reglab/housing_qa huggingface dataset:
IA Code § 514C.25 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.25 - Coverage for prosthetic devices.

514C.25 Coverage for prosthetic devices.   1. a. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall provide coverage benefits for medically necessary prosthetic devices when prescribed by a physician licensed under chapter 148. Such coverage benefits for medically necessary prosthetic devices shall provide coverage for medically necessary prosthetic devices that, at a minimum, equals the coverage and payment for medically necessary prosthetic devices provided under the most recent federal laws for health insurance for the aged and disabled pursuant to 42 U.S.C. §1395k, 13951, and 1395m, and  42 C.F.R. §410.100  ,  414.202  ,  414.210  , and  414.228  , as applicable.   b. For the purposes of this section, “prosthetic device” means an artificial limb device to replace, in whole or in part, an arm or leg.   2. a. This section applies to the following classes of third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after July 1, 2009:   (1) Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.   (2) An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.   (3) An individual or group health maintenance organization contract regulated under chapter 514B.   (4) A plan established pursuant to chapter 509A for public employees.   b. This section shall not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.   3. Notwithstanding subsection 1, paragraph “a”, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses that is issued for use in connection with a health savings account as authorized under Tit. XII of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. No. 108-173, may impose the same deductibles and out-of-pocket limits on the prosthetics coverage benefits required in this section that apply to substantially all health, medical, and surgical coverage benefits under the policy, contract, or plan.  2009 Acts, ch 89, §1; 2017 Acts, ch 148, §77
IA Code § 514C.29 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.29 - Services provided by a doctor of chiropractic.

514C.29 Services provided by a doctor of chiropractic.   1. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not impose a copayment or coinsurance amount on an insured for services provided by a doctor of chiropractic licensed pursuant to chapter 151 that is greater than the copayment or coinsurance amount imposed on the insured for services provided by a person engaged in the practice of medicine and surgery or osteopathic medicine and surgery under chapter 148 for the same or a similar diagnosed condition even if a different nomenclature is used to describe the condition for which the services are provided.   2. This section applies to the following classes of third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after July 1, 2012:   a. Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.   b. An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.   c. An individual or group health maintenance organization contract regulated under chapter 514B.   d. A plan established pursuant to chapter 509A for public employees.   3. This section shall not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.  2012 Acts, ch 1138, §36; 2017 Acts, ch 148, §81
IA Code § 514C.30 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.30 - Services provided by a physical therapist, occupational therapist, or speech pathologist.

514C.30 Services provided by a physical therapist, occupational therapist, or speech pathologist.   1. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not impose a copayment or coinsurance amount on an insured for services provided by a physical therapist licensed pursuant to chapter 148A, by an occupational therapist licensed pursuant to chapter 148B, or by a speech pathologist licensed pursuant to chapter 154F that is greater than the copayment or coinsurance amount imposed on the insured for services provided by a person engaged in the practice of medicine and surgery or osteopathic medicine and surgery under chapter 148 for the same or a similar diagnosed condition even if a different nomenclature is used to describe the condition for which the services are provided.   2. This section applies to the following classes of third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after July 1, 2015:   a. Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.   b. An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.   c. An individual or group health maintenance organization contract regulated under chapter 514B.   d. A plan established pursuant to chapter 509A for public employees.   3. This section shall not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.  2015 Acts, ch 137, §101, 162, 163; 2017 Acts, ch 148, §82
IA Code § 514C.33 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.33 - Services provided by provisionally licensed psychologists.

514C.33 Services provided by provisionally licensed psychologists.   1. Notwithstanding section 514C.6, a policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment of necessary behavioral health services provided by a person who holds a provisional license to practice psychology pursuant to section 154B.6, and who practices under the supervision of a supervisor who meets the qualifications determined by the board of psychology by rule.   2. A policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than the authority already granted by law, including the authority to provide supervision in person or remotely through electronic means as specified by rule of the board of psychology.   3. The requirements of this section apply to and supersede any conflicting requirements regarding services provided under a policy or contract which is delivered, issued for delivery, continued, or renewed in this state on or after June 1, 2018, and apply to and supersede any conflicting requirements regarding services contained in an existing policy or contract on the policy’s or contract’s anniversary or renewal date, whichever is later.   4. For the purposes of this section, third-party payment or prepayment includes an individual or group policy of accident or health insurance or individual or group hospital or health care service contract issued pursuant to chapter 509, 514, or 514A, an individual or group health maintenance organization contract issued and regulated under chapter 514B, or a preferred provider organization contract regulated pursuant to chapter 514F.   5. Nothing in this section shall be interpreted to require an individual or group health maintenance organization or a preferred provider organization or arrangement to provide payment or prepayment for services provided by a provisionally licensed psychologist providing behavioral health services under the supervision of a supervisor as specified in this section, unless the supervisor has entered into a contract or other agreement to provide behavioral health services with the individual or group health maintenance organization or the preferred provider organization or arrangement.  2018 Acts, ch 1165, §138, 139; 2019 Acts, ch 59, §236, 240
IA Code § 514C.34 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.34 - Health care services delivered by telehealth — coverage.

514C.34 Health care services delivered by telehealth — coverage.   1. As used in this section, unless the context otherwise requires:   a. “Health care professional” means the same as defined in section 514J.102.   b. “Health care services” means the same as defined in section 514J.102 and includes services for mental health conditions, illnesses, injuries, or diseases.   c. “Telehealth” means the delivery of health care services through the use of interactive audio and video. “Telehealth” does not include the delivery of health care services through an audio-only telephone, electronic mail message, or facsimile transmission.   2. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not discriminate between coverage benefits for health care services that are provided in person and the same health care services that are delivered through telehealth.   3. Health care services that are delivered by telehealth must be appropriate and delivered in accordance with applicable law and generally accepted health care practices and standards prevailing at the time the health care services are provided, including all rules adopted by the appropriate professional licensing board, pursuant to chapter 147, having oversight of the health care professional providing the health care services.   4. This section applies to the following classes of third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2019:   a. Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.   b. An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.   c. An individual or group health maintenance organization contract regulated under chapter 514B.   d. A plan established pursuant to chapter 509A for public employees.   5. This section shall not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.   6. The commissioner of insurance may adopt rules pursuant to chapter 17A as necessary to administer this section.  2018 Acts, ch 1055, §1  Referred to in §280A.1, 514C.35
IA Code § 514C.35 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES|Section 514C.35 - Behavioral health services provided in a school — coverage.

514C.35 Behavioral health services provided in a school — coverage.   1. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not deny coverage or payment for behavioral health services, including behavioral health services provided via telehealth, solely because the services are delivered in a school.   2. Nothing in this section shall be interpreted to do any of the following:   a. Require an insurer to pay for behavioral health services that are otherwise excluded from coverage under a policy, contract, or plan.   b. Require an insurer to pay for behavioral health services that are provided by an individual employed by or under contract with a school district or an educational service agency in a regular full-time or part-time position, or any other party that has not entered into a provider agreement with the insurer.   c. Prevent application of any other provision of a policy, contract, or plan.   3. This section applies to third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021, and to claims for reimbursement under such policies, contracts, or plans incurred on or after January 1, 2021.   4. For the purposes of this section:   a. “Behavioral health services” means services provided by a health care professional operating within the scope of the health care professional’s practice which address mental, emotional, medical, or behavioral conditions, illnesses, diseases, or problems.   b. “Educational service agency” means a governmental agency or government entity which is established and operated exclusively for the purpose of providing educational services to one or more educational institutions.   c. “Health care professional” means a physician or other health care practitioner licensed, accredited, registered, or certified to perform specified health care services consistent with state law.   d. “School” means all of the following:   (1) Any school, other than a public school, that is accredited pursuant to section 256.11 for any and all levels for grades one through twelve.   (2) Any school directly supported in whole or in part by taxation.   (3) An area education agency established pursuant to chapter 273.   e. “School district” means a school district described in chapter 274.   f. “Telehealth” means the same as defined in section 514C.34.  2020 Acts, ch 1105, §5; 2020 Acts, ch 1121, §66, 70  NEW section
IA Code § 514D.1 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES|Section 514D.1 - Purpose.

514D.1 Purpose.   The purpose of this chapter is to provide reasonable standardization, simplification, and disclosure of the terms and coverages of individual accident and sickness insurance policies issued under chapter 514A and individual subscriber contracts issued under chapter 514, in order to facilitate public understanding and comparison and to eliminate provisions which may be misleading or unreasonably confusing in connection with the purchase of coverage or the settlement of claims.  [C81, §514D.1]
IA Code § 514D.2 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES|Section 514D.2 - Definitions.

514D.2 Definitions.   As used in this chapter, unless the context otherwise requires:   1. “Accident and sickness insurance” means individual accident and sickness insurance within the meaning of section 514A.1. “Accident and sickness insurance” also means individual subscriber contracts for hospital service, or medical and surgical service, or individual pharmaceutical or optometric service issued under chapter 514, and for purposes of this chapter, corporations issuing contracts under chapter 514 are deemed to be engaged in the business of insurance.   2. “Form” means and includes policies, contracts, riders, endorsements and applications used in connection with the sale of accident and sickness insurance under chapter 514 or chapter 514A.   3. “Medicare” means the Health Insurance for the Aged Act, Tit. XVIII of the United States Social Security Act added by the amendment of 1965 as amended on or before July 1, 1980.   4. “Policy” means the entire contract between the insurer and the insured, including the policy riders, endorsements, and the application, if attached, and includes individual subscriber contracts issued under chapter 514.  [C81, §514D.2]  2013 Acts, ch 90, §154
IA Code § 514D.3 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES|Section 514D.3 - Standards for policies established.

514D.3 Standards for policies established.   1. The commissioner shall issue rules to establish specific standards, including standards of full and fair disclosure, that set forth the manner, content, and required disclosure for the sale of policies of individual accident and sickness insurance and individual subscriber contracts which shall be in addition to and in accordance with applicable laws of this state, including but not limited to sections 514A.1 to 514A.12. These rules may include, but shall not be limited to, any of the following subjects:   a. Terms of renewability.   b. Initial and subsequent conditions of eligibility.   c. Nonduplication of coverage provisions.   d. Coverage of dependents.   e. Coverage of persons eligible for Medicare by reason of age.   f. Preexisting conditions.   g. Termination of insurance.   h. Probationary periods.   i. Limitations.   j. Exceptions.   k. Reductions.   l. Elimination periods.   m. Requirements for replacement.   n. Recurrent conditions.   o. The definition of terms, including but not limited to the following: Hospital, accident, sickness, injury, physician, accidental means, total disability, partial disability, nervous disorder, guaranteed renewable, and noncancelable.   2. The commissioner may issue rules with respect to policies of individual accident and sickness insurance and individual subscriber contracts that specify prohibited policies or subscriber contracts, or prohibited policy or contract provisions which the commissioner finds to be unjust, unfair, or unfairly discriminatory to the policyholder or any person insured under the policy or any beneficiary. This subsection does not authorize the commissioner to prohibit a policy or policy provision or subscriber contract or contract provision which is specifically authorized by statute.   3. A rule issued by the commissioner under this section shall not apply to a conversion policy issued pursuant to a contractual conversion privilege under a group or individual policy of accident and sickness insurance when such group or individual contract contains provisions that are inconsistent with the requirements of this chapter or any rule issued under this chapter.   4. A rule issued by the commissioner under this section shall not apply to policies being issued to employees or members being added to a franchise plan, as defined in section 509.14, which is in existence on the effective date of the rule.  [C81, §514D.3]
IA Code § 514D.4 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES|Section 514D.4 - Standards for benefits established.

514D.4 Standards for benefits established.   1. The commissioner shall issue rules to establish minimum standards for benefits under each of the following categories of coverage contained in policies of individual accident and sickness insurance or subscriber contracts:   a. Basic hospital expense coverage.   b. Basic medical-surgical expense coverage.   c. Hospital confinement indemnity coverage.   d. Major medical expense coverage.   e. Disability income protection coverage.   f. Accident-only coverage.   g. Specified disease or specified accident coverage.   h. Medicare supplement coverage.   i. Limited benefit health coverage.   2. This section does not prohibit the issuance of a policy which combines two or more of the categories of coverage enumerated in paragraphs “a” to “f” of subsection 1. A category of coverage referred to in paragraph “g”, “h” or “i” of subsection 1 shall not be combined in a policy or contract either with another category of coverage referred to in paragraph “g”, “h” or “i” of subsection 1 or with a category of coverage referred to in any of paragraphs “a” to “f” of subsection 1 unless a rule issued by the commissioner specifically authorizes that combination of coverages.   3. The commissioner shall prescribe the method of identification of policies and contracts based upon coverages provided.   4. A policy of accident and sickness insurance or subscriber contract shall not be delivered or issued for delivery in this state unless the policy or contract meets the minimum standards prescribed under this section.   5. The commissioner may upon notice and hearing at any time after the initial filing or approval of any individual accident and sickness policy or subscriber contract form, withdraw approval or suspend further sale of the form if the benefits provided are unreasonable in relation to the premium charge. The commissioner shall establish reasonable and creditable anticipated minimum loss ratios for Medicare supplement and other accident and sickness insurance policies.   6. A rule issued by the commissioner under this section shall not apply to a conversion policy issued pursuant to a contractual conversion privilege under a group or individual policy of accident and sickness insurance when such group or individual contract contains provisions which are inconsistent with the requirements of this chapter or any rule issued under this chapter.   7. A rule issued by the commissioner under this section shall not apply to policies being issued to employees or members being added to a franchise plan, as defined in section 509.14, which is in existence on the effective date of the rule.  [C81, §514D.4; 81 Acts, ch 167, §2]  92 Acts, ch 1162, §34  Referred to in §508C.3, 514D.5
IA Code § 514D.6 (2021)
2021 Iowa Code|Title XIII - COMMERCE|Chapter 514D - ACCIDENT AND SICKNESS INSURANCE POLICIES|Section 514D.6 - Limitation on defenses.

514D.6 Limitation on defenses.   Notwithstanding section 514A.3, subsection 1, paragraph “b”, subparagraph 2, or any contrary provision of chapter 514, if the issuer of the policy of accident and sickness insurance or subscriber contract elects to use a simplified application form, with or without a question as to the applicant’s health at the time of application, but without any questions concerning the insured’s health history or medical treatment history, the policy or contract must cover any loss occurring after twelve months from the date of issue of the policy or contract from any preexisting condition not specifically excluded from coverage by terms of the policy or contract, and, except as so provided, the policy or contract shall not include wording that would permit a defense based upon preexisting conditions.  [C81, §514D.6]