Bill Text: IA HSB543 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to health insurance and the insurance division of the department of commerce, and providing for fees.
Spectrum: Committee Bill
Status: (N/A - Dead) 2020-02-12 - Committee report, recommending amendment and passage. H.J. 263. [HSB543 Detail]
Download: Iowa-2019-HSB543-Introduced.html
House
Study
Bill
543
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
DEPARTMENT
OF
COMMERCE/INSURANCE
DIVISION
BILL)
A
BILL
FOR
An
Act
relating
to
health
insurance
and
the
insurance
division
1
of
the
department
of
commerce,
and
providing
for
fees.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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H.F.
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Section
1.
NEW
SECTION
.
505.18A
State
innovation
waiver.
1
1.
The
commissioner
may
develop
by
rule
a
state
innovation
2
waiver
pursuant
to
section
1332
of
the
federal
Patient
3
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148.
4
2.
The
commissioner
may
submit
an
application
on
behalf
of
5
the
state
to
the
United
States
secretary
of
health
and
human
6
services
and
the
United
States
secretary
of
the
treasury
for
7
the
state
innovation
waiver
developed
pursuant
to
subsection
1.
8
3.
If
a
state
innovation
waiver
submitted
pursuant
to
9
subsection
2
is
approved
by
the
United
States
Secretary
of
10
health
and
human
services
and
the
United
States
secretary
11
of
the
treasury,
the
commissioner
may
implement
the
state
12
innovation
waiver
in
a
manner
consistent
with
applicable
state
13
and
federal
law.
14
4.
The
commissioner
may
adopt
emergency
rules
under
section
15
17A.4,
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
16
“b”
,
to
implement
the
provisions
of
this
section
and
the
rules
17
shall
be
effective
immediately
upon
filing
unless
a
later
date
18
is
specified
in
the
rules.
Any
rules
adopted
in
accordance
19
with
this
section
shall
also
be
published
as
a
notice
of
20
intended
action
as
provided
in
section
17A.4.
21
Sec.
2.
Section
507A.4,
subsection
9,
Code
2020,
is
amended
22
by
striking
the
subsection
and
inserting
in
lieu
thereof
the
23
following:
24
9.
Transactions
involving
a
multiple
employer
welfare
25
arrangement
as
defined
in
section
3
of
the
federal
Employee
26
Retirement
Income
Security
Act
of
1974,
29
U.S.C.
§1002,
27
paragraph
40,
or
a
multiple
employer
welfare
arrangement
formed
28
as
an
association
health
plan
pursuant
to
29
C.F.R.
pt.
2510,
29
that
meets
the
requirements
of
chapter
513D.
30
Sec.
3.
Section
509.1,
subsection
9,
Code
2020,
is
amended
31
to
read
as
follows:
32
9.
A
policy
of
group
health
insurance
coverage
issued
to
an
33
associated
health
plan
a
multiple
employer
welfare
arrangement
34
pursuant
to
section
513D.1
chapter
513D
that
is
subject
to
35
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regulation
by
the
commissioner.
1
Sec.
4.
Section
509.19,
subsection
2,
paragraph
d,
Code
2
2020,
is
amended
to
read
as
follows:
3
d.
A
multiple
employer
welfare
arrangement
,
as
defined
4
in
section
3
of
the
federal
Employee
Retirement
Income
5
Security
Act
of
1974,
29
U.S.C.
§1002
(40)
,
paragraph
40
,
or
a
6
multiple
employer
welfare
arrangement
formed
as
an
association
7
health
plan
pursuant
to
29
C.F.R.
pt.
2510,
that
meets
the
8
requirements
of
section
507A.4,
subsection
9
,
paragraph
“a”
9
chapter
513D
.
10
Sec.
5.
Section
513D.1,
Code
2020,
is
amended
by
striking
11
the
section
and
inserting
in
lieu
thereof
the
following:
12
513D.1
Multiple
employer
welfare
arrangements
and
association
13
health
plans.
14
1.
As
used
in
this
chapter,
unless
the
context
otherwise
15
requires:
16
a.
“AHP”
means
a
multiple
employer
welfare
arrangement
17
formed
as
an
association
health
plan
pursuant
to
29
C.F.R.
pt.
18
2510.
19
b.
“Commissioner”
means
the
commissioner
of
insurance.
20
c.
“MEWA”
means
a
multiple
employer
welfare
arrangement
as
21
defined
in
section
3
of
the
federal
Employee
Retirement
Income
22
Security
Act
of
1974,
29
U.S.C.
§1002,
paragraph
40.
23
2.
An
AHP
or
MEWA
that
offers
a
plan
to
or
maintains
a
group
24
health
plan
for
any
resident
of
this
state
shall
be
subject
to
25
the
jurisdiction
of
the
commissioner
and
shall
comply
with
all
26
of
the
following
requirements:
27
a.
The
AHP
or
MEWA
must
be
administered
by
an
insurer
28
authorized
to
do
the
business
of
insurance
in
this
state
or
29
an
authorized
third-party
administrator
that
holds
a
current
30
certificate
of
registration
pursuant
to
section
510.21.
31
b.
The
AHP
or
MEWA
must
be
established
by
a
trade,
32
industry,
or
professional
association
of
employers
that
has
a
33
constitution
or
bylaws,
is
organized
and
maintained
in
good
34
faith,
and
has
membership
stability
as
defined
by
rules
adopted
35
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by
the
commissioner.
1
c.
The
AHP
or
MEWA
must
register
with
the
commissioner
and
2
obtain
and
maintain
a
certificate
of
registration
issued
by
the
3
commissioner.
4
d.
The
AHP
or
MEWA
shall
comply
with
all
rules
and
solvency
5
standards
established
by
rules
adopted
by
the
commissioner.
6
3.
An
AHP
or
MEWA
that
does
not
meet
the
solvency
standards
7
pursuant
to
subsection
2,
paragraph
“d”
,
shall
be
subject
to
8
chapter
507C.
9
4.
An
AHP
or
MEWA
that
meets
all
of
the
requirements
of
10
subsection
2
shall
not
be
considered
any
of
the
following:
11
a.
An
insurance
company
or
association
of
whatever
kind
or
12
character
pursuant
to
section
432.1.
13
b.
A
member
of
the
Iowa
individual
health
benefit
14
reinsurance
association
pursuant
to
section
513C.10,
subsection
15
1.
16
c.
A
member
insurer
of
the
Iowa
life
and
health
insurance
17
guaranty
association
pursuant
to
section
508C.5.
18
5.
An
AHP
or
MEWA
that
is
registered
with
the
commissioner
19
pursuant
to
subsection
2,
paragraph
“c”
,
shall
annually
file
20
with
the
commissioner
on
or
before
March
1
a
copy
of
the
report
21
required
to
be
filed
by
the
AHP
or
MEWA
with
the
United
States
22
department
of
labor
pursuant
to
29
C.F.R.
§2520.101-2.
23
6.
An
AHP
or
MEWA
that
is
registered
with
the
commissioner
24
pursuant
to
subsection
2,
paragraph
“c”
,
shall
annually
file
25
with
the
commissioner
a
report
on
or
before
March
1
for
the
26
preceding
calendar
year.
The
annual
report
shall
contain
the
27
information
and
be
in
a
form
and
manner
as
prescribed
by
the
28
commissioner.
29
7.
A
foreign
or
domestic
AHP
or
MEWA
doing
business
in
the
30
state
shall
pay
fees
as
prescribed
by
the
commissioner
unless
31
otherwise
provided
by
law.
32
8.
A
MEWA
that
is
recognized
as
tax-exempt
under
Internal
33
Revenue
Code
section
501(c)(9)
and
that
is
registered
with
the
34
commissioner
prior
to
January
1,
2018,
shall
not
be
considered
35
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an
AHP
unless
the
MEWA
affirmatively
elects
to
be
treated
as
1
an
AHP.
2
Sec.
6.
Section
513D.2,
subsection
1,
Code
2020,
is
amended
3
to
read
as
follows:
4
1.
The
commissioner
of
insurance
shall
adopt
rules
,
as
5
necessary
,
pursuant
to
chapter
17A
to
administer
this
chapter
.
6
EXPLANATION
7
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
8
the
explanation’s
substance
by
the
members
of
the
general
assembly.
9
This
bill
relates
to
health
insurance
and
the
insurance
10
division
of
the
department
of
commerce.
11
The
bill
authorizes
the
commissioner
of
insurance
to
develop
12
by
rule
a
state
innovation
waiver
(waiver)
pursuant
to
section
13
1332
of
the
federal
Patient
Protection
and
Affordable
Care
Act,
14
Pub.
L.
No.
111-148,
and
to
submit
an
application
on
behalf
15
of
the
state
to
the
United
States
secretary
of
health
and
16
human
services
and
the
United
States
secretary
of
the
treasury
17
(secretaries)
for
the
waiver.
If
a
waiver
is
approved
by
the
18
secretaries,
the
commissioner
is
authorized
to
implement
the
19
waiver
in
a
manner
consistent
with
applicable
state
and
federal
20
law.
The
bill
authorizes
the
commissioner
to
adopt
emergency
21
rules
to
implement
the
waiver
and
the
rules
are
to
be
effective
22
immediately
upon
filing
unless
a
later
date
is
specified
in
the
23
rules.
Any
rules
that
are
adopted
must
also
be
published
as
a
24
notice
of
intended
action
as
provided
in
Code
section
17A.4.
25
The
bill
amends
Code
section
507A.4
and
provides
that
Code
26
chapter
507A
(unauthorized
insurers)
does
not
apply
to
a
27
multiple
employer
welfare
arrangement
(MEWA)
or
a
MEWA
formed
28
as
an
association
health
plan
(AHP)
that
meets
the
requirements
29
of
Code
chapter
513D.
The
bill
strikes
current
Code
section
30
513D.1
(association
health
plans)
and
replaces
it
with
new
31
provisions
which
detail
the
requirements
for
MEWAs
and
AHPs
32
that
offer
a
plan
to
or
that
maintain
a
group
health
plan
for
33
any
resident
of
Iowa.
An
“AHP”
is
defined
in
the
bill
as
a
MEWA
34
formed
as
an
association
health
plan
pursuant
to
29
C.F.R.
pt.
35
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_____
H.F.
_____
2510.
A
“MEWA”
is
defined
in
the
bill
as
a
multiple
employer
1
welfare
arrangement
as
defined
in
section
3
of
the
federal
2
Employee
Retirement
Income
Security
Act
of
1974,
29
U.S.C.
3
§1002,
paragraph
40.
4
The
bill
requires
an
AHP
or
MEWA
to
be
administered
by
either
5
an
insurer
authorized
to
do
the
business
of
insurance
in
this
6
state,
or
by
an
authorized
third-party
administrator
that
holds
7
a
current
certificate
of
registration.
The
AHP
or
MEWA
must
be
8
established
by
a
trade,
industry,
or
professional
association
9
of
employers
that
has
a
constitution
or
bylaws,
is
organized
10
and
maintained
in
good
faith,
and
has
membership
stability
as
11
defined
by
rules
adopted
by
the
commissioner.
The
AHP
or
MEWA
12
must
register
with
the
commissioner
and
obtain
and
maintain
a
13
certificate
of
registration
issued
by
the
commissioner.
The
14
bill
requires
that
an
AHP
or
MEWA
must
comply
with
all
rules
15
and
solvency
standards
established
by
rules
adopted
by
the
16
commissioner,
and
failure
to
do
so
subjects
the
AHP
or
MEWA
17
to
Code
chapter
507C
(insurers
supervision,
rehabilitation,
18
and
liquidation).
An
AHP
or
MEWA
that
meets
all
of
the
19
requirements
is
not
considered
an
insurance
company
or
20
association
of
whatever
kind
or
character
under
Code
section
21
432.1
(tax
on
gross
premiums
——
exclusions),
a
member
of
the
22
Iowa
individual
health
benefit
reinsurance
association,
or
a
23
member
insurer
of
the
Iowa
life
and
health
insurance
guaranty
24
association.
25
The
bill
requires
AHPs
and
MEWAs
that
are
registered
with
26
the
commissioner
to
annually
file
with
the
commissioner
on
or
27
before
March
1
a
copy
of
the
report
required
to
be
filed
by
28
the
AHP
or
MEWA
with
the
United
States
department
of
labor
29
pursuant
to
29
C.F.R.
§2520.101-2.
The
AHP
and
MEWA
must
also
30
file
an
annual
report
with
the
commissioner
on
or
before
March
31
1
that
covers
the
preceding
calendar
year.
The
annual
report
32
must
contain
the
information
and
be
in
a
form
and
manner
as
33
prescribed
by
the
commissioner.
34
A
foreign
or
domestic
AHP
or
MEWA
doing
business
in
the
35
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_____
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state
is
required
by
the
bill
to
pay
fees
as
prescribed
by
the
1
commissioner
unless
otherwise
provided
by
law.
2
The
bill
provides
that
a
MEWA
that
is
recognized
as
3
tax-exempt
under
Internal
Revenue
Code
section
501(c)(9),
and
4
that
is
registered
with
the
commissioner
prior
to
January
5
1,
2018,
shall
not
be
considered
an
AHP
unless
the
MEWA
6
affirmatively
elects
to
be
treated
as
an
AHP.
7
The
bill
makes
conforming
changes
to
Code
sections
509.1(9)
8
and
509.19(2).
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