As used in this chapter, unless the context otherwise requires:
1.“Account” means any of the four accounts created under section 508C.6.
2.“Association” means the Iowa life and health insurance guaranty association created in
section 508C.6.
3.“Authorized assessment”, or the term “authorized” when used in the context of an
assessment, means that a resolution has been passed by the board of directors of the
association whereby an assessment will be called immediately or in the future from member
insurers for a specified amount. An assessment is authorized when the resolution is passed.
4.“Benefit plan” means a specific employee, union, or association of natural persons
benefit plan.
5.“Called assessment”, or the term “called” when used in the context of an assessment,
means that a noti
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As used in this chapter, unless the context otherwise requires:
1. “Account” means any of the four accounts created under section 508C.6.
2. “Association” means the Iowa life and health insurance guaranty association created in
section 508C.6.
3. “Authorized assessment”, or the term “authorized” when used in the context of an
assessment, means that a resolution has been passed by the board of directors of the
association whereby an assessment will be called immediately or in the future from member
insurers for a specified amount. An assessment is authorized when the resolution is passed.
4. “Benefit plan” means a specific employee, union, or association of natural persons
benefit plan.
5. “Called assessment”, or the term “called” when used in the context of an assessment,
means that a notice has been issued by the association to member insurers requiring that
an authorized assessment be paid within the time frame set forth within the notice. An
authorized assessment becomes a called assessment when notice is mailed by the association
to member insurers.
6. “Commissioner” means the commissioner of insurance.
7. “Contractual obligation” means an obligation under a covered policy or contract or
a certificate under a group policy or contract, or a portion thereof for which coverage is
provided under section 508C.3.
§508C.5, IOWA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION 6
8. “Covered policy” or “covered contract” means a policy or contract, or a portion of a
policy or contract, for which coverage is provided under section 508C.3.
9. “Extra-contractual claim” means, without limitation, a claim relating to bad faith in the
payment of claims, punitive or exemplary damages, or attorney fees and costs.
10. “Health benefit plan” means any hospital or medical expense policy or certificate, or
health maintenance organization subscriber contract or any other similar health contract.
“Health benefit plan” does not include any of the following:
a. Accident-only insurance.
b. Credit insurance.
c. Dental-only insurance.
d. Vision-only insurance.
e. Medicare supplement insurance.
f. Benefits for long-term care, home health care, community-based care, or any
combination thereof.
g. Disability income insurance.
h. Coverage for an onsite medical clinic.
i. Specified disease, hospital confinement indemnity, or limited benefit health insurance if
the specific type of coverage does not provide coordination of benefits and is provided under
a separate policy or certificate.
11. “Impaired insurer” means a member insurer which is not an insolvent insurer and is
placed under an order of rehabilitation or conservation by a court of competent jurisdiction.
12. “Insolvent insurer” means a member insurer which is placed under an order of
liquidation with a finding of insolvency by a court of competent jurisdiction.
13. “Member insurer” means an insurer or health maintenance organization which is
licensed or which holds a certificate of authority to transact in this state any kind of insurance
or health maintenance business for which coverage is provided under section 508C.3, and
including an insurer or health maintenance organization whose license or certificate of
authority in this state has been suspended, revoked, not renewed, or voluntarily withdrawn
but does not include any of the following:
a. An entity which is a licensed company specified in section 508C.3, subsection 4,
paragraph “f” or “g”.
b. A mandatory state pooling plan.
c. A mutual assessment company or other person which operates on an assessment basis.
d. An insurance exchange.
e. An entity which issues a charitable gift annuity under chapter 508F.
f. An entity whose only business in this state is operating as a managed care organization.
For purposes of this paragraph, “managed care organization” means an entity that is under
contract with the department of health and human services to provide services to Medicaid
recipients and that also meets the definition of “health maintenance organization” in section
514B.1.
g. An entity similar to any of the entities enumerated in this subsection.
14. “Moody’s corporate bond yield average” means the monthly average corporate bond
yields published by Moody’s investors service, inc., or any successor thereto.
15. “Owner” of a policy of contract, “policy holder”, “policy owner”, or “contract owner”
means the person who is identified as the legal owner of a policy or contract under the terms
of the policy or contract or who is otherwise vested with legal title to the policy or contract
through a valid assignment completed in accordance with the terms of the policy or contract
and properly recorded as the owner on the books of the member insurer. “Owner”, “policy
holder”, “policy owner”, or “contract owner” does not include a person with a mere beneficial
interest in a policy or contract.
16. “Person” means an individual, corporation, limited liability company, government or
governmental subdivision or agency, business trust, estate, trust, partnership, association, or
any other legal entity.
17. “Plan sponsor” means any of the following:
a. The employer in the case of a benefit plan established or maintained by a single
employer.
7 IOWA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION, §508C.5
b. The employee organization in the case of a benefit plan established or maintained by
an employee organization.
c. In the case of a benefit plan established or maintained by two or more employers or
jointly by one or more employers and one or more employee organizations, the association,
committee, joint board of trustees, or other similar group of representatives of the parties
who establish or maintain the benefit plan.
18. “Premium” means amounts or consideration, by whatever name called, received
on covered policies or contracts less returned premiums, considerations, and deposits
and less dividends and experience credits. “Premium” does not include amounts for
consideration received for policies or contracts or for the portions of policies or contracts for
which coverage is not provided under section 508C.3, subsection 4, except that assessable
premium shall not be reduced on account of the provisions of section 508C.3, subsection 4,
paragraph “a”, relating to interest limitations and section 508C.3, subsection 5, paragraph
“a”, subparagraph (2), subparagraph division (a), relating to limitations with respect to one
individual, one participant, and one policy or contract owner. “Premium” shall not include
any of the following:
a. Premiumsinexcessoffivemilliondollarsonanunallocatedannuitycontractnotissued
under a governmental retirement plan, or its trustee, established under section 401, 403(b),
or 457 of the United States Internal Revenue Code.
b. With respect to multiple nongroup policies of life insurance owned by one owner,
whether the policy or contract owner is an individual, firm, corporation, or other person, and
whether the persons insured are officers, managers, employees, or other persons, premiums
in excess of five million dollars with respect to those polices or contracts, regardless of the
number of policies or contracts held by the owner.
19. “Principal place of business” of a plan sponsor or a person other than a natural person
means the single state in which the natural persons who establish policy for the direction,
control, and coordination of the operations of the entity as a whole primarily exercise that
function as determined pursuant to section 508C.8A.
20. “Receivership court” means a court in an insolvent or impaired insurer’s state having
jurisdiction over the conservation, rehabilitation, or liquidation of the insolvent or impaired
insurer.
21. “Resident” means a person to whom a contractual obligation is owed and who resides
inastateonthedateofentryofacourtorderthatdeterminesamemberinsurerisanimpaired
insurer or a court order that determines a member insurer is an insolvent insurer. A person
may be a resident of only one state, which in the case of a person other than a natural person
shall be the state of that person’s principal place of business. A citizen of the United States
who is a resident of a foreign country, or is a resident of a United States possession, territory,
or protectorate that does not have an association similar to the association created by this
chapter, shall be deemed a resident of the state or domicile of the member insurer that issued
the policy or contract.
22. “State” means a state, the District of Columbia, Puerto Rico, or a United States
possession, territory, or protectorate.
23. “Structured settlement annuity” means an annuity purchased in order to fund periodic
payments for a plaintiff or other claimant in payment for or with respect to personal injuries
suffered by the plaintiff or other claimant.
24. “Supplemental contract” means a written agreement entered into for the distribution
of proceeds under a life, health, or annuity policy or contract.
25. “Unallocated annuity contract” means a guaranteed investment contract, deposit
administration contract, or any other annuity contract which is not issued to and owned by
an individual, except to the extent of any annuity benefits guaranteed to an individual by
an insurer under such a contract or certificate.