House File 2236 H-8059 Amend House File 2236 as follows: 1 1. Page 8, after line 4 by inserting: 2 < Sec. ___. Section 514C.19, Code 2018, is amended to read 3 as follows: 4 514C.19 Prescription contraceptive coverage. 5 1. For purposes of this section: 6 a. “Dispense” means the same as defined in section 155A.3. 7 b. “Health care professional” means the same as defined in 8 section 514J.102. 9 c. “Prescription contraceptive” means a medically acceptable 10 oral drug or contraceptive patch or ring that is used to 11 prevent pregnancy, and requires a prescription. 12 1. 2. Notwithstanding the uniformity of treatment 13 requirements of section 514C.6 , a group policy , or contract , or 14 plan providing for third-party payment or prepayment of health 15 or medical expenses shall not do either of the following: 16 a. Exclude or restrict benefits for a prescription 17 contraceptive drugs or prescription contraceptive devices which 18 prevent conception and which are contraceptive that is approved 19 by the United States food and drug administration, or a generic 20 equivalents equivalent approved as substitutable a substitute 21 by the United States food and drug administration, if such 22 policy , or contract , or plan provides benefits a benefit for 23 any other outpatient prescription drugs drug or devices device . 24 Such policy, contract, or plan shall provide for payment to a 25 health care professional that dispenses any of the following to 26 a covered person: 27 (1) A three-month supply of a prescription contraceptive 28 the first time the prescription contraceptive is dispensed to 29 the covered person. 30 (2) A twelve-month supply of a prescription contraceptive 31 for any subsequent dispensing of the same prescription 32 contraceptive to the covered person. 33 (3) A three-month supply of a prescription vaginal 34 contraceptive ring. 35 -1- HF2236.3531 (2) 87 ko/rj 1/ 5 #1.

b. Exclude or restrict benefits for an outpatient 1 contraceptive services which are service that is provided 2 for the purpose of preventing conception if such policy , 3 or contract , or plan provides benefits a benefit for any 4 other outpatient services service provided by a health care 5 professional. 6 2. 3. A person who provides a group policy , or contract , or 7 plan providing for third-party payment or prepayment of health 8 or medical expenses which is subject to subsection 1 2 shall 9 not do any of the following: 10 a. Deny to an individual eligibility, or continued 11 eligibility, to enroll in or to renew coverage under the terms 12 of the policy , or contract , or plan because of the individual’s 13 use or potential use of such a prescription contraceptive 14 drugs drug or devices device , or use or potential use of an 15 outpatient contraceptive services service . 16 b. Provide a monetary payment or rebate to a covered 17 individual to encourage such individual to accept less than the 18 minimum benefits provided for under subsection 1 2 . 19 c. Penalize or otherwise reduce or limit the reimbursement 20 of a health care professional because such professional 21 prescribes a contraceptive drugs drug or devices device , or 22 provides a contraceptive services service . 23 d. Provide incentives an incentive , monetary or otherwise, 24 to a health care professional to induce such professional to 25 withhold from a covered individual a contraceptive drugs drug 26 or devices device , or a contraceptive services service from a 27 covered individual . 28 3. 4. This section shall not be construed to prevent a 29 third-party payor from including deductibles, coinsurance, or 30 copayments under the policy , or contract, or plan as follows: 31 a. A deductible, coinsurance, or copayment for benefits a 32 benefit for a prescription contraceptive drugs drug shall not 33 be greater than such deductible, coinsurance, or copayment for 34 any outpatient prescription drug for which coverage under the 35 -2- HF2236.3531 (2) 87 ko/rj 2/ 5

policy , or contract , or plan is provided. 1 b. A deductible, coinsurance, or copayment for benefits a 2 benefit for a prescription contraceptive devices device shall 3 not be greater than such deductible, coinsurance, or copayment 4 for any outpatient prescription device for which coverage under 5 the policy , or contract , or plan is provided. 6 c. A deductible, coinsurance, or copayment for benefits a 7 benefit for an outpatient contraceptive services service shall 8 not be greater than such deductible, coinsurance, or copayment 9 for any outpatient health care services service for which 10 coverage under the policy , or contract , or plan is provided. 11 4. 5. This section shall not be construed to require 12 a third-party payor under a policy , or contract , or plan 13 to provide benefits a benefit for an experimental or 14 investigational contraceptive drugs drug or devices device , or 15 experimental or investigational contraceptive services service , 16 except to the extent that such policy , or contract , or plan 17 provides coverage for any other experimental or investigational 18 outpatient prescription drugs drug or devices device , or 19 experimental or investigational outpatient health care services 20 service . 21 5. 6. This section shall not be construed to limit or 22 otherwise discourage the any of the following: 23 a. The use of a generic equivalent drugs drug approved 24 by the United States food and drug administration , whenever 25 if available and appropriate. This section , when a brand 26 name drug is requested by a covered individual and a suitable 27 generic equivalent is available and appropriate, shall not be 28 construed to prohibit a 29 b. A third-party payor from requiring the a covered 30 individual to pay a deductible, coinsurance, or copayment 31 consistent with subsection 3 4 , in addition to the difference 32 of the cost of the brand name drug less the maximum covered 33 amount for a generic equivalent. 34 7. This section shall not be construed to require a 35 -3- HF2236.3531 (2) 87 ko/rj 3/ 5

third-party payor to provide payment to a health care 1 professional for dispensing a prescription contraceptive to 2 replace a prescription contraceptive that has been dispensed 3 to a covered person and that has been misplaced, stolen, or 4 destroyed. This section shall not be construed to require a 5 third-party payor to replace covered prescriptions that are 6 misplaced, stolen, or destroyed. 7 6. 8. A person who provides an individual policy , or 8 contract , or plan providing for third-party payment or 9 prepayment of health or medical expenses shall make available 10 a coverage provision that satisfies the requirements in 11 subsections 1 2 through 5 7 in the same manner as such 12 requirements are applicable to a group policy , or contract , or 13 plan under those subsections. The policy , or contract , or plan 14 shall provide that the individual policyholder may reject the 15 coverage provision at the option of the policyholder. 16 7. 9. a. This section applies shall apply to the following 17 classes of third-party payment provider policies, contracts , or 18 policies and plans delivered, issued for delivery, continued, 19 or renewed in this state on or after July 1, 2000 2018 : 20 (1) Individual or group accident and sickness insurance 21 providing coverage on an expense-incurred basis. 22 (2) An individual or group hospital or medical service 23 contract issued pursuant to chapter 509 , 514 , or 514A . 24 (3) An individual or group health maintenance organization 25 contract regulated under chapter 514B . 26 (4) Any other entity engaged in the business of insurance, 27 risk transfer, or risk retention, which is subject to the 28 jurisdiction of the commissioner. 29 (5) A plan established pursuant to chapter 509A for public 30 employees. 31 b. This section shall not apply to accident-only, 32 specified disease, short-term hospital or medical, hospital 33 confinement indemnity, credit, dental, vision, Medicare 34 supplement, long-term care, basic hospital and medical-surgical 35 -4- HF2236.3531 (2) 87 ko/rj 4/ 5

expense coverage as defined by the commissioner, disability 1 income insurance coverage, coverage issued as a supplement 2 to liability insurance, workers’ compensation or similar 3 insurance, or automobile medical payment insurance. > 4 2. Title page, by striking lines 1 through 3 and 5 inserting < An Act relating to the commissioner of insurance 6 as the agent or attorney for service of process and as the 7 regulator of insurance coverage for dispensing of prescription 8 contraceptives, and resolving > 9 3. By renumbering as necessary. 10 ______________________________ BENNETT of Linn -5- HF2236.3531 (2) 87 ko/rj 5/ 5 #2. #3.