Missouri Revised Statutes
Chapter 376 - Life, Health and Accident Insurance
Section 376.712 - Effective date.

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.