r. A policy or contract providing any hospital, medical, prescription drug, or other health
care benefits pursuant to any of the following:
(1)42 U.S.C. ch. 7, subch. XVIII, Part C or Part D, commonly known as Medicare Part C
and D, or any regulations issued pursuant thereto.
(2)42 U.S.C. ch. 7, subch. XIX, commonly known as Medicaid, or any regulations issued
pursuant thereto.
s. Structured settlement annuity benefits to which a payee or beneficiary has transferred
the payee’s or beneficiary’s rights in a structured settlement factoring transaction as defined
in 26 U.S.C. §5891(c)(3)(A).
5. a. The benefits that the association may become obligated to cover shall in no event
exceed the lesser of either of the following: (1)The contractual obligations for which the member insurer is liab
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r. A policy or contract providing any hospital, medical, prescription drug, or other health
care benefits pursuant to any of the following:
(1) 42 U.S.C. ch. 7, subch. XVIII, Part C or Part D, commonly known as Medicare Part C
and D, or any regulations issued pursuant thereto.
(2) 42 U.S.C. ch. 7, subch. XIX, commonly known as Medicaid, or any regulations issued
pursuant thereto.
s. Structured settlement annuity benefits to which a payee or beneficiary has transferred
the payee’s or beneficiary’s rights in a structured settlement factoring transaction as defined
in 26 U.S.C. §5891(c)(3)(A).
5. a. The benefits that the association may become obligated to cover shall in no event
exceed the lesser of either of the following:
(1) The contractual obligations for which the member insurer is liable or would have been
liable if the member insurer were not an impaired or insolvent insurer.
(2) Any of the following:
(a) With respect to one life, regardless of the number of policies or contracts:
(i) Three hundred thousand dollars in life insurance death benefits, but not more than
one hundred thousand dollars in net cash surrender and net cash withdrawal values for life
insurance.
(ii) Five hundred thousand dollars for health benefit plans; three hundred thousand
dollars for health insurance benefits which are disability income protection coverage as
defined by the commissioner by rule pursuant to section 514D.4; three hundred thousand
dollars for long-term care insurance as defined in section 514G.103; or one hundred
thousand dollars for other health insurance benefits including any net cash surrender and
net cash withdrawal values.
(iii) Two hundred fifty thousand dollars in the present value of annuity benefits, including
net cash surrender and net cash withdrawal values.
(iv) With respect to each payee of a structured settlement annuity, or the beneficiary or
beneficiaries of the payee if the payee is deceased, two hundred fifty thousand dollars in
present value annuity benefits, in the aggregate, including net cash surrender and net cash
withdrawal values.
(b) (i) With respect to each individual participating in a retirement benefit plan
established under section 401, 403(b), or 457 of the United States Internal Revenue Code,
or each unallocated annuity contract account, excluding a plan established under section
401, 403(b), or 457 of the United States Internal Revenue Code, not more than two hundred
fifty thousand dollars in the aggregate, in present value annuity benefits, including net cash
surrender and net cash withdrawal values for the beneficiaries of the deceased individual.
(ii) However, the association shall not in any event be obligated to cover more than an
aggregateofthreehundredfiftythousanddollarsinbenefitswithrespecttoanyonelifeunder
subparagraph division (a) and this subparagraph division (b), except with respect to benefits
for health benefit plans under subparagraph division (a), subparagraph subdivision (ii), in
which case the aggregate liability of the association shall not exceed five hundred thousand
dollars with respect to any one individual, or more than five million dollars in benefits to
one owner of multiple nongroup policies of life insurance regardless of 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, and regardless of the number
of policies and contracts held by the owner.
5 IOWA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION, §508C.5
(c) With respect to a plan sponsor whose plan owns, directly or in trust, one or more
unallocated annuity contracts not included under subparagraph division (b), not more than
fivemilliondollarsinbenefits, regardlessofthenumberofcontractsheldbytheplansponsor.
However, where one or more such unallocated annuity contracts are covered contracts under
this chapter and are owned by a trust or other entity for the benefit of two or more plan
sponsors, the association shall provide coverage if the largest interest in the trust or entity
owning the contract is held by a plan sponsor whose principal place of business is in the state
but in no event shall the association be obligated to cover more than five million dollars in
benefits in the aggregate with respect to all such unallocated contracts.
b. The limitations on the association’s obligation to cover benefits that are set forth under
this subsection do not take into account the association’s subrogation and assignment rights
or the extent to which such benefits could be provided out of the assets of the impaired or
insolvent insurer attributable to covered policies. The cost of the association’s obligations
under this chapter may be met by the use of assets attributable to covered policies or
reimbursed to the association pursuant to the association’s subrogation and assignment
rights.
c. For purposes of this chapter, benefits provided by a long-term care rider to a life
insurance policy or annuity contract shall be considered the same type of benefits as the
base life insurance policy or annuity contract to which the long-term rider relates.
6. In performing its obligations to provide coverage under this chapter, the association
shall not be required to guarantee, assume, reinsure, reissue, or perform, or cause to be
guaranteed, assumed, reinsured, reissued, or performed, the contractual obligations of an
insolvent or impaired insurer under a covered policy or contract that do not materially affect
the economic values or economic benefits of the covered policy or contract.