Iowa insurance law and regulation
News that affects your health insurance and planning
May 26, 2019 – Status of alternative non-ACA health plans: Iowa does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market and limits the sale of short-term coverage more strictly than the federal government by limiting the initial contract duration of underwritten short-term coverage to 6 months. Iowa exempts some other coverage products from federal and state rules for individual market insurance: health plans sold by the Iowa Farm Bureau are not considered insurance under state law and are exempt from federal and state protections otherwise applicable to the individual insurance market.
March 20, 2019 -Health insurance companies are easing requirements to help people affected by recent flooding across parts of Iowa. Health plan participants may need help to access primary care and to get prescription refilled in the aftermath of flooding. Check for flood relief resources with your health plan.
The history of health care planning in Iowa (Information is outdated and links may be expired)
2/11/ 2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Iowa residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
6/26/2012 A new law HE 2465 regulating health insurance navigators becomes effective July 1, 2012 but actual enforcement is anticipated to occur at a later date. The specific regulatory requirements for licensing navigators in Iowa under the new law are currently being reviewed by the Department of Insurance in light of the ACA provisions. More information will be posted on www.OnlineNavigator.org when available.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Wellmark, UnitedHealthcare and Medical Associates Health Care are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
8/19/2011 The Iowa Department of Public Health received a federal grant of $681,773 to help uninsured teens enroll in Medicaid or CHIP.
7/10/2011 The U.S. Center for Consumer Information and Insurance Oversight announced that Iowa lacks proper resources or authority in the small-group market to effectively review large rate increases as required by federal law. The federal government will temporarily take over the task of reviewing small business health insurance rate increases that are more than 10%.
7/1/2011 The Iowa Open Enrollment Program for eligible children is available from July 1 until August 14, 2011. This state program is the result of federal health reform law enacted in 2010 that makes all children eligible for health insurance coverage. The 45 day open enrollment period is designed to ensure that parents enroll children on a permanent basis rather than only when medical care is required.
Participating insurance companies include: American Republic Insurance Company, Assurant Health, Celtic Insurance, Coventry Health, Golden Rule Insurance Company, Reserve National Insurance Company, Wellmark Blue Cross and Blue Shield of Iowa and World Insurance. OnlineAdviser provides enrollment support for Celtic Insurance through www.celticenrollment.com and Golden Rule Insurance throughwww.uhcenrollment.com . Specific details on eligibility, rates and enrollment procedures for the Iowa Open Enrollment Program are available directly from each insurance carrier. Due to the complex eligibility rules, additional application requirements and subtle distinctions in coverage under this program, we suggest that parents should speak with an insurance enrollment adviser to avoid obstacles and maximize the likelihood of approval.
OnlineAdviserTM Tony Novak reminds parents that an application for health insurance coverage may be made at any time without a qualifying event when the application includes a parent. A family-type application is not guaranteed acceptance so the applicants must meet regular health underwriting requirements when applying outside of the Iowa open enrollment program.
2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.
1/12/2011 Wellpoint Blue Cross Blue Shield rates will rise between 7.5% to 15% this year, according to the results of a new rate review process designed to detect and eliminate unwarranted price hikes. For individual consumers, the state and its’ outside actuary found that the 15% increase was warranted based on an increase in expected claims. More coverage on the Universal Health Insurance Blog.
12/28/2010 The state-run pre-existing condition insurance plan attracted only 56 Iowa residents this year despite the government-subsidized premium. This plan provides a health coverage option for consumers who have been uninsured for at least six months, have a pre-existing condition or have been denied health coverage because of their health condition, and are a U.S. citizen or are residing here legally. The federal government pays most of the premium cost. The plan was initially criticized for excessive taxpayer costs but the overall lack of public interest in this insurance was not anticipated.
12/16/2010 Iowa Department of Health officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, the Iowa Department of Health said that it would: 1) Establish an Interagency Planning Workgroup to ensure collaboration between the Iowa Department of Public Health, Iowa Department of Human Services (State Medicaid Agency), Iowa Insurance Division and the Iowa Department of Revenue 2) Create final recommendations, to include: a) Organizational structure for an insurance Exchange, c) Shared vision, d) Implementation plan that will include policy recommendations and core capabilities, e) Blueprint for outreach efforts, f) Sustainability plan that will address critical risk factors that will need to be managed, 3) Develop a comprehensive plan for implementation of an insurance Exchange in Iowa, 4) Further develop the planning process and expand stakeholder input, 5) Assess insurance Exchange options, 6) Coordinate planning efforts with existing State and federal programs to ensure integration with an insurance Exchange, 7) Assess the capacity and infrastructure required for implementation of an insurance Exchange in Iowa, 8) Determine administrative resource needs for implementation of an insurance Exchange, 9) Assess infrastructure and regulatory needs, and 10) Identify transition steps for implementation and sustainability based on recommendation of insurance Exchange structure.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Iowa is now available at Freedom Benefits.