2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 509A - GROUP INSURANCE FOR PUBLIC EMPLOYEES
509A.15 - CERTIFICATION OF SELF-INSURANCE PLANS -- EXEMPTION.

        509A.15  CERTIFICATION OF SELF-INSURANCE PLANS --
      EXEMPTION.
         1.  Within ninety days following the end of a fiscal year, the
      governing body of a self-insurance plan of a political subdivision or
      a school corporation shall file with the commissioner of insurance a
      certificate of compliance, actuarial opinion, and an annual financial
      report.  The filing shall be accompanied by a fee of one hundred
      dollars.  A penalty of fifteen dollars per day shall be assessed for
      failure to comply with the ninety-day filing requirement, except that
      the commissioner may waive the penalty upon a showing that special
      circumstances exist which justify the waiver.  The certificate shall
      be signed and dated by the appropriate public official representing
      the governing body, and shall certify the following:
         a.  That the plan meets the requirements of this chapter and
      the applicable provisions of the Iowa administrative code.
         b.  That an actuarial opinion has been attached to the
      certificate which attests to the adequacy of reserves, rates, and
      financial condition of the plan.  The actuarial opinion must include,
      but is not limited to, a brief commentary about the adequacy of the
      reserves, rates, and the financial condition of the plan, a test of
      the prior year claim reserve, a brief description of how the reserves
      were calculated, and whether or not the plan is able to cover all
      reasonably anticipated expenses.  The actuarial opinion shall be
      prepared, signed, and dated by a person who is a member of the
      American academy of actuaries.  If necessary, the actuary should
      assist the public body in preparing the annual financial report.  The
      annual financial report shall be in a format as prescribed by the
      commissioner.
         c.  That a written complaint procedure has been implemented.
      The certificate shall also list the number of complaints filed by
      participants under the written complaint procedure, and the
      percentage of participants filing written complaints, in the prior
      fiscal year.
         d.  That the governing body has contracted or otherwise
      arranged with a third-party administrator who holds a current
      certificate of registration issued by the commissioner pursuant to
      section 510.21, or with a person not required to obtain the
      certificate as a third-party administrator as defined in section
      510.11, subsection 2.
         2.  The commissioner shall by rule require the maintenance of
      confidentiality of information held by the plan administrator.
         3.  The failure of the governing body to provide the certificate
      of compliance required by subsection 1, or the failure of the
      governing body or plan administrator to abide by a requirement of the
      plan, this chapter, or applicable rule, is grounds for action against
      the plan, including cause for disapproval or discontinuance of the
      plan.
         4.  One or more political subdivisions of the state or one or more
      school corporations maintaining self-insured plans with yearly claims
      that do not exceed two percent of each entity's general fund budget
      shall be exempt from the requirements of this section where the plan
      insures employees for all or part of a deductible, coinsurance
      payments, drug costs, short-term disability benefits, vision
      benefits, or dental benefits.
         The yearly claim amount shall be determined annually on the policy
      renewal date, or an alternative date established by rule, by a plan
      administrator or political subdivision or school corporation employee
      to be designated by the plan administrator.  The exemption shall not
      apply for the year following a year in which yearly claims are
      determined to exceed two percent of the political subdivision's or
      school corporation's general fund budget.  

         88 Acts, ch 1112, § 104; 92 Acts, ch 1162, § 14; 93 Acts, ch 88, §
      10; 2000 Acts, ch 1200, §1; 2003 Acts, ch 91, §12; 2006 Acts, ch
      1117, §34, 35