House File 226 - Introduced
HOUSE FILE 226
BY BODEN
A BILL FOR
1 An Act relating to secondary health benefit plans’ access to
2 explanation of benefits from primary health benefit plans.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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 H.F. 226
1 Section 1. NEW SECTION. 514A.16 Explanation of benefits ——
2 secondary health benefit plans.
3 1. As used in this section, unless the context otherwise
4 requires:
5 a. “Covered person” means the same as defined in section
6 514J.102.
7 b. “Explanation of benefits” means a statement provided to a
8 covered person by the covered person’s health benefit plan that
9 explains the costs that the health benefit plan will cover for
10 the health care services received by the covered person.
11 c. “Health benefit plan” means a policy, contract,
12 certificate, or agreement offered or issued by a health carrier
13 to provide, deliver, arrange for, pay for, or reimburse any of
14 the costs of health care services.
15 d. “Health care services” means the same as defined in
16 section 514J.102.
17 2. If a covered person’s secondary health benefit plan
18 requests a copy of an explanation of benefits from a covered
19 person’s primary health benefit plan, the primary health
20 benefit plan shall provide a copy of the explanation of
21 benefits no later than twenty calendar days from the date of
22 the request.
23 EXPLANATION
24 The inclusion of this explanation does not constitute agreement with
25 the explanation’s substance by the members of the general assembly.
26 This bill relates to secondary health benefit plans’ (plan)
27 access to explanation of benefits from primary health benefit
28 plans. If a covered person’s secondary plan requests a copy
29 of an explanation of benefits (EOB) from a covered person’s
30 primary plan, the primary plan shall provide a copy of the EOB
31 no later than 20 calendar days from the date of the request.
32 “EOB” is defined in the bill.
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