Title XXIV — BUSINESS AND FINANCIAL INSTITUTIONS

376.1514. Written agreement required, contents. — 1. All providers offering medical services to members under a discount medical plan shall provide such services pursuant to a written agreement. The agreement may be entered into directly by the health care provider or by a health…

*376.1516. Written membership materials, required contents — forms to be filed with director, fee. — 1. Each benefit under the discount medical plan and every disclosure required under sections 376.1500 to 376.1532, shall be included in the written membership materials between th…

376.1518. Net worth to be maintained, amount. — 1. Each discount medical plan organization registered pursuant to sections* 376.1500 to 376.1532 shall at all times maintain a net worth of at least one hundred fifty thousand dollars. 2. The director may not allow a registration un…

376.1520. Notice of changes. — Each discount medical plan organization required to be registered pursuant to this section shall provide the director at least thirty days' advance notice of any change in the discount medical plan organization's name, address, principal business ad…

376.1522. List of providers to be maintained on website. — Each discount medical plan organization shall maintain a current list of the names and addresses of the providers with which it has contracted on a website page, the address of which shall be prominently displayed on all …

376.1524. Advertising and marketing materials, approval in writing required. — 1. All advertisements, marketing materials, brochures and discount cards used by marketers shall be approved in writing for such use by the discount medical plan organization. 2. The discount medical p…

376.1528. Rulemaking authority. — The director under the provisions of section 374.045 may promulgate rules to administer and interpret the provisions of sections 376.1500 to 376.1532. ­­-------- (L. 2007 H.B. 818 merged with S.B. 66) Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 81…

376.1530. Denial and refusal to issue registrations, when. — 1. The director may deny a registration to an applicant or refuse to renew, suspend, or revoke the registration of a registrant if the applicant or registrant, or an officer, director, or employee of the applicant or re…

376.1532. Violations, penalties. — 1. If the director determines that a person has engaged, is engaging, or has taken a substantial step toward engaging in a violation of sections 376.1500 to 376.1532, or a rule adopted or order issued pursuant thereto, or that a person has mater…

376.1550. Mental health coverage, requirements — definitions — exclusions. — 1. Notwithstanding any other provision of law to the contrary, each health carrier that offers or issues health benefit plans which are delivered, issued for delivery, continued, or renewed in this state…

376.1551. Federal mental health parity and addiction equity requirements — inapplicable, when — rulemaking authority. — 1. As used in this section, the following terms mean: (1) "Health benefit plan", the same meaning given to the term in section 376.1350; (2) "Health carrier", t…

376.1575. Definitions. — As used in sections 376.1575 to 376.1580*, the following terms shall mean: (1) "Completed application", a practitioner's application to a health carrier that seeks the health carrier's authorization for the practitioner to provide patient care services as…

376.1578. Credentialing procedure, health carrier duties — covered health services, payment, when — violations, mechanism for reporting. — 1. Within two working days after receipt of a credentialing application, the health carrier shall send a notice of receipt to the practitione…

376.1590. Status as living organ donor not sole factor for insurance coverage. — 1. As used in this section, the term "insurance policy" means a policy or other contract of life insurance as such term is defined in section 376.365, a policy of accident and sickness insurance as s…

376.160. Formation of stock and mutual companies. — The provisions of sections 376.070 to 376.090, relating to the formation of joint stock companies, shall apply, in all respects, to the formation of stock and mutual companies; and a certified copy of the articles shall be filed…

376.170. Special deposits for registered policies and annuity bonds. — All life insurance companies organized under the provisions of sections 376.010 to 376.670 shall deposit with the director of the department of commerce and insurance, in addition to other amounts required by …

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. — 1. The provisions of this chapter relating to health insurance, health maintenance organizations, health benefit…

376.1753. Services related to pregnancy, persons holding ministerial or tocological certification may provide. — Notwithstanding any law to the contrary, any person who holds current ministerial or tocological certification by an organization accredited by the National Organizati…

376.180. Certificates as to registration and reserves on policy — policies exempt, exceptions. — 1. After making the deposits mentioned in section 376.170, the company shall issue its policies of insurance or annuity bonds and each policy may have set out in the body thereof the …

[Repealed or reserved.]

376.1850. Exemption from insurance coverage for certain organization contracts — registration requirements — contract requirements — fee, amount — coverage. — 1. As used in this section, the following terms mean: (1) "Contract for health care benefits", a self-funded contractual …

376.190. Additional deposits required. — The director shall annually cause the registered policies and annuity bonds of each company outstanding and in force to be carefully valued, and whenever the total of the actual net value of such policies and annuity bonds exceeds the mark…

376.1900. Definitions — reimbursement for telehealth services, when. — 1. As used in this section, the following terms shall mean: (1) "Electronic visit", or "e-visit", an online electronic medical evaluation and management service completed using a secured web-based or similar e…

376.200. Definition of net value. — The term "net value" of any such registered policy or annuity bond as used in sections 376.010 to 376.670 shall be the total of the various reserve values thereof as defined by section 376.370, as same now is or as same may be subsequently amen…

376.2000. Citation of law — definitions. — 1. Sections 376.2000 to 376.2014 shall be known and may be cited as the "Health Insurance Marketplace Innovation Act of 2013". 2. As used in sections 376.2000 to 376.2014, the following terms mean: (1) "Department", the department of com…

376.2002. Navigators, license required — permitted acts — prohibited acts — exemptions. — 1. No individual or entity shall perform, offer to perform, or advertise any service as a navigator in this state, or receive navigator funding from the state or an exchange unless licensed …

376.2004. Application procedure. — 1. An individual applying for a navigator license shall make application to the department on a form developed by the director and declare under penalty of refusal, suspension, or revocation of the license that the statements made in the applica…

376.2006. Term of licensure — renewal — continuing education. — 1. A navigator license shall be valid for two years. 2. A navigator may file an application for renewal of a license and pay the renewal fee as prescribed by the director. Any navigator who fails to timely file for l…

376.2008. Consultation with licensed insurance producer, navigator to advise, when. — Upon contact with a person who acknowledges having existing health insurance coverage obtained through an insurance producer, a navigator shall advise the person to consult with a licensed insur…

376.2010. Sanction of license, when — restitution required, when — examination and investigation of records. — 1. The director may place on probation, suspend, revoke, or refuse to issue, renew, or reinstate a navigator license or may levy a fine not to exceed one thousand dollar…

376.2011. Violations, administrative orders, civil actions — penalty. — 1. If the director determines that a person has engaged, is engaging, or has taken a substantial step toward engaging in an act, practice, omission, or course of business constituting a violation of sections …

376.2012. Navigators duty to report, when. — 1. Each licensed navigator shall report to the director within thirty calendar days of the final disposition of the matter of any administrative action taken against him or her in another jurisdiction or by another governmental agency …

376.2014. Applicability — severability — rulemaking authority. — 1. The requirements of sections 379.930 to 379.952 and chapters 375, 376, 407 and any related rules shall apply to navigators. The activities and duties of a navigator shall be deemed to constitute transacting the b…

*376.2020. Contracts prohibiting disclosure of certain payments and costs are unenforceable. — 1. For purposes of this section, the following terms shall mean: (1) "Contractual payment amount" or "payment amount", shall mean the total amount a health care provider is to be paid f…

376.2030. Definitions. — As used in sections 376.2030 to 376.2036, the following terms mean: (1) "Health benefit plan", the same meaning as such term is defined in section 376.1350; (2) "Health care provider", the same meaning as such term is defined in section 376.1350; (3) "Hea…

376.2034. Restriction on step therapy protocol, patient to have access to override exception determination — procedure. — 1. If coverage of a prescription drug for the treatment of any medical condition is restricted for use by a health carrier, health benefit plan, or utilizatio…

376.2036. Enforcement — applicability to health insurance plans, when. — Notwithstanding any law to the contrary, the department of commerce and insurance shall enforce sections 376.2030 to 376.2036. The provisions of sections 376.2030 to 376.2036 shall apply to health insurance …

376.2050. Citation of act. — Sections 376.2050 to 376.2053 shall be known and may be cited as the "Unclaimed Life Insurance Benefits Act". ­­-------- (L. 2016 H.B. 2150)

376.2051. Definitions. — As used in sections 376.2050 to 376.2053, the following terms mean: (1) "Asymmetric conduct", an insurer's use of the death master file prior to January 1, 2018, in connection with searching for information regarding whether annuitants under the insurer's…

376.2052. Comparison of in-force policies to death master file — violation deemed an unfair trade practice. — 1. An insurer shall perform a comparison of its in-force life insurance policies, contracts, and retained asset accounts against a death master file on at least a semiann…

376.2053. Exemption from requirements, when. — An insurer that has not engaged in any asymmetric conduct prior to January 1, 2018, shall not be required to comply with the requirements of sections 376.2050 to 376.2053 with respect to any policies, contracts, or retained asset acc…

376.2080. Funding agreement defined — authority to issue — rulemaking authority. — 1. As used in this chapter and chapter 375, the term "funding agreement" means an agreement for an insurer to accept and accumulate funds and to make one or more payments at future dates in amounts…

376.210. Excess deposits. — Whenever the aggregate market value of the securities deposited by any company shall exceed the net reserve liability of the company on all of its registered policies and annuity bonds, the excess may be returned to the company, or, whenever the liabil…

376.220. May use realty to secure notes and bonds. — Should any company depositing under section 376.170 become the owner of real estate for its own use and accommodations, or become temporarily seized and possessed of real estate in satisfaction of debt for which such real estat…

376.230. Changing of securities on deposit. — Any company shall have the right at any time to change the securities on deposit with the director of the department of commerce and insurance by substituting a like amount of the character required in the first instance and to withdr…

376.240. Deposits to be held in trust by director. — The securities deposited under the provisions of section 376.170 shall be legally transferred to the director of the department of commerce and insurance, and so large an amount thereof as may be necessary to equal, at all time…

376.250. Deposits to be kept separate. — The securities deposited under section 376.170 shall be deposited and kept in the same manner, but separate from other deposits of the company. ­­-------- (RSMo 1939 § 5822) Prior revisions: 1929 § 5711; 1919 § 6122; 1909 § 6916

376.260. Fees collected by director of revenue. — The director of revenue, in addition to other fees allowed by law, shall be entitled to collect the following fees, including seal, from companies depositing under section 376.170: For issuing certificates of deposits, which he is…

376.270. Director may proceed against depositary companies. — If at any time the affairs of any life insurance company which has deposited securities under section 376.170 shall, in the opinion of the director, appear in such condition as to render the issuing of additional polic…

376.280. Capital necessary to do business — how invested. — 1. No joint stock or stock and mutual company formed under the provisions of sections 376.010 to 376.670, or the laws of this state, for any purpose mentioned in section 376.010, shall commence to do business or issue po…