Individual Iowa Health Insurance Rules

It is extremely advantageous for you and your family to get medical insurance that will cover medical expenses in case of an unexpected illness or injury. Of course, you will need to take time to think about your family's financial situation as well as their health status before you decide what kind of Iowa health insurance plan you should carry. The Iowa Insurance Division monitors the sale of individual medical insurance policies in Iowa.

An Iowa resident who has been insured for the last year and meets other requirements can receive a guarantee issue insurance policy. Otherwise, insurance companies can medically underwrite Iowa individual medical insurance policies. Policies which have been guarantee issued can have elimination riders placed on them and insurance companies may view 5 years of medical history as well as exclude medical conditions existing in the last year. The sex, age, job, and health of an applicant for individual medical insurance all affect the rate they will be charged. Certain limits, however, control how much an applicant's health affects their insurance rates.

Rules for Small Group Iowa Health Insurance

Small group health insurance policies in Iowa are guarantee issued and can be obtained by groups of between 2 and 50 persons. Being guarantee issued means that an employer who wants to get a small group policy for his workers cannot be denied coverage because of their medical history. Newly hired employees do not have to be added to these policies immediately upon being hired. If an applicant cannot prove that they had previous insurance coverage, the company they are applying to can exclude medical conditions present during the previous year. This is allowable because of the Health Insurance Portability and Accountability Act of 1996. Health insurance companies determine group rates based off of each individual's health. Still, group health insurance rates in Iowa must be within 25% of the state's indexed rate.

Continuation Coverage and COBRA in Iowa

A group Iowa health insurance plan that covers more over 20 people must allow members of that group to keep their coverage for 18 months after they leave the company that was providing that coverage. This continued coverage, or COBRA, lasts for 36 months in the case of dependent children, widows, and qualified disabled persons. COBRA rules require the insured to pay administration fees of 2% besides their normal premiums.

Regulation 29 of Chapter 509B of Iowa state law governs mini-COBRA coverage for employers who provide insurance for a group of between 2 and 19 people. If an individual with this type of coverage leaves their employment for one of the state's pre-determined qualifying reasons, they can keep their coverage for 9 months after leaving. All costs associated with this arrangement must be paid for by the individual. This arrangement is only good for people who were a part of their employer's health plan for at least 3 months before they left that job. When COBRA insurance benefits run out, people can get guarantee issue individual health insurance through Iowa's state risk pool if they qualify for HIPAA coverage.

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