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PO Box 71005, 2135 NW 108th Street

Clive, IA 50325

Government Affairs

IAHU represents all members with one unified and strong voice. On-going legislative and agency lobbying, a top priority of our Association will be designed to educate those who regulate our industry.

BULLETIN 20-08

To:      All Insurance Producers and Continuing Education Providers of Iowa
From: Doug Ommen, Iowa Insurance Commissioner
RE:      Iowa Insurance Division Transition to New Version of SBS in June
Date:   April 21, 2020
____________________________________________________

Effective June 10, 2020, Iowa will be transitioning to a new version of State Based Systems (SBS). The ability to submit any transactions to SBS or the National Insurance Producer Registry (NIPR) will be shut down on June 5, 2020 at 3:00 pm CDT and will be turned back on June 10, 2020 in the morning.

The Commissioner rescinds Bulletin 20-02 effective immediately which indicated that the transition to the new version of SBS would occur in May.

Any transaction submitted during this timeframe will be declined and fees will not be collected. This affects all the following Iowa applications:

  • · Resident Licensing (RL)
  • · Resident Licensing Renewals (RLR)
  • · Non- Resident Licensing (NRL)
  • · Non- Resident Licensing Renewals (NRR)
  • · Non- Resident Adjuster Licensing (NRAL)
  • · Non- Resident Adjuster Licensing Renewals (NRAR)
  • · Appointment and Terminations (Appt/Term)
  • · Contact Change Request (CCR)
  • · Continuing Education – posting of credits and submittals of course rosters

In addition, the Division will be making minor changes including requiring Designated Responsible Licensed Producers (DRLP) to be actively licensed and requiring the National Producer Number (NPN) for an individual instead of their tax identification number (SSN) for Appointment & Termination transactions.

More information will be available from the Iowa Insurance Division as it becomes available. Additional information will also be available at www.statebasedsystems.com as the transition date approaches.

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Iowa schools to extend closures through end of school year
Schools will continue voluntary and required continuous learning plans while school buildings are closed

FOR IMMEDIATE RELEASE: Friday, April 17, 2020

DES MOINES – Gov. Kim Reynolds and the Iowa Department of Education announced today that all school districts and nonpublic schools will be closed for the remainder of the school year and will continue to offer continuous learning to mitigate the spread of COVID-19. This also includes the cancellation of spring sports activities. 

“While I would like nothing more than to open up our schools and classrooms in May, we have to prioritize the health and safety of Iowans,” said Gov. Reynolds. “With our students at home, we must rely on continuous learning plans that are in place and prepare school districts for ‘Return to Learn’ in the fall. I greatly appreciate the work of Director Ann Lebo and all our school administrators, educators, and staff during this unprecedented time.”

The decision, which was announced today during Gov. Kim Reynolds’ press conference,

is based on recommendations from the Iowa Department of Public Health to ensure the health and safety of Iowa students, teachers, school administrators and other school staff. View that press conference here

“Iowa teachers should be commended for how quickly they have transitioned from the classroom to online and distance learning,” said Iowa Department of Education Director Ann Lebo. “Our schools have really stepped up to the plate and worked hard to develop and implement continuous learning solutions in only a matter of weeks. We appreciate everything schools and families are doing to support children’s well-being while continuing to support their academic progress while school buildings are closed.”

The governor and the Iowa Department of Education also announced that the state of Iowa will:

  • Waive instructional time requirements for the remainder of the 2019-2020 regularly scheduled academic year for schools that continue to provide continuous learning through one of two approved options, voluntary educational enrichment opportunities, required educational services, or a combination of the two.
  • Require schools to submit a Return to Learn Plan to the Iowa Department of Education by July 1 outlining ways they will address disruptions to learning as a result of COVID-19. This could include summer school, enrichment activities or other opportunities to address the needs of learners.
  • Waive the requirement that schools start no earlier than Aug. 23, allowing school districts and nonpublic schools to make local decisions about the length of their 2020-2021 academic year. 

The governor had previously ordered schools to close through April 30. All of Iowa’s 327 public school districts, as well as 179 nonpublic schools, currently offer continuous learning through one of the approved continuous learning options outlined above. Continuous learning encompasses a variety of approaches used to extend learning beyond brick and mortar buildings — online learning, e-learning, distance learning, including paper packets, and virtual learning.

School buildings will remain closed through the end of the school year except for approved meals site locations participating in the U.S. Department of Agriculture’s Summer Food Service Program and those providing temporary emergency childcare.

An announcement on summer sports activities and when other school-sponsored activities can resume will be made by June 1.

For more information, visit the Iowa Department of Education’s COVID-19 Guidance and Information web page.


BULLETIN 20-06 

To: All Health Insurance Companies Writing in the State of Iowa From: Doug Ommen, Iowa Insurance Commissioner
RE: Telehealth Services Flexibility and Reimbursement
Date: March 27, 2020

In light of Governor Reynolds’s March 26, 2020 proclamation continuing a State of Public Health Disaster Emergency, and to further mitigate the impact of COVID-19, Bulletin 20-06 provides guidance to individuals and entities regulated by the Iowa Insurance Division to increase the availability and usage of telehealth services. Using telehealth services, individuals are able to visit a health care professional from their home without having to travel to a medical office or hospital, helping minimize the risk of exposure to, and community spread of, COVID-19.

Iowa Code § 514C.34 prohibits discrimination between coverage benefits for health care services that are provided in person and the same health care services that are delivered through telehealth. Most health carriers are currently offering telehealth benefits in some form in their current plans. We find that it is in the interest of public health and safety for all health carriers licensed in this state to promote the use of telehealth services to policyholders and to encourage health care professionals to offer telehealth services during the COVID-19 public health emergency.

The Commissioner directs all health carriers licensed in this state

eliminate barriers to audio-only telephone transmission requirements for reimbursement of health care services and to explicitly allow the use of telephones, audio/video, secure

text messaging, email or use of a patient portal for the furnishing of telehealth services.
In order to facilitate the use of telehealth services, health carriers are also requested as follows:

  • Health carriers are requested to work with health care professionals to increase access to telehealth services.

  • Health carriers shall not limit telehealth services only to patients with COVID-19.

  • Health carriers shall modify existing telehealth payment methodologies to ensure that rates of

    payment to health care professionals for services delivered through telehealth are identical to the

    rates of payment established for services delivered for in-person visits.

  • Health carriers shall not limit, deny or reduce coverage or reimbursement for a covered health care

    service delivered through telehealth.

  • Health carriers who also administer self-funded employer based plans shall encourage all Iowa businesses to 

    to take any necessary action to remove cost-sharing or other financial barriers to the use of telehealth in their health insurance plans.

The Division will not take enforcement action against any health carrier making mid-year changes to the health benefit plan to provide greater coverage for telehealth services.

 

BULLETIN 20-05

To: Licensed resident insurance producers and state-registered securities professionals From: Doug Ommen, Iowa Insurance Commissioner
RE: Covid-19 Licensing Relief
Date: March 25, 2020

On March 22, 2020, Governor Reynolds signed a new proclamation continuing the State Public Health Emergency Declaration as a result of the Covid-19 outbreak. Among other relief, the proclamation provides professional licensing relief by suspending the regulatory professions of Iowa Code chapters 502 and 522B and related administrative rules to the extent they:

1. Impose requirements for in-person continuing education as a condition of professional license renewal or impose continuing education deadlines or requirements that are unable to be satisfied due to this Disaster Emergency; and

2. Set an expiration date or renewal requirement for a professional license that expires during the duration of the Proclamation.

The suspension of these two provisions extends through the duration of the Governor’s Proclamation and any future extension.

The Division is fully operational and continues to process applications and renewals of all licenses and registrations.

Insurance licensees may continue to be timely renewed, and the Iowa Insurance Division is implementing procedures to avoid suspensions and non-renewals and provides the following guidance to licensed resident insurance producers and state-registered securities professionals:

1. The Division will be waiving the classroom method requirement and proctor requirements for continuing education until further notice. Continuing Education requirements can now be met by completing self-study courses or classroom equivalent webinars. Many classroom equivalent webinars are live and interactive and offer a similar experience as classroom courses. Course availability can be found online here.

2. Producer License Renewals can be submitted up to 90 days in advance and should be submitted online at www.nipr.com. Should you have any questions with processing your renewal application please reach out to the division at This email address is being protected from spambots. You need JavaScript enabled to view it.or 515-725-0690.

The Division does not anticipate any changes to current procedures for state-registered securities professionals as online education is already permitted and registrations do not expire until the end of the calendar year. Applications for registration continue to be processed as they are received. State- registered securities professionals with questions can contact the Securities Bureau at 515-242-5310.

The Division reminds licensed insurance producers of the transition to a new version of SBS taking place between May 8 and May 14 which is the subject of Bulletin 20-02.

 

BULLETIN 20-04

To:       All Health Insurance Companies Writing in the State of Iowa
From:   Doug Ommen, Iowa Insurance Commissioner
RE:     Individual and Small Group Coverage Impacted by COVID-19
Date:    March 19, 2020

In light of Governor Reynolds’s March 17, 2020 proclamation of a State of Public Health Disaster Emergency (the “Proclamation”), the purpose of Bulletin 20-04 is to assist individuals and entities regulated by the Iowa Insurance Division who are impacted by the COVID-19 epidemic and the resulting economic disruptions.The Commissioner requests all health insurers and health maintenance organizations licensed in this state to allow a premium payment grace period for any Iowa individual health benefit plan as defined in Iowa Code section 513C.3 and to any health benefit plan issued to small employers under Iowa Code chapter 513B as follows:

  • Health insurers and health maintenance organizations are requested to put procedures in place allowing individual and small employer policyholders affected by the economic disruptions resulting from COVID-19 to request extensions for premium payments beyond the insurers’ normal payment due dates.
  • Health insurers and health maintenance organizations are requested to allow any individual or small group policyholder at least 60 days after a premium payment is due before terminating coverage for any such policyholder who has a premium payment initially due between March 17, 2020, and June 30, 2020.
  • To the extent that federal law requires a longer or shorter period for payment of premiums, federal law shall control. However, in light of the Proclamation, the Commissioner requests that issuers on the Federally Facilitated Exchange extend premium payment deadlines (such as deadlines for payment to effectuate coverage) and delay cancellations for non-payment of premium that are at least consistent with this Bulletin. The Division further requests that CMS exercise enforcement discretion regarding any provisions of federal law inconsistent with this Bulletin pursuant to section 7.1.4 of the Federally-facilitated Exchanges (FFEs) and Federally-facilitated Small Business Health Options Program (FF-SHOP) Enrollment Manual.
  • For those policies with an automatic bank draft or electronic funds transfer arrangement, health insurers and health maintenance organizations may continue payment deductions unless or until the policyholder terminates this arrangement with the insurer and financial institution.

The Division is not requesting that health insurers or health maintenance organizations waive any premiums or other consideration owed on any policy or contract. Nothing in this Bulletin should be construed as the Division requesting any health insurer or health maintenance organization to refrain from terminating coverage on the basis of fraud on the part of an insured.

We will update you as we get more information. Please watch for information to come from the insurance companies on how these will be handled.

 

House and Senate to Suspend Legislative Session 

(DES MOINES) -- This afternoon the House and Senate announced the legislative session will be suspended for a minimum of 30 days following the announcement of community spread of COVID-19 in Iowa. The decision was made in consultation with the Department of Public Health and Governor’s Office based on recommendations from the Center for Disease Control related to mass gatherings to protect vulnerable populations.
 
The House and Senate will convene on Monday at regular scheduled time to consider resolutions regarding continuity of government to ensure delivery of essential services to Iowans. Previously scheduled subcommittee and committee meetings have been cancelled. Standing committees will be on-call as needed.
 
The Capitol building will open on Monday at 11:00 am, with entrances open on the south and west sides. Prior to entering the Capitol, staff members and the public will be required to undergo a health screening administered by the Department of Public Health (this includes filling out a health questionnaire and temperature reading). All scheduled events, tours, and receptions at the Capitol are cancelled until further notice.
 
Members of the public over the age of 60 or with underlying health conditions (heart disease, diabetes, and lung disease) are encouraged to avoid the Capitol.
 
More information will be shared when it becomes available.

 

Bills that passed the House

HF 2553 PHARMACY BENEFIT MANAGERS 

Establishes requirements for a Pharmacy Benefit Manager to place a drug on the Maximum Allowable Cost list, including that the drug is available to pharmacies statewide. Requires a pharmacy have access to the list. Requires a PBM to update the list within seven days due to changes in acquisition cost or cost methodology. Prohibits a PBM from paying a pharmacy less for a prescription drug than it pays PBM affiliates. Requires that a PBM have an appeals process, with a dedicated phone and internet site. Prohibits PBM from requiring pharmacies to meet accreditation standards or surety requirements beyond state and federal requirements. Prohibits spread pricing and defines such pricing. Prohibits PBM from barring pharmacies from using direct delivery or mail delivery. Includes provisions barring PBMs from retroactively reducing claims. Commissioner: Requires the Insurance Commissioner to review PBM compensation to pharmacies and to adopt rules and take enforcement actions. Other: Makes the bill severable. Repeals some current enforcement provisions and makes conforming changes. 

The House PASSED the bill 100-0; it now GOES to the Senate 

HF 2138 INSULIN PRESCRIPTION COSTS 

Requires insurance coverage for prescription drugs to cap cost-sharing for insulin prescriptions at no more than $100 for a 30-day supply of insulin. 

H 8016 by A Meyer - Makes the supply period 31 days. ADOPTED 

H 8115 to H 8016 by James - Reduces the cost to $50. RULED NOT GERMANEMTSR FAILED 53-46 

The House PASSED the bill as amended 98-1; it now GOES to the Senate 

HF 2192 TELEHEALTH PAYMENTS 

Requires health carriers to reimburse health care providers for telehealth services at the same rate as in-person services as of January 2021. 

H 8028 by Fry - Requires tele-health procedures to be in real-time. Prohibits the health carrier from requiring additional health care professionals to be present. ADOPTED 

H 8035 to H 8028 by Fry - Corrective. ADOPTED 

The House PASSED the bill as amended 99-0; it now GOES to the Senate 

Amendments to Insulin BillHF2138 - Amendment was to remove all insulin drugs to at least one in each type of rapid-acting prescription insulin drugs, short-acting prescription insulin drugs, intermediate-acting prescription insulin drugs, or long-acting prescription insulin drugs. For information follow this link: https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=HF%202138

The following bills were released that are related to health care:

Continuity of CareHF2089 & SSB3117 - This bill provides that during a covered person's eligibility under a health benefit plan, inclusive of any open enrollment period, a health plan carrier, health benefit plan, or utilization review organization shall not limit or exclude coverage of a prescription drug for the covered person if the covered person is medically stable on the drug as determined by the prescribing health care professional, the drug was previously approved by the health carrier for coverage for the person, and the person's prescribing health care professional has prescribed the drug for the covered person's medical condition within the previous six months. For more information follow these links: https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hf2089 AND https://www.legis.iowa.gov/legislation/BillBook?ba=SSB3117&ga=88

Drug TransparencyHF2253 - This bill requires a manufacturer to file an annual report with the commissioner of insurance that discloses the wholesale acquisition cost for all prescription drugs manufactured by the manufacturer that were sold to a person in the state in the immediately preceding calendar year. For more information follow this link: https://www.legis.iowa.gov/legislation/BillBook?ba=HF2253&ga=88

Civil Action - Providers - HSB596 - The bill eliminates the exception to the limitation of $250,000 that would allow the jury to determine if the imposition of such a limitation would deprive the plaintiff of just compensation for the injuries sustained. For more information follow this link: https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=hsb596

SSB 3047 - 1332 Waiver

This bill relates to health insurance and the insurance division of the department of commerce. The bill authorizes the commissioner of insurance to develop by rule a state innovation waiver pursuant to section 1332 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and to submit an application on behalf of the state to the United States secretary of health and human services and the United States secretary of the treasury for the waiver. IAHU is in support of this current Senate Study Bill. Read more details here:  https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=SSB%203047 Reach out to Marcie Strouse with any questions. 

HSB 501 - Prescription Insulin drugs

This bill relates to prescription insulin drugs and coverage by policies, contracts, or plans providing for third-party payment or prepayment of health or medical expenses that provide coverage for prescription drugs. The bill requires a policy, contract, or plan providing for third-party payment of prepayment of health or medical expenses that provides coverage for prescription drugs to cap the total amount of cost-sharing that a covered person is required to pay for a prescription insulin drug to an amount not more than $100 for a 30-day supply, regardless of the amount or type of prescription insulin drug required to fill the covered person's prescription. IAHU is undecided at this time. Read more details here: https://www.legis.iowa.gov/legislation/BillBook?ga=88&ba=HSB%20501 Reach out to Marcie with any questions. 


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For more information – please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it.

HUPAC Chair

For questions regarding HUPAC, please contactRick Jedlicka

Rick Jedlicka
rick.jedlicka@northriskpartners.com

Government Relations Chair

For questions regarding government relations, please contactm strouse17

Marcie Strouse
marcie@capitol-benefits.com

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