) The issuer, or an agent or other entity acting on the issuer's behalf, materially misrepresented the policy's provisions in marketing the policy to the individual;
e.(1) The individual was enrolled under a Medicare supplement policy and terminated enrollment and subsequently enrolls, for the first time, with any Medicare+Choice organization under a Medicare+Choice plan under Part C of Medicare, any eligible organization under a contract under Section 1876 (Medicare risk or cost), any similar organization operating under demonstration project authority, an organization under an agreement under Section 1833(a)(1)(A) (health care prepayment plan), or a Medicare Select policy; and
(2) The subsequent enrollment under subparagraph "e"(1) terminated by the enrollee during any period within the first 12 months of such subsequent enrollment (during which the enrollee is permitted to terminate such subsequent enrollment under Section 1851(e) of the federal Social Security Act); or
f. The individual, upon first becoming enrolled for benefits under Part B of Medicare at age 65 or older enrolls in a Medicare+Choice plan under Part C of Medicare, and disenrolls from the plan by not later than 12 months after the effective date of enrollment.
37.24(3) Products to which eligible persons are entitled. The Medicare supplement policy to which eligible persons are entitled under:
a. Subrule 37.24(2), paragraphs "a," "b," "c," and "d," is a Medicare supplement policy which has a benefit package classified as Plan A, B, C, or F offered by any issuer.
b. Paragraph 37.24(2)"e" is the same Medicare supplement policy in which the individual was most recently previously enrolled, if available from the same issuer, or, if not so available, a policy described in paragraph 37.24(3)"a."
c. Paragraph 37.24(2)"f" shall include any Medicare supplement policy offered by any issuer.
37.24(4) Notification provisions.
a. At the time of an event described in subrule 37.24(2) because of which an individual loses coverage or benefits due to the termination of a contract or agreement, policy, or plan, the organization that terminates the contract or agreement, the issuer terminating the policy, or the administrator of the plan being terminated, respectively, shall notify the individual of the individual's rights under this subrule, and of the obligations of issuers of Medicare supplement policies under subrule 37.24(1). Such notice shall be communicated contemporaneously with the notification of termination.
b. At the time of an event described in subrule 37.24(2) because of which an individual ceases enrollment under a contract or agreement, policy, or plan, the organization that offers the contract or agreement, regardless of the basis for the cessation of enrollment, the issuer offering the policy, or the administrator of the plan, respectively, shall notify the individual of the individual's rights under this subrule, and of the obligations of issuers of Medicare supplement policies under subrule 37.24(1). Such notice shall be communicated within ten working days of the issuer receiving notification of disenrollment.
ITEM 5. Rescind 191--Chapter 37, Appendix C, and adopt the following new appendix in lieu thereof:

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance provides limited benefits, if you meet the policy conditions, for hospital or medical expenses that result from accidental injury. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance provides limited benefits, if you meet the policy conditions, for expenses relating to the specific services listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy. Medicare generally pays for most or all of these expenses.
This insurance provides limited benefits, if you meet the policy conditions, for hospital or medical expenses only when you are treated for one of the specific diseases or health conditions listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Hospice

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance pays a fixed amount, regardless of your expenses, if you meet the policy conditions, for one of the specific diseases or health conditions named in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Hospice

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance pays a fixed dollar amount, regardless of your expenses, for each day you meet the policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance pays limited reimbursement for expenses if you meet the conditions listed in the policy. It also pays a fixed amount, regardless of your expenses, if you meet other policy conditions. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Hospice care

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Some health care services paid for by Medicare may also trigger the payment of benefits from this policy.
This insurance provides limited benefits, if you meet the conditions listed in the policy. It does not pay your Medicare deductibles or coinsurance and is not a substitute for Medicare Supplement insurance.
Medicare generally pays for most or all of these expenses.
Medicare pays extensive benefits for medically necessary services regardless of the reason you need them. These include:

* Hospitalization

* Physician services

* Hospice

* Other approved items and services
This policy must pay benefits without regard to other health benefit coverage to which you may be entitled under Medicare or other insurance.

3 Check the coverage in all health insurance policies you already have.
3 For more information about Medicare and Medicare Supplement insurance, review the Guide to Health Insurance for People with Medicare, available from the insurance company.
3 For help in understanding your health insurance, contact your state insurance department or state senior insurance counseling program.

Further amend subrule 79.1(2) by rescinding the footnote at the end of the chart and inserting the following new footnote:
*As required by 1998 Iowa Acts, Senate File 2410, section 32, subsection 1, paragraph "j," the department, in consultation with provider representatives, shall allocate to targeted services the 2 percent increase in overall rates paid to chiropractors, dentists, durable medical equipment dealers, and physicians, placing a priority on primary and preventative care. The department will also allocate to targeted services the 2 percent increase in rates for hearing aid dealers provided by 1998 Iowa Acts, Senate File 2410, section 32, subsection 1, paragraph "i," placing a priority on primary and preventative care.
ITEM 2. Amend subrule 81.6(16), paragraph "e," as follows:
e. Effective January 1, 1998, the basis for establishing the maximum reimbursement rate for non-state-owned nursing facilities shall be the seventieth percentile of participating facilities' per diem rates as calculated from the December 31, 1997, report of "unaudited compilation of various costs and statistical data."
Beginning July 1, 1997 1998, the basis for establishing the maximum reimbursement rate for non-state-owned nursing facilities shall be the seventieth percentile of participating facilities' per diem rates as calculated from the June 30, 1997 1998, report of "unaudited compilation of various costs and statistical data."