2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 509B - CONTINUATION OF GROUP HEALTH INSURANCE
509B.3 - CONTINUATION OF BENEFITS.

        509B.3  CONTINUATION OF BENEFITS.
         A group policy delivered or issued for delivery in this state
      which insures employees or members for accident or health insurance
      on an expense-incurred or service basis, other than for specific
      diseases or for accidental injuries only, shall provide that
      employees or members whose coverage under the group policy would
      otherwise terminate because of termination of employment or
      membership may continue their accident or health insurance under that
      group policy, for themselves and their eligible dependents, subject
      to all of the group policy's terms and conditions applicable to those
      forms of insurance and subject to all of the following conditions:
         1.  Continuation shall only be available to an employee or member
      if the employee or member was continuously insured under the group
      policy, and for similar benefits under any group policy which it
      replaced, during the entire three months' period immediately
      preceding the termination.
         2.  Continuation shall not be available for a person who is or
      could be covered by Medicare.  Continuation shall not be available
      for a person who is or is eligible to be covered by another group
      insured or uninsured arrangement which provides accident or health
      coverage, unless the person was covered by that other group policy
      immediately prior to the termination.
         3.  Continuation may exclude dental care, vision care, or
      prescription drug benefits or other benefits provided under the group
      policy which benefits are in addition to accident or health benefits.

         4.  An employee or member who wishes continuation of coverage must
      request continuation in writing to the employer or group policyholder
      within the ten-day period following the later of either of the
      following:
         a.  The date of the termination.
         b.  The date the employee is given notice of the right of
      continuation as provided in section 509B.5 by either the employer or
      the group policyholder.
         If proper notice is given, the employee or member is not eligible
      to elect continuation more than thirty-one days after the date of
      termination.
         5.  An employee or member electing continuation shall pay monthly
      to the employer or group policyholder, in advance, the amount of
      contribution required by the employer or group policyholder, but not
      more than the group rate otherwise due for the insurance being
      continued under the group policy.  If proper notice is given, the
      election of continuation by the employee or member together with the
      first contribution required to establish contributions on a monthly
      basis in advance, shall be given to the employer or group
      policyholder within thirty-one days of the date the group insurance
      would otherwise terminate.
         6.  Continuation of insurance under the group policy for any
      person shall terminate when the person becomes eligible for Medicare
      or another group insured or uninsured accident or health arrangement,
      or earlier, when any of the following first occurs:
         a.  Nine months after the date the employee's or member's
      insurance under the policy would otherwise have terminated because of
      termination of employment or membership.
         b.  At the end of the period for which contributions were made
      if the employee or member fails to make timely payment of a required
      contribution and if proper notice is given as provided in section
      509B.5, subsection 2.
         c.  If the person covered is a former spouse, upon the former
      spouse's remarriage.
         d.  The date on which the group policy is terminated or, in
      the case of an employee, the date the employer terminates
      participation under the group policy.  However, if this paragraph
      applies and the coverage which would cease because of the employer's
      termination is replaced by similar coverage under a different group
      policy, all of the following apply:
         (1)  The employee, member, spouse, or eligible dependent may
      become covered under the different group policy, for the balance of
      the period that the employee or member would have remained covered
      under the prior group policy had a termination of the group policy as
      specified in paragraph "d" not occurred.
         (2)  The minimum level of benefits to be provided by the different
      group policy shall be the applicable level of benefits of the prior
      group policy, reduced by any benefits payable under the prior group
      policy.
         (3)  The prior group policy shall continue to provide benefits to
      the extent of its accrued liabilities and extensions of benefits as
      if the prior group policy had not been replaced by the different
      group policy.
         7.  A notification of the continuation privilege shall be included
      with or in each certificate of coverage and as otherwise provided in
      section 509B.5 and shall contain the time limits for requesting the
      continued coverage.
         8.  The spouse of an employee or member, and any covered dependent
      children of the employee or member, whose coverage under the group
      policy would otherwise terminate because of dissolution or annulment
      of marriage or death of the employee or member shall have the same
      contribution and notice responsibilities and privileges as provided
      under this chapter to the employee or member upon termination of
      employment or membership.  

         86 Acts, ch 1124, § 3; 87 Acts, ch 115, §62