Senate File 2349 H-8304 Amend the amendment, H-8303, to Senate File 2349, as passed 1 by the Senate, as follows: 2 1. By striking page 1, line 1, through page 4, line 35, and 3 inserting: 4 < Amend Senate File 2349, as passed by the Senate, as follows: 5 ___. By striking everything after the enacting clause and 6 inserting: 7 < Section 1. Section 507A.4, subsection 9, Code 2018, is 8 amended to read as follows: 9 9. a. Transactions involving a multiple employer welfare 10 arrangement, as defined in section 3 of the federal Employee 11 Retirement Income Security Act of 1974, 29 U.S.C. §1002, 12 paragraph 40, if the multiple employer welfare arrangement 13 meets all of the following conditions: 14 (1) The arrangement is administered by an authorized 15 insurer or an authorized third-party administrator. 16 (2) The arrangement has been in existence and provided 17 health insurance in Iowa for at least five years prior to July 18 1, 1997. 19 (3) (2) The arrangement was is established by a trade, 20 industry, or professional association of employers that 21 has a constitution or bylaws, and has been is organized and 22 maintained in good faith for at least ten continuous years 23 prior to July 1, 1997 with membership stability as defined by 24 rules adopted by the commissioner . 25 (4) (3) The arrangement registers with and obtains 26 and maintains a certificate of registration issued by the 27 commissioner of insurance . 28 (5) (4) The arrangement is subject to the jurisdiction 29 of the commissioner of insurance, including regulatory 30 oversight and complies with all rules and solvency standards as 31 established by rules adopted by the commissioner of insurance 32 pursuant to chapter 17A . 33 b. A multiple employer welfare arrangement registered with 34 the commissioner of insurance that does not meet the solvency 35 -1- H8303.4868 (1) 87 ko/rj 1/ 3 #1.

standards requirements established by rule adopted by the 1 commissioner of insurance is pursuant to chapter 17A shall be 2 subject to chapter 507C . 3 c. A multiple employer welfare arrangement that meets all 4 of the conditions of paragraph “a” shall not be considered any 5 of the following: 6 (1) An insurance company or association of any kind or 7 character under section 432.1 . 8 (2) A member of the Iowa individual health benefit 9 reinsurance association under section 513C.10 . 10 (3) A member insurer of the Iowa life and health insurance 11 guaranty association under section 508C.5, subsection 12 . 12 d. A multiple employer welfare arrangement registered with 13 the commissioner of insurance shall file with the commissioner 14 of insurance on or before March 1 of each year a copy of the 15 report required to be filed by the multiple employer welfare 16 arrangement with the United States department of labor pursuant 17 to 29 C.F.R. §2520.101-2 . A newly formed multiple employer 18 welfare arrangement shall file with the commissioner a copy 19 of the report required to be filed pursuant to 29 C.F.R. 20 §2520.101-2 by a newly formed multiple employer welfare 21 arrangement with the United States department of labor thirty 22 days prior to operating in any state. The copy shall be filed 23 with the commissioner within thirty calendar days of the date 24 that the multiple employer welfare arrangement files the report 25 with the United States department of labor. 26 e. When not otherwise provided, a A foreign or domestic 27 multiple employer welfare arrangement doing business in this 28 state shall pay to the commissioner of insurance the fees 29 as required in pursuant to section 511.24 unless otherwise 30 provided by law . 31 Sec. 2. Section 509.1, Code 2018, is amended by adding the 32 following new subsection: 33 NEW SUBSECTION . 8A. A policy of group health insurance 34 coverage issued to an associated health plan pursuant 35 -2- H8303.4868 (1) 87 ko/rj 2/ 3

to section 513D.1 that is subject to regulation by the 1 commissioner. 2 Sec. 3. Section 509.1, subsection 9, unnumbered paragraph 3 1, Code 2018, is amended to read as follows: 4 A policy issued to a resident of this state under a group 5 life, accident, or health insurance policy issued to a group 6 other than one described in subsections 1 through 8 8A , subject 7 to the following requirements: 8 Sec. 4. NEW SECTION . 513D.1 Association health plans. 9 The commissioner shall adopt rules that allow for the 10 creation of association health plans that are consistent with 11 the United States department of labor’s regulations in 29 12 C.F.R. pt. 2510. An association health plan created pursuant 13 to this chapter shall comply with chapter 514C and shall not 14 deny, exclude, or limit benefits for a member based on a 15 member’s preexisting condition. 16 Sec. 5. NEW SECTION . 513D.2 Rules and enforcement. 17 1. The commissioner shall adopt rules, as necessary, 18 pursuant to chapter 17A to administer this chapter. 19 2. The commissioner may take any enforcement action under 20 the commissioner’s authority to enforce compliance with this 21 chapter and chapter 514C. >> 22 ______________________________ OLDSON of Polk -3- H8303.4868 (1) 87 ko/rj 3/ 3