2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES
514D.5 - DISCLOSURE, MEDICARE INFORMATION, AND ADVERTISING.

        514D.5  DISCLOSURE, MEDICARE INFORMATION, AND
      ADVERTISING.
         1.  Except as otherwise provided in subsection 3, in order to
      provide for full and fair disclosure in the sale of individual
      accident and sickness insurance policies or subscriber contracts a
      policy or contract shall not be delivered or issued for delivery in
      this state unless the outline of coverage described in subsection 2
      either accompanies the policy or contract or is delivered to the
      applicant at the time application is made and unless an
      acknowledgment of receipt or certificate of delivery of the outline
      is provided the insurer.  In the event the policy or contract is
      issued on a basis other than that applied for, the outline of
      coverage properly describing the policy or contract must accompany
      the policy or contract when it is delivered and must clearly state
      that it is not the policy or contract for which application was made.

         2.  The commissioner shall prescribe the format and content of the
      outline of coverage required by subsection 1.  "Format" means
      style, arrangement, and overall appearance, including such items as
      the size, color, and prominence of type and the arrangement of text
      and captions.  The outline of coverage shall include all of the
      following:
         a.  A statement identifying the applicable category or
      categories of coverage provided by the policy or contract as
      prescribed in section 514D.4.
         b.  A description of the principal benefits and coverage
      provided in the policy or contract.
         c.  A statement of the exceptions, reductions, and limitations
      contained in the policy or contract.
         d.  A statement of the renewal provisions including any
      reservation by the insurer of a right to change premiums.
         e.  A statement that the outline is a summary of the policy or
      contract issued or applied for and that the policy or contract should
      be consulted to determine governing contractual provisions.
         If payment will not be made for services performed by a
      chiropractor acting within the scope of the chiropractor's license
      when those services would be compensable if performed by a medical
      doctor, then a statement that services performed by a chiropractor
      are not compensable shall be included in the outline of coverage.
         3.  The commissioner shall prescribe disclosure rules for Medicare
      supplement coverage which are determined to be in the public interest
      and which are designed to adequately inform the prospective insured
      of the need for and extent of coverage offered as Medicare supplement
      coverage.  For Medicare supplement coverage, the outline of coverage
      required by subsection 2 shall be furnished to the prospective
      insured with the application form.
         4.  The commissioner shall further prescribe by rule a standard
      form for and the contents of an informational brochure for persons
      eligible for Medicare by reason of age, which is intended to improve
      the buyer's ability to select the most appropriate coverage and to
      improve the buyer's understanding of Medicare.  Except in the case of
      direct response insurance policies, the commissioner may require by
      rule that this informational brochure be provided to prospective
      insureds eligible for Medicare concurrently with delivery of the
      outline of coverage.  With respect to direct response insurance
      policies, the commissioner may require by rule that this brochure
      must be provided to prospective insureds eligible for Medicare by
      reason of age upon request, but not later than at the time of
      delivery of the policy or contract.
         5.  The commissioner shall adopt rules prohibiting the advertising
      of forms titled as "nursing home" forms or inferring coverage for
      custodial care in a nursing facility as defined in section 135C.1
      unless such forms provide coverage for custodial care in a nursing
      facility as defined in section 135C.1.  

         Section History: Early Form

         [C81, § 514D.5] 

         Section History: Recent Form

         86 Acts, ch 1045, § 2; 90 Acts, ch 1039, §17; 2003 Acts, ch 141,
      §15