§ 252E.7 — Insurer authorization

Iowa § 252E.7

• Jurisdiction: Iowa
• Title VI: HUMAN SERVICES
• Ch. 252E: MEDICAL SUPPORT

Text

1. The entry of an order requiring a health benefit plan is authorization for enrollment
of the dependent if the dependent is otherwise eligible to be enrolled. If the obligor fails
to obtain coverage for a dependent, the insurer shall accept the signature of the obligee or
other legal custodian of the child or of an employee of the department on the application
for enrollment of the dependent under the health benefit plan. If the dependent is otherwise
eligibletobeenrolledintheplanpursuanttotheapplicabletermsandconditionsofthehealth
benefit plan and the standard enrollment guidelines of the insurer, the insurer shall allow
enrollmentofthedependentatanytime, notwithstandinganyenrollmentseasonrestrictions.
2. An insurer shall not deny enrollment of a child under the health benefit plan of the
obligor based on any of the following:
a. The child was born out of wedlock.
b. The child is not claimed as a dependent on the obligor’s federal income tax form.
c. The child does not reside with the obligor or in the insurer’s service area.
3. For purposes of processing claims for payment, the insurer shall accept the signature
of the obligee or other legal custodian of the child or of an employee of the department as
valid authorization for purposes of processing any medical expense claims on behalf of the
dependent for payment or reimbursement of medical services rendered to the dependent.
4. The insurer shall have immunity from any liability, civil or criminal, which might
otherwise be incurred or imposed for actions taken in implementing this section including,
but not limited to, the insurer’s release of any information, or the payment of any claims
for services by the insurer, or the insurer’s acceptance of applications for enrollment of the
dependent and medical expense claims for the dependent which are signed by the obligee
or an employee of the department pursuant to this section.
5. If a dependent has coverage under the health benefit plan of and through the insurer
of the obligor, the insurer shall make payment directly to the obligee, the provider, or the
department for claims submitted by the obligee, by the provider with the obligee’s approval,
or by the department.
6. Payments remitted to the obligor by the insurer for services received by the dependent
shall be recoverable by the obligee or the department from the obligor if not properly paid by
the obligor to the provider or the obligee.