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Health insurance continuation coverage — Iowa

Iowa law and the Consolidated Omnibus Budget Reconciliation Act (COBRA) require employers to provide continuation of health insurance coverage to employees (and dependents) who lose employer-provided coverage due to events such as job loss, job change, or divorce.

Iowa’s continuation coverage laws are found in Chapter 509B of the Iowa Code. Chapter 509B of the Iowa Code provides that group accident or health insurance policies issued by an insurance company or health maintenance organization (HMO) in the state of Iowa must provide certain continuation rights. However, self-insured plans are not subject to the Iowa continuation law.

COBRA applies to private and public employers (excluding the federal government) with 20 or more employees.

Iowa Code Chapter 509B technically applies to all group health insurance policies issued or provided in the state. The administrative rules provide that an employer who is subject to COBRA and satisfies its requirements will automatically satisfy Iowa Code Chapter 509B. Therefore, as a practical matter, Iowa continuation applies only to employers of fewer than 20 employees.

This chapter will first discuss coverage and responsibilities for these employers with 20 or fewer employees (who are not covered by COBRA) and...


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