Text: HF00567 Text: HF00569 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 513C.3, subsection 5, Code 2001, is 1 2 amended to read as follows: 1 3 5. "Carrier" means any entity that provides individual 1 4 health benefit plans in this state. For purposes of this 1 5 chapter, carrier includes an insurance company, a group 1 6 hospital or medical service corporation, a fraternal benefit 1 7 society, a health maintenance organization, and any other 1 8 entity providing an individual plan of health insurance or 1 9 health benefits subject to state insurance regulation, except 1 10 any entity establishing a plan under chapter 509A. "Carrier" 1 11 does not include an organized delivery system. 1 12 Sec. 2. Section 513C.5, subsection 2, Code 2001, is 1 13 amended to read as follows: 1 14 2. Notwithstanding subsection 1, the commissioner, with 1 15 the concurrence of the board of the Iowa individual health 1 16 benefit reinsurance association establishedin section 513C.101 17 under chapter 514E, may by order reduce or eliminate the 1 18 allowed rating bands provided under subsection 1, paragraphs 1 19 "a", "b", "c", and "e", or otherwise limit or eliminate the 1 20 use of experience rating.The commissioner shall also develop1 21a recommendation for the elimination of age as a rating1 22characteristic, and shall submit such recommendation by1 23January 8, 1996.1 24 Sec. 3. Section 513C.8, Code 2001, is amended to read as 1 25 follows: 1 26 513C.8 HEALTH BENEFIT PLAN STANDARDS. 1 27 The commissioner shall adopt by rule the form and level of 1 28 coverage of the basic health benefit plan and the standard 1 29 health benefit plan for the individual market which shall 1 30 provide benefits substantially similar to those as provided 1 31 for under chapter 513B with respect to small group coverage, 1 32 but which shall be appropriately adjusted every three years to 1 33 reflect the current state of the individual market. 1 34 Sec. 4. Section 513C.10, subsection 1, Code 2001, is 1 35 amended to read as follows: 2 1 1.A nonprofit corporation is established to be known as2 2theThe Iowa individual health benefit reinsurance association 2 3 is established as a nonprofit corporation. 2 4 a. All persons that provide health benefit plans in this 2 5 state including insurers providing accident and sickness 2 6 insurance under chapter 509, 514, or 514A; fraternal benefit 2 7 societies providing hospital, medical, or nursing benefits 2 8 under chapter 512B; and health maintenance organizations, 2 9 organized delivery systems, and all other entities providing 2 10 health insurance or health benefits subject to state insurance 2 11 regulation, except any entity establishing a plan under 2 12 chapter 509A, shall be members of this association. 2 13 b. The association shall be incorporated under chapter 2 14 504A, shall operate under a plan of operation established and 2 15 approved pursuant to chapter 504A, and shall exercise its 2 16 powers throughathe board of directors established underthis2 17sectionchapter 514E. 2 18 Sec. 5. Section 513C.10, subsections 2 through 5, Code 2 19 2001, are amended by striking the subsections. 2 20 Sec. 6. Section 513C.10, subsection 6, Code 2001, is 2 21 amended to read as follows: 2 22 6. Rates for basic and standard coverages as provided in 2 23 this chapter shall be determined by each carrier or organized 2 24 delivery system as the product of a basic and standard factor 2 25 and the lowest rate available for issuance by that carrier or 2 26 organized delivery system adjusted for rating characteristics 2 27 and benefits. Basic and standard factors shall be established 2 28 annually by the Iowa individual health benefit reinsurance 2 29 association board with the approval of the commissioner. 2 30 Multiple basic and standard factors for a distinct grouping of 2 31 basic and standard policies may be established. A basic and 2 32 standard factor is limited to a minimum value defined as the 2 33 ratio of the average of the lowest rate available for issuance 2 34 and the maximum rate allowable by law divided by the lowest 2 35 rate available for issuance. A basic and standard factor is 3 1 limited to a maximum value defined as the ratio of the maximum 3 2 rate allowable by law divided by the lowest rate available for 3 3 issuance. The maximum rate allowable by law and the lowest 3 4 rate available for issuance is determined based on the rate 3 5 restrictions under this chapter. For policies written after 3 6 January 1, 2002, rates for the basic and standard coverages as 3 7 provided in this chapter shall be calculated using the basic 3 8 and standard factors and shall be no lower than the maximum 3 9 rate allowable by law. However, to maintain assessable loss 3 10 assessments at or below one percent of total health insurance 3 11 premiums or payments as determined in accordance with 3 12 subsection 10, the Iowa individual health benefit reinsurance 3 13 association board with the approval of the commissioner may 3 14 increase the value for any basic and standard factor greater 3 15 than the maximum valueand. 3 16 The Iowa individual health benefit reinsurance association 3 17 may, with the approval of the commissioner,mayincrease cost 3 18 sharing provisions including, but not limited to, basic and 3 19 standard plan deductibles, coinsurance, or copayments. 3 20 Sec. 7. Section 514E.2, subsections 1, 2, and 13, Code 3 21 2001, are amended to read as follows: 3 22 1.There is established a nonprofit corporation known as3 23theThe Iowa comprehensive health insurance associationwhich3 24 is established as a nonprofit corporation. The association 3 25 shall assure that health insurance, as limited by sections 3 26 514E.4 and 514E.5, is made available to each eligible Iowa 3 27 resident and each federally eligible individual applying to 3 28 the association for coverage. The association shall also be 3 29 responsible for administering the Iowa individual health 3 30 benefit reinsurance association pursuant to all of the terms 3 31 and conditions contained in chapter 513C. 3 32 a. All carriers as defined in section 514E.1, subsection 3 33 3, and all organized delivery systems licensed by the director 3 34 of public health providing health insurance or health care 3 35 services in Iowa shall be members of the association. 4 1 b. The association shall operate under a plan of operation 4 2 established and approved under subsection 3 and shall exercise 4 3 its powers through a board of directors established under this 4 4 section. 4 5 2. The board of directors of the association shall consist 4 6of fourof all of the following: 4 7 a. Four members who shall be representatives of the four 4 8 largest domestic carriers of individual health insurance in 4 9 the state as of the calendar year ending December 31, 2000, 4 10 based on earned premium standards. 4 11 b. Three members who shall be representatives of the three 4 12 largest carriers of health insurance in the state, based on 4 13 earned premium standards, excluding Medicare supplement 4 14 coverage premiums, that are not otherwise represented. 4 15 c. Four members selected by the members of the 4 16 association, two of whom shall be representatives from 4 17 corporations operating pursuant to chapter 514 on July 1, 4 18 1989, or any successors in interest, and two of whom shall be 4 19 representatives of organized delivery systems or insurers 4 20 providing coverage pursuant to chapter 509 or 514A; four. 4 21 d. Four public members selected by the governor; the. 4 22 e. The commissioner or the commissioner's designee from 4 23 the division of insurance; and two. 4 24 f. Two members of the general assembly, one of whom shall 4 25 be appointed by the speaker of the house and one of whom shall 4 26 be appointed by the president of the senate, after 4 27 consultation with the majority leader and the minority leader 4 28 of the senate, who shall be ex officio,andnonvoting members. 4 29 PARAGRAPH DIVIDED. The composition of the board of 4 30 directors shall be in compliance with sections 69.16 and 4 31 69.16A. The governor's appointees shall be chosen from a 4 32 broad cross-section of the residents of this state. 4 33 Members of the board may be reimbursed from the moneys of 4 34 the association for expenses incurred by them as members, but 4 35 shall not be otherwise compensated by the association for 5 1 their services. 5 2 13. A member who, after July 1,19862001, has paid one or 5 3 more assessments levied under this chapter or chapter 513C may 5 4 take a credit against the premium taxes, or similar taxes, 5 5 upon revenues or income of the member that are imposed by the 5 6 state on health insurance premiums pursuant to chapter 432 or 5 7 payments subject to taxation under section 514B.31, up to the 5 8 amount of twenty percent of those taxes due, for each of the 5 9 five calendar years following the year for which an assessment 5 10 was paid, or until the aggregate of those assessments has been 5 11 offset by credits against those taxes if this occurs first. 5 12 If a member ceases doing business, all uncredited assessments 5 13 may be credited against its premium tax liability for the year 5 14 it ceases doing business. 5 15 EXPLANATION 5 16 This bill amends sections of Code chapters 513C and 514E, 5 17 dealing with the Iowa individual health benefit reinsurance 5 18 association and the Iowa comprehensive health insurance 5 19 association, respectively. 5 20 The bill amends Code section 513C.8 to provide that the 5 21 insurance commissioner will adjust the health plan standards 5 22 every three years to reflect the current state of the 5 23 individual market. 5 24 The bill amends Code section 513C.10 to exclude from 5 25 membership in the Iowa individual health benefit reinsurance 5 26 association entities that establish plans under Code chapter 5 27 509A, the chapter that addresses group insurance for public 5 28 employees. The bill also amends the definition of "carrier" 5 29 in Code section 513C.3 to exclude the same entities from the 5 30 definition. 5 31 The bill also amends Code section 513C.10 to provide that 5 32 the board of directors governing the Iowa individual health 5 33 benefit reinsurance association is established under Code 5 34 chapter 514E, rather than under Code section 513C.10, and also 5 35 divides existing language into paragraphs. A similar change 6 1 is made to Code section 513C.5 regarding the reference to Code 6 2 chapter 514E. Code section 513C.5 also deletes a reference to 6 3 a study that the commissioner has completed. 6 4 The bill deletes subsections of Code section 513C.10 that 6 5 address the board of directors for the Iowa individual health 6 6 benefit reinsurance association. 6 7 The bill amends Code section 513C.10 to provide that for 6 8 policies written after January 1, 2002, rates for the basic 6 9 and standard coverages shall be no lower that the maximum rate 6 10 allowable by law. In addition, the Iowa individual health 6 11 benefit reinsurance association may increase cost sharing 6 12 provisions with the approval of the commissioner. 6 13 The bill amends Code section 514E.2 to provide that the 6 14 Iowa comprehensive health insurance association shall be 6 15 responsible for administering the Iowa individual health 6 16 benefit reinsurance association pursuant to all of the terms 6 17 and conditions contained in Code chapter 513C. The bill also 6 18 divides existing language into paragraphs. 6 19 The bill also amends Code section 514E.2 regarding the 6 20 composition of the board of directors of the Iowa individual 6 21 health benefit reinsurance association, resulting in a merger 6 22 of the boards of the Iowa comprehensive health insurance 6 23 association and the Iowa individual health benefit reinsurance 6 24 association. The bill adds as member representatives the four 6 25 largest domestic carriers of the individual health insurance 6 26 in the state as of the calendar year ending December 31, 2000, 6 27 measured by an earned premium standard, and representatives of 6 28 the three largest carriers of health insurance in the state, 6 29 measured by an earned premium standard, excluding Medicare 6 30 supplement coverage premiums, that are not otherwise 6 31 represented. These are the same groups deleted under Code 6 32 section 513C.10 as the board of directors for the Iowa 6 33 individual health benefit reinsurance association. The bill 6 34 also divides existing language into paragraphs. 6 35 The bill also amends Code section 514E.2 to provide that a 7 1 credit against the premium taxes, or similar taxes, is 7 2 available to members who have paid one or more assessments 7 3 levied under Code chapter 514E or Code chapter 513C after July 7 4 1, 2001, rather than just under Code chapter 514E. 7 5 LSB 1772HV 79 7 6 jj/gg/8
Text: HF00567 Text: HF00569 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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