House Amendment 1002


PAG LIN




     1  1    Amend House File 1 as follows:
     1  2 #1.  Page 1, by inserting before line 1 the
     1  3 following:
     1  4                       <DIVISION I
     1  5            MINIMUM HOURLY WAGE REQUIREMENTS>
     1  6 #2.  Page 1, by inserting after line 35 the
     1  7 following:
     1  8                      <DIVISION II
     1  9           ASSOCIATION GROUP HEALTH CARE PLANS
     1 10    Sec.    .  Section 509.1, Code 2007, is amended by
     1 11 adding the following new subsection:
     1 12    NEW SUBSECTION.  7A.  A policy of group health
     1 13 insurance coverage, as defined in section 513B.2,
     1 14 issued by a small employer carrier, as defined in
     1 15 section 513B.2, to a bona fide association, subject to
     1 16 the following requirements:
     1 17    a.  The policy provides group health insurance
     1 18 coverage to eligible employees of members of a bona
     1 19 fide association that are small employers as defined
     1 20 in section 513B.2, and to the spouses and dependents
     1 21 of such employees.
     1 22    b.  The policy is issued to a bona fide
     1 23 association.  For the purposes of this subsection, a
     1 24 bona fide association is an association which meets
     1 25 all of the following requirements:
     1 26    (1)  The association is a trade, industry, or
     1 27 professional association which is organized in good
     1 28 faith as a nonprofit corporation under chapter 504 for
     1 29 purposes other than obtaining insurance and has been
     1 30 in existence and actively maintained for at least five
     1 31 continuous years at the time the policy is issued.
     1 32    (2)  The association does not condition membership
     1 33 in the association on the health status of employees
     1 34 of its members or the health status of the spouses and
     1 35 dependents of such employees.
     1 36    (3)  Group health insurance coverage offered by the
     1 37 association is available to all eligible employees of
     1 38 its members that are small employers as defined in
     1 39 section 513B.2 who choose to participate in the health
     1 40 insurance coverage offered, and to the spouses and
     1 41 dependents of such employees, regardless of the health
     1 42 status of such employees or their spouses and
     1 43 dependents.
     1 44    (4)  Group health insurance coverage offered by the
     1 45 association is available only to persons who are
     1 46 eligible employees of a small employer as defined in
     1 47 section 513B.2 that is a member of the association, or
     1 48 to the spouses or dependents of such employees.
     1 49    Sec.    .  Section 509.1, subsection 8, unnumbered
     1 50 paragraph 1, Code 2007, is amended to read as follows:
     2  1    A policy issued to a resident of this state under a
     2  2 group life, accident, or health insurance policy
     2  3 issued to a group other than one described in
     2  4 subsections 1 through 7 7A, subject to the following
     2  5 requirements:
     2  6    Sec.    .  Section 513B.2, subsection 6, paragraph
     2  7 a, subparagraph (3), Code 2007, is amended by striking
     2  8 the subparagraph and inserting in lieu thereof the
     2  9 following:
     2 10    (3)  The coverages are provided by a policy of
     2 11 group health insurance coverage through a bona fide
     2 12 association as provided in section 509.1, subsection
     2 13 7A, which meets the requirements for a class of
     2 14 business under section 513B.4.  A small employer
     2 15 carrier may condition coverages under such a policy of
     2 16 group health insurance coverage on any of the
     2 17 following requirements:
     2 18    (a)  Minimum levels of participation by employees
     2 19 of each member of a bona fide association that offers
     2 20 the coverage to its employees.
     2 21    (b)  Minimum levels of contribution by each member
     2 22 of a bona fide association that offers the coverage to
     2 23 its employees.
     2 24    (c)  A specified policy term, subject to annual
     2 25 premium rate adjustments as permitted by section
     2 26 513B.4.
     2 27    Sec.    .  Section 513B.2, subsection 6, paragraph
     2 28 a, Code 2007, is amended by adding the following new
     2 29 subparagraph:
     2 30    NEW SUBPARAGRAPH.  (4)  The coverages are provided
     2 31 by a policy of group health insurance coverage through
     2 32 two or more bona fide associations as provided in
     2 33 section 509.1, subsection 7A, which a small employer
     2 34 carrier has aggregated as a distinct grouping that
     2 35 meets the requirements for a class of business under
     2 36 section 513B.4.  After a distinct grouping of bona
     2 37 fide associations is established as a class of
     2 38 business, the small group carrier shall not remove a
     2 39 bona fide association from the class based on the
     2 40 claims experience of that association.  A small
     2 41 employer carrier may condition coverages under such a
     2 42 policy of group health insurance coverage on any of
     2 43 the following requirements:
     2 44    (a)  Minimum levels of participation by employees
     2 45 of each member of a bona fide association in the class
     2 46 that offers the coverage to its employees.
     2 47    (b)  Minimum levels of contribution by each member
     2 48 of a bona fide association in the class that offers
     2 49 the coverage to its employees.
     2 50    (c)  A specified policy term, subject to annual
     3  1 premium rate adjustments as permitted by section
     3  2 513B.4.
     3  3    Sec.    .  Section 513B.2, subsection 6, paragraph
     3  4 b, Code 2007, is amended to read as follows:
     3  5    b.  A small employer carrier may establish no more
     3  6 than two additional groupings under each of the
     3  7 subparagraphs in paragraph "a" on the basis of
     3  8 underwriting criteria which are expected to produce
     3  9 substantial variation in the health care costs.
     3 10                      DIVISION III
     3 11                  WELLNESS INITIATIVES
     3 12    Sec.    .  Section 513B.4, Code 2007, is amended by
     3 13 adding the following new subsection:
     3 14    NEW SUBSECTION.  6.  Notwithstanding subsection 4,
     3 15 a small employer carrier may offer to transfer a small
     3 16 employer into a different class of business with a
     3 17 lower index rate based upon claims experience,
     3 18 implementation of managed care or wellness programs,
     3 19 or health status improvement of the small employer
     3 20 since issue.
     3 21    Sec.    .  NEW SECTION.  513B.4B  SMALL EMPLOYER
     3 22 INCENTIVES == SUSPENSION OR MODIFICATION OF PREMIUM
     3 23 RATE RESTRICTIONS.
     3 24    1.  In order to encourage voluntary participation
     3 25 in wellness or disease management programs, a small
     3 26 employer carrier may offer premium credits or
     3 27 discounts to a small employer for the benefit of
     3 28 eligible employees of that small employer who
     3 29 participate in such a program.  An employee shall not
     3 30 be penalized in any way for not participating in such
     3 31 a program.
     3 32    2.  The commissioner shall adopt, by rule or order,
     3 33 provisions allowing suspension or modification of
     3 34 premium rate restrictions to enable a small employer
     3 35 carrier to provide premium credits or discounts to a
     3 36 small employer based on measurable reductions in costs
     3 37 of that small employer, including but not limited to
     3 38 tobacco use cessation, participation in established
     3 39 wellness or disease management programs, and reduced
     3 40 administrative or distribution costs.
     3 41                       DIVISION IV
     3 42                     EFFECTIVE DATE>
     3 43 #3.  Title page, line 1, by inserting after the
     3 44 word <to> the following:  <conditions of employment
     3 45 including>.
     3 46 #4.  Title page, line 1, by inserting after the
     3 47 word <requirements> the following:  <, association
     3 48 group health care plans, wellness initiatives,>.
     3 49
     3 50
     4  1                               
     4  2 KAUFMANN of Cedar
     4  3
     4  4
     4  5                               
     4  6 STRUYK of Pottawattamie
     4  7
     4  8
     4  9                               
     4 10 VAN FOSSEN of Scott
     4 11
     4 12
     4 13                               
     4 14 FORRISTALL of Pottawattamie
     4 15
     4 16
     4 17                               
     4 18 MAY of Dickinson
     4 19
     4 20
     4 21                               
     4 22 UPMEYER of Hancock
     4 23
     4 24
     4 25                               
     4 26 PAULSEN of Linn
     4 27
     4 28
     4 29                               
     4 30 ALONS of Sioux
     4 31
     4 32
     4 33                               
     4 34 ANDERSON of Page
     4 35
     4 36
     4 37                               
     4 38 ARNOLD of Lucas
     4 39
     4 40
     4 41                               
     4 42 BAUDLER of Adair
     4 43
     4 44
     4 45                               
     4 46 BOAL of Polk
     4 47
     4 48
     4 49                               
     4 50 CHAMBERS of O'Brien
     5  1
     5  2
     5  3                               
     5  4 CLUTE of Polk
     5  5
     5  6
     5  7                               
     5  8 DE BOEF of Keokuk
     5  9
     5 10
     5 11                               
     5 12 DEYOE of Story
     5 13
     5 14
     5 15                               
     5 16 DOLECHECK of Ringgold
     5 17
     5 18
     5 19                               
     5 20 DRAKE of Pottawattamie
     5 21
     5 22
     5 23                              
     5 24 GIPP of Winneshiek
     5 25
     5 26
     5 27                               
     5 28 GRANZOW of Hardin
     5 29
     5 30
     5 31                               
     5 32 GRASSLEY of Butler
     5 33
     5 34
     5 35                               
     5 36 GREINER of Washington
     5 37
     5 38
     5 39                               
     5 40 HUSEMAN of Cherokee
     5 41
     5 42
     5 43                               
     5 44 JACOBS of Polk
     5 45
     5 46
     5 47                               
     5 48 HOFFMAN of Crawford
     5 49
     5 50
     6  1                               
     6  2 LUKAN of Dubuque
     6  3
     6  4
     6  5                               
     6  6 L. MILLER of Scott
     6  7
     6  8
     6  9                               
     6 10 S. OLSON of Clinton
     6 11
     6 12
     6 13                               
     6 14 RAECKER of Polk
     6 15
     6 16
     6 17                               
     6 18 RANTS of Woodbury
     6 19
     6 20
     6 21                               
     6 22 RASMUSSEN of Buchanan
     6 23
     6 24
     6 25                               
     6 26 RAYHONS of Hancock
     6 27
     6 28
     6 29                               
     6 30 ROBERTS of Carroll
     6 31
     6 32
     6 33                               
     6 34 SANDS of Louisa
     6 35
     6 36
     6 37                               
     6 38 SCHICKEL of Cerro Gordo
     6 39
     6 40
     6 41                               
     6 42 SODERBERG of Plymouth
     6 43
     6 44
     6 45                               
     6 46 TJEPKES of Webster
     6 47
     6 48
     6 49                               
     6 50 TOMENGA of Polk
     7  1
     7  2
     7  3                               
     7  4 TYMESON of Madison
     7  5
     7  6
     7  7                               
     7  8 VAN ENGELENHOVEN of Marion
     7  9
     7 10
     7 11                               
     7 12 WATTS of Dallas
     7 13
     7 14
     7 15                               
     7 16 WIENCEK of Black Hawk
     7 17
     7 18
     7 19                               
     7 20 WINDSCHITL of Harrison
     7 21
     7 22
     7 23                               
     7 24 WORTHAN of Buena Vista
     7 25 HF 1.702 82
     7 26 av/gg/5470

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