Iowa public bodies (cities, counties, school districts, some hospitals) that maintain a self-insured group healthcare plan for its employees, are required to file a certification and a financial summary with the Iowa Insurance Division; this is done annually.  An executive summary of the legal requirements are shown below:
 
  • The governing statutes for Iowa public body self-insured plans are Iowa Code sections 509A.14 and 509A.15.
    Public body self-insured plans are subject to minimum plan standards pursuant to Iowa Administrative Code rule 191-35.20; state mandated benefits are required including those mandated by Iowa Code chapter 514C.  
  • The plan must contract with an independent actuary to attest to the adequacy of the reserves, rates, and the overall financial condition of the plan.
  • A separate plan fund must be established exclusively for the deposit of premiums and other assets pertaining to the plan.  The plan fund shall be disbursed only for specified plan expenses.  Iowa Administrative Code rule 191-35.20(3)(f) lists specific examples of plan expenses.
  • The plan must hold enough funds to cover the estimated required reserves, i.e., IBNR claim reserve and a claims fluctuation reserve .  The independent actuary determines the magnitude of these two reserves.
  • The public body must increase premiums rates (funding) or transfer funds from other sources (general fund, etc) if the plan is in a deficit mode.
  • The public body must contract with a registered third party administrator or licensed insurance company to administer the plan.
  • The plan must maintain aggregate and specific stop-loss coverage to protect the plan from catastrophic claims.
  • The financial summary and the actuarial opinion are reviewed to assess the financial condition of the plan.  The review includes an analysis of the loss experience, claim reserves, and trends.  If the plan reports a net loss for the year, the Iowa Insurance Division may recommend an increase in the funding rate, or request the public body’s administrative plan to eliminate the shortfall of funds.  The balance in the plan fund must be large enough to cover the required statutory reserves, i.e., IBNR and claims fluctuation reserve.
  • The State of Iowa 509A Certificate of Compliance and the financial summary page can be downloaded here.
  • For 28E self-funded Iowa public body multiple pool groups (multiple Iowa counties in a pool group -- for example), the plan must maintain a claims fluctuation reserve equivalent to two month of paid claims.  In addition, 28E pool groups must file quarterly financial statements as opposed to annual summaries required for single entity plans described above.  

New 28E plans that wish to self-fund under 509A must submit their 28E agreement to the Division for approval.  Additional requirements for 28E pool groups are contained in Iowa Administrative Code rule 191-35.20(2).  

Important changes regarding the submission of Iowa Public Body Self-insured Group Healthcare plans (509A and 28E plans)

The Iowa Insurance Division has implemented a new electronic process for the submission of the 509A Certificates of compliance. Effective July 1, 2020 all submissions must be submitted electronically via OPTins. All groups must continue to file their submissions on an annual basis within ninety days following the end of a fiscal year.

Please contact OPTins at optinsmktg@naic.org or 816-783-8787 to create an account.

Once you have created an account, please create a filing for the correct filing year (this is the fiscal year of the filing) under Iowa Renewals Reports and Applications. Entity type should be 509A Group. Filing Period Type should be 509A Group Annual.

Once you have created a filing you will be prompted to download the 509A renewal excel sheet. The first two tabs (Application or Renewal and Certificate of Compliance) are required to be completed. You may choose to complete the third tab or upload a copy of the financial summary in a separate attachment. Once you have completed the excel sheet save a copy of the completed form to your computer and upload the completed excel into OPTins.

If you need to make any changes to your filing please amend your filing and upload the corrected documents. This will ensure that the filing is edited and no duplicate filings are received.

Please contact OPTins at optinshelp@naic.org or 816-783-8500 for assistance with submitting your filing.

OPTins is a simple three-step process which facilitates the electronic submission of premium taxes, surplus lines taxes and state-specific filings. Fees are transmitted via ACH debit or ACH credit, to assure that your funds will be received by the state in a timely and secure manner. There is no special software to purchase or licensing fees - only a transaction fee of $10.00 per filing.
 
Getting started is easy. For ACH debit, please click on the following link, http://www.optins.org/getting_started.htm and complete the Implementation Forms - All Other (ACH Debit). If you would like to utilize ACH credit, please click on the previously mentioned link and complete the Implementation Forms - All Other (ACH Credit). Please note, ACH Credit is not a credit card. OPTins does not accept credit card payments. For more information on ACH debit and credit, please click on the following link http://www.optins.org/documents/OPTins_EFT_Implementation_Guide_Industry...

Once your paperwork is completed, please email to optinsmktg@naic.org. We will then begin the implementation process. Account setup takes about 7-10 business days.

ACH Debit

Please ensure your bank account does not have a debit block. If it does, you will need to provide your bank our Originator ID below to lift the debit block for NAIC/OPTins transactions. Additionally, if you will have large dollar amounts due, make sure your debit threshold is high enough to allow the debits to occur. If a debit block impedes the withdrawal, this may impact or delay your filings to the state. While you check this, the OPTins team will begin the account setup and follow up with you on any questions and next steps. We will send out logins once the account is setup.

Company ID (ACH Origination Number): 9870877295
Debiting Bank Account Name: NAIC

ACH Credit

If using the ACH Credit, step one is a penny test. This entails the transfer of a penny to ensure that you can push money to the NAIC with the required addenda information. The product specialist you work with will send you further info regarding the test. The penny test must be successful before the OPTins account can be setup.

If you have any questions, please do not hesitate to give our marketing team a call at 816-783-8787.

Frequently asked questions:

Why is the process going online? – The Iowa Insurance Division has received many requests to have our processes updated to allow for electronic submission. As many individuals are working remotely we have developed this method of submission to allow for continued submissions.

Is the registration process through the NAIC legitimate? – Yes, the Iowa Insurance Division utilizes several of the NAIC’s products for submissions and filing requirements.

Who is supposed to file the 509A? – The public entity will need to submit the filing.

Do I have to submit my filing online, or can I continue to mail in? – You will be required to submit your filing online effective July 1, 2020.

Do I have to pay for the filing online, or can I mail a check in? – You will need to submit the filing fee electronically and checks will no longer be accepted.

Will funds be withdrawn from my entity’s bank account, or can I push the filing fee to the IID (or whoever receives)?  Please see the information above regarding the two different payment options.

What is my NAIC # and my Group #? – Please leave these two items blank. 509A groups are not assigned these numbers.

How will information from my actuary be filed online? – Please upload the information or statement from your actuary as a separate attachment in the supporting documents.

Contact Us

If you need assistance, please contact the Iowa Insurance Division.