PocketLaw
Home
Catalog
Law Online
Teams
Our Free Mobile App
Life, Health and Accident Insurance
Law
Missouri Revised Statutes
Business and Financial Institutions
Life, Health and Accident Insurance
Checkout our iOS App for a better way to browser and research.
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.
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 authority.
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 health benefits provided, when — exclusions.
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 exhausted.
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 prayer for spiritual healing.
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.