Missouri Revised Statutes
Chapter 376 - Life, Health and Accident Insurance
Section 376.1115 - Coverage outline to be delivered to applicants, when, content.

Effective - 28 Aug 2002
376.1115. Coverage outline to be delivered to applicants, when, content. — 1. An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means which prominently direct the attention of the recipient to the document and its purpose. The director shall prescribe a standard format, including style, arrangement and overall appearance, and the content of an outline of coverage. In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form. In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form. In the case of a policy issued to a group defined in section 376.1100, an outline of coverage shall not be required to be delivered; provided that the information described in subdivisions (1) to (6) of subsection 2 of this section is contained in other materials relating to enrollment. Upon request, such other materials shall be made available to the director.
2. The outline of coverage shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions, and limitations contained in the policy;
(3) A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change the premium. Continuation or conversion provisions of group coverage shall be specifically described;
(4) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;
(5) A description of the terms under which the policy or certificate may be returned and premium refunded;
(6) A brief description of the relationship of cost of care and benefits; and
(7) A statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract under Section 7702B(b) of the Internal Revenue Code of 1986, as amended.
3. A certificate issued pursuant to a group long-term care insurance policy which policy is delivered or issued for delivery in this state shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions and limitations contained in the policy; and
(3) A statement that the group master policy determines governing contractual provisions.
4. If an application for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than thirty days after the date of approval.
5. At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy which provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of request shall make such delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the summary shall also include:
(1) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits;
(2) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits, if any, for each covered person;
(3) Any exclusions, reductions and limitations on benefits of long-term care;
(4) A statement that any long-term care inflation protection option that may be required by the laws of this state is not available under the policy; and
(5) If applicable to the policy type, the summary shall also include:
(a) A disclosure of the effects of exercising other rights under the policy;
(b) A disclosure of guarantees related to long-term care costs of insurance charges;
(c) Current and projected maximum lifetime benefits; and
(d) The provisions of the policy summary listed in paragraphs (a) to (c) of this subdivision may be incorporated into a basic illustration required to be delivered in accordance with sections 375.1509 or into the life insurance policy summary required to be delivered in accordance with section 376.706.
­­--------
(L. 1990 S.B. 765 § 6 subsecs. 2 to 5, A.L. 2002 H.B. 1568 merged with S.B. 1009)
Transferred 2002; formerly 376.957

<< Previous
Next >>

Structure Missouri Revised Statutes

Missouri Revised Statutes

Title XXIV - Business and Financial Institutions

Chapter 376 - Life, Health and Accident Insurance

Section 376.005 - Definitions.

Section 376.010 - Who may form company — purposes.

Section 376.015 - Involuntary unemployment insurance may be issued in connection with extension of credit or certain group life insurance, requirements.

Section 376.020 - Various companies defined.

Section 376.050 - Declaration of corporators.

Section 376.060 - Stock companies — content of charter.

Section 376.070 - To be submitted to attorney general.

Section 376.080 - Director to examine, when.

Section 376.090 - To furnish certificate of deposit, when.

Section 376.100 - Mutual companies — contents of charter.

Section 376.110 - To be submitted to attorney general.

Section 376.120 - Director to examine and certify, when.

Section 376.130 - To furnish certificate of deposit, when.

Section 376.142 - Stock company may become mutual — procedure — policyholders' meeting — acquisition of stock.

Section 376.143 - Stock company may acquire its own shares to be held in trust for mutual — appointment, powers and duties of trustees.

Section 376.144 - Acquisition of shares of dissenting stockholders, procedure — abandonment of mutualization.

Section 376.145 - Officers of stock company to continue as officers of mutual.

Section 376.146 - Board of directors or trustees of mutual, membership qualifications, term of office.

Section 376.147 - Meetings of board of mutual, notice — executive committee of board, powers.

Section 376.148 - Policyholders are members of mutual — voting rights — directors may alter articles — additional assessments prohibited.

Section 376.150 - Stock and mutual companies — content of charter.

Section 376.160 - Formation of stock and mutual companies.

Section 376.170 - Special deposits for registered policies and annuity bonds.

Section 376.180 - Certificates as to registration and reserves on policy — policies exempt, exceptions.

Section 376.190 - Additional deposits required.

Section 376.200 - Definition of net value.

Section 376.210 - Excess deposits.

Section 376.220 - May use realty to secure notes and bonds.

Section 376.230 - Changing of securities on deposit.

Section 376.240 - Deposits to be held in trust by director.

Section 376.250 - Deposits to be kept separate.

Section 376.260 - Fees collected by director of revenue.

Section 376.270 - Director may proceed against depositary companies.

Section 376.280 - Capital necessary to do business — how invested.

Section 376.290 - Deposit and transfer of securities.

Section 376.291 - Applicability and inapplicability.

Section 376.292 - Definitions.

Section 376.293 - Permissible investments — written plan for investments required.

Section 376.294 - Prohibited acts.

Section 376.295 - Additional prohibited acts — authorized actions.

Section 376.296 - Value of investments, how calculated.

Section 376.297 - Investment subsidiaries not permitted, when.

Section 376.298 - Acquisition of rate credit instruments, when.

Section 376.300 - Equity interests permitted, when.

Section 376.301 - Tangible personal property interests permitted, when.

Section 376.302 - Mortgage interests, may be acquired, when — other real estate interests.

Section 376.303 - Lending and repurchase, permitted when.

Section 376.304 - Acquisition of foreign investments, when.

Section 376.305 - Rulemaking authority.

Section 376.306 - Cash surrender value, life insurer may lend to policyholder, when.

Section 376.307 - Limits on acquisition of certain investments.

Section 376.308 - Secondary mortgage market act, not to preempt health insurer, when.

Section 376.309 - Separate account defined — establishment of account and special voting or control rights authorized — approved investments — approval of director required.

Section 376.310 - Investment of surplus and reserve funds by foreign companies.

Section 376.311 - Investment of capital reserve and surplus of life insurance companies in investment pools — definitions — qualifications — requirements.

Section 376.325 - Any willing provider provision — definitions.

Section 376.330 - Securities may be changed.

Section 376.350 - Reports to director.

Section 376.360 - Distribution of surplus funds to participating policyholders — method.

Section 376.365 - Standard valuation law — definitions.

Section 376.370 - Director to value reserves, methods.

Section 376.379 - Medication synchronization services, offer of coverage required.

Section 376.380 - Legal minimum standards for valuation — interest rates — valuation manual, operative date, effect of — reserves required — confidential information — exemptions for specific product forms or product lines.

Section 376.381 - Health insurance products, department duties.

Section 376.383 - Health care claims for reimbursement, how paid, when — definitions — clean claims, procedure — unpaid claims, procedure — fraudulent claims, notification to the department, procedure — requests for additional information, contents.

Section 376.384 - Reimbursement of claims, duties of health carriers — claims submitted in electronic format, when — compliance monitored by department — complaint procedures developed — standard medical code sets required, when — rulemaking authorit...

Section 376.385 - Diabetes — insurance coverage for equipment, supplies and self-management training.

Section 376.386 - Prescription drugs, one co-payment for dosage prescribed.

Section 376.387 - Pharmacy benefits manager, limitations and restrictions — enforcement.

Section 376.388 - Maximum allowable costs — definitions — contract requirements — reimbursement — appeals process required.

Section 376.390 - Reserve liability for group insurance — how computed.

Section 376.391 - Co-payments for chiropractic services, cap.

Section 376.392 - Prescription drug formularies, enrollees to be notified of changes to, when.

Section 376.393 - Pharmacy benefits manager, license required — definitions — complaints, procedure.

Section 376.395 - Definitions for group health conversion policy requirements.

Section 376.397 - Converted policy to be offered on termination of group health coverage, when — exceptions — terms and conditions.

Section 376.398 - Application to all group policies — effective, when.

Section 376.401 - Conversion rights — retirees — dependents of insured.

Section 376.403 - Benefit levels — group coverage may be provided in lieu of converted policy — delivery outside state, form.

Section 376.404 - Specific requirement requests of policyholder may be met by alteration.

Section 376.405 - Group health and accident policies, approval required — exempt, when, director's powers.

Section 376.406 - Newborn child to be covered under health policies, extent of coverage — notification of birth, when, effect of — definitions.

Section 376.407 - Advance practice nurse, claims for service to be reimbursed, when.

Section 376.410 - Insurance companies to maintain reserves — exemptions.

Section 376.421 - Group health insurance, authorized categories.

Section 376.422 - Direct response solicitation and sponsoring or endorsing entity, defined — certain group or individual insurers paying compensation to policyholder or sponsoring entity to notify policyholders.

Section 376.423 - Health insurance, claims for chiropractic services denial, qualified chiropractor to review, qualifications — investigation by department, when.

Section 376.424 - Group health insurance policies may be extended to insure family members or dependents.

Section 376.425 - Student accident policies, may not limit surgical benefits, when.

Section 376.426 - Group health policies, required provisions.

Section 376.427 - Assignment of benefits made by insured to provider — payment, how made — exceptions — all claims to be paid, when — out-of-network services, how paid.

Section 376.428 - Federal COBRA provisions to apply to group health insurance policies.

Section 376.429 - Coverage for certain clinical trials for prevention, early detection and treatment of cancer, restrictions — definitions — exclusions.

Section 376.431 - Employees or members of unions or associations, group or group-type basis coverage, sections 376.431 to 376.442 to apply.

Section 376.432 - Group-type basis, defined.

Section 376.433 - Self-insurance plans for health care, public entities — subject to Medicaid rights, obligations, and remedies.

Section 376.434 - Carrier liable for claims incurred during grace period, when — exceptions.

Section 376.435 - Claim information to be reported, when — covered lives defined.

Section 376.436 - Discontinuance notice by carrier, contents — notice forms furnished by carrier for distribution to policyholders.

Section 376.438 - Group policies, modifying or amending benefits shall provide extension of benefits in event of total disability at date of termination or discontinuance.

Section 376.441 - Carrier contract replaced by similar benefit plan of another carrier — liability of prior carrier — succeeding carrier coverage requirements.

Section 376.442 - Rules and regulations, procedure.

Section 376.446 - Enrollee cost-sharing responsibilities, health carriers to provide timely information — exceptions.

Section 376.450 - Citation of law — definitions (Missouri HIPAA).

Section 376.451 - Standards prohibiting discrimination.

Section 376.452 - Large group market, renewal or continuation of coverage required — nonrenewal or discontinuation permitted, when — conditions for discontinuation.

Section 376.453 - Premium — only cafeteria plans required, when.

Section 376.454 - Individual market, renewal or continuation at option of individual — nonrenewal or discontinuation permitted, when — discontinuation of a type of coverage, procedure.

Section 376.465 - Missouri health insurance rate transparency act — definitions — rate filing requirements, procedure — rulemaking authority.

Section 376.480 - Domestic companies may assume risks of foreign companies — duties of director.

Section 376.500 - Discriminations, rebates and favors prohibited — contracts to conform to policy.

Section 376.502 - Life insurers not to discriminate based on lawful travel destinations — violations, penalty.

Section 376.510 - Penalty for violation of section 376.500.

Section 376.531 - Life insurance policies, consent of insured required, exceptions — employers have insurable interest in employees, when, effects.

Section 376.540 - Policy, to whom payable.

Section 376.562 - Charitable, benevolent, educational and religious organizations may be beneficiary or owner of policy, life insurance, when — fraud or coercion, exception.

Section 376.570 - Foreign executor or administrator.

Section 376.580 - Misrepresentation.

Section 376.590 - Misrepresentations, false estimates and circulars prohibited — agents — notes to be held until policy delivered.

Section 376.600 - Penalty for violating section 376.590.

Section 376.610 - Defense in case of suits.

Section 376.620 - Suicide, effect on liability — refund of premiums, when.

Section 376.630 - Life insurance policies not to be forfeited or become invalid, when.

Section 376.640 - Paid-up policy may be demanded, when.

Section 376.650 - Rules of payment on commuted policy.

Section 376.660 - Foregoing provisions inapplicable, when.

Section 376.669 - Annuity contract requirements — paid-up annuity benefits, how calculated — cash surrender benefits, how calculated — applicable, when.

Section 376.670 - Provisions which shall be contained in life insurance policies, exceptions.

Section 376.671 - Provisions which shall be contained in annuity contracts — inapplicability date.

Section 376.673 - Life insurance policies, regulations relative to.

Section 376.674 - Life insurance policies, no cash surrender value, regulations relative to.

Section 376.675 - Life insurance policies and annuity contracts to be approved — exemption, when — director's powers — judicial review of disapproval.

Section 376.676 - Regulation of the valuation of life insurance policies — may adopt NAIC model regulation.

Section 376.677 - Life policies may be issued that have no cash surrender value prior to death — no policy loans so law regulating not applicable — requirements to issue.

Section 376.678 - Life insurance policies and annuity contracts, annual statement to holder required — company to furnish policy or contract information to holder upon request.

Section 376.679 - Life insurance company may reinsure for risks involving aircraft, limitation.

Section 376.680 - Assignment of incidents of ownership, group life policy, effect of.

Section 376.685 - Optometrists, health insurance plans not to limit fees charged unless reimbursed by plan — requirements — definitions.

Section 376.690 - Unanticipated out-of-network care, claim procedure — definitions — limitation on amount billed to patient — external arbitration process — rulemaking authority.

Section 376.691 - Group life policies, eligible groups authorized for issue — premiums, how paid.

Section 376.693 - Special group life policies, requirements — director's approval.

Section 376.694 - Group life, definitions of direct response solicitation and sponsoring or endorsing entity — certain insurers required to give notice of compensation to policyholder or endorsing entity.

Section 376.695 - Extension of policy to insure for loss due to death of spouse or dependent children, requirements, limitations.

Section 376.696 - Political subdivisions purchasing any insurance policies to submit to competitive bidding, when — renewal between bidding periods deemed extension.

Section 376.697 - Required provisions for group life policies.

Section 376.699 - Person insured by group policy entitled to individual life policy, notice requirements.

Section 376.700 - Purpose — use of additional material.

Section 376.702 - Application of law — exceptions.

Section 376.704 - Definitions.

Section 376.706 - Delivery of guide and summary required, when.

Section 376.708 - Required presentations and statements — company to maintain file.

Section 376.710 - Effect of omission.

Section 376.712 - Effective date.

Section 376.714 - Contents and form of buyer's guide.

Section 376.715 - Citation of law, purpose.

Section 376.717 - Coverages provided, persons covered — coverage not provided, when — maximum benefits allowable.

Section 376.718 - Definitions.

Section 376.720 - Association, created — accounts — director to supervise.

Section 376.722 - Board of directors, established, members, how selected — expense reimbursement.

Section 376.724 - Impaired insurers, association's options, duties — insolvent insurers, association's options, duties — alternative policies, requirements.

Section 376.725 - Terminated coverage, reissuance of, premium set, how — obligation to cease, date — interest rate, guaranteed minimum.

Section 376.726 - Nonpayment of premiums, effect of.

Section 376.728 - Law not applicable, when.

Section 376.730 - Liens, association may impose, when.

Section 376.732 - Director to have association's powers and duties, when — association may appear in court, when.

Section 376.733 - Assignment of rights to association by persons receiving benefits, when — subrogation rights.

Section 376.734 - Additional powers of association.

Section 376.735 - Assessments against members, when due, classes — amounts, how determined.

Section 376.737 - Deferment of assessment, how, when — maximum assessment — refund of, when — members may increase premiums to cover assessments.

Section 376.738 - Certificate of contribution, when issued.

Section 376.740 - Plan of operation, required, approval of director — provisions of plan.

Section 376.742 - Director, powers and duties.

Section 376.743 - Board of directors, powers.

Section 376.745 - Assessments, offset against tax liability, when, how.

Section 376.746 - Records of association meetings to be kept — association deemed creditor of insolvent or impaired insured.

Section 376.747 - Distribution of member insurer assets upon liquidation, priority of association.

Section 376.748 - Liquidation, recovery of distributions, when, exceptions, limitations.

Section 376.750 - Financial report, submitted to director, when — tax exempt status — immunity from liability.

Section 376.752 - Member insurer's deposit with director, exemption from, amount.

Section 376.754 - Stay of proceedings, insolvent insurer, when.

Section 376.755 - Advertising, use of guaranty association prohibited.

Section 376.756 - Summary document, association to prepare, contents — policy not covered by guaranty association to contain notice, form determined by director.

Section 376.758 - Law inapplicable to insolvent insurers on effective date of law.

Section 376.770 - Title of law.

Section 376.773 - Definitions.

Section 376.775 - Matters required in policies.

Section 376.776 - Hospital and medical expense provisions extended for certain handicapped and dependent children past normal coverage age.

Section 376.777 - Specifically required provisions — exemptions, when — director's powers — inapplicability of certain provisions to individual health insurance coverage.

Section 376.778 - Payment direct to public hospitals or clinics with or without assignment, when — provisions required in contracts.

Section 376.779 - Health insurance policies to offer coverage for treatment of alcoholism — exclusions.

Section 376.780 - Limits on provisions, effect of conflict of policy with law.

Section 376.781 - Speech and hearing disorders, companies to offer coverage, when — rules, procedure.

Section 376.782 - Mammography — low-dose screening, defined — health care policies to provide required coverage.

Section 376.783 - Insured bound only if copy of application attached to policy.

Section 376.785 - What does not constitute waiver of defenses.

Section 376.787 - Effect of age limit provision.

Section 376.789 - Definition of actual charge and actual fee.

Section 376.790 - Limits on applicability of law.

Section 376.791 - Portion of section 376.777 not applicable to individual health insurance coverage.

Section 376.800 - Misrepresentation made in obtaining individual accident and health policy no defense, exception.

Section 376.801 - Coverage for child health supervision services required — definitions — permitted limitations on benefits.

Section 376.805 - Elective abortion to be by optional rider and requires additional premium — elective abortion defined — health insurance exchanges not to offer coverage for elective abortions.

Section 376.806 - Refund of health insurance unearned premium on notice of death of insured — refunded to whom — definitions — exception — failure to notify within one year.

Section 376.807 - Policies not to reduce or deny benefits to persons eligible for medical assistance — deemed primary contract.

Section 376.810 - Definitions for policy requirements for chemical dependency.

Section 376.811 - Coverage required for chemical dependency by all insurance and health service corporations — minimum standards — offer of coverage may be accepted or rejected by policyholders, companies may offer as standard coverage — mental healt...

Section 376.814 - Rules and regulations authorized, department of mental health to advise department — procedure.

Section 376.816 - Adopted children to be provided health care coverage on the same basis as other dependents — effective from date of birth or on placement — placement defined.

Section 376.818 - Eligibility for Medicaid may not be considered by insurers.

Section 376.819 - MO HealthNet division to have right to payment for health care services provided.

Section 376.820 - Insurers may not deny coverage of child because of marital status of parents, residence or income tax dependency claim.

Section 376.821 - Insurers may not cancel health or dental insurance solely because the insured is incarcerated — insurer, defined.

Section 376.823 - Prohibition on kickbacks not applicable for rebates for certain chronic illnesses.

Section 376.845 - Definitions — eating disorders, coverage for diagnosis and treatment of — limitations on coverage.

Section 376.850 - Law, how cited.

Section 376.854 - Definitions.

Section 376.859 - Medicare supplement law applicable to what policies — policies not included.

Section 376.864 - Policies not to duplicate benefits provided by Medicare — preexisting conditions, limitations on — director to issue rules establishing standards.

Section 376.869 - Standards for policies, minimum, director to adopt.

Section 376.874 - Requirements of policy, return to policyholders.

Section 376.879 - Outline of coverage for fair disclosure — furnished to each applicant — format and content — rules and standards.

Section 376.881 - Policy certificate front page to contain notice of right to return and receive premium refund.

Section 376.882 - Cancellation of policy, refund required — notification.

Section 376.884 - Advertisement to be reviewed by director.

Section 376.886 - Regulations, requirements — rules, procedure.

Section 376.889 - Violations, penalty.

Section 376.890 - Invalidity of any section regulating Medicare supplement not to affect others.

Section 376.891 - Definitions.

Section 376.892 - Surviving spouse may continue coverage, when — divorced or separated spouse may continue coverage, when — services offered.

Section 376.893 - Divorced or separated spouse, continuation of coverage, notice — contents of notice — failure to elect, effect — application.

Section 376.894 - Amount of premium, date of payment — termination of right of continuation of coverage, grounds.

Section 376.900 - Definitions.

Section 376.905 - Administration by department, powers, duties — fees.

Section 376.910 - Certificate of authority required.

Section 376.915 - Application for certificate, content — renewal, content, filed when — extensions, fee.

Section 376.920 - Annual statement, form, contents.

Section 376.925 - Seven-day rescission period, all money or property to be refunded.

Section 376.930 - Insured to be furnished application for certificate and annual statement, when.

Section 376.935 - Certificates issued for one year — nontransferable — not endorsement by department.

Section 376.940 - Escrow account for entrance fees required, released when.

Section 376.945 - Escrow account, amount required — principal, how released, investment.

Section 376.950 - Board of directors, one member to be resident of facility.

Section 376.960 - Definitions.

Section 376.961 - Missouri health insurance pool created — members to be all health insurers in state — board of directors, members, terms, qualifications — transitioning resources.

Section 376.962 - Plan of operation to be submitted by board — effective when — failure to submit, director's duty to develop rules — plan content — amendments, procedure.

Section 376.964 - Board, powers and duties — including providing for issuing policies and reinsuring risks — staff appointment — rulemaking authority.

Section 376.965 - Board members not civilly liable for performance of duties, exception.

Section 376.966 - No employee to lose coverage by enrolling in pool — eligibility for pool coverage, ineligibility — medical underwriting considerations, notification required, when — expiration date.

Section 376.968 - Administration of pool by insurer or insurers by competitive bids — insurer's qualifications — board to establish criteria for bid content.

Section 376.970 - Administering insurer to serve for three years subject to removal for cause — duties — reports — bidding process.

Section 376.973 - Administering insurer at close of fiscal year to make accounting and assessment — how calculated — excess to be held at interest for future losses or to reduce premiums — future losses, defined — assessments, continuation of.

Section 376.975 - Member's proportion of participation in pool to be determined annually — deficits to be recouped by proportioned assessment — amount of assessment to be offset against certain taxes.

Section 376.978 - Director of revenue to determine reduced amount in county foreign insurance tax fund, state treasurer to reimburse fund by reducing amount to general revenue.

Section 376.980 - Pool member exempt from taxation of financial institution, may be allowed to offset against sales or use tax, when — excess of assessment over sales or use tax payable in any one year a credit in succeeding years until excess is exh...

Section 376.982 - Rulemaking procedure.

Section 376.984 - Abatement or deferring all or part of assessment of member, when — amount abated or deferred may be assessed against other members — deficiency liability.

Section 376.986 - Pool to offer medical coverage — premiums, how established — standard risk rate, how calculated — director to approve rates — exclusions — benefits reduced by other insurance or workers' compensation — medical expense to include pra...

Section 376.987 - High deductible health plans and establishment of health savings plans to be offered as options — definitions — rulemaking authority.

Section 376.989 - No liability, criminal or civil, for participation in pool by members.

Section 376.995 - Limited mandate health insurance policies defined — certain sections not to apply to limited mandate health insurance policies, exceptions — requirements to sell or issue — certain law to apply.

Section 376.998 - Health insurance mandate exemption for excepted benefit plans — definitions — procedure to exempt.

Section 376.1000 - Multiple employer self-insured health plan, defined.

Section 376.1002 - Certificate of authority required — penalty for noncompliance — law inapplicable, when — exempt organizations.

Section 376.1005 - Application for certificate of authority, form — fee — policy or other evidence of coverage provided to employees, form.

Section 376.1007 - Plan to file copy of bylaws, coverage and agreements with director.

Section 376.1010 - Excess stop-loss coverage maintained by plan.

Section 376.1012 - Funds collected from employers held in trust — requirements — board of trustees, elected, duties — annual report, filed when.

Section 376.1015 - Department not to grant approval, when.

Section 376.1017 - Plan to establish loss reserves — plan to establish surplus account, amount.

Section 376.1020 - Plan to maintain principal place of business in Missouri, exception.

Section 376.1022 - Dissolution of plan, application, procedure, granted when — distribution of assets, procedures.

Section 376.1025 - Director may adopt rules.

Section 376.1027 - Plan in unsound condition, powers of director.

Section 376.1030 - Agreement of employer to pay benefits, requirements, form — copy filed with director — no excuse from liability.

Section 376.1032 - Plan considered insurer, when.

Section 376.1035 - Chapter 376 applicable to plan.

Section 376.1037 - Plan subject to premium taxes.

Section 376.1040 - Plan not to be offered to public — marketing restrictions — exemption — use of brokers authorized.

Section 376.1042 - Marketing by agent, agency or broker violation of law.

Section 376.1045 - Injunctive relief, director may seek, when — procedures.

Section 376.1060 - Access to dental services not to be sold, assigned, or granted access without express authorization — definitions — requirements.

Section 376.1065 - Official notification communications, contracting entity requirements.

Section 376.1075 - Definitions.

Section 376.1077 - Administrator to have agreement with insurer, form, contents — termination, how.

Section 376.1080 - Payments of premiums and claims deemed paid, when.

Section 376.1082 - Records maintained by administrator for insurer — director may examine records — records owned by insurer, transfer allowed, when.

Section 376.1083 - Advertising restrictions for administrator.

Section 376.1084 - Insurer responsible for benefits and underwriting practices — insurer to conduct review of administrator, when.

Section 376.1085 - Premiums held in fiduciary capacity, duties — financial records, duties — withdrawals from fiduciary account by agreement only, contents — payment of claims.

Section 376.1087 - Commissions not to be contingent on savings in payment of claims — may be based on premiums collected.

Section 376.1088 - Notice to policyholder of administrator, contents, required — disclosure of receipts to insurer.

Section 376.1090 - Materials delivered to administrator for insured to be promptly delivered.

Section 376.1092 - Certificate of authority, required, application, contents, fee — refusal to issue, when — renewal — bond, required when.

Section 376.1093 - Annual report filed with director, when — contents — filing fee, amount.

Section 376.1094 - Certificate of authority, suspension or revocation, grounds — civil action, when.

Section 376.1095 - Rules and regulations, promulgation.

Section 376.1100 - Law, how cited — definitions.

Section 376.1103 - Laws applicable, Medicare supplement laws not applicable — purpose — policies or riders must be in compliance.

Section 376.1106 - Policies issued in other states may be issued to residents of Missouri if in compliance with Missouri regulations.

Section 376.1109 - Policies, content requirements, provisions prohibited — rules authorized — cancellation, refund required — limitation on rate increases.

Section 376.1112 - Director to provide buyer's guide — content — advertising of long-term care policies to contain notice of availability of guide.

Section 376.1115 - Coverage outline to be delivered to applicants, when, content.

Section 376.1118 - Benefits funded by a life insurance death benefit acceleration, reports to policyholder required, content.

Section 376.1121 - Denial of claim, long-term care insurance, duties of issuer.

Section 376.1124 - Rescinding of a long-term care policy, permitted when — grounds for contesting — no field issuance, when.

Section 376.1127 - Nonforfeiture benefit option required for long-term care insurance policies, requirements of offer — rulemaking authority.

Section 376.1130 - Rulemaking authority.

Section 376.1186 - State-based health benefit exchanges prohibited without statutory authority — executive order to establish prohibited — state agency restrictions — taxpayer standing — definitions.

Section 376.1190 - Health care mandates — review by oversight division — actuarial analysis.

Section 376.1199 - Coverage for certain obstetrical/gynecological services — exclusion of contraceptive coverage permitted, when — rulemaking authority.

Section 376.1200 - Certain policies to offer coverage for treatment of breast cancer — limitation on deductible, lifetime maximum benefit — administration of benefits — application, effect.

Section 376.1209 - Mastectomy — mandatory insurance coverage for prosthetic devices and reconstructive surgery — no time limit to be imposed.

Section 376.1210 - Maternity benefits, minimum hospital stays, exceptions — notice of benefits, contents — attending physician defined — rulemaking.

Section 376.1215 - Immunizations, mandated coverage, exceptions, rulemaking.

Section 376.1218 - Insurance coverage for children enrolled in the Part C early intervention system (First Steps).

Section 376.1219 - PKU formula and low protein modified food products covered by insurance, when — exceptions.

Section 376.1220 - Insurance coverage for newborn hearing screenings mandated.

Section 376.1222 - Prostheses and scalp prostheses to be provided for children under eighteen by Medicaid, children's health insurance and the consolidated plan — no additional insurance cost — amount allowable.

Section 376.1224 - Definitions — insurance coverage required — limitations on coverage — maximum benefit amount, adjustments — reimbursements, how made — applicability to plans.

Section 376.1225 - Mandated coverage for general anesthesia and hospital charges for dental care, when — prior authorization required, when — exceptions.

Section 376.1226 - Fee schedule for services not covered under health benefit plans — definitions.

Section 376.1228 - Hearing aids coverage for children required — amount of coverage — exclusions — additional state costs subject to appropriations.

Section 376.1230 - Chiropractic care coverage, rates, terms, conditions, limits, and exclusions.

Section 376.1232 - Insurers to offer coverage for prosthetics.

Section 376.1235 - No co-payments or coinsurance for physical or occupational therapy services, when — actuarial analysis of cost, when.

Section 376.1237 - Refills for prescription eye drops, required, when — definitions.

Section 376.1250 - Cancer screening, health insurance coverage required, when, types.

Section 376.1253 - Second opinion, right of newly diagnosed cancer patients, attending physician to inform — insurance coverage for such second opinions required, when.

Section 376.1257 - Orally administered anticancer medications, plan to provide coverage no less favorable than IV or injected medications — definitions — requirements — effective date.

Section 376.1275 - Coverage for human leukocyte antigen testing for bone marrow transplantation required, when — exceptions.

Section 376.1290 - Coverage for lead testing.

Section 376.1300 - Reorganization of a domestic mutual life insurance company, authority.

Section 376.1305 - Formation of holding company, application — shareholder approval.

Section 376.1307 - Issuance of shares.

Section 376.1309 - Member's interest — nontransference of membership — immunity from liability — assessments, not imposed — security, membership interest.

Section 376.1312 - Nonapplicability of certain provisions of insurance holding companies law.

Section 376.1315 - Incorporation of mutual holding company, authority, approval.

Section 376.1318 - Powers of mutual holding company, engaging in business of insurance, no authority, affiliation and merger agreements.

Section 376.1322 - Mutual holding company subject to supervision of director, dissolution or liquidation — demutualization.

Section 376.1345 - Method of reimbursement not to require fee, discount, or remuneration — notification requirements — electronic funds transfer, when — overpayment, procedure — violation, penalty.

Section 376.1350 - Definitions.

Section 376.1353 - Utilization review activities monitored.

Section 376.1356 - Utilization review entity monitored, when.

Section 376.1359 - Written utilization program implemented, filed with the director.

Section 376.1361 - Documented clinical review criteria used in a utilization program — medical director qualifications — compensation of utilization review services.

Section 376.1363 - Utilization review decisions, procedures.

Section 376.1364 - Unique confirmation number required, prior authorization review — secure electronic transmission for prior authorizations — single cover page, contents.

Section 376.1365 - Reconsideration of an adverse determination, when.

Section 376.1367 - Emergency services benefit determination, coverage required, when.

Section 376.1369 - Certification of compliance, when.

Section 376.1372 - Certification and member handbook to include utilization review procedures — website or provider portal, prior authorization requirements available on.

Section 376.1375 - Registry of grievances maintained, procedures — definitions.

Section 376.1378 - Grievances and certificate of compliance filed with the director, when.

Section 376.1382 - First- and second-level grievance review for managed care plans, first-level procedures.

Section 376.1385 - Second-level review procedures.

Section 376.1387 - Appeals of grievances determined by the director.

Section 376.1389 - Expedited grievance review procedure.

Section 376.1399 - Rules, effective, when — rules invalid and void, when.

Section 376.1400 - Explanation of benefits, standardized information used, contents, when.

Section 376.1403 - Referrals, standardized information used, content, when.

Section 376.1450 - Enrollee's right to receive documents and materials in printed or electronic form, when.

Section 376.1500 - Definitions.

Section 376.1502 - Requirements for transaction of business.

Section 376.1504 - Registration requirements — term of registration — renewal.

Section 376.1506 - Violations, penalty.

Section 376.1508 - Processing fee — cancellation of membership, effect of.

Section 376.1510 - Prohibited acts.

Section 376.1512 - Required disclosures.

Section 376.1514 - Written agreement required, contents.

Section 376.1516 - Written membership materials, required contents — forms to be filed with director, fee.

Section 376.1516 - Written membership materials, required contents — forms to be submitted to director.

Section 376.1518 - Net worth to be maintained, amount.

Section 376.1520 - Notice of changes.

Section 376.1522 - List of providers to be maintained on website.

Section 376.1524 - Advertising and marketing materials, approval in writing required.

Section 376.1528 - Rulemaking authority.

Section 376.1530 - Denial and refusal to issue registrations, when.

Section 376.1532 - Violations, penalties.

Section 376.1550 - Mental health coverage, requirements — definitions — exclusions.

Section 376.1551 - Federal mental health parity and addiction equity requirements — inapplicable, when — rulemaking authority.

Section 376.1575 - Definitions.

Section 376.1578 - Credentialing procedure, health carrier duties — covered health services, payment, when — violations, mechanism for reporting.

Section 376.1590 - Status as living organ donor not sole factor for insurance coverage.

Section 376.1750 - Health care sharing ministry, provisions not to apply to — ministry not engaging in the business of insurance, when — health care sharing ministry defined.

Section 376.1753 - Services related to pregnancy, persons holding ministerial or tocological certification may provide.

Section 376.1800 - Definitions — medical retainer agreements not insurance — agreement requirements — use of health savings accounts for fees.

Section 376.1900 - Definitions — reimbursement for telehealth services, when.

Section 376.2000 - Citation of law — definitions.

Section 376.2002 - Navigators, license required — permitted acts — prohibited acts — exemptions.

Section 376.2004 - Application procedure.

Section 376.2006 - Term of licensure — renewal — continuing education.

Section 376.2008 - Consultation with licensed insurance producer, navigator to advise, when.

Section 376.2010 - Sanction of license, when — restitution required, when — examination and investigation of records.

Section 376.2011 - Violations, administrative orders, civil actions — penalty.

Section 376.2012 - Navigators duty to report, when.

Section 376.2014 - Applicability — severability — rulemaking authority.

Section 376.2020 - Contracts prohibiting disclosure of certain payments and costs are unenforceable.

Section 376.2030 - Definitions.

Section 376.2034 - Restriction on step therapy protocol, patient to have access to override exception determination — procedure.

Section 376.2036 - Enforcement — applicability to health insurance plans, when.

Section 376.2050 - Citation of act.

Section 376.2051 - Definitions.

Section 376.2052 - Comparison of in-force policies to death master file — violation deemed an unfair trade practice.

Section 376.2053 - Exemption from requirements, when.

Section 376.2080 - Funding agreement defined — authority to issue — rulemaking authority.