Title XXIV — BUSINESS AND FINANCIAL INSTITUTIONS

376.005. Definitions. — As used in this chapter, unless otherwise clearly indicated by the context, the following words mean: (1) "Department", the department of commerce and insurance; and (2) "Director", the director of the department of commerce and insurance. ­­-------- (L. 2…

376.010. Who may form company — purposes. — Any number of persons, not less than thirteen, may associate and form a company for the purpose of making insurance upon the lives of individuals, and every assurance pertaining thereto or connected therewith (including, for policies is…

376.015. Involuntary unemployment insurance may be issued in connection with extension of credit or certain group life insurance, requirements. — Corporations doing the business specified in section 376.010 may also make insurance to provide a periodic indemnity for involuntary u…

376.020. Various companies defined. — Corporations doing the business mentioned in section 376.010, which are owned and controlled entirely by the stockholders, and in neither the management nor the profits of which the policyholders participate, shall be considered "joint stock …

376.050. Declaration of corporators. — The persons mentioned in section 376.010 shall be designated as "corporators", and such corporators, desiring to form a company for the purpose of transacting the business mentioned in said section, or any part of the same, shall file in the…

376.060. Stock companies — content of charter. — When such corporators propose to form a joint stock company for the purposes designated in section 376.010, the charter comprised in the declaration mentioned in section 376.050 shall set forth (1) The name assumed by such corporat…

376.070. To be submitted to attorney general. — Whenever the corporators have filed the declaration required by section 376.050 and also the proof of publication therein required by the affidavit of the publisher of the newspaper in which the publication was made, his foreman or …

376.080. Director to examine, when. — Upon being notified that the capital stock named in the charter has been subscribed, and two hundred thousand dollars thereof paid in, the director shall make an examination, or cause one to be made by some disinterested person specially appo…

376.090. To furnish certificate of deposit, when. — When the corporators have fully complied with the requirements of the preceding sections, and the laws of this state governing the organization of private corporations, and said corporation has deposited with the director of the…

376.100. Mutual companies — contents of charter. — When such corporators propose to form a mutual company, for the purpose designated in section 376.010, the charter comprised in the declaration mentioned in section 376.050 shall set forth: (1) The name assumed by such corporatio…

376.1000. Multiple employer self-insured health plan, defined. — 1. As used in sections 376.1000 to 376.1045, a "multiple employer self-insured health plan" is any plan or arrangement which is not fully insured and which is either: (1) Offered by a staff or employee leasing compa…

376.1002. Certificate of authority required — penalty for noncompliance — law inapplicable, when — exempt organizations. — 1. It is unlawful for any multiple employer self-insured health plan to transact business in this state without a certificate of authority issued by the dire…

376.1005. Application for certificate of authority, form — fee — policy or other evidence of coverage provided to employees, form. — 1. Application for a certificate of authority shall be made on forms prescribed by the director of the department of commerce and insurance. No mul…

376.1007. Plan to file copy of bylaws, coverage and agreements with director. — At the time application for a certificate of authority is made, the multiple employer self-insured health plan shall file with the director a copy of the plan's bylaws, all schedules of benefits, and …

376.1010. Excess stop-loss coverage maintained by plan. — A multiple employer self-insured health plan shall maintain aggregate excess stop-loss coverage and individual excess stop-loss coverage provided by an insurer licensed by the state to write accident and health insurance o…

376.1012. Funds collected from employers held in trust — requirements — board of trustees, elected, duties — annual report, filed when. — Funds collected from the participating employers under multiple employer self-insured health plans shall be held in trust subject to the follo…

376.1015. Department not to grant approval, when. — The department shall not grant or renew approval as to any plan if the department determines: (1) Any trustee is incompetent or untrustworthy; (2) That any trustee has been found guilty of, or has pled guilty or no contest to a …

376.1017. Plan to establish loss reserves — plan to establish surplus account, amount. — 1. A plan shall establish loss reserves for all incurred losses, both reported and unreported, and for unearned premiums. 2. A plan also shall establish a surplus account equal to the greater…

376.1020. Plan to maintain principal place of business in Missouri, exception. — Each multiple employer self-insured health plan shall have and maintain its principal place of business in this state or shall appoint the director of the department of commerce and insurance as its …

376.1022. Dissolution of plan, application, procedure, granted when — distribution of assets, procedures. — 1. A plan that desires to cease existence shall apply to the director for authority to dissolve. Applications to dissolve shall be on forms prescribed by the director and s…

376.1025. Director may adopt rules. — The director may adopt regulations which are necessary to implement the provisions of sections 376.1000 to 376.1045 and to ensure the safe and proper operation of multiple employer self-insured health plans in this state. No rule or portion o…

376.1027. Plan in unsound condition, powers of director. — 1. If the director is of the opinion that a multiple employer self-insured health plan is in an unsound condition, that it has failed to comply with the law or any applicable regulations or orders issued by the director, …

376.1030. Agreement of employer to pay benefits, requirements, form — copy filed with director — no excuse from liability. — 1. A multiple employer self-insured health plan shall require each employer, as a condition of participation in the plan, to execute an agreement by which …

376.1032. Plan considered insurer, when. — For the purposes of sections 375.930 to 375.948 and sections 375.1000 to 375.1018, a multiple employer self-insured health plan shall be considered an "insurer". ­­-------- (L. 1993 H.B. 709 § 35)

376.1035. Chapter 376 applicable to plan. — The provisions of this chapter relating to group health and group accident insurance, including policy approval provisions, shall apply to all multiple employer self-insured health plans licensed to do business in this state. ­­--------…

376.1037. Plan subject to premium taxes. — Multiple employer self-insured health plans licensed in this state shall be subject to those taxes set out in sections 148.310 to 148.461. ­­-------- (L. 1993 H.B. 709 § 37)

376.1040. Plan not to be offered to public — marketing restrictions — exemption — use of brokers authorized. — 1. No multiple employer self-insured health plan shall be offered or advertised to the public. No plan shall be sold, solicited, or marketed by persons or entities defin…

376.1042. Marketing by agent, agency or broker violation of law. — The sale, solicitation or marketing of any plan in violation of section 376.1040 by an agent, agency or broker shall constitute a violation of section 375.141. ­­-------- (L. 1993 H.B. 709 § 39, A.L. 2019 S.B. 514…

376.1045. Injunctive relief, director may seek, when — procedures. — The director may, in addition to any other remedy or sanction authorized under the insurance laws of this state, seek injunctive relief against any unauthorized insurer under section 375.786 or any unauthorized …

376.1060. Health care services — definitions — limitations on third-party access, requirements — inapplicability, when. — 1. As used in this section, the following terms shall mean: (1) "Contracting entity", any person or entity, including a health carrier, that is engaged in the…

376.1065. Official notification communications, contracting entity requirements. — 1. As used in this section, the following terms shall mean: (1) "Contracting entity", any health carrier, as such term is defined in section 376.1350, subject to the jurisdiction of the department …

376.1075. Definitions. — As used in sections 376.1075 to 376.1095, the following terms mean: (1) "Administrator", "third-party administrator" or "TPA", a person who directly or indirectly solicits or effects coverage of, underwrites, collects charges or premiums from, or adjusts …

376.1077. Administrator to have agreement with insurer, form, contents — termination, how. — 1. No administrator shall act as such without a written agreement between the administrator and the insurer, and such written agreement shall be retained as part of the official records o…

376.1080. Payments of premiums and claims deemed paid, when. — If an insurer uses the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured party shall be deemed to have been received by the insurer,…

376.1082. Records maintained by administrator for insurer — director may examine records — records owned by insurer, transfer allowed, when. — 1. Every administrator shall maintain and make available to the insurer complete books and records of all transactions performed on behal…

376.1083. Advertising restrictions for administrator. — An administrator may use only such advertising pertaining to the business underwritten by an insurer as has been approved in writing by the insurer in advance of its use. ­­-------- (L. 1993 H.B. 709 § 45)

376.1084. Insurer responsible for benefits and underwriting practices — insurer to conduct review of administrator, when. — 1. If an insurer uses the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria …

376.1085. Premiums held in fiduciary capacity, duties — financial records, duties — withdrawals from fiduciary account by agreement only, contents — payment of claims. — 1. All insurance charges or premiums collected by an administrator on behalf of or for an insurer or insurers,…

376.1087. Commissions not to be contingent on savings in payment of claims — may be based on premiums collected. — 1. An administrator shall not enter into any agreement or understanding with an insurer in which the effect is to make the amount of the administrator's commissions,…

376.1088. Notice to policyholder of administrator, contents, required — disclosure of receipts to insurer. — 1. When the services of an administrator are used, the administrator shall provide a written notice to, and approved by, the insurer to covered individuals advising them o…

376.1090. Materials delivered to administrator for insured to be promptly delivered. — Any policies, certificates, booklets, termination notices or other written communications delivered by the insurer to the administrator for delivery to insured parties or covered individuals sh…

376.1092. Certificate of authority, required, application, contents, fee — refusal to issue, when — renewal — bond, required when. — 1. No person shall act as, or offer to act as, or hold himself out to be an administrator in this state without a valid certificate of authority as…

376.1093. Annual report filed with director, when — contents — filing fee, amount. — 1. Each administrator shall file an annual report for the preceding calendar year with the director on or before March first of each year, or within such extension of time therefor as the directo…

376.1094. Certificate of authority, suspension or revocation, grounds — civil action, when. — 1. The director shall suspend or revoke the certificate of authority of an administrator if the director finds that the administrator: (1) Is in an unsound financial condition; (2) Is us…

376.1095. Rules and regulations, promulgation. — The director shall have the power to promulgate such rules and regulations as are necessary to implement the provisions of sections 376.1075 to 376.1095. No rule or portion of a rule promulgated under the authority of sections 376.…

376.110. To be submitted to attorney general. — Whenever the corporators have filed the declaration required by section 376.050 and also proof of the publication therein required by the affidavit of the publisher of the newspaper in which the publication was made, his foreman or …

376.1100. Law, how cited — definitions. — 1. Sections 376.1100 to 376.1130 may be known and cited as the "Long-term Care Insurance Act". 2. As used in sections 376.1100 to 376.1130, unless the context requires otherwise, the following terms mean: (1) "Applicant": (a) In the case …

376.1103. Laws applicable, Medicare supplement laws not applicable — purpose — policies or riders must be in compliance. — 1. The provisions of sections 376.1100 to 376.1130 shall apply to policies delivered or issued for delivery in this state on or after August 28, 2002. Sectio…

376.1106. Policies issued in other states may be issued to residents of Missouri if in compliance with Missouri regulations. — No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described i…

376.1109. Policies, content requirements, provisions prohibited — rules authorized — cancellation, refund required — limitation on rate increases. — 1. The director may adopt regulations that include standards for full and fair disclosure setting forth the manner, content and req…