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IOWA LIFE & HEALTH

Addendum: for use with Iowa Life and Health online ExamFX courses and study guides version #22294en (Life) and 22295en (L&H), per exam content outline updates effective 1/1/2019.

LIFE AND HEALTH

Iowa Laws, Rules, and Regulations Common to All Lines

Insurance Notices and Documents – Electronic Delivery

Electronic delivery refers to notices or documents sent to an electronic mail address with the consent of two or more parties. Delivery also refers to the posting of that information onto an electronic network or internet site.

Insurers are prohibited from delivering notice of cancellation, nonrenewal, or termination of a policy to an insured through electronic means, unless otherwise given approval by the Commissioner. However, courtesy copies of such notices may be sent as long as the original notice was delivered by postal mail.

Other notices and documents may be sent electronically, as long as the following requirements are met:

• The party has consented to the delivery method;
• Prior to delivery, the party is provided a clear statement stating that they choose to elect paper notices and documents, all or particular transactions, notices of nonrenewal, cancellation or termination, and any other documents relevant to the policy;
• The party is made aware of any hardware or software required to access electronic deliveries;
• The party is alerted of any change in hardware or software requirements;
• The policy does not allow for denial based on failure to obtain electronic consent; and
• Withdrawal from electronic consent does not affect the effectiveness, validity, or enforceability of a notice or document.

HEALTH

Iowa Laws, Rules, and Regulations Pertinent to Health Only

E. Special Programs

HIPIOWA

The Iowa Comprehensive Health Insurance Association (HIPIOWA) is a nonprofit organization established to assure that health insurance is available to eligible Iowa residents who are unable to obtain individual health coverage. All carriers and any relevant delivery systems in Iowa must be members of the Association. The Association has the same authority granted to carriers licensed to issue health insurance.

In addition, it may:

• Be exempt from any state fees and taxes;
• Enter into contracts as necessary or proper to carry out this chapter;
• Sue or be sued;
• Take necessary legal action to avoid payment of improper claims;
• Utilize a medical review committee to determine the appropriate level of health care services required;
• Establish rates, scales of rates, rate classifications, and rating adjustments. These rates cannot be unreasonable in relation to the coverage provided or the Association’s expenses;
• Pool risks or separate accounts among members or groups;
• Appoint, from among members, appropriate committees;
• Hire independent consultants as necessary;
• Advise applicants of the availability of other coverages; and
• Include a provision providing for subrogation rights by the Association in certain cases.

The Association is subject to examination by the Commissioner and the Legislative Fiscal Committee of the Legislative Council. Not later than April 30 of each year, the board must submit a financial report for the preceding calendar year to both parties. Every carrier must provide notice of the availability of coverage under the Association to anyone who is eligible.

Iowa residents rejected for health insurance coverage or for health care services, or those who could only obtain health insurance at a rate higher than that of the Association, are eligible for coverage under the Association.

These restrictions will be void if the individual is

• Incapable off full-time employment by reason of mental or physical disability; or
• Dependent upon the person in whose name the contract is issued.

Proof of incapacity or dependency must be furnished within 120 days of the applicable limiting age. This proof may be required by the carrier annually, after an initial waiting period of 2 years.

HIPIOWA does not offer health coverage to the following individuals (unless they are otherwise qualified):

• Those who are not Iowa residents;
• Those who terminated coverage by the Association within the past 12 months;
• Inmates of a public institution;
• Those whose premiums are paid for or reimbursed under any government sponsored program; or
• Those who have not been rejected by or who have similar coverage from another carrier.

IOWA PROPERTY & CASUALTY

Addendum: for use with Iowa Property and Casualty online ExamFX courses and study guides version #21106en/21109en per exam content outline updates effective 1/1/2019.

Iowa Laws, Rules, and Regulations Common to All Lines

Use of Credit Information

When utilizing credit information to underwrite or rate risks, an insurer is prohibited from the following:

• Using an insurance score based on the insured's gender, race, ethnicity, religion, income, address, zip code, marital status, or nationality;
• Cancelling, denying or refusing to renew a policy based on the insured's credit information, without any other underwriting factors;
• Basing an insured's renewal rate off of credit information alone;
• Taking adverse action solely based on the insured not having a credit card account;
• Only taking into consideration the absence of credit information when underwriting or rating personal insurance, unless when treating the applicant as if he or she has neutral credit or excludes use of credit information;
• Taking adverse action as a result of credit information, unless it's calculated prior to 90 days of insurance being written or a renewal being issued; and
• Utilizing credit scores, unless they have been recalculated or updated no later than 36 months following the previous obtainment of credit information.

If the insurer receives notice of incomplete or incorrect credit information from the consumer reporting agency or the insured, the insurer must re-underwrite and re-rate the insured within 30 days of receiving the notice. If it is determined the insured overpaid the premium, the insurer must refund the amount overpaid.

When using credit information in underwriting or rating, the insurer must disclose on the application that the applicant may obtain the credit information. Upon adverse action against the insured, the insurer must notify the insured and provide an explanation. Insurers must file all credit scoring models or other scoring processes with the Commissioner of Insurance.

Upon written request from an insured, insurers must provide exceptions for extraordinary life circumstances. In response to a request, the insurer may require written verifiable documentation and a description of the significance. Examples of extraordinary life circumstances include, but are not limited to:

• Serious illness or injury;
• Death of a spouse, child, or parent;
• Catastrophic event;
• Identify theft; and
• Military deployment.

Insurance Notices and Documents – Electronic Delivery

Electronic delivery refers to notices or documents sent to an electronic mail address with the consent of two or more parties. Delivery also refers to the posting of that information onto an electronic network or internet site.

Insurers are prohibited from delivering notice of cancellation, nonrenewal, or termination of a policy to an insured through electronic means, unless otherwise given approval by the Commissioner. However, courtesy copies of such notices may be sent as long as the original notice was delivered by postal mail.

Other notices and documents may be sent electronically, as long as the following requirements are met:

• The party has consented to the delivery method;
• Prior to delivery, the party is provided a clear statement stating that they choose to elect paper notices and documents, all or particular transactions, notices of non-renewal, cancellation or termination, and any other documents relevant to the policy;
• The party is made aware of any hardware or software required to access electronic deliveries;
• The party is alerted of any change in hardware or software requirements;
• The policy does not allow for denial based on failure to obtain electronic consent; and
• Withdrawal from electronic consent does not affect the effectiveness, validity, or enforce ability of a notice or document.