Senate File 565 - Introduced SENATE FILE 565 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO SSB 1039) A BILL FOR An Act providing for the continuation of health insurance in 1 certain circumstances for the surviving spouse and each 2 surviving child of employees of the state of Iowa and 3 including retroactive applicability provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1361SV (3) 91 nls/ko
S.F. 565 Section 1. NEW SECTION . 509A.13E Health insurance coverage 1 surviving spouse and children of employees of the state of 2 Iowa. 3 1. For the purposes of this section, eligible employee 4 of the state of Iowa means an employee of the state of 5 Iowa, including but not limited to any department, agency, 6 board, bureau, or commission of the state of Iowa, who is 7 participating in a state health or medical group insurance plan 8 under chapter 509A which covers the employee at the time of 9 death of the employee and whose death has been determined by 10 the department of administrative services to be the direct and 11 proximate result of a traumatic personal injury incurred in the 12 performance of the employees work duties, and to whom none of 13 the following applies: 14 a. The employees death resulted from stress, strain, 15 occupational illness, or a chronic, progressive, or congenital 16 illness, including but not limited to a disease of the heart, 17 lungs, or respiratory system, unless the traumatic personal 18 injury was a substantial contributing factor to the employees 19 death. 20 b. The employees death was caused by the employees 21 intentional misconduct, or by the employees intent to cause 22 the employees own death. 23 c. The employee was voluntarily intoxicated at the time of 24 the employees death. 25 d. The employee was performing the employees duties in a 26 grossly negligent manner at the time of the employees death. 27 2. a. The governing body of the state shall permit 28 continuation of existing health insurance coverage or 29 reenrollment in previously existing coverage for the surviving 30 spouse and each surviving child of an eligible employee of the 31 state of Iowa. 32 b. The governing body of the state shall permit continuation 33 of existing health insurance coverage for the surviving spouse 34 and each surviving child of an employee of the state of Iowa 35 -1- LSB 1361SV (3) 91 nls/ko 1/ 4
S.F. 565 who dies and who is reasonably expected to be determined to be 1 an eligible employee of the state of Iowa, until such time as 2 the determination of eligibility is made. 3 3. The governing body of the state shall not be required to 4 pay for the cost of the health insurance under this section; 5 however, the governing body of the state may pay the full cost 6 or a portion of the cost of the health insurance, in which case 7 the department, agency, board, bureau, commission, or other 8 employing entity of the eligible employee of the state of Iowa 9 shall bear the cost of such health insurance. If the full 10 cost or a portion of the cost of the coverage is not paid by 11 the governing body of the state, the surviving spouse and each 12 surviving child who is eligible for health insurance under this 13 section may elect to continue coverage by paying that portion 14 of the cost of the health insurance not paid by the governing 15 body of the state. 16 4. The governing body of the state shall notify the 17 provider of health insurance coverage for state employees of 18 the identity of the surviving spouse and each surviving child 19 who is to be provided health insurance coverage pursuant to the 20 requirements of this section. 21 5. The governing body of the state shall implement 22 continuation of health insurance coverage for the surviving 23 spouse and each surviving child of an eligible employee of 24 the state of Iowa in a manner that ensures that the health 25 insurance coverage provided under this section is the payor of 26 last resort. 27 6. a. This section shall not require continuation of health 28 insurance coverage if the surviving spouse or a surviving child 29 who would otherwise be entitled to continuation of health 30 insurance coverage under this section was, through the actions 31 of the surviving spouse or the surviving child, a substantial 32 contributing factor to the death of the eligible employee of 33 the state of Iowa. 34 b. This section shall not require continuation of health 35 -2- LSB 1361SV (3) 91 nls/ko 2/ 4
S.F. 565 insurance coverage if the surviving spouse or a surviving child 1 becomes ineligible for health insurance coverage under the 2 terms of the health insurance coverage obtained by the state 3 for reasons other than the death of the eligible employee of 4 the state of Iowa, including but not limited to ineligibility 5 under this chapter, remarriage of the surviving spouse, or 6 ineligibility for continuing coverage for a surviving child 7 pursuant to section 509A.13B. 8 Sec. 2. RETROACTIVE APPLICABILITY. This Act applies 9 retroactively to January 1, 2024. 10 EXPLANATION 11 The inclusion of this explanation does not constitute agreement with 12 the explanations substance by the members of the general assembly. 13 This bill provides for the continuation of health insurance 14 (insurance) in certain circumstances for the surviving spouse 15 (spouse) and each surviving child (child) of an eligible 16 employee of the state of Iowa (eligible employee). The bill 17 defines eligible employee as an employee of the state of 18 Iowa, including but not limited to any department, agency, 19 board, bureau, or commission of the state of Iowa, who is 20 participating in a state health or medical group insurance 21 plan under Code chapter 509A which covers the employee at the 22 time of death of the employee and whose death is determined by 23 the department of administrative services to be the direct and 24 proximate result of a traumatic personal injury incurred in 25 the performance of their work duties, and to whom none of the 26 factors detailed in the bill apply. 27 The state must permit continuation of existing insurance, or 28 reenrollment in previously existing insurance, for the spouse 29 and each child of an eligible employee. The bill requires 30 the state to permit continuation of existing insurance for 31 the spouse and each child of an employee who dies and who 32 is reasonably expected to be determined to be an eligible 33 employee, until the determination of eligibility is made. 34 The bill does not require the state to pay for the cost of 35 -3- LSB 1361SV (3) 91 nls/ko 3/ 4
S.F. 565 the insurance; however, the state may pay the full cost or 1 a portion of the cost, in which case the department, agency, 2 board, bureau, commission, or other employing entity of the 3 eligible employee shall bear the cost of such insurance. If 4 the full cost or a portion of the cost of the insurance is not 5 paid by the state, the spouse and each child who is eligible 6 for insurance may elect to continue coverage by paying that 7 portion of the cost of the insurance not paid by the state. 8 The state must notify the provider of the insurance of the 9 identity of the spouse and each child who is to be provided 10 insurance pursuant to the requirements of the bill. 11 The state shall implement continuation of insurance under 12 the bill in a manner that ensures the coverage under the bill 13 is the payor of last resort. 14 The bill does not require continuation of insurance if 15 the spouse or a child who would otherwise be entitled to 16 continuation of insurance was, through the actions of the 17 spouse or of the child, a substantial contributing factor to 18 the death of the eligible employee, or the spouse or a child 19 becomes ineligible for insurance coverage under the terms of 20 the insurance coverage obtained by the state for reasons other 21 than the death of the eligible employee. 22 The bill applies retroactively to January 1, 2024. 23 -4- LSB 1361SV (3) 91 nls/ko 4/ 4