A bill for an act relating to the establishment of a health insurance pool for municipal employees.

This bill creates a centralized health insurance pool for municipal employees in Iowa, directly affecting cities and counties that choose to join. It requires the state department to conduct a competitive online bidding process ("health carrier reverse auction") where insurers submit progressively lower prices to provide health plans, with strict technology and security standards for the bidding platform. Municipalities must opt in by July 2027 (needing 10% of counties and cities to participate), and the first pool must be operational by July 1, 2028, covering active employees and retirees in specific Medicare programs. The process aims to lower costs through transparency, including automated claim reviews and market checks to ensure ongoing competitive pricing.