CHAPTER 514EIOWA COMPREHENSIVE HEALTH INSURANCE ASSOCIATIONReferred to in 87.4, 296.7, 331.301, 364.4, 505.28, 505.29, 513C.3, 513C.5, 513C.10, 669.14, 670.7
514E.1Definitions.
514E.2Iowa comprehensive health insurance association.
514E.3Health insurance trust fund deposit of moneys. Repealed by 97 Acts, ch 103, §56.
514E.4Association policy — coverage and benefit requirements — deductibles — coinsurance.
514E.5Iowa choice health care coverage. Repealed by 2009 Acts, ch 118, §4, 5.
514E.6Iowa choice health care coverage advisory council. Repealed by 2009 Acts, ch 118, §4, 5.
514E.7Policies — eligible persons — dependent coverage — preexisting conditions.
514E.8Policies — renewal provisions — election to continue coverage upon death of policyholder.
514E.9Rules.
514E.10Collective action — immunity.
514E.11Notice of association policy.
514E.1Definitions.As used in this chapter, unless the context otherwise requires:1.  “Association” means the Iowa comprehensive health insurance association established by section 514E.2.2.  “Association policy” means an individual or group policy issued by the association that provides the coverage as set forth in the benefit plans adopted by the association’s board of directors and approved by the commissioner.3.  “Carrier” means an insurer providing accident and sickness insurance under chapter 509, 514, 514A and includes a health maintenance organization established under chapter 514B if payments received by the health maintenance organization are considered premiums pursuant to section 514B.31 and are taxed under chapter 432. “Carrier” also includes a corporation which becomes a mutual insurer pursuant to section 514.23 and any other person as defined in section 4.1, subsection 20, who is or may become liable for the tax imposed by chapter 432.4.  “Church plan” means the same as defined in the federal Employee Retirement Income Security Act of 1974, 29 U.S.C. §3(33).5.  “Commissioner” means the commissioner of insurance.6.  “Creditable coverage” means health benefits or coverage provided to an individual under any of the following:a.  A group health plan.b.  Health insurance coverage.c.  Part A or Part B Medicare pursuant to Tit. XVIII of the federal Social Security Act.d.  Medicaid pursuant to Tit. XIX of the federal Social Security Act, other than coverage consisting solely of benefits under section 1928 of that Act.e.  10 U.S.C. ch. 55.f.  A health or medical care program provided through the Indian health service or a tribal organization.g.  A state health benefits risk pool.h.  A health plan offered under 5 U.S.C. ch. 89.i.  A public health plan as defined under federal regulations.j.  A health benefit plan under section 5(e) of the federal Peace Corps Act, 22 U.S.C. §2504(e).k.  The hawk-i program authorized by chapter 514I.7.  “Federally eligible individual” means an individual who satisfies the following:a.  For whom, as of the date on which the individual seeks coverage under this chapter, the aggregate of the periods of creditable coverage is eighteen or more months with no more than a sixty-three day lapse of coverage, and whose most recent prior creditable coverage was under a group health plan, governmental plan, or church plan, or health insurance coverage offered in connection with any such plan.b.  Who is not eligible for coverage under a group health plan, Part A or Part B of Tit. XVIII of the federal Social Security Act, or a state plan under Tit. XIX of that Act, or any successor program, and does not have other health insurance coverage.c.  With respect to whom the most recent coverage within the coverage period described in paragraph “a” was not terminated based on a nonpayment of premiums or fraud.d.  If the individual had been offered the option of continuation coverage under a COBRA continuation provision or under a similar state program, and elected such coverage.e.  Who, if the individual elected continuation coverage as provided in paragraph “d”, has exhausted the continuation coverage under the provision or program.f.  Who has been confirmed eligible under the federal Trade Adjustment Act of 2002, Pub. L. No. 107-210, as a recipient under that Act, by the department of workforce development and the federal internal revenue service.8.  “Governmental plan” means as defined under section 3(32) of the federal Employee Retirement Income Security Act of 1974 and any federal governmental plan.9.a.  “Group health plan” means an employee welfare benefit plan as defined in section 3(1) of the federal Employee Retirement Income Security Act of 1974, to the extent that the plan provides medical care including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.b.  For purposes of this subsection, “medical care” means amounts paid for any of the following:(1)  The diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting a structure or function of the body.(2)  Transportation primarily for and essential to medical care referred to in subparagraph (1).(3)  Insurance covering medical care referred to in subparagraph (1) or (2).c.  For purposes of this chapter, the following apply:(1)  A plan, fund, or program established or maintained by a partnership which, but for this subsection, would not be an employee welfare benefit plan, shall be treated as an employee welfare benefit plan which is a group health plan to the extent that the plan, fund, or program provides medical care, including items and services paid for as medical care for present or former partners in the partnership or to the dependents of such partners, as defined under the terms of the plan, fund, or program, either directly or through insurance, reimbursement, or otherwise.(2)  With respect to a group health plan, the term “employer” includes a partnership with respect to a partner.(3)  With respect to a group health plan, the term “participant” includes the following:(a)  With respect to a group health plan maintained by a partnership, an individual who is a partner in the partnership.(b)  With respect to a group health plan maintained by a self-employed individual under which one or more of the self-employed individual’s employees are participants, the self-employed individual, if that individual is, or may become, eligible to receive benefits under the plan or the individual’s dependents may be eligible to receive benefits under the plan.10.  “Health care services” means services, the coverage of which is authorized under chapter 509, chapter 514, chapter 514A, or chapter 514B as limited by benefit plans established by the association’s board of directors, with the approval of the commissioner and includes services for the purposes of preventing, alleviating, curing, or healing human illness, injury or physical disability.11.  “Health insurance” means accident and sickness insurance authorized by chapter 509, 514, or 514A.12.a.  “Health insurance coverage” means health insurance coverage offered to individuals, including group conversion coverage.b.  “Health insurance coverage” does not include any of the following:(1)  Coverage for accident-only, or disability income insurance.(2)  Coverage issued as a supplement to liability insurance.(3)  Liability insurance, including general liability insurance and automobile liability insurance.(4)  Workers’ compensation or similar insurance.(5)  Automobile medical-payment insurance.(6)  Credit-only insurance.(7)  Coverage for on-site medical clinic care.(8)  Other similar insurance coverage, specified in federal regulations, under which benefits for medical care are secondary or incidental to other insurance coverage or benefits.c.  “Health insurance coverage” does not include benefits provided under a separate policy as follows:(1)  Limited-scope dental or vision benefits.(2)  Benefits for long-term care, nursing home care, home health care, or community-based care.(3)  Any other similar limited benefits as provided by rule of the commissioner.d.  “Health insurance coverage” does not include benefits offered as independent noncoordinated benefits as follows:(1)  Coverage only for a specified disease or illness.(2)  A hospital indemnity or other fixed indemnity insurance.e.  “Health insurance coverage” does not include Medicare supplemental health insurance as defined under section 1882(g)(1) of the federal Social Security Act, coverage supplemental to the coverage provided under 10 U.S.C. ch. 55 and similar supplemental coverage provided to coverage under group health insurance coverage.13.  “Insured” means an individual who is provided qualified comprehensive health insurance under an association policy, which policy may include dependents and other covered persons.14.  “Involuntary termination” includes but is not limited to termination of group conversion coverage or where benefits under a state or federal law providing for continuation of coverage upon termination of employment will cease or have ceased.15.  “Medicaid” means the federal-state assistance program established under Tit. XIX of the federal Social Security Act.16.  “Medicare” means the federal government health insurance program established under Tit. XVIII of the Social Security Act.17.  “Policy” means a contract, policy, or plan of health insurance.18.  “Policy year” means a consecutive twelve-month period during which a policy provides or obligates the carrier to provide health insurance.19.  “Preexisting condition exclusion”, with respect to coverage, means a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date.86 Acts, ch 1156, §1, 89 Acts, ch 304, §1003, 97 Acts, ch 103, §42, 43, 98 Acts, ch 1100, §70, 2000 Acts, ch 1058, §47, 2001 Acts, ch 69, §23, 2002 Acts, ch 1111, §16, 2003 Acts, ch 108, §131, 2004 Acts, ch 1110, §40 – 43, 2004 Acts, ch 1158, §6 – 9, 2008 Acts, ch 1123, §25, 26, 2008 Acts, ch 1188, §17, 2009 Acts, ch 118, §2, 5, 2017 Acts, ch 148, §83, 84Referred to in 514E.2514E.2Iowa comprehensive health insurance association.1.  The Iowa comprehensive health insurance association is established as a nonprofit corporation. The association shall assure that benefit plans as authorized in section 514E.1, subsection 2, for an association policy, are made available to each eligible Iowa resident and each federally eligible individual applying to the association for coverage. The association shall also be responsible for administering the Iowa individual health benefit reinsurance association pursuant to all of the terms and conditions contained in chapter 513C.a.  All carriers providing health insurance or health care services in Iowa, whether on an individual or group basis, and all other insurers designated by the association’s board of directors and approved by the commissioner shall be members of the association.b.  The association shall operate under a plan of operation established and approved under subsection 3 and shall exercise its powers through a board of directors established under this section.2.a.  The board of directors of the association shall consist of all of the following:(1)  Two members who shall be representatives of the two largest domestic carriers of individual health insurance in the state as of the calendar year ending December 31, 2000, based on earned premium standards.(2)  Three members who shall be representatives of the three largest carriers of health insurance in the state, based on earned premium standards, excluding Medicare supplement coverage premiums, that are not otherwise represented.(3)  Two members selected by the members of the association, one of whom shall be a representative from a corporation operating pursuant to chapter 514 on July 1, 1989, or any successor in interest, and one of whom shall be a representative of an insurer providing coverage pursuant to chapter 509 or 514A.(4)  Four public members selected by the governor.(5)  The commissioner or the commissioner’s designee from the division of insurance.(6)  Four members of the general assembly, one of whom shall be appointed by the speaker of the house of representatives, one of whom shall be appointed by the minority leader of the house of representatives, one of whom shall be appointed by the president of the senate after consultation with the majority leader, and one of whom shall be appointed by the minority leader of the senate, who shall be ex officio, nonvoting members.b.  The composition of the board of directors shall be in compliance with sections 69.16 and 69.16A. The governor’s appointees shall be chosen from a broad cross-section of the residents of this state.c.  Members of the board may be reimbursed from the moneys of the association for expenses incurred by them as members, but shall not be otherwise compensated by the association for their services.3.  The association shall submit to the commissioner a plan of operation for the association and any amendments necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation becomes effective upon approval in writing by the commissioner prior to the date on which the coverage under this chapter must be made available. After notice and hearing, the commissioner shall approve the plan of operation if the plan is determined to be suitable to assure the fair, reasonable, and equitable administration of the association, and provides for the sharing of association losses, if any, on an equitable and proportionate basis among the member carriers. If the association fails to submit a suitable plan of operation within one hundred eighty days after the appointment of the board of directors, or if at any later time the association fails to submit suitable amendments to the plan, the commissioner shall adopt, pursuant to chapter 17A, rules necessary to implement this section. The rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner. In addition to other requirements, the plan of operation shall provide for all of the following:a.  The handling and accounting of assets and moneys of the association.b.  The amount and method of reimbursing members of the board.c.  Regular times and places for meeting of the board of directors.d.  Records to be kept of all financial transactions, and the annual fiscal reporting to the commissioner.e.  Procedures for selecting the board of directors and submitting the selections to the commissioner for approval.f.  The periodic advertising of the general availability of health insurance coverage from the association.g.  Additional provisions necessary or proper for the execution of the powers and duties of the association.4.  The plan of operation may provide that the powers and duties of the association may be delegated to a person who will perform functions similar to those of the association. A delegation under this section takes effect only upon the approval of both the board of directors and the commissioner. The commissioner shall not approve a delegation unless the protections afforded to the insured are substantially equivalent to or greater than those provided under this chapter.5.  The association has the general powers and authority enumerated by this subsection and executed in accordance with the plan of operation approved by the commissioner under subsection 3. The association has the general powers and authority granted under the laws of this state to carriers licensed to issue health insurance. In addition, the association may do any of the following:a.  Enter into contracts as necessary or proper to carry out this chapter.b.  Sue or be sued, including taking any legal action necessary or proper for recovery of any assessments for, on behalf of, or against participating carriers.c.  Take legal action necessary to avoid the payment of improper claims against the association or the coverage provided by or through the association.d.  Establish or utilize a medical review committee to determine the reasonably appropriate level and extent of health care services in each instance.e.  Establish appropriate rates, scales of rates, rate classifications, and rating adjustments, which rates shall not be unreasonable in relation to the coverage provided and the reasonable operations expenses of the association.f.  Pool risks among members.g.  Issue association policies on an indemnity or provision of service basis providing the coverage required by this chapter.h.  Administer separate pools, separate accounts, or other plans or arrangements considered appropriate for separate members or groups of members.i.  Operate and administer any combination of plans, pools, or other mechanisms considered appropriate to best accomplish the fair and equitable operation of the association.j.  Appoint from among members appropriate legal, actuarial, and other committees as necessary to provide technical assistance in the operation of the association, policy and other contract design, and any other functions within the authority of the association.k.  Hire independent consultants as necessary.l.  Develop a method of advising applicants of the availability of other coverages outside the association.m.  Include in its policies a provision providing for subrogation rights by the association in a case in which the association pays expenses on behalf of an individual who is injured or suffers a disease under circumstances creating a liability upon another person to pay damages to the extent of the expenses paid by the association but only to the extent the damages exceed the policy deductible and coinsurance amounts paid by the insured. The association may waive its subrogation rights if it determines that the exercise of the rights would be impractical, uneconomical, or would work a hardship on the insured.6.  Rates for coverages issued by the association shall reflect rating characteristics used in the individual insurance market. The rates for a given classification shall not be more than one hundred fifty percent of the average premium or payment rate for the classification charged by the five carriers with the largest health insurance premium or payment volume in the state during the preceding calendar year. In determining the average rate of the five largest carriers, the rates or payments charged by the carriers shall be actuarially adjusted to determine the rate or payment that would have been charged for benefits similar to those issued by the association.7.a.  Following the close of each calendar year, the association shall determine the net premiums and payments, the expenses of administration, and the incurred losses of the association for the year. The association shall certify the amount of any net loss for the preceding calendar year to the commissioner of insurance and director of revenue. Any loss shall be assessed by the association to all members in proportion to their respective shares of total health insurance premiums or payments for subscriber contracts received in Iowa during the second preceding calendar year, or with paid losses in the year, coinciding with or ending during the calendar year or on any other equitable basis as provided in the plan of operation. In sharing losses, the association may abate or defer in any part the assessment of a member, if, in the opinion of the board, payment of the assessment would endanger the ability of the member to fulfill its contractual obligations. The association may also provide for an initial or interim assessment against members of the association if necessary to assure the financial capability of the association to meet the incurred or estimated claims expenses or operating expenses of the association until the next calendar year is completed. Net gains, if any, must be held at interest to offset future losses or allocated to reduce future premiums.b.  For purposes of this subsection, “total health insurance premiums” and “payments for subscriber contracts” include, without limitation, premiums or other amounts paid to or received by a member for individual and group health plan care coverage provided under any chapter of the Code or Acts, and “paid losses” includes, without limitation, claims paid by a member operating on a self-funded basis for individual and group health plan care coverage provided under any chapter of the Code or Acts. For purposes of calculating and conducting the assessment, the association shall have the express authority to require members to report on an annual basis each member’s total health insurance premiums and payments for subscriber contracts and paid losses. A member is liable for its share of the assessment calculated in accordance with this section regardless of whether it participates in the individual insurance market.8.  The association shall conduct periodic audits to assure the general accuracy of the financial data submitted to the association, and the association shall have an annual audit of its operations, made by an independent certified public accountant.9.  The association is subject to examination by the commissioner of insurance. Not later than April 30 of each year, the board of directors shall submit to the commissioner a financial report for the preceding calendar year in a form approved by the commissioner.10.  The association is subject to oversight by the legislative fiscal committee of the legislative council. Not later than April 30 of each year, the board of directors shall submit to the legislative fiscal committee a financial report for the preceding year in a form approved by the committee.11.  All policy forms issued by the association must be filed with and approved by the commissioner before their use.12.  The association is exempt from payment of all fees and all taxes levied by this state or any of its political subdivisions.13.  An insurer may offset an assessment made pursuant to this chapter against its premium tax liability pursuant to chapter 432 to the extent of twenty percent of the amount of the assessment for each of the five calendar years following the year in which the assessment was paid. If an insurer ceases doing business, all uncredited assessments may be credited against its premium tax liability for the year it ceases doing business.86 Acts, ch 1156, §2, 89 Acts, ch 304, §1004 – 1006, 90 Acts, ch 1223, §28, 97 Acts, ch 103, §44 – 48, 2001 Acts, ch 125, §7, 2003 Acts, ch 145, §286, 2004 Acts, ch 1110, §44 – 46, 2004 Acts, ch 1158, §10 – 13, 21, 2005 Acts, ch 70, §14 – 16, 51, 2008 Acts, ch 1156, §50, 58, 2008 Acts, ch 1188, §18, 2009 Acts, ch 118, §3, 5, 2017 Acts, ch 148, §85, 86Referred to in 513C.11, 514E.1514E.3Health insurance trust fund deposit of moneys.Repealed by 97 Acts, ch 103, §56. 514E.4Association policy — coverage and benefit requirements — deductibles — coinsurance.The association policy shall pay for medically necessary eligible health care services as established in the benefit plans adopted by the association’s board of directors and approved by the commissioner. The plans shall provide benefits, deductibles, and coinsurance that reflect the current state of the individual insurance market. The board may modify the benefits provided under the plans to reflect the current state of the individual insurance market with the approval of the commissioner.1986 Acts, ch 1156, §4; 1990 Acts, ch 1039, §18; 2004 Acts, ch 1110, §47; 2004 Acts, ch 1158, §14514E.5Iowa choice health care coverage.Repealed by 2009 Acts, ch 118, §4, 5. 514E.6Iowa choice health care coverage advisory council.Repealed by 2009 Acts, ch 118, §4, 5. 514E.7Policies — eligible persons — dependent coverage — preexisting conditions.1.a.  An individual who is and continues to be a resident is eligible for plan coverage if evidence is provided of any of the following:(1)  A notice of rejection or refusal to issue substantially similar insurance for health reasons by one carrier.(2)  A refusal by a carrier to issue insurance except at a rate exceeding the plan rate.(3)  That the individual is a federally defined eligible individual.(4)  That the individual has a health condition that is established by the association’s board of directors, with the approval of the commissioner, to be eligible for plan coverage.(5)  That the individual has coverage under a basic or standard health benefit plan under chapter 513C.b.  A rejection or refusal by a carrier offering only stoploss, excess of loss, or reinsurance coverage with respect to an applicant under paragraph “a”, subparagraphs (1) and (2), is not sufficient evidence for purposes of this subsection.c.  The association shall rescind coverage for an individual who no longer resides in the state.2.a.  An association policy shall provide that coverage of a dependent unmarried person terminates when the person becomes nineteen years of age or, if the person is enrolled full time in an accredited educational institution, terminates at twenty-five years of age. The policy shall also provide in substance that attainment of the limiting age does not operate to terminate coverage when the person is and continues to be both of the following:(1)  Incapable of self-sustaining employment by reason of an intellectual disability or physical disability.(2)  Primarily dependent for support and maintenance upon the person in whose name the contract is issued.b.  Proof of incapacity and dependency must be furnished to the carrier within one hundred twenty days of the person’s attainment of the limiting age, and subsequently as may be required by the carrier, but not more frequently than annually after the two-year period following the person’s attainment of the limiting age.3.  An association policy that provides coverage for a family member of the person in whose name the contract is issued shall also provide, as to the family member’s coverage, that the health insurance benefits applicable for children include the coverage required under section 514C.1.4.a.  A preexisting condition exclusion shall not apply to a federally defined eligible individual.b.  Plan coverage shall not impose any preexisting condition exclusion as follows:(1)  In the case of a child who is adopted or placed for adoption before attaining eighteen years of age and who, as of the last day of the thirty-day period beginning on the date of the adoption or placement for adoption, is covered under creditable coverage. This subparagraph shall not apply to coverage before the date of such adoption or placement for adoption.(2)  In the case of an individual who, as of the last day of the thirty-day period beginning with the date of birth, is covered under creditable coverage.(3)  Relating to pregnancy as a preexisting condition.(4)  In the case of an individual transferring to an association policy from a basic or standard health benefit plan under chapter 513C beginning on or after January 1, 2005.c.  Plan coverage shall exclude charges or expenses incurred during the first six months following the effective date of coverage for preexisting conditions. Such preexisting condition exclusions shall be waived to the extent that similar exclusions, if any, have been satisfied under any prior health insurance coverage which was involuntarily terminated, provided both of the following apply:(1)  Application for association coverage is made no later than sixty-three days following such involuntary termination and, in such case, coverage under the plan is effective from the date on which such prior coverage was terminated.(2)  The applicant is not eligible for continuation rights that would provide coverage substantially similar to plan coverage.d.  This subsection does not prohibit preexisting conditions coverage in an association policy that is more favorable to the insured than that specified in this subsection.e.  If the association policy contains a waiting period for preexisting conditions, an insured may retain any existing coverage the insured has under an insurance plan that has coverage equivalent to the association policy for the duration of the waiting period only.5.  An individual is not eligible for coverage by the association if any of the following apply:a.  The individual is at the time of application eligible for health care benefits under chapter 249A.b.  The individual has terminated coverage by the association within the past twelve months, except that this paragraph does not apply to an applicant who is a federally eligible individual.c.  The individual is an inmate of a public institution, except that this paragraph does not apply to an applicant who is a federally defined eligible individual.d.  The individual premiums are paid for or reimbursed under any government sponsored program or by any government agency or health care provider, except as an otherwise qualifying full-time employee, or dependent of the employee, of a government agency or health care provider.e.  The individual, on the effective date of the coverage applied for, has not been rejected for, already has, or will have coverage similar to an association policy as an insured or covered dependent. This paragraph does not apply to an applicant who is a federally eligible individual.f.  The individual is eligible for Medicare based upon age.6.  The association is not required to make plan coverage available to an individual who is covered or is eligible for any continued group coverage under Internal Revenue Code §4980B, the federal Employee Retirement Income Security Act of 1974, codified at 29 U.S.C. §1001 et seq., the federal Public Health Service Act of July 1, 1944, codified at 42 U.S.C. §201 et seq., or any continued group coverage required by the state. For purposes of this subsection, an individual who would have been eligible for such continuation of group coverage, but is not eligible solely because the individual or other responsible party failed to make the required election of coverage during the applicable time period, or terminated such coverage prior to the end of such applicable time period, shall be deemed to be eligible for such group coverage until the date on which the individual’s continuing group coverage would have expired had an election been made or a termination not occurred.86 Acts, ch 1156, §7, 90 Acts, ch 1163, §1 – 3, 96 Acts, ch 1129, §113, 97 Acts, ch 103, §52, 53, 98 Acts, ch 1100, §71, 2004 Acts, ch 1110, §48, 49, 2004 Acts, ch 1158, §15 – 17, 2005 Acts, ch 70, §17, 51, 2006 Acts, ch 1117, §64, 2008 Acts, ch 1123, §27, 2012 Acts, ch 1019, §136, 2017 Acts, ch 148, §87, 88514E.8Policies — renewal provisions — election to continue coverage upon death of policyholder.1.  An association policy shall contain provisions under which the association is obligated to renew the coverage for an individual until the day the individual becomes eligible for Medicare coverage based on age, provided that any individual who is covered by an association policy and is eligible for Medicare coverage based on age prior to January 1, 2005, may continue to renew the coverage under the association policy.2.  The association shall not change the rates for association policies except on a class basis with a clear disclosure in the policy of the association’s right to do so.3.  An association policy shall provide that upon the death of the individual in whose name the policy is issued, every other individual then covered under the contract may elect, within a period specified in the policy, to continue coverage under the same or a different policy until such time as the person would have ceased to be entitled to coverage had the individual in whose name the policy was issued lived.1986 Acts, ch 1156, §8; 2004 Acts, ch 1110, §50; 2004 Acts, ch 1158, §18; 2005 Acts, ch 70, §18,51; 2006 Acts, ch 1030, §84514E.9Rules.Pursuant to chapter 17A, the commissioner shall adopt rules to provide for disclosure by carriers of the availability of insurance coverage from the association, and to otherwise implement this chapter.86 Acts, ch 1156, §9, 97 Acts, ch 103, §54, 2017 Acts, ch 148, §89514E.10Collective action — immunity.Neither the participation by carriers or members in the association, the establishment of rates, forms, or procedures for coverage issued by the association, nor any joint or collective action required by this chapter shall be the basis of any legal civil action, or criminal liability against the association or members of it either jointly or separately.1986 Acts, ch 1156, §10514E.11Notice of association policy.Every carrier, including a health maintenance organization subject to chapter 514B, authorized to provide health care insurance or coverage for health care services in Iowa, shall provide a notice of the availability of coverage by the association to any person who receives a rejection of coverage for health insurance or health care services, or a rate for health insurance or coverage for health care services that will exceed the rate of an association policy, and that person is eligible to apply for health insurance provided by the association. Application for the health insurance shall be on forms prescribed by the association’s board of directors and made available to the carriers and other entities providing health care insurance or coverage for health care services regulated by the commissioner.86 Acts, ch 1156, §11, 97 Acts, ch 103, §55, 2004 Acts, ch 1110, §51, 2004 Acts, ch 1158, §19, 2017 Acts, ch 148, §90