Medical insurance is an important precaution that one cannot
afford live without. Being the main member of the family, your
interests lie in the protection of your family against unforeseen
circumstances such as illness or injury. Before choosing a
particular health policy, a detailed evaluation of your family's
healthcare needs and your personal finances is crucial. If you
reside in Iowa, you have the option to choose from various product
alternatives. The Iowa Insurance Division regulates the legislature
under which the Iowa health insurers can sell private medical
insurance to individuals and families.
Individual health insurance policies in Iowa may be medically underwritten by the insurance carriers. For residents with 12 months of prior creditable coverage which meets specified criteria, carriers must guarantee issue standardized policies. Elimination riders are permitted under these policies. Under guarantee issue individual healthcare insurance policies there is a 12 month look back and exclusionary period limit on pre-existing medical conditions. All other individual healthcare insurance policies provide for a 60 month look back and 12-month exclusionary period limit on pre-existing medical conditions. Premium rates in Iowa will vary depending upon the applicant's health status, age, gender and occupation, with limitations placed on how much an individual health insurer can increase your premium based upon your health status.
For medical insurance purposes, a small group can range from 2 to 50 employees. Iowa laws provide for group health insurance to be written and offered on a guarantee issue basis. Under this premise, an eligible employee may not be refused health insurance coverage based upon his past or current health history. Employers may request a waiting period from the date of hire prior to allowing qualified employees to enroll in the group plan. Under the federal Health Insurance Portability and Accountability Act of 1996, insurance carriers may impose a 6 month look back and a 12-month exclusionary period for pre-existing conditions on all applicants who do not have prior creditable coverage. Premium rates can be determined by the health status of the employees within the group, but the rates may not vary by more than plus or minus 25 percent of the indexed rate.
Groups of more than 20 insured employees must follow federal
COBRA guidelines which allow any employee to remain on the group
health plan for 18 months or 36 months after leaving employment
with the company, regardless of the reason they are leaving. In
some special cases, widows, dependent children etc. may be eligible
to remain on COBRA for 36 months. This includes person that meet
disability guidelines. The premium amount, plus a 2% administration
fee will be charged directly to the insured.
Iowa has a state mandated mini-COBRA program, established through Chapter 509B, in combination with and Regulation 29, which applies to groups of 2-19 employees. Under the state regulated COBRA program an employee suffering a qualifying event may opt, at their sole expense, to continue their health insurance coverage through their employer-sponsored group health plan. Continuation coverage under state regulations provides for an additional 9 months of coverage. To qualify, an employee must have been insured under the group health plan for at least 3 months prior to the date of termination. Continuations plans are available to persons that have exhausted their COBRA benefits. The state risk pool is another option for HIPAA eligible persons to receive guaranteed issue individual health insurance.