The bill establishes a health insurance pool for municipal employees in Iowa, requiring the Department of Administrative Services to contract with a health carrier for its administration. It mandates the department to conduct a reverse auction to accept bids from health carriers for health benefit plans, with the first auction to be completed by July 1, 2028. Municipalities must submit a letter of intent to participate in the pool by July 1, 2027, and the pool will only be established if at least 10% of the counties and cities in the state opt in. Once established, any municipality can join the pool.

Additionally, the bill outlines the responsibilities of the department in administering the health insurance pool, including the evaluation of bids and the management of administrative costs, which municipalities will reimburse based on their size. The bill also stipulates that the Commissioner of Insurance will adopt rules to facilitate its implementation. The reverse auction process is designed to ensure competitive pricing for health benefit plans, with provisions for market checks and the ability to vacate auction outcomes if bids do not meet cost expectations.