2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES
514D.4 - STANDARDS FOR BENEFITS ESTABLISHED.

        514D.4  STANDARDS FOR BENEFITS ESTABLISHED.
         1.  The commissioner shall issue rules to establish minimum
      standards for benefits under each of the following categories of
      coverage contained in policies of individual accident and sickness
      insurance or subscriber contracts:
         a.  Basic hospital expense coverage.
         b.  Basic medical-surgical expense coverage.
         c.  Hospital confinement indemnity coverage.
         d.  Major medical expense coverage.
         e.  Disability income protection coverage.
         f.  Accident-only coverage.
         g.  Specified disease or specified accident coverage.
         h.  Medicare supplement coverage.
         i.  Limited benefit health coverage.
         2.  This section does not prohibit the issuance of a policy which
      combines two or more of the categories of coverage enumerated in
      paragraphs "a" to "f" of subsection 1.  A category of
      coverage referred to in paragraph "g", "h" or "i" of
      subsection 1 shall not be combined in a policy or contract either
      with another category of coverage referred to in paragraph "g",
      "h" or "i" of subsection 1 or with a category of coverage
      referred to in any of paragraphs "a" to "f" of subsection 1
      unless a rule issued by the commissioner specifically authorizes that
      combination of coverages.
         3.  The commissioner shall prescribe the method of identification
      of policies and contracts based upon coverages provided.
         4.  A policy of accident and sickness insurance or subscriber
      contract shall not be delivered or issued for delivery in this state
      unless the policy or contract meets the minimum standards prescribed
      under this section.
         5.  The commissioner may upon notice and hearing at any time after
      the initial filing or approval of any individual accident and
      sickness policy or subscriber contract form, withdraw approval or
      suspend further sale of the form if the benefits provided are
      unreasonable in relation to the premium charge.  The commissioner
      shall establish reasonable and creditable anticipated minimum loss
      ratios for Medicare supplement and other accident and sickness
      insurance policies.
         6.  A rule issued by the commissioner under this section shall not
      apply to a conversion policy issued pursuant to a contractual
      conversion privilege under a group or individual policy of accident
      and sickness insurance when such group or individual contract
      contains provisions which are inconsistent with the requirements of
      this chapter or any rule issued under this chapter.
         7.  A rule issued by the commissioner under this section shall not
      apply to policies being issued to employees or members being added to
      a franchise plan, as defined in section 509.14, which is in existence
      on the effective date of the rule.  

         Section History: Early Form

         [C81, § 514D.4; 81 Acts, ch 167, § 2] 

         Section History: Recent Form

         92 Acts, ch 1162, § 34
         Referred to in § 514D.5