519A.5 Policy forms and rates. 1. The rates, rating plans, rating classifications, and policy forms and endorsements applicable to insurance written by the association and the statistical and experience datarelating thereto shall be subject to sections 519A.2 through 519A.4, this section, and sections519A.6 through 519A.13 and to the provisions of the general insurance code which are notinconsistent with the purposes and provisions of this chapter. 2. All policies issued by the association shall provide for a continuous period of coverage beginning with their respective effective dates. All policies shall terminate at 12:01 a.m. twoyears from the date of finding of an emergency by the commissioner, or earlier in accordancewith sections 519A.2 through 519A.4, this section, and sections 519A.6 through 519A.13; orbecause of failure of the policyholder to pay any premium or stabilization reserve fund chargeor portion of either when due. All policies shall be issued subject to the group retrospectiverating plan and the stabilization reserve fund authorized by this chapter. No policy form shallbe used by the association unless it has been filed with and approved by the commissioner. 3. trospectiverating plan and the stabilization reserve fund authorized by this chapter. No policy form shallbe used by the association unless it has been filed with and approved by the commissioner. 3. The commissioner shall specify whether policy forms and the rate structure shall be on a 'claims-made' or 'occurrence' basis and coverage shall be provided by the associationonly on the basis specified by the commissioner. The commissioner shall specify the 'claims-made' basis only if the contract makes provision for residual 'occurrence' coverageupon the retirement, death, disability or removal from this state of the insured. Provisionmay be made for a premium charge allocable to any such residual 'occurrence' coverageand such premium charges for such residual coverage shall be segregated and separatelymaintained for such purpose which may include the reinsurance of all or a part of thatportion of the risk. 4. The rates, rating plans, rating rules, and rating classifications applicable to the insurance written by the association shall be on an actuarially sound basis, giving dueconsideration to the group retrospective rating plan and the stabilization reserve fund, andshall be able to the insurance written by the association shall be on an actuarially sound basis, giving dueconsideration to the group retrospective rating plan and the stabilization reserve fund, andshall be calculated to be self-supporting. 5. All policies issued by the association shall be subject to a nonprofit group retrospective rating plan to be approved by the commissioner under which the final premium for allpolicyholders of the association, as a group, will be equal to the administrative expenses,loss and loss adjustment expenses and taxes, plus a reasonable allowance for contingenciesand servicing. Policyholders shall be given full credit for all investment income, net ofexpenses and a reasonable management fee, on policyholder supplied funds. The standardpremium, before retrospective adjustment, for each policy issued by the association shallbe established for portions of the policy period coinciding with the association’s fiscal yearon the basis of the association’s rates, rating plans, rating rules, and rating classificationsthen in effect. The maximum final premium for all policyholders of the association, as agroup, shall be limited as provided in section 519A.6, subsection lans, rating rules, and rating classificationsthen in effect. The maximum final premium for all policyholders of the association, as agroup, shall be limited as provided in section 519A.6, subsection 5. Since the business ofthe association is subject to the nonprofit group retrospective rating plan required by thissubsection, there shall be a presumption that the rates filed and premiums imposed by theassociation are not unreasonable or excessive. 6. The association shall certify to the commissioner the estimated amount of any deficit remaining after the stabilization reserve fund has been exhausted in payment of themaximum final premium for all policyholders of the association. Within sixty days after thatcertification the commissioner shall authorize the members of the association to commencerecoupment of their respective shares of the deficit by deducting their share of the deficitfrom past or future premium taxes due the state of Iowa. The association shall amendthe amount of its certification of deficit to the commissioner as the values of its incurredlosses become finalized and the members of the association shall amend their recoupmentprocedure accordingly. 7. mount of its certification of deficit to the commissioner as the values of its incurredlosses become finalized and the members of the association shall amend their recoupmentprocedure accordingly. 7. In the event that sufficient funds are not available for the sound financial operation of the association, all members shall contribute to the financial requirements of the association Sat Dec 23 00:51:50 2023 Iowa Code 2024, Section 519A.5 (17, 0) §519A.5, MEDICAL MALPRACTICE INSURANCE 2 in the manner provided for in section 519A.8. Any contribution shall be reimbursed to themembers by recoupment as provided in subsection 6. [C77, 79, 81, §519A.5]2002 Acts, ch 1111, §33; 2016 Acts, ch 1073, §154Referred to in §519A.1, 519A.2, 519A.3, 519A.4, 519A.10, 519A.13 Sat Dec 23 00:51:50 2023 Iowa Code 2024, Section 519A.5 (17, 0)
Iowa Legal Code