Iowa Admin. Code r. 191-40.26

Current through Register Vol. 47, No.14, January 8, 2025

Rule 191-40.26 - Notice of cancellation, nonrenewal or termination of enrollment

(1)Purpose and definitions.

a.Purpose. The purpose of this rule is to clarify the authorized methods of delivery for notices of cancellation, nonrenewal or termination by a health maintenance organization, so as to implement the various consumer protections intended by Iowa Code sections 514B17. and 514B17A. and rule 191-4010. (514B).

b.Definitions. As used in Iowa Code section 505B1. and this rule:

"Commissioner " means the Iowa insurance commissioner or insurance division.

"Notice of cancellation, nonrenewal or termination" means:

1. Notice of an insurance company's termination of an insurance policy at the end of a term or before the termination date;

2. Notice of an insurance company's decision or intention not to renew a policy; and

3. For purposes of notices required by Iowa Code sections 514B17. and 514B17A. and rule 191-4010. (514B), "notice of cancellation, nonrenewal or termination" includes but is not limited to a health maintenance organization's notice to an enrollee of cancellation or rescission of membership.

(2)Scope. This rule shall apply to all insurance companies holding a certificate of authority to operate an HMO under the provisions of Iowa Code chapter 514B.

(3)Delivery. For any notice of cancellation, nonrenewal or termination by a health maintenance organization under Iowa Code sections 514B17. and 514B17A. and rule 191-4010. (514B) to be effective, a health maintenance organization must, within the time frame established by law, deliver the notice to the person to whom notice is required to be provided either in person or by mail through the U.S. Postal Service to the last-known address of the person to whom notice is required to be provided. The use of U.S. Postal Service Intelligent Mail® fulfills any requirement in Iowa Code sections 514B17. and 514B17A. and rule 191-4010. (514B) for certified mail or certificate of mailing as proof of mailing.

(4)Electronic transmissions. Notwithstanding the requirements of subrule 40.26(3), if an insurer receives, pursuant to 191-subrule 4.24(2), approval from the commissioner of a manner of electronic delivery of a notice of cancellation, nonrenewal or termination of a policy, the approved manner shall satisfy the notice requirements of Iowa Code sections 514B17. and 514B17A. and rule 191-4010. (514B).

This rule is intended to implement Iowa Code chapter 505B.

Iowa Admin. Code r. 191-40.26

Adopted by IAB May 27, 2015/Volume XXXVII, Number 24, effective 7/1/2015

Amended by IAB February 17, 2016/Volume XXXVIII, Number 17, effective 3/23/2016