House File 2339 H-8282 Amend House File 2339 as follows: 1 1. Page 11, after line 7 by inserting: 2 < Sec. ___. Section 514E.1, Code 2011, is amended by 3 adding the following new subsection: 4 NEW SUBSECTION . 12A. “HIPIOWA-FED” means the 5 limited liability company organized by the association 6 for the purposes of administering the state of Iowa 7 temporary high-risk insurance pool program pursuant to 8 a contract with the United States department of health 9 and human services. 10 Sec. ___. Section 514E.2, subsection 2, Code 2011, 11 is amended by striking the subsection and inserting in 12 lieu thereof the following: 13 2. a. The board of directors of the association 14 shall consist of seven voting members and seven 15 nonvoting members. The voting members shall be 16 appointed by the governor, subject to confirmation by 17 the senate. The governor shall designate one voting 18 member as chairperson and one as vice chairperson. 19 b. The voting members of the board of directors 20 shall be appointed by the governor as follows: 21 (1) Two persons who represent the interests of 22 small business from nominations made to the governor 23 by nationally recognized groups that represent the 24 interests of small business. 25 (2) Two persons who represent the interests of 26 consumers from nominations made to the governor 27 by nationally recognized groups that represent the 28 interests of consumers. 29 (3) One person who is an insurance producer 30 licensed under chapter 522B. 31 (4) One person who is a health care actuary or 32 economist with expertise in health insurance. 33 (5) One person who is a health care provider. 34 c. The nonvoting members are as follows: 35 (1) The commissioner or the commissioner’s 36 designee. 37 (2) The director of human services or the 38 director’s designee. 39 (3) The director of public health or the director’s 40 designee. 41 (4) Four members of the general assembly, 42 one appointed by the speaker of the house of 43 representatives, one appointed by the minority leader 44 of the house of representatives, one appointed by the 45 majority leader of the senate, and one appointed by the 46 minority leader of the senate. 47 d. Meetings of the board of directors shall be held 48 at the call of the chairperson or upon the request of 49 at least two voting members. Four voting members shall 50 -1- HF2339.5181 (1) 84 av/nh 1/ 5 #1.

constitute a quorum and the affirmative vote of four 1 voting members shall be necessary for any action taken 2 by the board. 3 e. The voting members of the board of directors 4 shall be appointed for staggered terms of three years 5 within sixty days after the effective date of this 6 section of this Act and by December 15 of each year 7 thereafter. The initial terms of the voting members 8 of the board shall be staggered at the discretion 9 of the governor. A voting member of the board is 10 eligible for reappointment. The governor shall fill a 11 vacancy on the board in the same manner as the original 12 appointment for the remainder of the term. 13 f. Members of the board may be reimbursed from the 14 moneys of the association for expenses incurred by them 15 as members, but shall not be otherwise compensated by 16 the association for their services. 17 Sec. ___. Section 514E.2, subsection 4, Code 2011, 18 is amended to read as follows: 19 4. a. The plan of operation may provide that the 20 powers and duties of the association may be delegated 21 to a person who will perform functions similar to those 22 of the association. A delegation under this section 23 takes effect only upon the approval of both the board 24 of directors and the commissioner. The commissioner 25 shall not approve a delegation unless the protections 26 afforded to the insured are substantially equivalent to 27 or greater than those provided under this chapter . 28 b. A delegation made to a person pursuant to 29 this subsection shall be subject to annual review 30 by the government oversight standing committees of 31 the general assembly. Within sixty days after the 32 effective date of this section of this Act and annually 33 thereafter, any person to whom the powers and duties of 34 the association have been delegated pursuant to this 35 subsection shall submit a report to the government 36 oversight committees setting forth the following: 37 (1) The scope of the functions performed by the 38 person. 39 (2) Any contractual provisions between the person 40 and the association or between the person and any other 41 entity on behalf of the association. 42 (3) An accounting of the activities and services 43 performed by the person on behalf of the association. 44 (4) An accounting of all payments made to the 45 person by the association, including but not limited to 46 an itemization of the services rendered and the amount 47 of each payment apportioned to the performance of each 48 activity or service. 49 (5) Any other information requested by the board 50 -2- HF2339.5181 (1) 84 av/nh 2/ 5

of directors of the association, the commissioner of 1 insurance, or the government oversight committees. 2 Sec. ___. Section 514E.2, Code 2011, is amended by 3 adding the following new subsection: 4 NEW SUBSECTION . 5A. The association shall accept 5 third-party payment of premiums for an individual 6 enrolled in health insurance coverage from the 7 association. 8 Sec. ___. Section 514E.2, subsection 7, Code 2011, 9 is amended by adding the following new paragraph: 10 NEW PARAGRAPH . 0b. Following the close of each 11 calendar year, HIPIOWA-FED shall determine the net 12 premiums and payments, the expenses of administration, 13 and the incurred losses of the program for the year. 14 HIPIOWA-FED shall certify the amount of any net loss 15 for the preceding calendar year to the commissioner of 16 insurance and director of revenue and to the United 17 States department of health and human services. In the 18 event that additional federal funding is not provided 19 to HIPIOWA-FED to offset the loss, the loss shall be 20 assessed by the association on behalf of HIPIOWA-FED to 21 all members of the association in proportion to their 22 respective shares of total health insurance premiums 23 or payments for subscriber contracts received in Iowa 24 during the second preceding calendar year, or with paid 25 losses in the year, coinciding with or ending during 26 the calendar year or on any other equitable basis as 27 provided in the plan of operation of the association 28 or as required by the United States department of 29 health and human services. In sharing losses, the 30 association, on behalf of HIPIOWA-FED, may abate or 31 defer in any part the assessment of a member, if, in 32 the opinion of the board of the association, payment 33 of the assessment would endanger the ability of the 34 member to fulfill its contractual obligations. The 35 association, on behalf of HIPIOWA-FED, may also provide 36 for an initial or interim assessment against members of 37 the association if necessary to assure the financial 38 capability of HIPIOWA-FED to meet the incurred or 39 estimated claims expenses or operating expenses of the 40 temporary high-risk insurance pool program until the 41 next calendar year is completed. Net gains, if any, 42 must be held at interest to offset future losses or 43 allocated to reduce future premiums. 44 Sec. ___. Section 514E.2, Code 2011, is amended by 45 adding the following new subsections: 46 NEW SUBSECTION . 12A. The association shall be 47 considered a governmental body for purposes of chapter 48 21 and a government body for purposes of chapter 22. 49 A person to whom the association delegates the duties 50 -3- HF2339.5181 (1) 84 av/nh 3/ 5

and powers of the association shall be considered a 1 governmental body for purposes of chapter 21 and a 2 government body for purposes of chapter 22 to the 3 extent that the person carries out the powers and 4 duties of the association. 5 NEW SUBSECTION . 12B. HIPIOWA-FED shall be 6 considered a governmental body for purposes of chapter 7 21 and a government body for purposes of chapter 22. 8 A person to whom the duties and powers of the limited 9 liability company are delegated shall be considered 10 a governmental body for purposes of chapter 21 and 11 a government body for purposes of chapter 22 to the 12 extent that the person carries out the powers and 13 duties of the limited liability company. 14 Sec. ___. Section 514E.7, subsection 5, paragraph 15 d, Code 2011, is amended by striking the paragraph. 16 Sec. ___. Section 514J.103, subsection 1, Code 17 Supplement 2011, is amended to read as follows: 18 1. Except as provided in subsection 2 , this chapter 19 shall apply to all health carriers , including health 20 carriers issuing a policy or certificate that provides 21 coverage for dental care . 22 Sec. ___. Section 514J.103, subsection 2, paragraph 23 a, Code Supplement 2011, is amended to read as follows: 24 a. A policy or certificate that provides coverage 25 only for a specified disease, specified accident or 26 accident-only, credit, disability income, hospital 27 indemnity, long-term care, dental care, vision care, or 28 any other limited supplemental benefit. > 29 2. Page 16, after line 17 by inserting: 30 < Sec. ___. REQUEST FOR AMENDMENT OF CONTRACT 31 PROVISIONS BY HIPIOWA-FED. Within thirty days after 32 enactment of the sections of this Act amending sections 33 514E.1 and 514E.2, HIPIOWA-FED, the limited liability 34 company organized by the Iowa comprehensive health 35 insurance association for the purpose of administering 36 the state of Iowa temporary high-risk insurance pool 37 program pursuant to a contract with the United States 38 department of health and human services, shall request 39 that the United States department of health and human 40 services amend the requirements of the contract between 41 HIPIOWA-FED and the department to allow HIPIOWA-FED 42 to accept third-party payment of premiums for an 43 individual enrolled in the program. > 44 3. Page 16, after line 21 by inserting: 45 < 2. The section of this Act amending section 46 514E.1. 47 3. The sections of this Act amending section 48 514E.2. > 49 4. By renumbering as necessary. 50 -4- HF2339.5181 (1) 84 av/nh 4/ 5 #2. #3.