Missouri Administrative Code

(Rescinded August 30, 2018) AUTHORITY: section 208.553.3(5), RSMo Supp. 2001. Emergency rule filed Jan. 16, 2002, effective March 1, 2002, expired Aug. 27, 2002. Original rule filed Jan. 16, 2002, effective Aug. 30, 2002. Rescinded: Filed Jan. 5, 2018, effective Aug. 30, 2018.

tion Process (Rescinded August 30, 2018) AUTHORITY: section 208.553.3(5), RSMo Supp. 2001. Emergency rule filed Jan. 16, 2002, effective March 1, 2002, expired Aug. 27, 2002. Original rule filed Jan. 16, 2002, effective Aug. 30, 2002. Rescinded: Filed Jan. 5, 2018, effective Aug.…

(Rescinded August 30, 2018) ...............................................................3 19 CSR 90-2.040 Termination or Suspension from the Program (Rescinded August 30, 2018) .......3 19 CSR 90-2.050 Appeal Process (Rescinded August 30, 2018) ................................…

sion from the Program (Rescinded August 30, 2018) AUTHORITY: section 208.553.3(5), RSMo Supp. 2001. Emergency rule filed Jan. 16, 2002, effective March 1, 2002, expired Aug. 27, 2002. Original rule filed Jan. 16, 2002, effective Aug. 30, 2002. Rescinded: Filed Jan. 5, 2018, effec…

(Rescinded August 30, 2018) AUTHORITY: section 208.553.3(5), RSMo Supp. 2001. Emergency rule filed Jan. 16, 2002, effective March 1, 2002, expired Aug. 27, 2002. Original rule filed Jan. 16, 2002, effective Aug. 30, 2002. Rescinded: Filed Jan. 5, 2018, effective Aug. 30, 2018. JO…

Program AUTHORITY: section 208.553.3(5), RSMo Supp. 2001. Emergency rule filed Feb. 15, 2002, effective March 1, 2002, expired Aug. 27, 2002. MATT BLUNT (9/30/02) CODE OF STATE REGULATIONS 3 Secretary of State

other questions or complaints arising from changes, coverage or rates to the division. PURPOSE: This rule reflects the current the treatment of the consumer by an insur- This section also approves workers’ compen- organization of the Department of Commerce ance company or insuran…

(Rescinded May 30, 2008) ...................................................................4 JOHN R. ASHCROFT (10/31/19) CODE OF STATE REGULATIONS 1 Secretary of State Chapter 1—Organization 20 CSR 10-1 Title 20—DEPARTMENT OF maintain statutory autonomy. All seven (7) forms, var…

required to attend the meeting for the purpose commission. The director of professional PURPOSE: This rule complies with sections of discussing or deciding the department’s registration is located at PO Box 1335, 3605 610.023 and 610.028, RSMo regarding Missouri Boulevard, Jeffer…

ment (see section 610.021(7), RSMo). Tests provided in this rule or by applicable law, PURPOSE: This rule complies with sections and examinations are repeated indefinitely; work papers shall not become open to public 610.023 and 610.028, RSMo regarding public (F) Preparation, inc…

1991).* Emergency rule filed Jan. 21, 1992, (Rescinded September 30, 2019) effective Jan. 31, 1992, expired May 29, AUTHORITY: section 374.045, RSMo 2000. 1992. Original rule filed Jan. 21, 1992, Original rule filed Jan. 8, 1992, effective effective June 25, 1992. May 14, 1992. A…

(Rescinded September 30, 2019) (Rescinded July 30, 2019) AUTHORITY: section 374.045, RSMo 2000. AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 8, 1992, effective Original rule filed March 3, 1992, effective May 14, 1992. Amended: Filed Oct. 25, Aug. 6, 1992. Amen…

(Rescinded September 30, 2019) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 8, 1992, effective May 14, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed March 8, 2019, effective Sept. 30, 2019.

Qualifications PURPOSE: This rule sets comparable stan- dards to those stated in section 374.120, RSMo relating to the qualifications of the department’s reinsurance analyst. (1) The following standards are the minimum standards for the position of reinsurance ana- lyst. The rein…

ing Committee (Rescinded January 30, 2020) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 15, 1992, effective Sept. 6, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed July 18, 2019, effective Jan. 30, 2020.

Group (Rescinded January 30, 2020) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 15, 1992, effective Sept. 6, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed July 18, 2019, effective Jan. 30, 2020.

Hotline Task Group (Rescinded January 30, 2020) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 15, 1992, effective Sept. 6, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed July 18, 2019, effective Jan. 30, 2020.

Group (Rescinded January 30, 2020) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 15, 1992, effective Sept. 6, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed July 18, 2019, effective Jan. 30, 2020.

Group (Rescinded January 30, 2020) AUTHORITY: section 374.045, RSMo 2000. Original rule filed Jan. 15, 1992, effective Sept. 6, 1992. Amended: Filed Oct. 15, 2007, effective May 30, 2008. Rescinded: Filed July 18, 2019, effective Jan. 30, 2020. JOHN R. ASHCROFT (12/31/19) CODE OF…

percentage of claims in which the insurer has first-party claimants all pertinent benefits, performed an act described in section coverages or other provisions of an insurance PURPOSE: This rule sets forth definitions 375.1007(2), RSMo, or violated 20 CSR policy under which a cla…

Pertinent Communication 1, 1996, effective June 30, 1997. Amended: appropriate notation shall be made in the Filed May 13, 2019, effective Nov. 30, 2019. claim file of the insurer. PURPOSE: This rule effectuates or aids in (C) If the insurer needs more time to deter- the interpre…

(Rescinded July 30, 2008) ...................................................................4 20 CSR 100-1.050 Standards for Prompt, Fair, and Equitable Settlement of Claims ......................4

(3) Provision of necessary claim forms, Fair, and Equitable Settlement of Claims pose of notifying the third-party claimant of instructions and reasonable assistance to first- the provision of a statute of limitations. party claimants within ten (10) working days PURPOSE: This ru…

Benefit Plans (Rescinded October 30, 2011) .............................................6 20 CSR 100-1.070 Identification Cards Issued by Health Carriers ............................................6 20 CSR 100-1.100 Claims Involving Public Adjusters or Solicitors................…

Issued by Health Carriers adjuster or solicitor. 2018, effective July 30, 2019. PURPOSE: This rule sets forth the require- (1) No insurance company authorized to do ments for an identification card issued to the business of insurance in Missouri shall insureds or enrollees by hea…

Rescinded: Filed April 8, 2011, effective Oct. Adjusters or Solicitors 30, 2011. AUTHORITY: sections 374.045 and 376.778, PURPOSE: This rule effectuates or aids in RSMo 1986 and 376.427, RSMo Supp. 1990. the interpretation of section 375.1007(4), Original rule filed April 25, 199…

(Rescinded July 30, 2019) ...................................................................6 20 CSR 100-1.300 Assignment of Benefits (Rescinded July 30, 2019) .......................................6 JOHN R. ASHCROFT (10/31/19) CODE OF STATE REGULATIONS 1 Secretary of State Cha…

ning Practices physical or mental impairment, except where (Rescinded July 30, 2019) the refusal, limitation or rate differential is based on sound actuarial principles or is AUTHORITY: section 374.045, RSMo 2000. related to actual or reasonably anticipated This rule was previous…

Partial Blindness or Physical or Mental Impairment ....................................3

(Rescinded July 30, 2008) ...................................................................3 JOHN R. ASHCROFT (6/30/19) CODE OF STATE REGULATIONS 1 Secretary of State Chapter 2—Unfair Trade Practices 20 CSR 100-2 Title 20—DEPARTMENT OF Regarding Physical or Mental Impairment. I…

Reports (Rescinded July 30, 2019) AUTHORITY: sections 374.045, 375.992, and 375.993, RSMo 2000 and sections 375.991 and 375.994, RSMo Supp. 2007. Original rule filed Sept. 15, 1992, effective June 7, 1993. Amended: Filed Nov. 1, 2007, effective July 30, 2008. Rescinded: Filed Dec…

(Rescinded July 30, 2019) ty, association, or individual. AUTHORITY: section 374.045, RSMo 2000. (2) Except as provided for under subsection Original rule filed Nov. 1, 2007, effective July (2)(B)— 30, 2008. Rescinded: Filed Dec. 13, 2018, (A) Upon receipt of any inquiry from the…

books and Standards postmark determines the date of mailing. (Rescinded July 30, 2019) When the requested response is not produced by the person within twenty (20) days, this AUTHORITY: section 374.045, RSMo 2000. nonproduction is deemed a violation of this Original rule filed No…

(Rescinded July 30, 2019) inquiry by the department. If another statute or regulation requires a shorter response AUTHORITY: section 374.045, RSMo 2000. time, the shorter response time is controlling. Original rule filed Nov. 1, 2007, effective July This regulation operates only …

the Consumer Affairs Division included. The following day begins the peri- od of computation. Each consecutive calen- PURPOSE: This rule sets forth with greater dar day is counted. The last day of the period specificity the standards for responding to so computed is to be include…

an Adverse Determination against requesting the health carrier (or 376.1399, RSMo Supp. 2007.* Original rule party) to respond in writing with their posi- filed Nov. 3, 1997, effective June 30, 1998. PURPOSE: This rule sets forth with greater tion and all supporting documentation…

cedures independent review organization (IRO). An (1) A written notification of an adverse deter- mination shall be printed in clear legible type unresolved grievance shall include a differ- PURPOSE: This rule sets forth with greater of at least twelve (12)-point font. ence of op…

Information on which transactions are conducted; or as permitted under subsections (4)(A), (4)(B), B. Places a link on a screen that con- and (4)(C) of this rule; PURPOSE: The purpose of this rule is to 5. Provided that the licensee provides sumers frequently access, such as a pa…

guarding Customer Information or use of the information that could result in changing business arrangements, such as substantial harm or inconvenience to any cus- mergers and acquisitions, alliances and joint PURPOSE: This rule establishes standards tomer. ventures, outsourcing a…

tices of insurers or companies licensed to do son under contract to the department, who is PURPOSE: This rule sets out the scope of the business in this state that deviate significant- qualified by education, experience, and, rules in this chapter and provides definitions ly from…

(2) If the analysis supports further investiga- (Rescinded July 30, 2019) tion or review by the division into a particu- lar insurer or practice, the following continu- AUTHORITY: section 374.045, RSMo 2000. um of market conduct actions may be Original rule filed Nov. 1, 2007, ef…

that the director may initiate to assess and address the market PURPOSE: This rule sets out the scope of the rules in this chapter and practices of individual insurers or companies, beginning and provides definitions to aid in the interpretation of the rules with market analysis …

2. Confirmed complaint(s) against the company indicating PURPOSE: This rule implements the purposes of section 374.185, a particular practice or a complaint ratio that deviates RSMo, and establishes uniform standards for the director in significantly from the norm; applying the d…

conduct examinations, the director will apply the following PURPOSE: This rule establishes procedures for a hearing conducted standards in evaluating factual support for a warrant when to review cause to issue a market conduct examination warrant another jurisdiction is consideri…

(Rescinded July 30, 2019) did not evaluate the specific area or issue of concern to the director or a specific requirement of Missouri law, the director AUTHORITY: section 374.045, RSMo 2000. Original rule filed Nov. may issue an examination warrant for a targeted examination 1, …

(Rescinded July 30, 2019) will accept documentation that the company has made a similar modification in this state, in lieu of initiating a market AUTHORITY: sections 374.045 and 374.205, RSMo 2000 and conduct action or examination related to that practice or section 374.185, RSM…

specific state laws or regulations, which differ substantially PURPOSE: This rule implements the purposes of section 374.185, from those of the examining jurisdiction. RSMo, and establishes relevant standards for the director in applying the discretion authorized in issuing warra…

Association of Insurance Commissioners (NAIC) Market PURPOSE: This rule implements the purposes of section 374.185, Regulation Handbook, or in department regulations, if RSMo, and establishes uniform standards for providing notice of inconsistent with the NAIC Market Regulation H…

AUTHORITY: sections 374.045, 374.185, 374.205, and 374.207, RSMo 2016.* Original rule filed April 1, 2008, effective Nov. 30, PURPOSE: This rule implements the purposes of section 374.185, 2008. Amended: Filed Dec. 13, 2018, effective July 30, 2019. RSMo, and establishes uniform …