[Prior to 10/22/86, see
Insurance Department[510], renamed Insurance Division[191] under the “umbrella”
of Department of Commerce by the 1986 Iowa Acts, Senate File 2175]
ORGANIZATION AND PROCEDURES
CHAPTER 1
ORGANIZATION OF DIVISION
1.2(502,505) Location and contact information
1.3(22,502,505) Public information and inspection of records
2.1(17A) Petition for declaratory order
2.6(17A) Service and filing of petitions and other papers
2.9(17A) Refusal to issue order
2.10(17A) Contents of declaratory order—effective date
2.12(17A) Effect of a declaratory order
3.1(17A) Scope and applicability
3.4(17A) Requests for contested case proceeding
3.5(17A) Commencement of hearing; notice
3.8(17A) Telephone proceedings
3.10(17A) Consolidation—severance
3.12(17A) Service and filing of pleadings and other papers
3.16(17A) Prehearing conference
3.23(17A) Ex parte communication
3.25(17A) Interlocutory appeals
3.28(17A) Applications for rehearing
3.29(17A) Stay of agency action
3.30(17A) No factual dispute contested cases
3.31(17A) Emergency adjudicative proceedings
3.32(502,505,507B) Summary cease and desist orders
3.33(17A,502,505) Informal settlement
3.34(17A,502,505) Witness fees
CHAPTER 4
AGENCY PROCEDURE FOR
RULE MAKING AND WAIVER OF RULES
DIVISION I
AGENCY PROCEDURE FOR RULE MAKING
4.2(17A) Advice on possible rules before notice of proposed rule adoption
4.3(17A) Public rule–making docket
4.4(17A) Notice of proposed rule making
4.7(17A,25B) Fiscal impact statement
4.8(17A) Time and manner of rule adoption
4.9(17A) Variance between adopted rule and rule proposed in Notice of Intended Action
4.10(17A) Exemptions from public rule–making procedures
4.11(17A) Concise statement of reasons
4.12(17A) Contents, style, and form of rule
4.13(17A) Agency rule–making record
4.15(17A) Effectiveness of rules prior to publication
4.16(17A) General statements of policy
4.17(17A) Review of rules by division
4.18(17A) Petition for rule making
division ii
waiver and variance rules
4.23(17A) Applicability of Division II of Chapter 4
4.24(17A) Criteria for waiver or variance
4.27(17A) Additional information
4.33(17A) Cancellation of a waiver
REGULATION OF INSURERS
CHAPTER 5
REGULATION OF INSURERS—
GENERAL PROVISIONS
5.2(505,507) Examination for admission
5.3(507,508,515) Submission of quarterly financial information
5.4(505,508,515,520) Surplus notes
5.5(505,515,520) Maximum allowable premium volume
5.6(505,515,520) Treatment of various items on the financial statement
5.7(505) Ordering withdrawal of domestic insurers from states
5.9(505) Rate and form filings
5.10(511) Life companies—permissible investments
5.13(508,515) Loans to officers, directors, employees, etc.
5.15(508,512B,514,514B,515,520)
Accounting practices and procedures manual and annual statement instructions
5.20(508) Computation of reserves
unearned premium
reserves on
mortgage guaranty insurance policies
5.21(515C) Unearned premium reserve factors
5.22(515C) Contingency reserve
5.24(507C) Commissioner’s authority
5.25(505) Annual audited financial reports
5.26(508,515) Participation in the NAIC Insurance Regulatory Information System
5.27(508,515,520) Asset valuation
5.28(508,515,520) Risk–based capital and surplus
5.29(508,515) Actuarial certification of reserves
5.30(515) Single
maximum risk—
fidelity and surety risks
5.31(515) Reinsurance contracts
5.32(511,515) Investments in medium grade and lower grade obligations
5.33(510) Credit for reinsurance
5.34(508) Actuarial opinion and memorandum
5.41(508) Tax
on gross premiums—
life companies
5.42(432) Cash refund of premium tax
5.43(510) Managing general agents
DISCLOSURE OF
MORTGAGE LOAN
APPLICATIONS
5.53(535A) Form and content of reports
5.54(535A) Additional information required
CHAPTER 6
ORGANIZATION OF DOMESTIC
INSURANCE COMPANIES
6.2(506) Promoters contributions
6.7(506) Qualifications of management
CHAPTER 7
DOMESTIC STOCK INSURERS PROXIES
proxy regulations
7.1(523) Application of regulation
7.2(523) Proxies, consents and authorizations
7.3(523) Disclosure of equivalent information
7.5(523) Information to be furnished to stockholders
7.6(523) Requirements as to proxy
7.7(523) Material required to be filed
7.8(523) False or misleading statements
7.9(523) Prohibition of certain solicitations
7.10(523) Special provisions applicable to election contests
SCHEDULE A
INFORMATION REQUIRED IN PROXY STATEMENT
SCHEDULE
B
INFORMATION TO BE INCLUDED IN STATEMENTS
FILED BY OR ON BEHALF OF A PARTICIPANT
(OTHER THAN THE INSURER) IN A PROXY
SOLICITATION IN AN ELECTION CONTEST
POLICYholder PROXY SOLICITATION
7.12(523) Conditions—revocation
7.14(523) Solicitation by agents—use of funds
STOCK TRANSACTION REPORTING
7.20(523) Statement of changes of beneficial ownership of securities
CHAPTER 8
BENEVOLENT ASSOCIATIONS
8.5(512A) Fees, dues and assessments
8.10(512A) Directors and officers
8.12(512A) Bookkeeping and accounts
INSURANCE AGENTS
CHAPTER 10
LICENSING OF INSURANCE
PRODUCERS
DIVISION I
LICENSING OF INSURANCE PRODUCERS
10.1(522B) Purpose and authority
10.3(522B) Requirement to hold a license
10.4(522B) Licensing of resident producers
10.5(522B) Licensing of nonresident producers
10.6(522B) Issuance of license
10.7(522B) License lines of authority
10.9(522B) License reinstatement
10.11(522B) Temporary licenses
10.12(522B) Change in name, address or state of residence
10.13(522B) Reporting of actions
10.14(522B) Commissions and referral fees
10.16(522B) Appointment renewal
10.17(522B) Appointment terminations
10.18(522B) Licensing of a business entity
10.19(522B) Violations and penalties
10.20(252J) Suspension for failure to pay child support
10.21(261) Suspension for failure to pay student loan
10.22(522B) Administration of examinations
10.25(522B) Insurer duties regarding federal flood insurance
DIVISION II
LICENSING OF CAR RENTAL COMPANIES
AND EMPLOYEES
(Effective March 15, 2000)
10.53(522A) Requirement to hold a license
10.54(522A) Limited licensee application process
10.55(522A) Counter employee licenses
10.56(522A) Duties of limited licensees
10.58(522A) Limitation on fees
10.59(522A) Change in name or address
10.60(522A) Violations and penalties
CHAPTER 11
CONTINUING EDUCATION FOR
INSURANCE PRODUCERS
11.1(505,522B) Statutory
authority—
purpose—applicability
11.3(505,522B) Continuing education requirements for producers
11.4(505,522B) Proof of completion of continuing education requirements
11.5(505,522B) Course approval
11.6(505,522B) Topic guidelines
11.7(505,522B) CE course renewal
11.9(505,522B) CE provider approval
11.10(505,522B) CE provider’s responsibilities
11.11(505,522B) Prohibited
conduct—
CE providers
11.12(505,522B) Outside vendor
11.13(505,522B) CE course audits
11.14(505,522B) Fees and costs
CHAPTER 12
PORT OF ENTRY REQUIREMENTS
12.2(508,515) Trust and other admission requirements
12.3(508,515) Examination and preferred supervision
12.4(508,515) Surplus required
UNFAIR TRADE PRACTICES
CHAPTER 14
LIFE INSURANCE ILLUSTRATIONS
MODEL REGULATION
14.3(507B) Applicability and scope
14.5(507B) Policies to be illustrated
14.6(507B) General rules and prohibitions
14.7(507B) Standards for basic illustrations
14.8(507B) Standards for supplemental illustrations
14.9(507B) Delivery of illustration and record retention
14.10(507B) Annual report; notice to policyowners
14.11(507B) Annual certifications
CHAPTER 15
UNFAIR TRADE PRACTICES
DIVISION I
sales practices
15.4(507B) Life insurance cost and benefit disclosure requirements
15.5(507B) Health insurance sales to individuals 65 years of age or older
15.6(507B) Preneed funeral contracts or prearrangements
15.7(507B) Twisting prohibited
15.8(507B) Producer responsibilities
15.9(507B) Right to return a life insurance policy or annuity (free look)
15.10(507B) Uninsured/underinsured
automobile coverage—
notice required
15.11(507B) Unfair discrimination
15.12(507B) Testing restrictions of insurance applications for the human immunodeficiency virus
15.13(507B) Records maintenance
15.14(505,507B) Enforcement
section—
cease and desist and penalty orders
DIVISION II
claims
15.31(507B) General claims settlement guidelines
15.32(507B) Prompt payment of certain health claims
15.33(507B) Audit procedures for medical claims
15.41(507B) Claims settlement guidelines for property and casualty insurance
15.42(507B) Acknowledgment of communications by property and casualty insurers
15.43(507B) Standards for settlement of automobile insurance claims
15.44(507B) Standards for determining replacement cost and actual cost values
15.45(507B) Guidelines for use of aftermarket crash parts in motor vehicles
DIVISION III
disclosure for small face amount life insurance policies
15.54(507B) Disclosure requirements
DIVISION IV
Annuity disclosure requirements
15.62(507B) Applicability and scope
15.64(507B) Standards for delivery of disclosure document and Buyer’s Guide
15.65(507B) Content of disclosure documents
15.66(507B) Report to contract owners
DIVISION v
SUITABILITY IN ANNUITY TRANSACTIONS
15.69(507B) Applicability and scope
15.71(507B) Duties of insurers and of insurance producers
15.72(507B) Mitigation of responsibility
DIVISION VI
INDEXED PRODUCTS TRAINING REQUIREMENT
15.82(507B,522B) Special training required
15.83(507B,522B) Conduct of training course
15.84(507B,522B) Insurer duties
15.85(507B,522B) Verification of training
15.87(507B,522B) Compliance date
CHAPTER 16
REPLACEMENT OF LIFE
INSURANCE AND ANNUITIES
division i
DIVISION II
(Effective July 1, 2000)
16.24(507B) Duties of producers
16.25(507B) Duties
of all insurers that use producers on or after
January 1, 2001
16.26(507B) Duties of replacing insurers that use producers
16.27(507B) Duties of the existing insurer
16.28(507B) Duties of insurers with respect to direct–response solicitations
16.29(507B) Violations and penalties
CHAPTER 17
LIFE AND HEALTH
REINSURANCE AGREEMENTS
17.1(508) Authority and purpose
17.3(508) Accounting requirements
18.1(523I,566A) Perpetual care cemeteries
18.2(523I,566A) Administration
18.3(523I,566A) Public access to hearings
18.6(523I,566A) Annual report by perpetual care cemeteries
18.7(523I,566A) Annual reports and perpetual care cemetery permits
PROPERTY AND CASUALTY INSURANCE
CHAPTER 20
PROPERTY AND CASUALTY INSURANCE RATE AND FORM FILING PROCEDURES
DIVISION I
FORM AND RATE REQUIREMENTS
20.1(505,509,514A,515,515A,515F)
General filing requirements
20.4(505,509,514A,515,515A,515F)
Policy form filing
20.5(515A) Rate or manual rule filing
20.6(515A) Exemption from filing requirement
20.8(515A) Rate filings for crop–hail insurance
20.11(515) Exemption from form and rate filing requirements
DIVISION II
IOWA FAIR PLAN ACT
20.44(515,515F) Eligible risks
20.46(515,515F) Administration
20.47(515,515F) Duties of the governing committee
20.48(515,515F) Annual and special meetings
20.49(515,515F) Application for insurance
20.50(515,515F) Inspection procedure
20.51(515,515F) Procedure after inspection and receipt of application
20.52(515,515F) Reasonable underwriting standards for property coverage
20.53(515,515F) Reasonable underwriting standards for liability coverage
20.54(515,515F) Cancellation; nonrenewal and limitations; review of eligibility
20.57(515,515F) Public education
20.58(515,515F) Cooperation and authority of producers
20.59(515,515F) Review by commissioner
20.60(515,515F) Indemnification
CHAPTER 21
REQUIREMENTS FOR EXCESS AND SURPLUS LINES, RISK RETENTION GROUPS AND PURCHASING
GROUPS
21.2(515) Qualified surplus lines carriers’ duties
21.4(515) Producers’ duty to insured; evidence of coverage
21.6(515E) Risk retention groups
21.7(515E) Procedures for qualification as a risk retention group
21.8(515E) Procedures for qualification as a purchasing group
21.9(515,515E) Failure to comply; penalties
CHAPTER 22
FINANCIAL GUARANTY INSURANCE
22.2(515) Financial requirements and reserves
CHAPTER 23
MOTOR VEHICLE SERVICE CONTRACTS
23.2(516E) Applicability and scope
23.3(516E) Application of insurance laws
23.5(516E) Public access to hearings
23.6(516E) Public access to records
23.10(516E) Prohibited acts—unfair discrimination or trade practices
23.11(516E) Prohibited acts—unfair or deceptive trade practices involving used or rebuilt parts
23.13(516E) Procedures for public complaints
CHAPTER 24
IOWA RETIREMENT FACILITIES
24.7(523D) Address for filings
24.10(523D) Financial statements, studies, and forecasts
24.11(523D) Amendments to the disclosure statement
24.12(523D) Standards for the disclosure statement
CHAPTER 25
MILITARY SALES PRACTICES
25.1(505) Purpose and authority
25.5(505) Practices declared false, misleading, deceptive or unfair on a military installation
25.6(505) Practices declared false, misleading, deceptive or unfair regardless of location
25.7(505) Reporting requirements
25.8(505) Violation and penalties
CHAPTER 27
PREFERRED PROVIDER ARRANGEMENTS
27.3(514F) Preferred provider arrangements
27.4(514F) Health benefit plans
27.5(514F) Preferred provider participation requirements
27.6(514F) General requirements
27.8(514F) Health care insurer requirements
CHAPTER 28
CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE
28.3(509) Rights and treatment of debtors
28.4(509) Policy forms and related material
28.5(509) Determination of reasonableness of benefits in relation to premium charge
28.7(509) Credit life insurance rates
28.8(509) Credit accident and health insurance
28.10(509) Experience reports and adjustment of prima facie rates
28.11(509) Use of rates—direct business only
28.12(509) Supervision of credit insurance operations
28.13(509) Prohibited transactions
28.14(509) Disclosure and readability
28.17(509) Fifteen–day free examination
CHAPTER 29
CONTINUATION RIGHTS UNDER GROUP
ACCIDENT AND HEALTH
INSURANCE POLICIES
29.2(509B) Notice regarding continuation rights
29.3(509B) Qualifying events for continuation rights
29.4(509B) Interplay between chapter 509B and COBRA
29.5(509B) Effective date for compliance
LIFE AND HEALTH INSURANCE
CHAPTER 30
LIFE INSURANCE POLICIES
30.4(508) Prohibitions, regulations and disclosure requirements
30.5(508) General filing requirements
30.6(508) Backdating of life policies
30.7(508,515) Expiration date of policy vs. charter expiration date
30.8(509) Electronic delivery of group life insurance certificates
CHAPTER 31
LIFE INSURANCE COMPANIES—
VARIABLE ANNUITIES CONTRACTS
31.2(508) Insurance company qualifications
31.3(508) Filing, policy forms and provision
31.4(508) Separate account or accounts and investments
CHAPTER 32
DEPOSITS BY A DOMESTIC LIFE
COMPANY IN A CUSTODIAN BANK
OR CLEARING CORPORATION
32.3(508) Requirements upon custodial account and custodial agreement
32.4(508) Requirements upon custodians
32.5(508,511) Deposit of securities
CHAPTER 33
VARIABLE LIFE INSURANCE
MODEL REGULATION
33.3(508A) Qualification of insurer to issue variable life insurance
33.4(508A) Insurance policy requirements
33.5(508A) Reserve liabilities for variable life insurance
33.7(508A) Information furnished to applicants
33.9(508A) Reports to policyholders
33.12(508A) Separability article
CHAPTER 34
NONPROFIT HEALTH SERVICE CORPORATIONS
34.3(514) Annual report requirements
34.6(514) Participating hospital contracts
34.7(514) Composition, nomination, and election of board of directors
CHAPTER 35
ACCIDENT AND HEALTH INSURANCE
35.5(509) Application and certificates not required
35.7(509) General filing requirements
35.8(509) Electronic delivery of accident and health group insurance certificates
35.20(509A) Life and health self–funded plans
35.21(509) Review of certificates issued under group policies
large group health insurance coverage
35.24(509) Eligibility to enroll
35.25(509) Special enrollments
35.26(509) Group health insurance coverage policy requirements
35.27(509) Methods of counting creditable coverage
35.28(509) Certificates of creditable coverage
35.29(509) Notification requirements
35.31(509) Disclosure requirements
35.33(514C) Emergency services
35.35(509) Reconstructive surgery
CONSUMER GUIDE
35.37(514K) Information filing requirements
35.38(514K) Limitation of information published
35.39(514C) Contraceptive coverage
CHAPTER 36
INDIVIDUAL ACCIDENT AND HEALTH—MINIMUM STANDARDS
36.2(514D) Applicability and scope
36.5(514D) Prohibited policy provisions
36.6(514D) Accident and sickness minimum standards for benefits
36.7(514D) Required disclosure provisions
36.8(507B) Requirements for replacement
36.9(514D) Filing requirements
CHAPTER 37
MEDICARE SUPPLEMENT
INSURANCE MINIMUM STANDARDS
37.2(514D) Applicability and scope
37.4(514D) Policy definitions and terms
37.8(514D) Standard Medicare supplement benefit plans
37.9(514D) Medicare Select policies and certificates
37.11(514D) Standards for claims payment
37.12(514D) Loss ratio standards and refund or credit of premium
37.13(514D) Filing and approval of policies and certificates and premium rates
37.14(514D) Permitted compensation arrangements
37.15(514D) Required disclosure provisions
37.16(514D) Requirements for application forms and replacement coverage
37.17(514D) Filing requirements for advertising
37.18(514D) Standards for marketing
37.19(514D) Appropriateness of recommended purchase and excessive insurance
37.20(514D) Reporting of multiple policies
37.23(514D) Prohibition against using SHIIP prepared materials
37.24(514D) Guarantee issue for eligible persons
CHAPTER 38
COORDINATION OF BENEFITS
DIVISION I
38.4(509,514) Model COB contract provision
38.5(509,514) Order of benefits
38.6(509,514) Reduction
in a plan’s benefits when it is secondary—
general
38.7(509,514) Reasonable cash value of services
38.8(509,514) Excess and other nonconforming provisions
38.9(509,514) Allowable expense
38.11(509,514) Effective date—existing contracts
DIVISION II
38.12(509,514) Purpose and applicability
38.14(509,514) Use of model COB contract provision
38.15(509,514) Rules for coordination of benefits
38.16(509,514) Procedure to be followed by secondary plan to calculate benefits and pay a claim
38.17(509,514) Notice to covered persons
38.18(509,514) Miscellaneous provisions
38.19(509,514) Effective date for existing contracts
CHAPTER 39
LONG–TERM CARE INSURANCE
39.3(514G) Applicability and scope
39.6(514G) Policy practices and provisions
39.7(514G) Required disclosure provisions
39.8(514G) Prohibition against postclaims underwriting
39.9(514D,514G) Minimum standards for home health care benefits in long–term care insurance policies
39.10(514D,514G) Requirement to offer inflation protection
39.11(514D,514G) Requirements for application forms and replacement coverage
39.14(514G) Filing requirement
39.15(514D,514G) Standards for marketing
39.18(514G) Standard format outline of coverage
39.19(514G) Requirement to deliver shopper’s guide
39.20(514G) Policy summary and delivery of life insurance policies with long–term care riders
39.22(514G) Unintentional lapse
39.24(514G) Incontestability period
39.25(514G) Required disclosure of rating practices to consumers
39.26(514G) Initial filing requirements
39.27(514G) Reporting requirements
39.28(514G) Premium rate schedule increases
39.30(514G) Standards for benefit triggers
CHAPTER 40
HEALTH MAINTENANCE ORGANIZATIONS
(Health and Insurance—Joint Rules)
40.3(514B) Inspection of evidence of coverage
40.4(514B) Governing body and enrollee representation
40.7(514B) Change of ownership
40.8(514B) Termination of services
40.10(514B) Cancellation of enrollees
40.11(514B) Application for certificate of authority
40.15(514B) Cash or asset management agreements
40.18(514B) Provider contracts
40.20(514B) Emergency services
40.22(514B) Health maintenance organization requirements
40.23(514B) Disclosure requirements
40.25(514B) Electronic delivery of accident and health group insurance certificates
CHAPTER 41
LIMITED SERVICE ORGANIZATIONS
41.3(514B) Inspection of evidence of coverage
41.4(514B) Governing body and enrollee representation
41.7(514B) Change of ownership
41.9(514B) Cancellation of enrollees
41.10(514B) Application for certificate of authority
41.11(514B) Net equity and deposit requirements
41.14(514B) Cash or asset management agreements
41.16(514B) Provider contracts
41.18(514B) Emergency services
41.20(514B) Limited service organization requirements
41.21(514B) Disclosure requirements
CHAPTER 42
GENDER–BLENDED MINIMUM NONFORFEITURE STANDARDS FOR LIFE INSURANCE
42.3(508) Use of gender–blended mortality tables
42.4(508) Unfair discrimination
42.6(508) 2001 CSO Mortality Table
CHAPTER 43
ANNUITY MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR
ANNUITIES
43.3(508) Individual annuity or pure endowment contracts
43.4(508) Group annuity or pure endowment contracts
43.5(508) Application
of the 1994
GAR Table
44.6(508) 2001 CSO Mortality Table
INSURANCE HOLDING COMPANY SYSTEMS
CHAPTER 45
INSURANCE HOLDING
COMPANY SYSTEMS
45.3(521A) Subsidiaries of domestic insurers
45.4(521A) Control acquisition of domestic insurer
45.5(521A) Registration of insurers
45.6(521A) Alternative and consolidated registrations
45.8(521A) Disclaimers and termination of registration
45.9(521A) Transactions subject to prior notice—notice filing
45.10(521A) Extraordinary dividends and other distributions
CHAPTER 46
MUTUAL HOLDING COMPANIES
46.3(521A) Application—contents—process
46.4(521A) Plan of reorganization
46.5(521A) Duties of the commissioner
46.6(521A) Regulation—compliance
46.7(521A) Reorganization of domestic mutual insurer with mutual insurance holding company
46.8(521A) Reorganization of foreign mutual insurer with mutual insurance holding company
46.9(521A) Mergers of mutual insurance holding companies
46.11(521A) Regulation of holding company system
46.12(521A) Reporting of stock ownership and transactions
CHAPTER 47
VALUATION OF LIFE
INSURANCE POLICIES
47.4(508) General calculation requirements for basic reserves and premium deficiency reserves
47.7(508) 2001 CSO Mortality Table
viatical and life settlements
CHAPTER 48
VIATICAL AND LIFE SETTLEMENTS
48.1(508E) Purpose and authority
48.3(508E) License requirements
48.4(508E) Approval of viatical settlement contracts and disclosure statements
48.6(508E) Reporting requirements
48.8(508E) Examination or investigations
48.9(508E) Requirements and prohibitions
48.10(508E) Advertising for viatical settlements
48.11(508E) Fraud prevention and control
48.12(508E) Penalties; injunctions; civil remedies; cease and desist
CHAPTER 49
FINANCIAL INSTRUMENTS USED IN HEDGING TRANSACTIONS
49.3(511) Guidelines and internal control procedures
49.4(511) Documentation requirements
49.5(511) Trading requirements
SECURITIES
CHAPTER 50
REGULATION OF SECURITIES
OFFERINGS AND THOSE WHO ENGAGE IN THE SECURITIES BUSINESS
DIVISION I
DEFINITIONS AND ADMINISTRATION
50.2(502) Cost of audit or inspection
50.3(502) Interpretative opinions or no–action letters
division ii
registration of broker–dealers and agents
50.10(502) Broker–dealer registrations, renewals, amendments, succession, and withdrawals
50.12(502) Agent and issuer registrations, renewals and amendments
50.13(502) Agent continuing education requirements
50.14(502) Broker–dealer record–keeping requirements
50.15(502) Broker–dealer minimum financial requirements and financial reporting requirements
50.16(502) Dishonest or unethical practices in the securities business
50.18(502) Limited registration of Canadian broker–dealers and agents
50.19(502) Brokerage services by national and state banks
50.20(502) Broker–dealers having contracts with national and state banks
50.21(502) Brokerage services by credit unions, savings banks, and savings and loan institutions
DIVISION III
REGISTRATION OF INVESTMENT ADVISERS, INVESTMENT ADVISER REPRESENTATIVES, AND
FEDERAL COVERED INVESTMENT ADVISERS
50.30(502) Electronic filing with designated entity
50.31(502) Investment adviser applications and renewals
50.32(502) Application for investment adviser representative registration
50.33(502) Examination requirements
50.34(502) Notice filing requirements for federal covered investment advisers
50.35(502) Withdrawal of investment adviser registration
50.36(502) Investment adviser disclosure statement
50.39(502) Custody of client funds or securities by investment advisers
50.40(502) Minimum financial requirements for investment advisers
50.41(502) Bonding requirements for investment advisers
50.42(502) Record–keeping requirements for investment advisers
50.43(502) Financial reporting requirements for investment advisers
50.44(502) Solely incidental services by certain professionals
DIVISION IV
RULES COVERING ALL REGISTERED PERSONS
DIVISION V
rEGISTRATION OF SECURITIES
50.60(502) Notice filings for investment company securities offerings
50.61(502) Registration of small corporate offerings
50.62(502) Streamlined registration for certain equity securities
50.63(502) Registration of multijurisdictional offerings
50.64(502) Form of financial statements
50.65(502) Reports contingent to registration by qualification
50.66(502) NASAA guidelines and statements of policy
50.67(502) Amendments to registration by qualification
50.68(502) Delivery of prospectus
DIVISION VI
exemptions
50.80(502) Uniform limited offering exemption
50.81(502) Notice filings for Rule 506 offerings
50.82(502) Notice filings for agricultural cooperative associations
50.83(502) Unsolicited order exemption
50.84(502) Solicitation of interest exemption
50.85(502) Internet offers exemption
50.87(502) Nonprofit securities exemption
50.88(502) Transactions with specified investors
DIVISION VII
FRAUD AND OTHER PROHIBITED CONDUCT
50.100(502) Fraudulent practices
50.103(502) Investment advisory contracts
DIVISION VIII
VIATICAL SETTLEMENT INVESTMENT CONTRACTS
50.112(502) Advertising of viatical settlement investment contracts
CHAPTER 54
RESIDENTIAL SERVICE CONTRACTS
54.5(523C) Application of insurance laws
54.11(523C) Misrepresentations of government approval
54.12(523C) Public access to hearings
54.13(523C) Public access to records
54.14(523C) Procedure for public complaints
54.20(523C) Service company licenses
54.21(523C) Suspension or revocation of license
54.22(523C) Licenses not transferable
54.30(523C) Forms of contracts
54.40(523C) Cessation of business—records
54.50(523C) Prohibited acts or practices
54.52(523C) Investigations and subpoenas
CHAPTER 55
licensing of public adjusters
55.3(82GA,HF499) License required to operate as public adjuster
55.4(82GA,HF499) Application for license
55.5(82GA,HF499) Issuance of resident license
55.6(82GA,HF499) Public adjuster examination
55.7(82GA,HF499) Exemptions from examination
55.8(82GA,HF499) Nonresident license reciprocity
55.9(82GA,HF499) Terms of licensure
55.10(82GA,HF499) Evidence of financial responsibility
55.11(82GA,HF499) Continuing education
55.12(82GA,HF499) License denial, nonrenewal or revocation
55.14(82GA,HF499) Contract between public adjuster and insured
55.15(82GA,HF499) Escrow accounts
55.16(82GA,HF499) Record retention
55.17(82GA,HF499) Standards of conduct of public adjuster
55.18(82GA,HF499) Public adjuster fees
55.21(82GA,HF499) Severability
CHAPTER 56
WORKERS’ COMPENSATION GROUP SELF–INSURANCE
56.1(87,505) General provisions
56.3(87,505) Requirements for self–insurance
56.6(87,505) Rates and reporting of rates
56.7(87,505) Special provisions
56.8(87,505) Certificate of approval; termination
56.10(87,505) Board
of trustees—
membership, powers, duties, and prohibitions
56.11(87,505) Association membership; termination; liability
56.12(87,505) Requirements of sales agents
56.13(87,505) Requirements for continued approval
56.14(87,505) Misrepresentation prohibited
56.17(87,505) Premium payment; reserves
56.18(87,505) Deficits and insolvencies
56.19(87,505) Grounds for nonrenewal or revocation of a certificate of relief from insurance
56.20(87,505) Hearing and appeal
56.21(87,505) Existing approved self–insurers
56.22(87,505) Severability clause
CHAPTER 57
WORKERS’ COMPENSATION
SELF–INSURANCE FOR INDIVIDUAL EMPLOYERS
57.1(87,505) General provisions
57.3(87,505) Requirements for self–insurance
57.4(87,505) Additional security requirements
57.5(87,505) Application for an individual self–insurer
57.10(87,505) Periodic examination
57.11(87,505) Grounds for nonrenewal or revocation of a certificate of relief from insurance
57.12(87,505) Hearing and appeal
57.13(87,505) Existing approved self–insurers
57.14(87,505) Severability clause
CHAPTER 58
THIRD–PARTY ADMINISTRATORS
58.4(510) Application by corporation, association or benefit society
58.7(510) Change of information
58.8(510) Inquiry by commissioner
58.10(510) Periodic examination
58.11(510) Grounds for denial, nonrenewal, suspension or revocation of certificate
58.13(510) Severability clause
MANAGED HEALTH CARE
70.5(505,514F) Retroactive application
70.6(505,514F) Variances allowed
70.7(505,514F) Confidentiality
70.8(76GA,ch1202) Utilization review of postdelivery benefits and care
70.9(505,507B,514F) Enforcement
HEALTH BENEFIT PLANS
CHAPTER 71
SMALL GROUP HEALTH
BENEFIT PLANS
71.3(513B) Applicability and scope
71.4(513B) Establishment of classes of business
71.5(513B) Transition for assumptions of business from another carrier
71.6(513B) Restrictions relating to premium rates
71.7(513B) Requirement to insure entire groups
71.8(513B) Case characteristics
71.9(513B) Application to reenter state
71.10(513B) Creditable coverage
71.11(513B) Rules related to fair marketing
71.12(513B) Status of carriers as small employer carriers
71.13(513B) Restoration of coverage
71.14(513B) Basic health plan and standard health plan policy forms
71.15(513B) Methods of counting creditable coverage
71.16(513B) Certificates of creditable coverage
71.17(513B) Notification requirements
71.18(513B) Special enrollments
71.19(513B) Disclosure requirements
71.21(514C) Emergency services
71.23(513B) Reconstructive surgery
71.24(514C) Contraceptive coverage
71.25(513B) Suspension of the small employer health reinsurance program
71.26(513B) Uniform health insurance application form
CHAPTER 72
LONG–TERM CARE ASSET
PRESERVATION PROGRAM
72.2(249G) Applicability and scope
72.4(249G) Qualification of long–term care insurance policies and certificates
72.5(249G) Standards for marketing
72.6(249G) Minimum benefit standards for qualifying policies and certificates
72.7(249G) Required policy and certificate provisions
72.8(249G) Prohibited provisions in certified policies or certificates
72.9(249G) Reporting requirements
72.10(249G) Maintaining auditing information
72.11(249G) Reporting on asset protection
72.12(249G) Preparing a service summary
72.14(249G) Auditing and correcting deficiencies in issuer record keeping
CHAPTER 73
HEALTH INSURANCE
PURCHASING COOPERATIVES
73.2(75GA,ch158) Applicability and scope
73.4(75GA,ch158) Division duties— application—filing requirements— license—audits and examinations
73.5(75GA,ch158) Fidelity bond—letter of credit
73.6(75GA,ch158) Annual report
73.7(75GA,ch158) Business plan
73.9(75GA,ch158) Health insurance purchasing cooperative—product offerings—exemptions
73.10(75GA,ch158) Insurance risk
73.12(75GA,ch158) Election—disclosure and confidentiality
73.13(75GA,ch158) Structure—merger and consolidation
73.14(75GA,ch158) Conflict of interest
73.15(75GA,ch158) Nondiscrimination and retaliatory protections
73.16(75GA,ch158) Annual health insurance or health care benefits plan selection
73.17(75GA,ch158) License subject to conditions—waivers
73.19(75GA,ch158) Data collection—quality evaluation
73.20(75GA,ch158) Examination—costs
73.21(75GA,ch158) Trade practices
73.22(75GA,ch158) Grounds for denial, nonrenewal, suspension or revocation of certificate
73.23(75GA,ch158) Hearing and appeal
74.2(505) Applicability and scope
74.4(505) Access to health care or health insurance for an employee
74.5(505) Employer participation
74.6(505) Violation of chapter
CHAPTER 75
IOWA INDIVIDUAL
HEALTH BENEFIT PLANS
75.3(513C) Applicability and scope
75.4(513C) Establishment of blocks of business
75.5(513C) Transition for assumptions of business from another carrier or ODS
75.6(513C) Restrictions relating to premium rates
75.7(513C) Availability of coverage
75.8(513C) Disclosure of information
75.9(513C) Standards to ensure fair marketing
75.10(513C) Basic health benefit plan and standard health benefit plan policy forms
75.11(513C) Maternity benefit rider
75.12(513C) Disclosure requirements
75.14(514C) Emergency services
75.17(513C) Reconstructive surgery
75.18(514C) Contraceptive coverage
76.3(514J) Notice of coverage decision and content
76.4(514J) External review request
76.5(514J) Certification process
76.7(514J) Decision notification
76.8(514J) Carrier information
76.9(514J) Certification of independent review entity
CHAPTER 77
MULTIPLE EMPLOYER WELFARE ARRANGEMENTS
77.1(507A) Certificate of registration
77.2(507A) Application for certificate of registration
77.3(507A) Financial requirements
77.7(507A) Agreements and management contracts
77.11(507A) Suspension or revocation of certificate
CHAPTER 78
UNIFORM PRESCRIPTION DRUG INFORMATION CARD
INSURANCE COVERAGE FOR
PEDIATRIC PREVENTIVE SERVICES
80.2(505,514H) Applicability and scope
80.4(505,514H) Policy definitions
CHAPTER 81
POSTDELIVERY BENEFITS AND CARE
81.2(76GA,ch1202) Applicability and scope
81.3(76GA,ch1202) Postdelivery benefits
CHAPTER 90
FINANCIAL AND HEALTH
INFORMATION REGULATION
DIVISION I
RULES FOR FINANCIAL INFORMATION
90.3(505) Initial privacy notice to consumers required
90.4(505) Annual privacy notice to customers required
90.5(505) Information to be included in privacy notices
90.6(505) Form of opt–out notice to consumers and opt–out methods
90.7(505) Revised privacy notices
90.10(505) Limits on redisclosure and reuse of nonpublic personal financial information
90.11(505) Limits on sharing account number information for marketing purposes
90.15(505) Notice through a Web site
90.16(505) Licensee exception to notice requirement
DIVISION Ii
RULES FOR HEALTH INFORMATION
90.17(505) Disclosure of nonpublic personal health information
90.19(505) Delivery of authorization request
90.20(505) Relationship to federal rules
90.21(505) Relationship to state laws
90.22(505) Protection of Fair Credit Reporting Act
DIVISION IIi
safeguarding customer information
90.37(505) Information security program
90.38(505) Examples of methods of development and implementation
CHAPTER 91
2001 CSO MORTALITY TABLE
91.3(508) 2001 CSO Mortality Table
91.6(508) Gender–blended table
CHAPTER 92
UNIVERSAL LIFE INSURANCE
92.1(508) Purpose and authority
92.6(508) Mandatory policy provisions
92.7(508) Disclosure requirements
92.8(508) Periodic disclosure to policyowner
92.9(508) Interest–indexed universal life insurance policies
CHAPTER 93
CONDUIT DERIVATIVE TRANSACTIONS
93.3(511,521A) Provisions not applicable
93.4(511,521A) Standards for conduit derivative transactions
93.5(511,521A) Internal controls
93.6(511,521A) Reporting requirements for conduit derivative transactions
93.7(511,521A) Conduit ownership
93.8(511,521A) Exemption from applicability
CHAPTER 94
PREFERRED MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES
94.3(508) 2001 CSO Preferred Class Structure Mortality Table
REGULATED INDUSTRIES
SALES OF CEMETERY MERCHANDISE, FUNERAL MERCHANDISE AND FUNERAL SERVICES
CHAPTER 100
GENERAL PROVISIONS
100.1(523A,82GA,SF559) Purpose
100.2(523A,82GA,SF559) Definitions
100.3(523A,82GA,SF559) Contact and correspondence
CHAPTER 101
TRUST DEPOSITS AND TRUST FUNDS
101.1(523A,82GA,SF559) Trust income withdrawals
101.2(523A,82GA,SF559) Amount of trust income withdrawn
101.3(523A,82GA,SF559) Allocation of trust income to purchasers’ accounts
101.4(523A,82GA,SF559) Credit for trust income withdrawn
101.5(523A,82GA,SF559) Time period during which trust income may be withdrawn
101.6(523A,82GA,SF559) Application of contract law
101.7(523A,82GA,SF559) Consumer price index adjustment
101.8(523A,82GA,SF559) Cancellation refunds
CHAPTER 102
WAREHOUSED MERCHANDISE
102.1(523A,82GA,SF559) Funeral and cemetery merchandise delivered to the purchaser or warehoused
102.2(523A,82GA,SF559) Storage facilities
CHAPTER 103
LICENSING OF PRENEED SELLERS AND SALES AGENTS
103.1(523A,82GA,SF559) Requirement for a preneed seller license or a sales agent license
103.2(523A,82GA,SF559) Application and licensing of preneed seller or sales agent
103.3(523A,82GA,SF559) Change of ownership or sale of business of preneed seller
103.4(523A,82GA,SF559) License renewal
103.5(523A,82GA,SF559) Denial of license applications or of applications for renewal
103.7(252J) Suspension for failure to pay child support
103.8(261) Suspension for failure to pay student loan
CHAPTER 104
CONTINUING EDUCATION FOR SALES AGENTS
104.1(523A,82GA,SF559) Continuing education requirements
104.2(523A,82GA,SF559) Proof of completion of continuing education requirements
104.3(523A,82GA,SF559) Standards for continuing education activities
104.4(523A,82GA,SF559) Qualifications of presenters and proof of attendance
104.5(523A,82GA,SF559) Acceptable areas of continuing education
104.6(523A,82GA,SF559) Academic coursework
104.7(523A,82GA,SF559) Reviews
CHAPTER 105
STANDARDS OF CONDUCT AND PROHIBITED PRACTICES
105.1(523A,82GA,SF559) Purpose
105.2(523A,82GA,SF559) Numbering purchase agreements
105.3(523A,82GA,SF559) Records maintenance
105.4(523A,82GA,SF559) Annual reports
105.5(523A,82GA,SF559) Fidelity bond or insurance
105.6(523A,82GA,SF559) Grounds for discipline
CHAPTER 106
DISCIPLINARY PROCEDURES
106.1(523A,82GA,SF559) Investigations
Penalties
Administrative procedures
ORGANIZATION AND PROCEDURES
chapter 1
ORGANIZATION OF DIVISION
[Prior to 10/22/86, Insurance Department[510]]
191—1.1(502,505) Organization. The insurance division is headed by the commissioner of insurance who is assisted by a first deputy commissioner and other deputy and assistant commissioners. The functions of the division are divided into five bureaus.
1.1(1) The administrative bureau provides staff support to the commissioner and is responsible for legal services, budgetary and personnel services. General oversight of the division operations is provided through interaction with the public, the insurance industry, and other state and federal agencies.
1.1(2) The company regulation bureau is responsible for the following:
a. Regulating of all domestic and foreign insurance companies licensed in Iowa through licensure, analysis and financial and market examinations.
b. Examining the financial condition of Iowa insurance companies not less than once every five years. Foreign companies are examined as deemed appropriate. The bureau ensures compliance with National Association of Insurance Commissioners accreditation mandates, and financial examination and analysis standards.
c. Serving as a general insurance information repository and resource for both insurers and consumers regarding, for example: insurance companies’ status, addresses, telephone numbers, certifications, and financial statements; statutory construction; guaranty fund calculations; powers of attorney; compilation of statistics; and publication of annual governor’s report.
d. Reviewing and approving filed company transactions including, but not limited to, approval of acquisitions and mergers of domestic insurers, intercompany contractual agreements and assumption reinsurance agreements.
e. Authorizing and overseeing individual and group workers’ compensation self–insurance.
f. Authorizing, examining and analyzing benevolent associations.
g. Authorizing and reviewing multiple employer welfare arrangements.
h. Registering and verifying compliance for risk retention groups.
i. Supervising the rehabilitation and liquidation of insurance companies.
j. Auditing and monitoring premium tax remittances for admitted companies and supervising statutory deposits.
k. Reviewing and approving admission applications for foreign surplus lines insurers as well as conducting premium tax audits associated with the nonadmitted insurance industry.
1.1(3) The market regulation bureau is responsible for the following:
a. Ensuring fair treatment of consumers and preventing unfair or deceptive trade practices in the insurance and securities marketplaces. Inquiries from the public are answered and consumer complaints regarding insurance producers, insurers, broker–dealers, securities agents, investment advisers, and investment adviser representatives are received, reviewed, and investigated. Administrative actions are taken where appropriate, and criminal matters are referred to prosecutors for potential action.
b. Operating the senior health insurance information program (SHIIP), which provides training to senior volunteers throughout the state. These volunteers then provide free, confidential health insurance counseling to Iowa seniors. Issues addressed include Medicare, Medicare subscription drug coverage, Medicare supplement insurance, long–term care insurance, insurance claims, and all other health insurance policies. This program is primarily funded by a Centers for Medicare and Medicaid Services grant.
c. Reviewing, approving or disapproving property, casualty, life and health forms and, where provided by law, premium rates of certain types of insurance.
d. Performing actuarial analysis of life and health insurance plans funded by certain public bodies.
e. Licensing insurance producers and overseeing the continuing education that insurance producers are required to complete.
f. Monitoring surplus lines placement, registering purchasing groups, and overseeing the payment of premium taxes for surplus lines business including that which is placed through purchasing groups and risk retention groups.
g. Registering managing general agents and legal expense insurers.
h. Registering and monitoring third–party administrators.
i. Registering and monitoring health maintenance organizations.
j. Licensing advisory organizations.
1.1(4) The fraud bureau confronts the problem of insurance fraud by prevention, investigation, and prosecution of fraudulent insurance acts in an effort to reduce the amount of premium dollars used to pay fraudulent insurance claims, as set forth in Iowa Code chapter 507E.
1.1(5) The securities and regulated industries bureau is responsible for administering and enforcing the Iowa uniform securities Act through enforcement, licensing, and securities registration to ensure investor protection and a positive climate for capital formation. The bureau also is responsible for protecting the public by administering and enforcing rules related to motor vehicle service contracts, residential service contracts, retirement facilities, cemeteries, and preneed purchase agreements for cemetery merchandise, funeral merchandise and funeral services.
191—1.2(502,505) Location and contact information. The insurance division is located at 330 East Maple in Des Moines, Polk County, Iowa. The general telephone number for the division is (515)281–5705 or 1–877–955–1212. The division’s Web site is www.iid.state.ia.us.
FAIR INFORMATION PRACTICES
The insurance division hereby adopts the rules on fair information practices of the Governor’s Task Force on Uniform Rules of Agency Procedure to appear as subrules 1.3(1) to 1.3(8) with amendments. The uniform rules are printed in the first volume of the Iowa Administrative Code.
191—1.3(22,502,505) Public information and inspection of records.
1.3(1) Definitions. As used in this chapter:
“Agency” means the insurance division of the department of commerce.
“Confidential records” are records which are not available as a matter of right for examination and copying by members of the public under law. Confidential records include records that the agency is prohibited by law from making available for examination by members of the public, and records that are specified as confidential by Iowa Code section 22.7, or other provisions of law, but that may be disclosed upon order of a court, the lawful custodian of the record, or by another person duly authorized to release the record. Mere inclusion in a record of information declared confidential by an applicable provision of law does not necessarily make that entire record a confidential record.
“Custodian” means the agency or a person lawfully delegated authority by the agency to act for the agency in implementing Iowa Code chapter 22.
“Open record” means a record other than a confidential record.
“Personally identifiable information” means information about or pertaining to an individual which identifies the individual and which is contained in a record system and does not include information pertaining to corporations.
“Record” means all or part of a “public record,” as defined in Iowa Code section 22.1 that is owned by or in the physical possession of the agency.
“Record system” means any group of records under the control of the agency from which a record may be retrieved by a personal identifier such as the name of the individual, number, symbol or other unique retriever assigned to the individual.
1.3(3) Requests for access to records.
a. Location of record. A request for access to a record should be directed to the office of the bureau where the record is kept. If the location of the record is not known by the requester, the request shall be directed to the division’s receptionist at (515)281–5705 or toll–free at 1–877–955–1212, or in writing to Iowa Insurance Division, 330 East Maple, Des Moines, Iowa 50319–0065. The division will forward the request to the appropriate person.
b. Office hours. Records shall be made available from 8 a.m. to 4 p.m. daily, excluding Saturdays, Sundays and legal holidays.
c. Telephone access. The general telephone number for the insurance division is (515)281–5705 or toll–free at 1–877–955–1212.
d. Internet access. The division’s Internet Web site home page is www.iid.state.ia.us. The page from which the division’s bulletins are available is http://www.iid.state.ia.us/news_media/bulletins.asp.
e. Request for access. Requests for access to open records may be made in writing, in person, or by telephone. Requests shall identify the particular records sought by name or description in order to facilitate the location of the record. Mail or telephone requests shall include the name, address, and telephone number of the person requesting the information. A person shall not be required to give a reason for requesting an open record.
f. Response to requests. The division provides a public access room with photocopiers and work surfaces. Space is limited and advance reservations are requested. A location will be made available as soon as feasible. Subject to availability of the public access room or an alternative location in the division’s offices, access to an open record shall be provided promptly upon request unless the size or nature of the request makes prompt access infeasible. If the size or nature of the request for access to an open record requires time for compliance, the division shall comply with the request as soon as feasible. Access to an open record may be delayed for one of the purposes authorized by Iowa Code section 22.8(4) or 22.10(4), or to permit the division time to redact personally identifiable information from the record. The custodian shall promptly give notice to the requester of the reason for any delay in access to an open record and an estimate of the length of that delay and, upon request, shall promptly provide that notice to the requester in writing. The division may deny access to the record by members of the public only on the grounds that such denial is warranted under Iowa Code sections 22.8(4) and 22.10(4), or that it is a confidential record, or that its disclosure is prohibited by a court order.
g. Fees. Copies of an open record may be made in the division’s public access room. Price schedules for published materials and for photocopies of records shall be determined by the division and prominently posted in the public access room. The payment of fees may be waived when the imposition of fees is inequitable or when a waiver is in the public interest. When the mailing of copies of records is requested, the actual costs of the mailing will be charged to the requester.
The following additional subrules are also adopted:
1.3(9) Data processing system. The agency currently has certain data processing systems which match, collate or permit the comparison of personally identifiable information in one record system with personally identifiable information in another record system.
1.3(10) Agency records routinely available for public inspection. The agency collects and maintains the following records that are open records, some of which may contain personally identifiable information:
a. Financial statements of insurers.
b. Rate and policy form filings by insurers.
c. The records of rule making, declaratory ruling, and contested case proceedings.
d. Agent licensure records.
e. The records of premium tax and fee collection.
f. Insurer acquisition and reinsurance records.
g. Securities issuer registration records, exemption filings, and agent or broker–dealer records, except those pertaining to a broker–dealer audit or investigation, unless released by the division at a hearing upon the broker–dealer’s registration.
h. License, permit, registration, exemption, or other required filings in connection with membership sales, business opportunity promotions, residential service contracts, loan brokers, and motor vehicle service contracts.
i. Various legal and technical publications related to insurance.
j. All other records that are not confidential records under subrule 1.3(11).
1.3(11) Records which are confidential records. Confidential agency records are the following:
a. Trade secrets recognized and protected by law. Iowa Code section 22.7(3).
b. Records that represent and constitute the work product of an attorney, which are related to litigation or claim made by or against a public body. Iowa Code section 22.7(4).
c. Reports made to the agency which, if released, would give advantage to competitors and serve no public purpose. Iowa Code section 22.7(6). Included in this category are insurer examination reports prior to expiration of the 20–day period set forth in rule 191—5.1(507) for requesting a hearing before the commissioner of insurance upon the report and if a hearing is requested, until the commissioner enters a decision upon the report, and reports of the National Association of Insurance Commissioners’ Insurance Regulatory Information System.
d. Personal information in confidential personnel records of the division. Iowa Code section 22.7(10).
e. Communications not required by law, rule, or procedure that are made to a government body or to any of its employees by identified persons outside of government, to the extent that the government body receiving those communications could reasonably believe that those persons would be discouraged from making them to the government body if they were available for general public examination. Notwithstanding this provision:
(1) The communication is a public record to the extent the person outside of government making that communication consents to its treatment as a public record.
(2) Information contained in the communication is a public record to the extent it can be disclosed without directly or indirectly indicating the identity of the person outside of government making it or enabling others to ascertain the identity of that person.
(3) Information contained in the communication is a public record to the extent it indicates the date, time, specific location, and immediate facts and circumstances surrounding the occurrence of a crime or other illegal act, except to the extent its disclosure would plainly and seriously jeopardize a continuing investigation or pose a clear and present danger to the safety of any person. In any action challenging the failure of the lawful custodian to disclose any particular information of the kind enumerated in this paragraph, the burden of proof is on the lawful custodian to demonstrate that the disclosure of that information would jeopardize an investigation or would pose a clear and present danger. Iowa Code section 22.7(18).
f. Complaint files, investigation files, other investigative reports and other investigative information of the agency relating to discipline of licensed insurance agents, except as allowed under Iowa Code section 505.8(6), 505.17, 507A.10, or 507B.3.
g. Insurance holding company system registration and holding company examination records unless the statutory determination in favor of publication is made. Iowa Code section 521A.7.
h. Reports and recommendations by insurer guaranty associations regarding insolvent or impaired insurers. Iowa Code sections 508C.12(3), 508C.12(5), 515B.10(2).
i. Investigation material in the possession of the superintendent of securities pertaining to violation of the securities laws unless released by the superintendent pursuant to statute. Iowa Code section 502.603(1)“c.”
j. All records relating to prearranged funeral contracts except upon the approval of the commissioner of insurance or the attorney general. Iowa Code section 523A.2(1)“e.”
k. Any other records made confidential by law.
191—1.4(505) Service of process. A party to a proceeding who requests that the commissioner provide service of process as allowed by law shall pay a fee to the Iowa insurance division of $50.
These rules are intended to implement Iowa Code sections 22.11, 505.1 and 505.29.
[Filed 7/1/75]
[Filed emergency 7/1/86—published 7/30/86, effective 7/1/86]
[Editorially transferred from [510] to [191], IAC Supp. 10/22/86; see IAB 7/30/86]
[Filed 3/18/88, Notice 1/13/88—published 4/6/88, effective 5/11/88]
[Filed 9/16/98, Notice 4/8/98—published 10/7/98, effective 11/11/98]
[Filed 12/15/04, Notice 10/27/04—published 1/5/05, effective 2/9/05]
[Filed 1/12/07, Notice 12/6/06—published 1/31/07, effective 3/7/07]
[Prior to
2/11/87, see 191—2.6]
191—2.1(17A) Petition for declaratory order.
2.1(1) Any person or agency may file a petition with the insurance division for a declaratory order as to the applicability to specified circumstances of a statute, rule or order within the primary jurisdiction of the division, at the address disclosed in rule 191—1.2(502,505). A petition is deemed filed when it is received. The division shall provide petitioner with a file–stamped copy of the petition if petitioner provides the agency an extra copy for this purpose. The petition must be typewritten or legibly handwritten in ink and must substantially conform to the following form:
|
BEFORE THE INSURANCE DIVISION OF THE STATE OF IOWA |
||||
|
Petition by (Name of Petitioner) |
} |
PETITION
FOR |
||
2.1(2) The petition shall provide the following information:
a. A clear and concise statement of all relevant facts upon which the order is requested.
b. A citation and the relevant language of the specific statutes, rules, policies, decisions, or orders, whose applicability or interpretation is questioned, and any other relevant law.
c. The questions petitioner wants answered, stated clearly and concisely.
d. The answers to the questions desired by petitioner and a summary of the reasons urged by petitioner in support of those answers.
e. The reasons for requesting the declaratory order and disclosure of petitioner’s interest in the outcome.
f. A statement indicating whether petitioner is currently a party to another proceeding involving the questions at issue and whether, to petitioner’s knowledge, those questions have been decided by, are pending determination by, or are under investigation by, any governmental entity.
g. Any request by petitioner for a meeting provided for by rule 2.7(17A).
The petition must be dated and signed by petitioner or petitioner’s representative. It must also include the name, mailing address, and telephone number of petitioner and petitioner’s representative, and a statement indicating the person to whom communications concerning the petition should be directed.
191—2.2(17A) Notice of petition. Within seven days after receipt of a petition for a declaratory order, the insurance division shall give notice of the petition to all persons not served by petitioner pursuant to rule 2.6(17A) to whom notice is required by any provision of law. The division may also give notice to any other persons.
191—2.3(17A) Intervention. A person may file a petition for intervention at any time prior to issuance of an order and may be allowed to intervene in a proceeding for a declaratory order at the discretion of the insurance division.
191—2.4(17A) Briefs. Petitioner or any intervenor shall file a brief in support of the position urged.
191—2.5(17A) Inquiries. Inquiries concerning the status of a declaratory proceeding may be made to the insurance division at the address disclosed in rule 191—1.2(502,505).
191—2.6(17A) Service and filing of petitions and other papers.
2.6(1) Every petition for declaratory order, petition for intervention, brief, or other paper filed in a proceeding for a declaratory order shall be served upon each of the parties of record to the proceeding. The party filing a document is responsible for service.
2.6(2) All petitions for declaratory orders, petitions for intervention, briefs, or other papers in a proceeding for a declaratory order shall be filed with the insurance division at the address disclosed in rule 191—1.2(502,505). All petitions, briefs, or other papers required to be served upon a party shall be filed simultaneously with the division.
2.6(3) Method of service, time of filing, and proof of mailing shall be as provided by rule 3.12(17A).
191—2.7(17A) Consideration. Upon request by petitioner, the insurance division must schedule a brief and informal meeting between the original petitioner, all intervenors, and the commissioner or a member of the commissioner’s staff, to discuss the questions raised.
191—2.8(17A) Action on petition.
2.8(1) Within the time allowed by 1998 Iowa Acts, chapter 1202, section 13(5), after receiving a petition for a declaratory order, the insurance division shall take action on the petition as required by 1998 Iowa Acts, chapter 1202, section 13(5).
2.8(2) The date of issuance of an order is as defined in rule 3.2(17A).
191—2.9(17A) Refusal to issue order.
2.9(1) The insurance division shall not issue a declaratory order where prohibited by 1998 Iowa Acts, chapter 1202, section 13(1), and may refuse to issue a declaratory order on some or all questions raised for the following reasons:
a. The petition does not substantially comply with the required form.
b. The petition does not contain facts sufficient to demonstrate that petitioner will be aggrieved or adversely affected by failure of the division to issue an order.
c. The agency does not have jurisdiction over the questions presented in the petition.
d. The questions presented by the petition are also presented in a current rule making, contested case, or other agency or judicial proceeding, that may definitively resolve them.
e. The questions presented by the petition would more properly be resolved in a different type of proceeding or by another body with jurisdiction over the matter.
f. The facts or questions presented in the petition are unclear, overbroad, insufficient, or otherwise inappropriate as a basis upon which to issue an order.
g. There is no need to issue an order because the questions raised in the petition have been settled due to a change in circumstances.
h. The petition is not based upon facts calculated to aid in the planning of future conduct but is, instead, based solely upon prior conduct in an effort to establish the effect of that conduct or to challenge an agency decision already made.
i. The petition requests a declaratory order that would necessarily determine the legal rights, duties, or responsibilities of other persons who have not joined in the petition, intervened separately, or filed a similar petition and whose position on the questions presented may fairly be presumed to be adverse to that of petitioner.
j. Petitioner requests the division to determine whether a statute is unconstitutional on its face.
2.9(2) A refusal to issue a declaratory order must indicate the specific grounds for refusal and constitutes final agency action on the petition.
2.9(3) Refusal to issue a declaratory order pursuant to this provision does not preclude filing of a new petition that seeks to eliminate the grounds for refusal to issue a ruling.
191—2.10(17A) Contents of declaratory order—effective date. In addition to the ruling itself, a declaratory order must contain the date of its issuance, the name of petitioner and all intervenors, the specific statutes, rules, policies, decisions, or orders involved, the particular facts upon which it is based, and the reasons for its conclusion.
A declaratory order is effective on the date of issuance.
191—2.11(17A) Copies of orders. A copy of all orders issued in response to a petition for a declaratory order shall be mailed promptly to the original petitioner and all intervenors.
191—2.12(17A) Effect of a declaratory order. A declaratory order has the same status and binding effect as a final order issued in a contested case proceeding. It is binding on the insurance division, petitioner, and any intervenors and is applicable only in circumstances where the relevant facts and the law involved are indistinguishable from those on which the order was based. As to all other persons, a declaratory order serves only as precedent and is not binding on the division. Issuance of a declaratory order constitutes final agency action on the petition.
These rules are intended to implement Iowa Code chapter 17A as amended by 1998 Iowa Acts, chapter 1202.
[Filed 1/1/75]
[Filed 3/2/79, Notice 1/10/79—published 3/21/79, effective 4/26/79]
[Editorially transferred from [510] to [191], IAC Supp. 10/22/86, see IAB 7/30/86]
[Filed 1/23/87, Notice 11/5/86—published 2/11/87, effective 3/18/87]
[Filed 4/30/99, Notice 3/24/99—published 5/19/99, effective 6/23/99]
[Prior to 10/22/86, Insurance Department[510]]
191—3.1(17A) Scope and applicability. This chapter applies to contested case proceedings conducted by the insurance division.
191—3.2(17A) Definitions. Except where otherwise specifically defined by law or the context otherwise requires:
“Commissioner” means the commissioner of insurance or the commissioner’s designee.
“Contested case” means a proceeding defined by Iowa Code section 17A.2(5), and includes any matter defined as a no factual dispute contested case under 1998 Iowa Acts, chapter 1202, section 14.
“Issuance” means the date of mailing of a decision or order or date of delivery if service is by other means unless another date is specified in the order.
“License” means the whole or a part of any permit, certificate, approval, registration, charter or similar form of permission required by statute.
“Party” means each person or agency named or admitted as a party or properly seeking and entitled as of right to be admitted as a party.
“Presiding officer” means the commissioner, the commissioner’s designee or an administrative law judge from the department of inspections and appeals.
“Proposed decision” means the administrative law judge’s recommended findings of fact, conclusions of law, decision, and order in a contested case in which the commissioner did not preside.
191—3.3(17A) Time requirements.
3.3(1) Time shall be computed as provided in Iowa Code section 4.1(34).
3.3(2) For good cause, the presiding officer may extend or shorten the time to take any action, except as precluded by statute. Except for good cause stated in the record, before extending or shortening the time to take any action, the presiding officer may afford all parties an opportunity to be heard or to file written arguments.
191—3.4(17A) Requests for contested case proceeding. Any person claiming an entitlement to a contested case proceeding shall file a written request for such a proceeding within the time specified by the particular rules or statutes governing the subject matter or, in the absence of such law, the time spec–ified in the agency action in question. The request shall be filed with the insurance division, at the address disclosed in rule 191—1.2(502,505).
The request for a contested case proceeding shall state the name and address of the requester, identify the specific agency action which is disputed and, where the requester is represented by a lawyer, identify the provisions of law or precedent requiring or authorizing a contested case proceeding in the particular circumstances involved, and shall include a short and plain statement of the issues of material fact in dispute.
191—3.5(17A) Commencement of hearing; notice.
3.5(1) Delivery of the notice of hearing constitutes commencement of the contested case proceeding. Delivery shall be accomplished in the manner described below, at least 15 days before the hearing date unless the parties agree to a shorter time period, or unless otherwise provided by statute.
a. For nonlicensed persons, delivery may be accomplished by:
(1) Personal service as provided in the Iowa Rules of Civil Procedure; or
(2) Certified mail, return receipt requested; or
(3) First–class mail; or
(4) Publication, as provided in the Iowa Rules of Civil Procedure.
b. For licensees, delivery shall be executed by:
(1) Personal service as provided in the Iowa Rules of Civil Procedure; or
(2) Restricted certified mail.
3.5(2) The notice of hearing shall be prepared in the form of an order and contain the following information:
a. A statement of the time, place, and nature of the hearing;
b. A statement of the legal authority and jurisdiction under which the hearing is to be held;
c. A reference to the particular sections of the statutes and rules involved;
d. A short and plain statement of the matters asserted. If the insurance division or other party is unable to state the matters in detail at the time the notice is served, the initial notice may be limited to a statement of the issues involved. Thereafter, upon written application, a more definite and detailed statement shall be furnished;
e. Identification of all parties including the name, address and telephone number of the person who will act as advocate for the division and of parties’ counsel where known;
f. Reference to the procedural rules governing conduct of the contested case proceeding;
g. Reference to the procedural rules governing informal settlement;
h. Identification of the presiding officer and address, if known. If not known, a description of who generally will serve as presiding officer; and
i. Notification of the time period in which a party may request, under 1998 Iowa Acts, chapter 1202, section 15(1), and rule 3.6(17A), that the presiding officer be an administrative law judge.
j. Notification that failure to file an answer within 20 days of service may result in default.
3.5(3) An answer shall be filed within 20 days of service of the notice of hearing unless otherwise ordered. A party may move to dismiss or apply for a more definite and detailed statement when appropriate.
a. An answer shall show on whose behalf it is filed and specifically admit, deny, or otherwise answer all material allegations of the notice of hearing. The answer shall state any facts deemed to show an affirmative defense and contain as many additional defenses as the pleader may claim.
b. An answer shall state the name, address and telephone number of the person filing the answer, the person or entity on whose behalf it is filed, and the attorney representing that person, if any.
c. Any allegation in the notice of hearing not denied in the answer is considered admitted. The presiding officer may refuse to consider any defense not raised in the answer which could have been raised on the basis of facts known when the answer was filed if any party would be prejudiced.
3.5(4) Any notice of hearing or other charging document may be amended before a responsive pleading has been filed. Amendments to a notice of hearing or charging document after a responsive pleading has been filed and to an answer may be allowed with the consent of the other parties or in the discretion of the presiding officer who may impose terms or grant a continuance.
3.5(5) The hearing in a contested case proceeding shall be held within 90 days after the date of the notice of hearing, subject to the provisions of rule 3.17(17A).
191—3.6(17A) Presiding officer.
3.6(1) If the presiding officer is not an administrative law judge, any party wishing to request that the presiding officer assigned to render a proposed decision be an administrative law judge employed by the department of inspections and appeals must file a written request with the insurance division within 20 days after service of a notice of hearing identifying or describing the presiding officer as the commissioner or members of the commissioner’s staff.
3.6(2) The commissioner may deny the request only upon a finding that one or more of the following apply:
a. Neither the commissioner nor any designee under whose authority the contested case is to take place is a named party to the proceeding or a real party in interest to that proceeding.
b. There is a compelling need to expedite issuance of a final decision in order to protect the public health, safety, or welfare.
c. An administrative law judge with the qualifications identified in subrule 3.6(4) is unavailable to hear the case within a reasonable time.
d. The case involves significant policy issues of first impression that are inextricably intertwined with the factual issues presented.
e. The demeanor of the witnesses is likely to be dispositive in resolving the disputed factual issues.
f. Funds are unavailable to pay the costs of an administrative law judge and an interagency appeal.
g. The request was not timely filed.
h. The request is not consistent with a specified statute.
i. A statute requires the commissioner or designee to serve as presiding officer.
j. The contested case arises from matters asserted pursuant to Iowa Code chapters 507A, 507B, 508B, 515G and 521A.
3.6(3) The commissioner or designee shall issue a written ruling specifying the grounds for its decision within 20 days after a request for an administrative law judge is filed. If the ruling is contingent upon the availability of an administrative law judge with the qualifications identified in subrule 3.6(4), the parties shall be notified at least ten days prior to hearing if a qualified administrative law judge will not be available.
3.6(4) An administrative law judge assigned to act as presiding officer in insurance and securities matters shall be admitted to practice law before the courts of the state of Iowa.
3.6(5) Except as provided otherwise by another provision of law, all rulings by an administrative law judge acting as presiding officer are subject to appeal to the commissioner. A party must seek any available intra–agency appeal in order to exhaust adequate administrative remedies.
191—3.7(17A) Waiver of procedures. Unless otherwise precluded by law, the parties in a contested case proceeding may waive any provision of this chapter. However, the insurance division may exercise discretion to refuse to give effect to such a waiver when the waiver is to be inconsistent with the public interest.
191—3.8(17A) Telephone proceedings.
3.8(1) The presiding officer may resolve preliminary procedural motions by telephone conference in which all parties have been afforded notice and an opportunity to participate.
3.8(2) The presiding officer may, on the officer’s own motion or as requested by a party, order hearings or argument to be held by telephone conference or other electronic means in which all parties have an opportunity to participate. Any party may call witnesses by telephone, with 14 days’ advance notice to all parties and the presiding officer. Failure of a party to make timely disclosure may result in the disallowance of testimony by telephone.
191—3.9(17A) Disqualification.
3.9(1) A presiding officer or other person shall withdraw from participation in the making of any proposed or final decision in a contested case if that person:
a. Has a personal bias or prejudice concerning a party or a representative of a party;
b. Has personally investigated, prosecuted or advocated in connection with that case, the specific controversy underlying that case, another factually related contested case with common disputed facts, or a pending controversy with common disputed facts that may culminate in a contested case involving the same parties;
c. Is subject to the authority, direction or discretion of any person who has personally investigated, prosecuted or advocated in connection with that contested case, the specific controversy underlying that contested case, or a factually related contested case with common disputed facts or controversy involving the same parties;
d. Has acted as counsel to any person who is a private party to that proceeding within the past two years;
e. Has a personal financial interest in the outcome of the case or any other significant personal interest that could be substantially affected by the outcome of the case;
f. Has a spouse or relative within the third degree of relationship that is (1) a party to the case, or an officer, director or trustee of a party; (2) a lawyer in the case; (3) known to have an interest that could be substantially affected by the outcome of the case; or (4) likely to be a material witness in the case; or
g. Has any other legally sufficient cause to withdraw from participation in the decision making in the case.
3.9(2) The term “personally investigated” means taking affirmative steps to interview witnesses directly or to obtain documents or other information directly. The term “personally investigated” does not include general direction and supervision of assigned investigators, unsolicited receipt of information which is relayed to assigned investigators, review of another person’s investigative work product in the course of determining whether there is probable cause to initiate a proceeding, or exposure to factual information while performing other agency functions, including fact gathering for purposes other than investigation of the matter which culminates in a contested case. Factual information relevant to the merits of a contested case received by a person who later serves as presiding officer in that case shall be disclosed if required by Iowa Code section 17A.17 as amended by 1998 Iowa Acts, chapter 1202, section 19, and subrules 3.9(3) and 3.23(9).
3.9(3) In a situation where a presiding officer or other person knows of information which might reasonably be deemed to be a basis for disqualification and decides voluntary withdrawal is unnecessary, that person shall submit the relevant information for the record by affidavit and shall provide for the record a statement of the reasons for the determination that withdrawal is unnecessary.
3.9(4) To request disqualification of a presiding officer, a party shall file a motion supported by an affidavit pursuant to 1998 Iowa Acts, chapter 1202, section 19(7). The motion shall be filed as soon as practical after the reason alleged in the motion becomes known to the party. If, during the course of the hearing, a party first becomes aware of evidence of bias or other grounds for disqualification, the party may move for disqualification but shall establish the grounds by the introduction of evidence into the record.
If the presiding officer determines that disqualification is appropriate, the presiding officer shall withdraw. If the presiding officer determines that withdrawal is not required, the presiding officer shall enter an order to that effect. A party requesting disqualification may seek an interlocutory appeal under rule 3.25(17A) and seek a stay under rule 3.29(17A).
191—3.10(17A) Consolidation—severance.
3.10(1) The presiding officer may consolidate contested case proceedings where (a) the matters at issue involve common parties or common questions of fact or law; (b) consolidation would expedite and simplify consideration of the issues involved; and (c) consolidation would not adversely affect the rights of any of the parties to those proceedings.
3.10(2) The presiding officer may, for good cause shown, order any contested case proceedings or portions thereof severed.
3.11(1) Petition for intervention requirements:
a. Any petition required in a contested case proceeding shall be filed within 20 days of delivery of the notice of hearing or subsequent order of the presiding officer, unless otherwise ordered.
b. A petition shall state in separately numbered paragraphs the following:
(1) The persons or entities on whose behalf the petition is filed;
(2) The particular provisions of statutes and rules involved;
(3) The relief demanded and the facts and law relied upon for such relief; and
(4) The name, address and telephone number of petitioner and petitioner’s attorney, if any.
3.11(2) An answer to a petition for intervention shall be filed within 20 days of service of the petition unless otherwise ordered. A party may move to dismiss or apply for a more definite and detailed statement when appropriate.
a. An answer shall show on whose behalf it is filed and specifically admit, deny, or otherwise answer all material allegations of the pleading to which it responds. It shall state any facts deemed to show an affirmative defense and contain as many additional defenses as the pleader may claim.
b. An answer shall state the name, address and telephone number of the person filing the answer, the person or entity on whose behalf it is filed, and the attorney representing that person, if any.
c. Any allegation in the petition not denied in the answer is considered admitted. The presiding officer may refuse to consider any defense not raised in the answer which could have been raised on the basis of facts known when the answer was filed if any party would be prejudiced.
3.11(3) Any petition for intervention may be amended before a responsive pleading has been filed. Amendments to pleadings after a responsive pleading has been filed and to an answer may be allowed with the consent of the other parties or in the discretion of the presiding officer who may impose terms or grant a continuance.
191—3.12(17A) Service and filing of pleadings and other papers.
3.12(1) Every pleading, motion, document, or other paper filed in a contested case proceeding and every paper relating to discovery in such a proceeding shall be served upon each of the parties of record to the proceeding, including the person designated as advocate or prosecutor for the insurance division, at the time of filing. Except for an application for rehearing as provided in Iowa Code section 17A.16(2), the party filing a document is responsible for service on all parties.
3.12(2) Service upon a party represented by an attorney shall be made upon the attorney unless otherwise ordered. Service is made by delivering or mailing a copy to the attorney at the attorney’s last–known address. Service upon an unrepresented party shall be made by delivering or mailing a copy to the party’s last–known address. Service by mail is complete upon mailing, except where otherwise specifically provided by statute, rule, or order.
3.12(3) After the notice of hearing, all pleadings, motions, documents or other papers in a contested case proceeding shall be filed with the presiding officer.
3.12(4) Except where otherwise provided by law, a document is deemed filed at the time it is delivered to the presiding officer, delivered to an established courier service for immediate delivery to that office, or mailed by first–class mail or state interoffice mail to that office, so long as there is proof of mailing.
3.12(5) Proof of mailing includes either: a legible United States Postal Service postmark on the envelope, a certificate of service, a notarized affidavit, or a certification in substantially the following form: