Employers have no obligation under Iowa law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements limit how the plan may be designed.
Group long-term care insurance issued in Iowa must provide covered individuals with a basis for continuation or conversion of coverage (191 IAC 39.6).
Long-term care policies may not limit or exclude coverage by type of illness, treatment, medical condition, or accident. However, policies may exclude:
• Preexisting conditions or diseases;
• Mental or nervous disorders (except for Alzheimer’s disease or similar forms of irreversible dementia);
• Alcoholism and drug addiction;
• Illnesses, treatments, or medical conditions arising out of war or act of war (whether declared or undeclared); participation in a felony, riot, or insurrection; service in the armed forces or auxiliary units; attempted suicide (sane or insane) or an intentional self-inflicted injury; or aviation as a non-fare-paying passenger;
• Treatment provided in a government facility (unless otherwise required by law); services for which benefits are available under Medicare or other governmental program (except Medicaid); any state or federal workers’ compensation, employer’s liability or occupational disease law, or any motor vehicle no-fault law; services provided by a member of the covered person’s immediate family; and services for which no charge is normally made in the absence of insurance;
• Expenses for services or items available or paid under another long-term care insurance or health insurance policy; and
• In the case of a ...