2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES
514C.3A - DISCLOSURES RELATING TO DENTAL COVERAGE REIMBURSEMENT RATES.

        514C.3A  DISCLOSURES RELATING TO DENTAL COVERAGE
      REIMBURSEMENT RATES.
         1.  An individual or group policy of accident or health insurance
      or individual or group hospital or health care service contract
      issued pursuant to chapter 509, 514, or 514A, and delivered, amended,
      or renewed on or after July 1, 1995, that provides dental care
      benefits with a base payment for those benefits determined upon a
      usual and customary fee charged by licensed dentists, shall disclose
      all of the following:
         a.  The frequency of the determination of the usual and
      customary fee.
         b.  A general description of the methodology used to determine
      usual and customary fees, including geographic considerations.
         c.  The percentile that determines the maximum benefit that
      the insurer or nonprofit health service corporation will pay for any
      dental procedure, if the usual and customary fee is determined by
      taking a sample of fees submitted on actual claims from licensed
      dentists and then determining the benefit by selecting a percentile
      of those fees.
         2.  The disclosure shall be provided upon request to all group and
      individual policyholders and subscribers.  All proposals for dental
      care benefits shall inform the prospective policyholder or subscriber
      that information regarding usual and customary fee determinations is
      available from the insurer or nonprofit health service corporation.
      All employee benefit descriptions or supplemental documents shall
      notify the employee that information regarding reimbursement rates is
      available from the employer.  

         95 Acts, ch 78, §1; 95 Acts, ch 209, §26