Iowa Code 513B.6 – Disclosure of rating practices and renewability provisions
Current as of: 2023 | Check for updates
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A small employer carrier shall make reasonable disclosure in solicitation and sales materials provided to small employers of all of the following:
1. The extent to which premium rates for a specific small employer are established or adjusted due to the claim experience, health status, or duration of coverage of the employees or dependents of the small employer.
Terms Used In Iowa Code 513B.6
- Carrier: means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including an insurance company offering sickness and accident plans, a health maintenance organization, a nonprofit health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services. See Iowa Code 513B.2
- Case characteristics: means demographic or other relevant characteristics of a small employer, as determined by a small employer carrier, which are considered by the insurer in the determination of premium rates for the small employer. See Iowa Code 513B.2
- following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
- Small employer: means a person actively engaged in business who, on at least fifty percent of the employer's working days during the preceding year, employed at least one and not more than fifty full-time equivalent eligible employees. See Iowa Code 513B.2
- Small employer carrier: means any carrier which offers health benefit plans covering the employees of a small employer. See Iowa Code 513B.2
2. The provisions concerning the small employer carrier‘s right to change premium rates and factors, including case characteristics, which affect changes in premium rates.
3. The provisions relating to any preexisting condition provision.
4. The provisions relating to renewability of coverage.