Iowa Insurance License

Online

$50

Online

$50

Triennially by the end of the registration anniversary month, however, business entities may choose a month other than its registration anniversary month for its license term.

• The only action being performed is as an employer administering its employee benefit plan or the plan of an affiliated employer under common management and control.
• The only action being performed is as a trust exempt from taxation under Section 507(a) of the Internal Revenue Code and its trustees and employees acting pursuant to such trust, or a custodian and the custodian’s agents or employees acting pursuant to a custodian account that meets the requirements of Section 401(f) of the Internal Revenue Code.
• The only action being performed is as a person licensed as a managing general agent in this state when acting within the scope of activities conveyed under such a license.
• The administrator is an insurer that underwrites, collects charges, collateral or premiums from, or adjusts or settles claims for no one other than its policyholders, subscribers and certificate holders.
• The third-party administrator is affiliated with a licensed insurer and only acts as a third-party administrator for the direct and assumed insurance business of the affiliated insurer.
• A person only acts as a third-party administrator for a group plan based in another state that has fewer than 100 insureds under the plan residing in Iowa.
• A person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, only in connection with life, annuity or health coverage provided by a self-funded plan other than a governmental or church plan.
• An administrator operating solely as a single-employer trust or Taft-Hartley labor union trust as defined under ERISA.

Exception from Registration Requirement Form

IAC 191-58.3(1)

Online

$100

Online

$100

Triennially by the end of the registration anniversary month.

Online

Annually by July 1.

IAC 191-58.11

Each registered third-party administrator shall file by July 1 an annual report in a form and manner as prescribed by the commissioner. The report shall:

• Be verified by at least two officers of the third-party administrator;
• Include audited financial statements prepared by an independent certified public accountant using generally accepted accounting principles;
• Be prepared on a consolidated basis; and
• Include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:
  • Amounts shown on the consolidated audited financial report shall be shown on the worksheet;
  • Amounts for each entity shall be stated separately; and
  • Explanations of consolidating and eliminating entries shall be included.

• The only action being performed is as an employer administering its employee benefit plan or the plan of an affiliated employer under common management and control.
• The only action being performed is as a trust exempt from taxation under Section 507(a) of the Internal Revenue Code and its trustees and employees acting pursuant to such trust, or a custodian and the custodian’s agents or employees acting pursuant to a custodian account that meets the requirements of Section 401(f) of the Internal Revenue Code.
• The only action being performed is as a person licensed as a managing general agent in this state when acting within the scope of activities conveyed under such a license.
• The administrator is an insurer that underwrites, collects charges, collateral or premiums from, or adjusts or settles claims for no one other than its policyholders, subscribers and certificate holders.
• The third-party administrator is affiliated with a licensed insurer and only acts as a third-party administrator for the direct and assumed insurance business of the affiliated insurer.
• A person only acts as a third-party administrator for a group plan based in another state that has fewer than 100 insureds under the plan residing in Iowa.
• A person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, only in connection with life, annuity or health coverage provided by a self-funded plan other than a governmental or church plan.
• An administrator operating solely as a single-employer trust or Taft-Hartley labor union trust as defined under ERISA.

Exception from Registration Requirement Form

IAC 191-58.3(1)

Uniform Application for Business Entity License/Registration

Mail or online.

$100

Upon receipt by the Iowa Insurance Division, notification of approval is generally sent via email within 5-10 business days.

By signing the application, you agree that every owner, partner, officer, or director of the business entity, or member or manager of a limited liability company, either a) does not have a current child support obligation, or b) has a child-support obligation and is currently in compliance with that obligation.

• A certified copy of the corporate or organizational documents or a certificate of good standing from the Iowa Secretary of State
• Evidence of a surety bond in the required minimum amount
• A list of all insurance companies or other entities for which you currently act as a third party administrator (or pharmacy benefits manager, if applicable)
• Business narrative describing the activities the third party administrator will be performing on behalf of its clients
• Biographical affidavits for all officers, directors, key managerial personnel, and individuals with 10% or more beneficial ownership
• Prior authorization form meeting the requirements pursuant to Iowa Code section 505.26.

Online

$100

Triennially by the end of the registration anniversary month.

Online

Annually by July 1.

IAC 191-58.11

Each registered third-party administrator shall file by July 1 an annual report in a form and manner as prescribed by the commissioner. The report shall:

• Be verified by at least two officers of the third-party administrator;
• Include audited financial statements prepared by an independent certified public accountant using generally accepted accounting principles;
• Be prepared on a consolidated basis; and
• Include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:
  • Amounts shown on the consolidated audited financial report shall be shown on the worksheet;
  • Amounts for each entity shall be stated separately; and
  • Explanations of consolidating and eliminating entries shall be included.

Entities that perform utilization review solely under contract with
the federal government for review of patients eligible for services under:

• Title XVIII (Medicare) of the federal Social Security Act;
• The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); or
• Any other federal employee health benefit plan

IAC § 70.3(3)

Online

$0

• Proof of current Health Utilization Management or other utilization review accreditation from URAC or NCQA

Online

$0

Annually by March 1.