509A.15 Certification of self-insurance plans — exemption. 1. a. Within ninety days following the end of a fiscal year, the governing body of a self-insurance plan of a political subdivision or a school corporation shall file with thecommissioner of insurance a certificate of compliance, actuarial opinion, and an annualfinancial report. The filing shall be accompanied by a fee of one hundred dollars. A penaltyof fifteen dollars per day shall be assessed for failure to comply with the ninety-day filingrequirement, except that the commissioner may waive the penalty upon a showing thatspecial circumstances exist which justify the waiver. The certificate shall be signed anddated by the appropriate public official representing the governing body, and shall certifythe following: (1) That the plan meets the requirements of this chapter and the applicable provisions of the Iowa administrative code. (2) That an actuarial opinion has been attached to the certificate which attests to the adequacy of reserves, rates, and financial condition of the plan. (3) That a written complaint procedure has been implemented. uarial opinion has been attached to the certificate which attests to the adequacy of reserves, rates, and financial condition of the plan. (3) That a written complaint procedure has been implemented. The certificate shall also list the number of complaints filed by participants under the written complaint procedure,and the percentage of participants filing written complaints, in the prior fiscal year. (4) That the governing body has contracted or otherwise arranged with a third-party administrator who holds a current certificate of registration issued by the commissionerpursuant to section 510.21, or with a person not required to obtain the certificate as athird-party administrator as defined in section 510.11, subsection 2. b. The actuarial opinion must include but is not limited to a brief commentary about the adequacy of the reserves, rates, and the financial condition of the plan, a test of the prioryear claim reserve, a brief description of how the reserves were calculated, and whether ornot the plan is able to cover all reasonably anticipated expenses. The actuarial opinion shallbe prepared, signed, and dated by a person who is a member of the American academy ofactuaries. whether ornot the plan is able to cover all reasonably anticipated expenses. The actuarial opinion shallbe prepared, signed, and dated by a person who is a member of the American academy ofactuaries. c. If necessary, the actuary should assist the public body in preparing the annual financial report. The annual financial report shall be in a format as prescribed by the commissioner. 2. The commissioner shall by rule require the maintenance of confidentiality of information held by the plan administrator. 3. The failure of the governing body to provide the certificate of compliance required by subsection 1, or the failure of the governing body or plan administrator to abide by arequirement of the plan, this chapter, or applicable rule, is grounds for action against theplan, including cause for disapproval or discontinuance of the plan. 4. a. One or more political subdivisions of the state or one or more school corporations maintaining self-insured plans with yearly claims that do not exceed two percent of eachentity’s general fund budget shall be exempt from the requirements of this section wherethe plan insures employees for all or part of a deductible, coinsurance payments, drug xceed two percent of eachentity’s general fund budget shall be exempt from the requirements of this section wherethe plan insures employees for all or part of a deductible, coinsurance payments, drug costs,short-term disability benefits, vision benefits, or dental benefits. b. The yearly claim amount shall be determined annually on the policy renewal date, or an alternative date established by rule, by a plan administrator or political subdivision orschool corporation employee to be designated by the plan administrator. The exemption shallnot apply for the year following a year in which yearly claims are determined to exceed twopercent of the political subdivision’s or school corporation’s general fund budget. 88 Acts, ch 1112, §104; 92 Acts, ch 1162, §14; 93 Acts, ch 88, §10; 2000 Acts, ch 1200, §1; 2003 Acts, ch 91, §12; 2006 Acts, ch 1117, §34, 35; 2012 Acts, ch 1023, §109 Sat Dec 23 00:42:02 2023 Iowa Code 2024, Section 509A.15 (18, 0)
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