Missouri Revised Statutes
Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans
Section 354.285 - Management agreements to control corporation, notice to department, when — examination requirements — violations.

Effective - 28 Aug 1983
354.285. Management agreements to control corporation, notice to department, when — examination requirements — violations. — 1. All agreements or contracts under which any person, organization or corporation enjoys in fact the exclusive or dominant right to manage or control any corporation subject to the provisions of sections 354.010 to 354.380 to the substantial exclusion of the board of directors, officers, attorney in fact or other lawful management shall be filed with the director on his request.
2. The director, for the purpose of ascertaining the assets, conditions and affairs of any corporation subject to the provisions of sections 354.010 to 354.380, may examine the books, records, documents and assets of any person having a contract or agreement as provided in subsection 1 to the extent necessary to determine the financial condition of such corporation. The failure or refusal of any such person to submit his books, papers, accounts, records or affairs to the reasonable inspection or examination of the director shall be grounds for the suspension or revocation of the certificate of authority of the corporation to do business in this state.
3. No agreement or contract as provided in subsection 1 shall operate to the financial detriment of the corporation in such manner as to endanger its financial stability or otherwise be hazardous to the members and creditors of the corporation.
4. On examination of any agreement or contract, if the director finds it violates the provisions of this section, he shall proceed in accordance with the provisions of section 354.180.
5. Any person, organization or corporation having a management contract as provided in subsection 1 hereof shall within five days of execution of such contract provide notice of such contract to the director of the department of commerce and insurance.
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(L. 1983 H.B. 127)

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Structure Missouri Revised Statutes

Missouri Revised Statutes

Title XXIII - Corporations, Associations and Partnerships

Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans

Section 354.010 - Definitions.

Section 354.015 - Health services corporations, laws applicable to — exceptions.

Section 354.020 - Preexisting health services corporation to amend articles, effect of.

Section 354.025 - Corporate purposes and authority.

Section 354.027 - Discrimination in coverage or reimbursement for covered service by licensed persons, prohibited.

Section 354.030 - For-profit corporations excluded from act.

Section 354.035 - Procedure for organization of corporation.

Section 354.040 - Articles of incorporation, required information and contents.

Section 354.045 - Issuance of certificate, effect of.

Section 354.050 - General powers of corporation.

Section 354.055 - Certificate of authority required — expiration of, extended how.

Section 354.060 - Director to issue certificate, when.

Section 354.065 - Articles of incorporation, how amended — copy to director, when.

Section 354.070 - Certificate of authority automatically extended, when.

Section 354.075 - Capital required to do business.

Section 354.080 - Reserves required, how computed.

Section 354.085 - Membership contract forms, approval by director, when — time for filing — time for disapproval.

Section 354.090 - Health services corporation contracts, purposes, parties to.

Section 354.095 - Limitation of membership and benefits — certain benefits to be provided, when.

Section 354.105 - Annual report required, contents of.

Section 354.115 - Member's grievance, how and where filed — director may investigate, court action not barred.

Section 354.120 - Rules and regulations by director authorized — procedure, review.

Section 354.125 - Corporation not liable for injuries resulting from medical services rendered members.

Section 354.130 - Exemption from certain taxes, exceptions.

Section 354.140 - Dissolution, liquidation or rehabilitation of corporation, procedure for.

Section 354.145 - Appeal from director's actions or decisions, how taken.

Section 354.150 - Fees — waiver, when.

Section 354.152 - Premiums, dues or fees subject to restrictions — violation, hearing — order prohibiting.

Section 354.155 - Disclaimer as to nonhealth services corporations.

Section 354.165 - Certain organizations exempt.

Section 354.175 - Wage continuation plans by employer exempt.

Section 354.180 - Administrative order, director to issue, when.

Section 354.190 - Examinations, procedures.

Section 354.195 - Records of examination, duty to keep.

Section 354.200 - Examinations, false testimony, penalty.

Section 354.205 - Examinations — costs, how paid.

Section 354.207 - Second medical opinion to be allowed by health services corporations, procedure, costs.

Section 354.210 - Director may seek relief, when.

Section 354.215 - Examiner's sick leave to apply to health services corporations.

Section 354.220 - Director may bring suit to recover fees or sums.

Section 354.225 - Enrollment representative, defined — annual report to furnish information — solicitors of members to be insurance agent or broker, exception.

Section 354.230 - License required for enrollment representative.

Section 354.235 - Enrollment representative — license issued when, qualifications.

Section 354.240 - Nonresident may be licensed — examination waived, when.

Section 354.265 - Nonrenewable temporary license issued, when.

Section 354.275 - Violations by enrollment representatives, penalties.

Section 354.280 - Officers of corporation found to be of known bad character or incompetent — authority to transact business, effect.

Section 354.285 - Management agreements to control corporation, notice to department, when — examination requirements — violations.

Section 354.290 - Examiner's duties — examination contents — hearing on reports allowed — publication of report, when.

Section 354.295 - Certificate of authority not to be issued if controlling management involved in improper actions.

Section 354.300 - Certificate of authority suspended or revoked, when.

Section 354.305 - Corporation advertising assets also to show liabilities — penalties.

Section 354.315 - Data processing system authorized, cost, amount allowed — amortization not to exceed ten years.

Section 354.320 - Corporate funds and securities use for private gain by officers and employees prohibited, penalty.

Section 354.325 - Investigation by director of investments — records to be kept by division — criminal action, when.

Section 354.330 - Public official failing to perform duties as to investment violations, penalty.

Section 354.335 - Damages allowed if corporation without reasonable cause refuses to pay.

Section 354.340 - Unsatisfied judgments against corporation — suspension or revocation of certificate of authority until judgment satisfied.

Section 354.345 - Court decree of specific performance — membership contract, failure of corporation to comply, procedure, effect.

Section 354.350 - Fraudulent or bad faith conduct — investigation by division — hearing, procedure.

Section 354.355 - Injunctions, permanent or temporary, grounds, procedure — dissolution of corporation or rehabilitation, procedure.

Section 354.357 - Receivership, grounds, procedure.

Section 354.362 - Newborn child coverage required — notice of birth, when, effect.

Section 354.380 - Certain provisions of insurance law to be applicable.

Section 354.400 - Definitions.

Section 354.405 - Certificate of authority, who may make application — foreign corporation may qualify, requirements — procedure.

Section 354.407 - PACE projects not deemed health maintenance organizations, when.

Section 354.410 - Certificate issued, when — annual deposit, requirements — capital account, amount, contents.

Section 354.415 - Powers of organization.

Section 354.420 - Advisory panels to afford enrollees participation in policy decisions.

Section 354.425 - Bonding of officers who disburse or invest funds — bond requirements.

Section 354.430 - Evidence of coverage, requirements — rights of enrollee — toll-free telephone number required.

Section 354.435 - Annual reports filed with director, when — content — forms.

Section 354.440 - Information to be available to enrollees.

Section 354.441 - Disclosures to subscribers shall not be prohibited or restricted.

Section 354.442 - Disclosure information to enrollees required, when.

Section 354.443 - Financial disclosures to the department required by health maintenance organizations, when.

Section 354.444 - Administrative orders for violations — voluntary forfeitures, civil actions.

Section 354.445 - Complaints by enrollees, organization to establish system.

Section 354.450 - Investments authorized.

Section 354.455 - Deposit required, how made.

Section 354.460 - Advertising not to be untrue or misleading — deceptive solicitation — prohibited — how determined.

Section 354.462 - Enrollee, grounds for disenrollment.

Section 354.464 - Names not authorized for use, exceptions.

Section 354.465 - Examinations by division, when — costs, how paid.

Section 354.470 - Suspension or revocation, when — effect.

Section 354.475 - Insurance companies or health service company may organize and operate a health maintenance organization.

Section 354.480 - Rehabilitation, liquidation, or conservation, grounds, procedure — enrollee's priorities — claims, priority.

Section 354.485 - Rules and regulations authorized.

Section 354.490 - Certificate of authority, denial, suspension or revocation, grounds — procedure.

Section 354.495 - Fees to be paid to director.

Section 354.500 - Conferences called by director as to suspected or potential violations.

Section 354.505 - Laws regulating insurance or health service corporations not to apply, exceptions.

Section 354.510 - Public documents, all filings and required reports.

Section 354.515 - Confidential information, diagnosis, treatment, health of enrollees or applicants, exceptions.

Section 354.520 - Mergers, consolidations, control of organization, requirements.

Section 354.525 - Health provision collective bargaining agreements or contracts — charge for coverage, how determined.

Section 354.530 - Severability clause.

Section 354.535 - Pharmacist, emergency situation, may take an assignment of enrollee's right to reimbursement — health maintenance organizations shall only contract with entities licensed by the board of pharmacy — requirements for drug prescription...

Section 354.536 - Continuation of dependent child coverage, when — dependent child defined.

Section 354.540 - Health maintenance organization of bordering states may be admitted to do business — procedure.

Section 354.545 - Exempt plans and companies.

Section 354.546 - Second medical opinion to be allowed by health maintenance organizations, procedure, costs.

Section 354.550 - Laws not applicable to community health companies.

Section 354.551 - Health maintenance organizations may offer point of service (POS) riders, when.

Section 354.552 - Community-based health maintenance organizations, requirements.

Section 354.554 - Standing referrals for certain members of community-based health maintenance organizations, when.

Section 354.556 - Trustees, vacancies, elections.

Section 354.558 - Materials provided to prospective purchasers.

Section 354.559 - Disclosure to members, restrictions and prohibitions.

Section 354.560 - Payment arrangements, department to adopt rules — disclosure of financial arrangements — confidentiality.

Section 354.562 - Grievance procedures, rulemaking authority.

Section 354.563 - Medicare rules to apply to community-based health maintenance organizations, when.

Section 354.565 - Community-based health maintenance organization designation given, when — revocation.

Section 354.567 - Community-based health maintenance organizations subject to other laws regarding health maintenance organizations.

Section 354.570 - Rulemaking — procedure.

Section 354.600 - Definitions.

Section 354.603 - Sufficiency of health carrier network, requirements, criteria — access plan filed with the department, when.

Section 354.606 - Providers notified of specific covered services, when — hold harmless provision — cessation of operations procedure — selection standards for health care professionals, filing with the department.

Section 354.609 - Termination of a contract, procedure.

Section 354.612 - Continuation of care after provider termination, when.

Section 354.615 - Referrals to appropriate providers, when.

Section 354.618 - Open referral health plans offered, when — definitions — obstetrician/ gynecologist services to be offered, when — eye care providers, discrimination against, prohibited — exemptions.

Section 354.621 - Intermediary and participating provider requirements.

Section 354.624 - Proposed provider contract forms filed with the director — contracts maintained at place of business, available for review, when.

Section 354.627 - Liability of a health carrier, when.

Section 354.636 - Contract requirements after January 1, 1998.

Section 354.650 - Definitions.

Section 354.652 - Designation as essential community provider, procedure, qualifications.

Section 354.654 - Department of health and senior services, duties — rulemaking authority.

Section 354.656 - Inclusion of essential community providers in health care network, exceptions.

Section 354.658 - Designation nontransferable, site specific — annual affidavit required — notice of certain changes, required when.

Section 354.700 - Definitions.

Section 354.702 - Prepaid dental plans, who may offer — certificate of authority required — certain state laws not to apply.

Section 354.703 - Director may order violators to cease and desist, hearing — noncompliance, director's remedies.

Section 354.704 - Application for certificate of authority, content.

Section 354.705 - Certificate of authority granted, when.

Section 354.707 - Capital, surplus, security required — cash, securities, bond to be deposited or filed with director, director to return deposit, when — security subject to final judgments — security not required for prepaid dental plans funded by g...

Section 354.710 - Reserve requirements — reserve not required for prepaid dental plans funded by government — surplus requirement for prepaid dental plans in existence January 1, 1987, additional time.

Section 354.712 - Contract or contract certificate to be issued to enrollees, content, copy to be filed with director — newborn child to be covered, when, extent of coverage, notification of birth and additional premium, when, effect of.

Section 354.715 - Providers of dental care, written contract with prepaid dental plan corporations, review and mediation procedures for enrollees required.

Section 354.717 - Director, powers — financial examinations, when, by whom made and paid.

Section 354.720 - Annual report, required, content.

Section 354.721 - Agents, registration required — rules and regulations authorized.

Section 354.722 - Revocation or suspension of certificate of authority, when — notice, civil suit authorized — suspension, revocation, activity permitted.

Section 354.723 - Rulemaking authorized.

Section 354.725 - Exclusion, labor organization's health plans.