House Study Bill 264

                                       HOUSE FILE       
                                       BY  (PROPOSED COMMITTEE ON
                                            COMMERCE, REGULATION AND
                                            LABOR BILL BY CHAIRPERSON
                                            HANSEN)


    Passed House, Date                Passed Senate,  Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to exempt transactions of unauthorized insurers.
  2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  3 TLSB 2934YC 80
  4 kk/sh/8

PAG LIN

  1  1    Section 1.  Section 507A.4, Code 2003, is amended by adding
  1  2 the following new subsections:
  1  3    NEW SUBSECTION.  10.  Transactions in this state involving
  1  4 the joint purchase of administrative services by self=insured
  1  5 employers where each self=insured employer in the joint
  1  6 purchasing arrangement is individually financially responsible
  1  7 for the payment of claims for its employees and has at least
  1  8 one hundred employees eligible for the employee health benefit
  1  9 program.  For the purpose of this subsection, "administrative
  1 10 services" means claims, membership, billing, member service,
  1 11 provider networks, utilization review, case management,
  1 12 disease management, data reporting, or other services related
  1 13 to the management of a self=insured employee health benefit
  1 14 program.
  1 15    NEW SUBSECTION.  11.  Transactions in this state involving
  1 16 the joint purchase of aggregate stop loss or specific stop
  1 17 loss insurance by employers self=insuring their employee
  1 18 health benefit program where the specific stop loss does not
  1 19 cover claims of less than ten thousand dollars in the year
  1 20 2003 or of claims less than ten thousand dollars in future
  1 21 years plus an inflation factor determined by the insurance
  1 22 division of the department of commerce, and where the
  1 23 aggregate stop loss does not have an attachment point of less
  1 24 than one hundred ten percent of expected claims covered by the
  1 25 stop loss agreement.
  1 26                           EXPLANATION
  1 27    This bill provides an exemption from the provisions of Code
  1 28 chapter 507A, related to unauthorized insurers, for
  1 29 transactions involving the joint purchase of administrative
  1 30 services by self=insured employers where each self=insured
  1 31 employer jointly purchasing is individually financially
  1 32 responsible for its employees' claims and has at least 100
  1 33 eligible employees for the health benefit program.
  1 34    The bill also provides an exemption from the provisions of
  1 35 Code chapter 507A, related to unauthorized insurers, for
  2  1 transactions involving the joint purchase of aggregate stop
  2  2 loss or specific stop loss insurance by self=insured employers
  2  3 where the specific stop loss covers no less than a minimum
  2  4 yearly claim amount, and where the aggregate stop loss does
  2  5 not have an attachment point of less than 110 percent of
  2  6 expected claims.
  2  7 LSB 2934YC 80
  2  8 kk/sh/8