Effective - 28 Aug 1991
374.194. Health coverage providers to be subject to jurisdiction of department, exceptions — examination to be performed, when — requirements of health coverage providers. — 1. Notwithstanding any other provision of law to the contrary, and except as provided in this section, any person or other entity which provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department of commerce and insurance, unless the person or other entity shows that while providing such services it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government.
2. A person or entity may show that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, by providing to the director of the department of commerce and insurance the appropriate certificate, license or other document issued by the other governmental agency which permits or qualifies it to provide those services.
3. Any person or entity which is unable to show under subsection 2 of this section that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, shall submit to an examination by the director of the department of commerce and insurance to determine the organization and solvency of the person or the entity, and to determine whether or not such person or entity complies with the applicable provisions of chapters 374 to 385.
4. Any person or entity unable to show that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, shall be subject to all appropriate provisions of chapters 374 to 385 regarding the conduct of its business.
5. Any production agency or administrator which advertises, sells, transacts or administers the coverage of this state described in subsection 1 of this section and which is required to submit to an examination by the director of the department of commerce and insurance under subsection 3 of this section, if such coverage is not fully insured or otherwise fully covered by an admitted life of disability insurer, nonprofit health services plan, or nonprofit health care plan shall advise every purchaser, prospective purchaser, and covered person of such lack of insurance or other coverage. Any administrator which advertises or administers the coverage in this state described in subsection 1 of this section and which is required to submit to an examination by the director of the department of commerce and insurance under subsection 3 of this section shall advise any production agency of the elements of the coverage, including the amount of stop-loss insurance in effect.
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(L. 1991 H.B. 385, et al. § 113)
Structure Missouri Revised Statutes
Title XXIV - Business and Financial Institutions
Chapter 374 - Department of Commerce and Insurance
Section 374.005 - Department created, duties — definitions.
Section 374.007 - Statutory reference changes authorized.
Section 374.010 - Department — general powers.
Section 374.020 - Director — qualifications — appointment.
Section 374.030 - Director — oath — bond.
Section 374.040 - Director — duties — administrative hearing commission law not applicable.
Section 374.045 - Director authorized to make rules and regulations, procedure, this chapter.
Section 374.047 - Willful violation of state law, order — notice.
Section 374.050 - Seal of office — effect.
Section 374.051 - Refusal of license and nonrenewal, applicant may appeal, procedure.
Section 374.055 - Grievance procedure.
Section 374.056 - Rulemaking authority, delivery methods.
Section 374.057 - Filing of records and signatures authorized when in compliance with federal law.
Section 374.060 - Office location and hours.
Section 374.070 - Office and records, public — copies — records disposed of or destroyed, when.
Section 374.071 - Insurance records exempt from public disclosure — release permitted, when.
Section 374.075 - Divisions, director may establish.
Section 374.080 - Deputy director, appointment, powers — governor to appoint, when.
Section 374.085 - Division of consumer affairs, duties — legal adviser may assist.
Section 374.100 - Actuary — duties — fees.
Section 374.110 - Examiner — duties — assistants — fees.
Section 374.130 - Chief clerk, duties and powers.
Section 374.170 - Forms furnished companies.
Section 374.180 - Director to prepare report — publication — special reports.
Section 374.182 - Organization plan to be submitted — contents.
Section 374.185 - Uniformity of regulation, director to cooperate.
Section 374.190 - Investigation of companies.
Section 374.202 - Purpose of law — definitions.
Section 374.210 - False testimony — refusal to furnish information — penalties.
Section 374.215 - Failure to timely file report or statement, penalty.
Section 374.216 - False financial statements, filing of — penalty.
Section 374.217 - Covenant not to sue officers of insurer, prohibited — no force and effect.
Section 374.220 - Expenses, how paid.
Section 374.230 - Fees — paid to director.
Section 374.240 - Suit to recover fees — penalties.
Section 374.250 - Accounts of director.
Section 374.270 - Department may elect workers' compensation coverage — coverage, how provided.
Section 374.280 - Civil penalty or forfeiture ordered when, how enforced.
Section 374.284 - Health insurance advisory committee established, members, duties.
Section 374.285 - Expungement of certain disciplinary action records.
Section 374.300 - Financial institution defined.
Section 374.310 - Refusal to grant or renew insurance license, when.
Section 374.350 - Short title.
Section 374.351 - Intent of compact.
Section 374.400 - Definitions.
Section 374.405 - Reports of premiums and loss data required, when — director may review.
Section 374.415 - Product liability insurance reports required — when — contents.
Section 374.420 - Insurers not liable because of compliance.
Section 374.425 - Time for compliance may be waived or extended.
Section 374.450 - Definitions.
Section 374.455 - Premium and loss data, annual report — available to public.
Section 374.500 - Definitions.
Section 374.503 - Certificate required for utilization review agents, exceptions.
Section 374.505 - Application for certificate, content, form, fee.
Section 374.507 - Information may be required by department of commerce and insurance.
Section 374.510 - Minimum requirements for utilization review agents.
Section 374.515 - Rules and regulations authorized.
Section 374.695 - Citation of law.
Section 374.700 - Definitions.
Section 374.702 - License required, restrictions on practice.
Section 374.705 - Department, powers and duties — fees, how determined.
Section 374.710 - License required for bail bond agents, application, qualifications — exceptions.
Section 374.717 - Prohibited acts.
Section 374.720 - Examination, form, content — reexamination fee.
Section 374.730 - License, biannual renewal, fee.
Section 374.740 - Nonresident license requirements.
Section 374.750 - Refusal to issue or renew license — applicant's right to hearing.
Section 374.760 - Unsatisfied judgments, affidavit filed monthly, form — content.
Section 374.764 - Alleged violations and complaints, procedure.
Section 374.775 - Bonds of one thousand dollars or less — fee — additional fee — prohibited.
Section 374.783 - Surety recovery agents, license required — director to license, powers.
Section 374.785 - Apprehension of defendant, permitted where.
Section 374.786 - Renewal, procedure.
Section 374.787 - Complaint procedure.
Section 374.788 - Apprehension standards for breach of surety agreement or absconding.