Missouri Revised Statutes
Chapter 103 - Health Plan for State Employees
Section 103.089 - Medicare benefits participants, effect.

Effective - 28 Aug 2011
103.089. Medicare benefits participants, effect. — Participants in the program of medical benefits coverage provided by sections 103.003 to 103.175 who are eligible for Medicare benefits and who are not eligible for the program of medical benefits coverage provided under sections 103.083 to 103.098 to be their primary plan of coverage benefits shall be provided substantially similar benefits provided participants who are not eligible for Medicare benefits. Medical benefits coverage provided under sections 103.003 to 103.175 shall be coordinated with Medicare benefits for participants covered by part A or part B, or both, of Medicare benefits, or for participants eligible for but not covered by part A or part B, or both, of Medicare benefits, reduced by an amount determined by the claims administrator to provide a benefit equivalent to the amount which would be provided on a coordination of benefit basis for such participants if such participants were covered by part A or part B, or both, of Medicare benefits. As used in sections 103.083 to 103.098, the term "Medicare benefits" shall include those medical benefits provided by Title XVIII, A and B, Public Law 89-97, 1965 amendments to the federal Social Security Act (42 U.S.C. Section 301, et seq.) and amendments thereto. Any participating member agency having employees or eligible retirees not covered by Medicare shall authorize the plan at its option to enroll those individuals for medical benefits as provided by Title XVIII, A and B, Public Law 89-97, 1965 amendments to the federal Social Security Act whenever they become eligible for such benefits and the plan shall pay the premium for such enrollment on behalf of that person. The Medicare premium amounts shall be included in the rate established by the actuary for providing medical benefits coverage to such a participating member agency. Anyone not authorizing this Medicare enrollment shall be denied coverage.
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(L. 1992 H.B. 1574 § 2 subsec. 3, A.L. 2011 H.B. 270)

Structure Missouri Revised Statutes

Missouri Revised Statutes

Title VIII - Public Officers and Employees, Bonds and Records

Chapter 103 - Health Plan for State Employees

Section 103.003 - Definitions.

Section 103.005 - Missouri consolidated health care plan established, purpose — powers to carry out plan.

Section 103.008 - Administration to be by board of trustees — members, qualifications, appointment, terms — vacancies.

Section 103.010 - MOSERS medical staff will serve jointly on both boards — rates and services, decisions prior to January 1, 1994, to be made by MOSERS board.

Section 103.012 - Board chairman and vice chairman elected annually by secret ballot — powers and duties.

Section 103.014 - Executive director appointed by board, not to be board member — powers and duties.

Section 103.016 - Executive director and staff to be state employees — board members not to be employed by plan for four years after leaving board, exception.

Section 103.019 - Staff salaries to be set by board.

Section 103.020 - Summons and writs to be served on executive director.

Section 103.023 - Actuary or actuarial firm to give technical advice.

Section 103.025 - Annual audit of records and accounts by CPA.

Section 103.027 - Records to be open to public — annual report on financial condition of plan, content.

Section 103.029 - Attorney at law may be employed for legal advice and representation.

Section 103.032 - Investment counselors may be employed for investment advice, qualifications, duties.

Section 103.036 - Benefit trust fund account to be established by board, purpose — powers of board to carry out duties.

Section 103.039 - Deposit of funds — commingling of funds prohibited — executive director to be responsible, bond required.

Section 103.042 - Board to serve without compensation — expenses authorized — board members performing duties not to suffer loss of their regular compensation.

Section 103.045 - Meetings of board, held where and how set — notice to board members.

Section 103.047 - Board members to have one vote — six members to be quorum — majority vote of trustees present for official actions — meeting not required, procedure to determine will of board.

Section 103.050 - Principal office for plan to be in Jefferson City, seal — courts to take judicial notice.

Section 103.055 - Errors in members or providers receiving more or less than entitled to — board's power to correct or recover overpayments.

Section 103.057 - False statement or falsifying record of plan, penalty.

Section 103.059 - Rules authorized, duties of board.

Section 103.061 - Inspection by board of accounts and records of participants in plan or requesting participants.

Section 103.064 - Subpoena of witnesses or production of records, powers of board.

Section 103.067 - Trustees and employees not to profit from plan transactions — acceptance of gratuity or compensation to influence investment, penalties.

Section 103.070 - Tax exemptions for plan's assets.

Section 103.075 - Plan to become effective on January 1, 1994 — prior to effective date employees' retirement medical care plan to remain in effect.

Section 103.078 - Foster parents permitted to purchase, when.

Section 103.079 - Health care programs sponsored by other state agencies may become part of consolidated plan, procedure — departments may review plan and withdraw, when — higher education entities may become part of consolidated plan, procedure.

Section 103.080 - High deductible plans and health savings accounts to be offered — definitions — premiums — consumer-driven health care plans — rulemaking authority.

Section 103.083 - Medical benefit coverage, board's authority to contract for — comparable benefits for employees relying on spiritual healing.

Section 103.084 - Recommendation to change to an October first plan year for health care provider contracts.

Section 103.085 - Termination of coverage, when, exceptions, certain persons may choose to continue coverage, requirements.

Section 103.089 - Medicare benefits participants, effect.

Section 103.095 - General assembly members, elected officials and employees who cease to hold office may continue coverage — time limitation to elect coverage.

Section 103.098 - Thirty-day enrollment period for state employees, retirees and dependents — preexisting condition not covered for twelve months.

Section 103.100 - Cost of medical benefit program, estimated amount, how computed — notification of authorized medical benefit options — recommendation of portion to be paid by employees — appropriations requested.

Section 103.105 - Participating member agencies to pay executive director monthly — payment deposited in health fund.

Section 103.110 - Certification of costs of providing recommended options — premium amounts, payment — deposit in fund.

Section 103.115 - Consultants, former employees from certain state agencies, judges or teachers to be compensated for advice which will be paid toward medical benefits, amount.

Section 103.130 - Agencies joining plan to be by majority vote of governing body, procedure — coverage to be effective, when — must be offered to all eligible employees, retirees and dependents of agency.

Section 103.133 - Withdrawal from plan — participating agencies and political subdivisions, procedure — termination of plan effective, when.

Section 103.136 - Agencies and political subdivisions, coverage by plan after termination, two-year period, exception, board action.

Section 103.138 - Plan not responsible for liabilities prior to effective date — for participating agencies and political subdivisions.

Section 103.141 - Participating agencies and political subdivisions, persons eligible for plan.

Section 103.145 - Enrollment period of thirty days for employees, retirees and dependents of participating member agency.

Section 103.150 - Coverage to terminate when person no longer employee of participating member agency — exceptions.

Section 103.155 - Reimbursement by participating member agency of start-up costs incurred solely for member agency.

Section 103.158 - Premiums to be paid by participating agencies — deposit into fund.

Section 103.163 - Delinquent participating member agency, effect — first lien on member agency's fund — writ of mandamus for payment.

Section 103.165 - Termination of agency's participation in plan for failure to pay — no payment of claims during period of nonpayment.

Section 103.170 - Deficiency in year participating member agencies withdraw to be prorated by the actuary.

Section 103.175 - Feasibility of agencies and school district retirees not having joined plan to join — board to study and report.

Section 103.178 - Alternative system of benefits for treatment of chemical dependency, pilot project — design of project, report.