2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514K - HEALTH CARE PLAN INFORMATION
514K.1 - HEALTH CARE PLAN DISCLOSURES -- INFORMATION TO ENROLLEES.

        514K.1  HEALTH CARE PLAN DISCLOSURES -- INFORMATION TO
      ENROLLEES.
         1.  A health maintenance organization, an organized delivery
      system, or an insurer using a preferred provider arrangement shall
      provide to each of its enrollees at the time of enrollment, and shall
      make available to each prospective enrollee upon request, written
      information as required by rules adopted by the commissioner and the
      director of public health.  The information required by rule shall
      include, but not be limited to, all of the following:
         a.  A description of the plan's benefits and exclusions.
         b.  Enrollee cost-sharing requirements.
         c.  A list of participating providers.
         d.  Disclosure of the existence of any drug formularies used
      and, upon request, information about the specific drugs included in
      the formulary.
         e.  An explanation for accessing emergency care services.
         f.  Any policies addressing investigational or experimental
      treatments.
         g.  The methodologies used to compensate providers.
         h.  Performance measures as determined by the commissioner and
      the director.
         i.  Information on how to access internal and external
      grievance procedures.
         2.  The commissioner and the director shall annually publish a
      consumer guide providing a comparison by plan on performance
      measures, network composition, and other key information to enable
      consumers to better understand plan differences.  

         99 Acts, ch 41, §21