Bill Text: IA HF2527 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to pet insurance and pet wellness programs.
Spectrum: Partisan Bill (Democrat 7-0)
Status: (Introduced - Dead) 2024-02-15 - Introduced, referred to Commerce. H.J. 275. [HF2527 Detail]
Download: Iowa-2023-HF2527-Introduced.html
House
File
2527
-
Introduced
HOUSE
FILE
2527
BY
AMOS
JR.
,
GAINES
,
KRESSIG
,
CAHILL
,
FORBES
,
WILBURN
,
and
ISENHART
A
BILL
FOR
An
Act
relating
to
pet
insurance
and
pet
wellness
programs.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
NEW
SECTION
.
515L.1
Definitions.
1
1.
For
purposes
of
this
chapter:
2
a.
“Chronic
condition”
means
a
condition
that
can
be
treated
3
or
managed,
but
not
cured.
4
b.
“Congenital
anomaly
or
disorder”
means
a
condition
5
that
is
present
from
birth,
whether
inherited
or
caused
by
6
the
environment,
which
may
cause
or
contribute
to
illness
or
7
disease.
8
c.
“Hereditary
disorder”
means
an
abnormality
that
is
9
genetically
transmitted
from
a
parent
to
the
parent’s
offspring
10
and
that
may
cause
or
contribute
to
illness
or
disease.
11
d.
“Insurance
producer”
or
“producer”
means
a
person
12
licensed
pursuant
to
chapter
522B
and
trained
pursuant
to
13
section
515L.6
to
sell,
solicit,
or
negotiate
pet
insurance.
14
e.
“Insurer”
means
an
entity
qualified
and
licensed
by
the
15
insurance
division
to
transact
the
business
of
pet
insurance
16
in
this
state.
17
f.
“
Orthopedic
condition”
means
a
condition
that
affects
18
the
bones,
skeletal
muscle,
cartilage,
tendons,
ligaments,
or
19
joints
of
a
pet.
“Orthopedic
condition”
includes
but
is
not
20
limited
to
elbow
dysplasia,
hip
dysplasia,
intervertebral
disc
21
degeneration,
patellar
luxation,
and
ruptured
cranial
cruciate
22
ligaments.
“Orthopedic
conditions”
shall
not
include
cancer
or
23
metabolic,
hemopoietic,
or
autoimmune
diseases.
24
g.
“Pet
insurance”
means
an
insurance
policy
that
provides
25
coverage
for
accidents
or
illnesses
of
a
pet.
26
h.
“Preexisting
condition”
means
a
pet’s
condition
for
which
27
any
of
the
following
are
true
prior
to
the
effective
date
of
a
28
pet
insurance
policy
or
during
any
waiting
period:
29
(1)
A
veterinarian
has
provided
medical
advice
regarding
30
the
condition.
31
(2)
The
pet
has
received
previous
treatment
for
the
32
condition.
33
(3)
Based
on
information
from
verifiable
sources,
the
pet
34
had
signs
or
symptoms
directly
related
to
the
condition
for
35
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which
a
claim
is
being
made.
A
condition
for
which
coverage
1
is
afforded
on
a
pet
insurance
policy
shall
not
be
considered
2
a
preexisting
condition
on
any
renewal
of
the
pet
insurance
3
policy.
4
i.
“Veterinarian”
means
a
person
licensed
under
chapter
169.
5
j.
“Veterinary
expenses”
means
any
costs
associated
6
with
medical
advice,
diagnosis,
care,
or
treatment
by
a
7
veterinarian,
or
the
cost
of
prescription
drugs
prescribed
by
a
8
veterinarian.
9
k.
“Waiting
period”
means
the
period
of
time
specified
10
by
a
pet
insurance
policy
that
must
transpire
before
some
11
or
all
of
the
coverage
under
the
pet
insurance
policy
shall
12
begin.
“Waiting
period”
shall
not
apply
to
the
renewal
of
a
pet
13
insurance
policy.
14
l.
“Wellness
program”
means
a
subscription
or
15
reimbursement-based
program
that
provides
goods
and
services
to
16
promote
the
general
health,
safety,
or
well-being
of
a
pet.
An
17
entity
that
offers,
promotes,
or
sells
a
wellness
program
to
a
18
resident
of
this
state
shall
not
engage
in
any
activity
that
19
constitutes
the
business
of
insurance
in
this
state.
20
2.
The
definitions
in
this
section
shall
apply
to
the
21
interpretation
of
any
contract
for
pet
insurance
entered
into
22
in
this
state.
23
Sec.
2.
NEW
SECTION
.
515L.2
Scope.
24
This
chapter
shall
apply
to
pet
insurance
policies
that
25
are
delivered,
issued
for
delivery,
renewed,
sold,
solicited,
26
negotiated,
or
offered
in
this
state.
27
Sec.
3.
NEW
SECTION
.
515L.3
Required
disclosures.
28
1.
Disclosures
prior
to
entering
into
a
contract.
An
insurer
29
shall
disclose
to
a
person
prior
to
entering
into
a
contract
30
for
pet
insurance
all
of
the
following:
31
a.
Whether
the
pet
insurance
policy
excludes
coverage
due
32
to
any
of
the
following:
33
(1)
A
preexisting
condition.
34
(2)
A
hereditary
disorder.
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(3)
A
congenital
anomaly
or
disorder.
1
(4)
A
chronic
condition.
2
b.
If
the
pet
insurance
policy
includes
any
other
3
exclusions,
the
pet
insurance
policy
must
include
a
statement
4
that
other
exclusions
may
apply,
and
the
applicant
should
refer
5
to
the
exclusions
section
of
the
pet
insurance
policy
for
more
6
information.
7
c.
Any
waiting
period
required
by
the
pet
insurance
policy,
8
any
provisions
that
limit
coverage
during
a
waiting
period,
9
and
any
deductibles,
coinsurance,
or
annual
or
lifetime
policy
10
limits.
11
d.
Whether
the
pet
insurer
reduces
coverage
or
increases
12
premiums
based
on
the
policyholder’s
claim
history,
the
age
of
13
the
covered
pet,
or
a
change
in
the
geographic
location
of
the
14
policyholder.
15
e.
Whether
the
underwriting
company
differs
from
the
brand
16
name
used
to
market
and
sell
the
pet
insurance.
17
2.
Right
to
examine
and
return
the
policy.
18
a.
Unless
a
pet
insurance
policyholder
has
filed
a
claim
19
under
a
pet
insurance
policy,
the
policyholder
shall
maintain
20
the
right
to
examine
and
return
the
policy
to
the
insurer
21
within
fifteen
days
of
receipt
and
to
have
the
policyholder’s
22
premium
refunded
if,
after
examination
of
the
policy,
the
23
policyholder
is
not
satisfied
for
any
reason.
24
b.
A
pet
insurance
policy
shall
contain
a
notice
prominently
25
printed
on
the
first
page
of
the
policy,
and
on
the
first
26
page
of
any
certificates
or
riders,
that
includes
specific
27
instructions
to
complete
a
return.
28
c.
A
refund
issued
under
paragraph
“a”
shall
be
paid
to
29
the
policyholder
within
thirty
calendar
days
after
the
insurer
30
receives
the
returned
policy.
31
3.
Claim
payments.
An
insurer
shall
clearly
disclose
32
a
summary
description
of
the
basis
or
formula
on
which
the
33
insurer
determines
claim
payments
under
the
insurer’s
pet
34
insurance
policy
within
the
pet
insurance
policy,
prior
to
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issuance
of
the
pet
insurance
policy,
and
on
the
insurer’s
1
internet
site.
2
4.
Benefit
schedules.
If
an
insurer
uses
a
benefit
schedule
3
to
determine
claim
payments
under
a
pet
insurance
policy,
the
4
insurer
shall
do
all
of
the
following:
5
a.
Clearly
disclose
the
applicable
benefit
schedule
within
6
the
pet
insurance
policy.
7
b.
Disclose
all
benefit
schedules
used
by
the
insurer
8
on
the
insurer’s
internet
site
and
on
the
insurer’s
program
9
administrator’s
internet
site,
if
applicable.
10
5.
Usual
and
customary
fees.
If
an
insurer
determines
11
claim
payments
under
a
pet
insurance
policy
based
on
usual
and
12
customary
fees,
or
any
other
reimbursement
limitation
based
on
13
prevailing
veterinary
service
provider
charges,
the
insurer
14
shall
do
all
of
the
following:
15
a.
Include
a
usual
and
customary
fee
limitation
provision
in
16
the
pet
insurance
policy
that
clearly
describes
the
insurer’s
17
basis
for
determining
usual
and
customary
fees
and
how
that
18
basis
is
applied
in
calculating
claim
payments.
19
b.
Disclose
the
insurer’s
basis
for
determining
usual
20
and
customary
fees
on
the
insurer’s
internet
site
and
on
the
21
insurer’s
program
administrator’s
internet
site,
if
applicable.
22
6.
Veterinary
examinations.
If
a
medical
examination
by
a
23
veterinarian
is
required
for
coverage
under
a
pet
insurance
24
policy,
the
insurer
shall
clearly
disclose
the
required
25
aspects
of
the
examination,
and
whether
documentation
from
the
26
examination
may
result
in
a
preexisting
condition
exclusion.
27
7.
Internet
site
disclosures.
A
pet
insurer
shall
include
28
a
summary
of
all
policy
provisions
required
by
subsections
29
1
through
6
in
a
separate
document
that
is
provided
to
all
30
policyholders
upon
issuance
of
the
pet
insurance
policy,
and
31
that
may
be
accessed
on
the
main
page
of
the
insurer’s
internet
32
site
and
on
the
insurer’s
program
administrator’s
internet
33
site,
if
applicable.
34
8.
Disclosures
upon
issuance
or
delivery.
At
the
time
a
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pet
insurance
policy
is
delivered
or
issued
for
delivery,
an
1
insurer
shall
provide
a
written
disclosure
to
the
policyholder
2
that
contains
all
of
the
following:
3
a.
The
mailing
address,
telephone
number,
and
internet
site
4
of
the
department
of
insurance
and
financial
services.
5
b.
The
address
and
customer
service
telephone
number
of
the
6
insurer,
or
of
the
agent
or
broker
of
record.
7
c.
If
the
policy
is
issued
or
delivered
by
an
agent
or
8
broker,
a
statement
advising
the
policyholder
to
contact
the
9
agent
or
broker
for
assistance.
10
d.
Any
other
disclosures
required
by
law
or
rule.
11
Sec.
4.
NEW
SECTION
.
515L.4
Policy
conditions.
12
1.
An
insurer
may
issue
a
pet
insurance
policy
that
excludes
13
coverage
on
the
basis
of
a
preexisting
condition
provided
that
14
the
insurer
complies
with
the
disclosure
requirement
under
15
section
515L.3,
subsection
1,
paragraph
“a”
.
The
pet
insurer
16
shall
have
the
burden
of
proving
that
a
preexisting
condition
17
exclusion
applies
to
the
condition
for
which
a
policyholder
18
makes
a
claim.
19
2.
a.
An
insurer
shall
not
issue
a
pet
insurance
policy
20
that
imposes
any
of
the
following:
21
(1)
A
waiting
period
for
accidents.
22
(2)
A
waiting
period
upon
effectuation
of
the
policy
that
23
exceeds
thirty
calendar
days
for
illnesses
or
orthopedic
24
conditions
not
resulting
from
an
accident.
25
b.
If
an
insurer
issues
a
pet
insurance
policy
that
imposes
26
a
waiting
period,
the
insurer
shall
include
a
provision
in
27
the
pet
insurance
policy
allowing
for
waiver
of
the
waiting
28
period
upon
completion
of
a
medical
examination,
paid
for
by
29
the
policyholder
unless
the
pet
insurance
policy
provides
30
otherwise.
An
insurer
may
require
a
medical
examination
under
31
this
paragraph
to
be
conducted
by
a
veterinarian,
may
specify
32
the
elements
to
be
included
as
part
of
an
examination,
and
may
33
require
documentation
of
the
medical
examination.
An
insurer
34
shall
not
specify
elements
to
be
included
as
part
of
the
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examination
that
unreasonably
restrict
a
policyholder’s
ability
1
to
waive
a
waiting
period.
2
3.
An
insurer
shall
not
require
a
veterinary
examination
of
3
a
pet
covered
under
a
pet
insurance
policy
as
a
condition
for
4
the
renewal
of
the
pet
insurance
policy.
5
4.
Any
prescriptive,
wellness,
or
noninsurance
benefits
6
included
in
a
pet
insurance
policy
shall
comply
with
all
state
7
insurance
laws
and
rules.
8
Sec.
5.
NEW
SECTION
.
515L.5
Wellness
programs.
9
1.
An
insurer
or
a
producer
shall
not
do
any
of
the
10
following:
11
a.
Require
a
person
to
participate,
or
to
not
participate,
12
in
a
wellness
program
as
a
prerequisite
to
purchasing
a
pet
13
insurance
policy.
14
b.
Market
a
wellness
program
as
pet
insurance.
15
c.
Market
a
wellness
program
during
the
offer,
sale,
16
solicitation,
or
negotiation
of
pet
insurance.
17
2.
A
wellness
program
sold
by
an
insurer
or
a
producer
shall
18
comply
with
all
of
the
following:
19
a.
The
costs
associated
with
the
wellness
program
shall
be
20
separate
and
identifiable
from
any
pet
insurance
policy
sold
21
by
the
insurer
or
a
producer.
22
b.
The
terms
and
conditions
for
the
wellness
program
shall
23
be
separate
from
any
pet
insurance
policy
sold
by
the
insurer
24
or
a
producer.
25
c.
The
products
or
coverages
available
through
the
wellness
26
program
shall
not
duplicate
products
or
coverages
available
27
through
a
pet
insurance
policy
sold
by
the
insurer
or
producer.
28
d.
The
advertising
of
the
wellness
program
shall
not
be
29
misleading
as
to
the
nature
of
the
wellness
program.
30
3.
An
insurer
or
a
producer
that
engages
in
the
sale
of
31
a
wellness
program
shall
clearly
disclose
to
a
person
prior
32
to
the
person
purchasing
the
wellness
program
all
of
the
33
following:
34
a.
A
statement
that
a
wellness
program
is
not
a
pet
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insurance
policy.
1
b.
The
mailing
address,
telephone
number,
and
internet
site
2
of
the
department
of
insurance
and
financial
services.
3
c.
The
address
and
customer
service
telephone
number
of
the
4
insurer,
or
of
the
producer,
agent,
or
broker
of
record.
5
d.
Any
coverage
included
in
a
pet
insurance
contract
that
is
6
described
as
wellness
shall
be
considered
insurance.
7
Sec.
6.
NEW
SECTION
.
515L.6
Insurance
producer
training.
8
1.
An
insurance
producer
shall
not
sell,
solicit,
or
9
negotiate
pet
insurance
until
the
producer
has
completed
10
training
as
required
by
this
section
and
is
licensed
under
11
chapter
522B.
12
2.
An
insurer
shall
require
that
the
insurer’s
insurance
13
producers
are
trained
as
required
by
this
section
and
have
been
14
trained
on
the
coverages
and
conditions
of
all
pet
insurance
15
policies
offered
by
the
insurer.
16
3.
Training
for
insurance
producers
shall
include
17
information
on
all
of
the
following
topics:
18
a.
Preexisting
conditions,
hereditary
disorders,
congenital
19
anomalies
or
disorders,
and
chronic
conditions
in
pets,
and
20
applicable
pet
insurance
coverages.
21
b.
Waiting
periods
required
by
pet
insurance
policies,
if
22
any.
23
c.
Rating,
underwriting,
renewal,
and
other
related
24
administrative
topics
as
it
relates
to
pet
insurance.
25
Sec.
7.
NEW
SECTION
.
515L.7
Rules.
26
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
27
chapter
17A
to
administer
this
chapter.
28
EXPLANATION
29
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
30
the
explanation’s
substance
by
the
members
of
the
general
assembly.
31
This
bill
relates
to
pet
insurance
policies
and
wellness
32
programs.
33
The
bill
applies
to
pet
insurance
policies
(policies)
34
that
are
delivered,
issued
for
delivery,
renewed,
sold,
35
-7-
LSB
5545YH
(4)
90
nls/ko
7/
11
H.F.
2527
solicited,
negotiated,
or
offered
in
this
state.
Prior
to
1
entering
into
a
contract
for
pet
insurance,
an
insurer
shall
2
disclose
to
a
person
whether
the
policy
excludes
coverage
3
due
to
a
preexisting
condition,
a
hereditary
disorder,
a
4
congenital
anomaly
or
disorder,
a
chronic
condition,
or
any
5
other
exclusions.
Prior
to
entering
into
a
contract
for
pet
6
insurance,
an
insurer
shall
also
disclose
to
a
person
any
7
waiting
period
required
by
the
policy
and
any
limitation
on
8
coverage
during
a
waiting
period.
In
addition,
the
insurer
9
must
disclose
whether
the
pet
insurer
reduces
coverage
or
10
increases
premiums
based
on
the
policyholder’s
claim
history,
11
the
age
of
the
covered
pet,
or
a
change
in
the
geographic
12
location
of
the
policyholder,
and
whether
the
underwriting
13
company
differs
from
the
brand
name
used
to
market
and
sell
14
the
pet
insurance
product.
“Chronic
condition”,
“congenital
15
anomaly
or
disorder”,
“hereditary
disorder”,
“insurer”,
“pet
16
insurance”,
“preexisting
condition”,
and
“waiting
period”
are
17
defined
in
the
bill.
18
Under
the
bill,
unless
a
pet
insurance
policyholder
has
19
filed
a
claim
under
a
policy,
the
policyholder
shall
maintain
20
the
right
to
examine
and
return
the
policy
to
the
insurer
21
within
15
days
of
receipt,
and
to
have
the
policyholder’s
22
premium
refunded
if
the
policyholder
is
not
satisfied
for
any
23
reason.
A
policy
shall
contain
a
notice
that
includes
specific
24
instructions
to
complete
a
return,
and
any
refund
issued
to
a
25
policyholder
shall
be
paid
within
30
days
after
the
insurer
26
receives
the
returned
policy.
27
The
bill
requires
an
insurer
to
clearly
disclose
prior
28
to
issuance
of
a
policy,
and
on
the
insurer’s
internet
site,
29
a
summary
description
of
the
basis
or
formula
on
which
the
30
insurer
determines
claim
payments
under
the
policy.
An
insurer
31
shall
also
disclose
within
a
policy,
and
on
the
insurer’s
32
internet
site,
a
benefit
schedule
if
the
insurer
uses
a
benefit
33
schedule
to
determine
claim
payments
under
a
policy,
and
a
34
usual
and
customary
fee
limitation
provision
if
the
insurer
35
-8-
LSB
5545YH
(4)
90
nls/ko
8/
11
H.F.
2527
determines
claim
payments
under
a
policy
based
on
usual
and
1
customary
fees
or
any
other
reimbursement
limitation
based
2
on
prevailing
veterinary
service
provider
charges.
The
bill
3
requires
an
insurer
to
clearly
disclose
whether
a
medical
4
examination
by
a
veterinarian
is
required
for
coverage
under
a
5
policy,
the
required
aspects
of
the
examination,
and
whether
6
documentation
from
the
examination
may
result
in
a
preexisting
7
condition
exclusion.
8
A
pet
insurer
shall
include
a
summary
of
all
disclosures
9
required
by
the
bill
in
a
separate
document
that
is
provided
to
10
all
policyholders
upon
issuance
of
a
policy,
and
that
may
be
11
accessed
on
the
main
page
of
the
insurer’s
internet
site.
12
At
the
time
a
pet
insurance
policy
is
delivered
or
issued
13
for
delivery,
an
insurer
shall
provide
a
written
disclosure
to
14
the
policyholder
that
contains
the
mailing
address,
telephone
15
number,
and
internet
site
of
the
department
of
insurance
and
16
financial
services,
the
address
and
customer
service
telephone
17
number
of
the
insurer
or
of
the
agent
or
broker
of
record,
and,
18
if
the
policy
is
issued
or
delivered
by
an
agent
or
broker,
a
19
statement
advising
the
policyholder
to
contact
the
agent
or
20
broker
for
assistance.
21
Under
the
bill,
an
insurer
may
issue
a
policy
that
excludes
22
coverage
on
the
basis
of
a
preexisting
condition
provided
that
23
the
insurer
complies
with
the
disclosure
requirements.
The
24
bill
prohibits
an
insurer
from
issuing
a
policy
that
imposes
25
a
waiting
period
that
exceeds
30
calendar
days
for
illnesses
26
or
orthopedic
conditions
not
resulting
from
an
accident,
or
27
any
waiting
period
for
accidents.
If
an
insurer
issues
a
pet
28
insurance
policy
that
imposes
a
waiting
period,
the
insurer
29
shall
include
a
provision
in
the
pet
insurance
policy
allowing
30
for
waiver
of
the
waiting
period
upon
completion
of
a
medical
31
examination
pursuant
to
the
requirements
in
the
bill.
32
The
bill
prohibits
an
insurer
from
requiring
a
veterinary
33
examination
of
a
pet
covered
under
a
policy
as
a
condition
for
34
the
renewal
of
the
policy.
The
bill
requires
any
prescriptive,
35
-9-
LSB
5545YH
(4)
90
nls/ko
9/
11
H.F.
2527
wellness,
or
noninsurance
benefits
included
in
a
policy
to
1
comply
with
all
state
insurance
laws.
The
bill
prohibits
2
an
insurer
from
requiring
a
person
to
participate,
or
not
3
to
participate,
in
a
wellness
program
as
a
prerequisite
to
4
purchasing
a
policy.
“Wellness
program”
is
defined
in
the
5
bill.
6
The
bill
prohibits
an
insurer
from
marketing
a
wellness
7
program
as
pet
insurance,
or
marketing
a
wellness
program
8
during
the
sale,
solicitation,
or
negotiation
of
pet
insurance.
9
A
wellness
program
sold
by
an
insurer
shall
keep
the
costs
10
associated
with
the
wellness
program
separate
and
identifiable
11
from
any
policy
sold
by
the
insurer,
the
terms
and
conditions
12
for
the
wellness
program
shall
be
separate
from
any
policy
13
sold
by
the
insurer,
the
products
or
coverages
available
14
through
the
wellness
program
shall
not
duplicate
products
or
15
coverages
available
through
a
policy,
and
the
advertising
16
of
the
wellness
program
shall
not
be
misleading
as
to
the
17
nature
of
the
wellness
program.
An
insurer
that
engages
in
18
the
sale
of
a
wellness
program
shall
clearly
disclose
to
a
19
person
prior
to
purchasing
the
wellness
program
a
statement
20
that
a
wellness
program
is
not
an
insurance
policy,
the
mailing
21
address,
telephone
number,
and
internet
site
of
the
department
22
of
insurance
and
financial
services,
the
address
and
customer
23
service
telephone
number
of
the
insurer
or
of
the
agent
or
24
broker
of
record,
and
a
disclosure
that
coverages
included
in
25
the
pet
insurance
contract
that
are
described
as
wellness
shall
26
be
considered
insurance.
27
The
bill
prohibits
an
insurance
producer
from
selling,
28
soliciting,
or
negotiating
a
pet
insurance
product
until
29
after
the
insurance
producer
is
licensed
as
an
insurance
30
producer
and
has
completed
training
as
required
by
the
bill.
31
“Insurance
producer”
is
defined
in
the
bill.
An
insurer
shall
32
require
that
insurance
producers
are
trained
according
to
33
the
requirements
detailed
in
the
bill,
and
require
that
they
34
have
also
been
trained
on
the
coverages
and
conditions
of
the
35
-10-
LSB
5545YH
(4)
90
nls/ko
10/
11
