§ 509A.15 — Certification of self-insurance plans — exemption

Iowa § 509A.15

• Jurisdiction: Iowa
• Title XIII: COMMERCE
• Ch. 509A: GROUP INSURANCE FOR PUBLIC EMPLOYEES

Text

1. a. Within ninety days following the end of a fiscal year, the governing body of a
self-insurance plan of a political subdivision or a school corporation shall file with the
commissioner of insurance a certificate of compliance, actuarial opinion, and an annual
financial report. The filing shall be accompanied by a fee of one hundred dollars. A penalty
of fifteen dollars per day shall be assessed for failure to comply with the ninety-day filing
requirement, except that the commissioner may waive the penalty upon a showing that
special circumstances exist which justify the waiver. The certificate shall be signed and
dated by the appropriate public official representing the governing body, and shall certify
the following:
(1) That the plan meets the requirements of this chapter and the applicable provisions of
the Iowa administrative code.
(2) That an actuarial opinion has been attached to the certificate which attests to the
adequacy of reserves, rates, and financial condition of the plan.
(3) That a written complaint procedure has been implemented. The certificate shall also
list the number of complaints filed by participants under the written complaint procedure,
and the percentage of participants filing written complaints, in the prior fiscal year.
(4) That the governing body has contracted or otherwise arranged with a third-party
administrator who holds a current certificate of registration issued by the commissioner
pursuant to section 510.21, or with a person not required to obtain the certificate as a
third-party administrator as defined in section 510.11, subsection 2.
b. The actuarial opinion must include but is not limited to a brief commentary about the
adequacy of the reserves, rates, and the financial condition of the plan, a test of the prior
year claim reserve, a brief description of how the reserves were calculated, and whether or
not the plan is able to cover all reasonably anticipated expenses. The actuarial opinion shall
be prepared, signed, and dated by a person who is a member of the American academy of
actuaries.
c. If necessary, the actuary should assist the public body in preparing the annual financial
report. The annual financial report shall be in a format as prescribed by the commissioner.
2. The commissioner shall by rule require the maintenance of confidentiality of
information held by the plan administrator.
3. The failure of the governing body to provide the certificate of compliance required
by subsection 1, or the failure of the governing body or plan administrator to abide by a
requirement of the plan, this chapter, or applicable rule, is grounds for action against the
plan, including cause for disapproval or discontinuance of the plan.
4. a. One or more political subdivisions of the state or one or more school corporations
maintaining self-insured plans with yearly claims that do not exceed two percent of each
entity’s general fund budget shall be exempt from the requirements of this section where
the plan insures employees for all or part of a deductible, coinsurance payments, drug costs,
short-term disability benefits, vision benefits, or dental benefits.
b. The yearly claim amount shall be determined annually on the policy renewal date, or
an alternative date established by rule, by a plan administrator or political subdivision or
schoolcorporationemployeetobedesignatedbytheplanadministrator. Theexemptionshall
§509A.15, GROUP INSURANCE FOR PUBLIC EMPLOYEES 8
not apply for the year following a year in which yearly claims are determined to exceed two
percent of the political subdivision’s or school corporation’s general fund budget.