Title XXIV, BUSINESS AND FINANCIAL INSTITUTIONS

376.779. Health insurance policies to offer coverage for treatment of alcoholism — exclusions. — 1. All health plans or policies that are individually underwritten or provide for such coverage for specific individuals and the members of their families, which provide for hospital …

376.780. Limits on provisions, effect of conflict of policy with law. — 1. Other policy provisions. No policy provision which is not subject to section 376.777 shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the pr…

376.781. Speech and hearing disorders, companies to offer coverage, when — rules, procedure. — 1. All group health insurance policies providing coverage on an expense-incurred basis, all group service or indemnity contracts issued by a not-for-profit health service corporation, a…

376.782. Mammography — low-dose screening, defined — health care policies to provide required coverage — no physician referral, when. — 1. As used in this section, the term "low-dose mammography screening" means the X-ray examination of the breast using equipment specifically des…

376.783. Insured bound only if copy of application attached to policy. — 1. The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof, or the insurer…

376.785. What does not constitute waiver of defenses. — The acknowledgment by an insurer of the receipt of notice given under any policy covered by sections 376.770 to 376.800, or the furnishing of forms for filing proofs of loss, or the acceptance of such proofs, or the investig…

376.787. Effect of age limit provision. — If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the …

376.789. Definition of actual charge and actual fee. — 1. (1) This section applies to an individual or a group specified disease insurance policy issued to any person that contains the terms "actual charge" or "actual fee" without containing an express definition of the term. (2)…

376.790. Limits on applicability of law. — Nothing in sections 376.770 to 376.800 shall apply to or affect (1) any policy of workers' compensation insurance or any policy of liability insurance with or without supplementary expense coverage therein; or (2) any policy or contract …

376.791. Portion of section 376.777 not applicable to individual health insurance coverage. — 1. The provisions of subdivisions (4) and (5) of subsection 2 of section 376.777 shall not apply to any individual health insurance coverage. The term "individual health insurance covera…

376.800. Misrepresentation made in obtaining individual accident and health policy no defense, exception. — Anything in the law to the contrary notwithstanding, no misrepresentation made in obtaining or securing a policy of insurance covered by sections 376.770 to 376.800 shall b…

376.801. Coverage for child health supervision services required — definitions — permitted limitations on benefits. — 1. This section shall be known and may be cited as the "Child Health Insurance Reform Plan". 2. As used in this section, the following terms mean: (1) "Child heal…

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. — 1. No health insurance contracts, plans, or policies delivered or issued for delivery in the…

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. — 1. As used in this section, the following terms mean: (1) "Health insurance contract", any one of the following w…

376.807. Policies not to reduce or deny benefits to persons eligible for medical assistance — deemed primary contract. — 1. No contract of medical expense insurance, delivered or issued for delivery, amended or renewed in this state after August 13, 1988, by a self-insured or sel…

376.810. Definitions for policy requirements for chemical dependency. — As used in sections 376.810 to 376.814, the following terms mean: (1) "Chemical dependency", the psychological or physiological dependence upon and abuse of drugs, including alcohol, characterized by drug tol…

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.…

376.814. Rules and regulations authorized, department of mental health to advise department — procedure. — 1. The department of commerce and insurance shall promulgate rules and regulations, pursuant to section 376.982 and chapter 536, and the department of mental health shall ad…

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. — 1. No health carrier or health benefit plan that offers or issues health benefit plans, other than Medicaid he…

376.818. Eligibility for Medicaid may not be considered by insurers. — No individual or group insurance policy providing coverage on an expense-incurred basis, no individual or group service or indemnity contract issued by a not-for-profit health services corporation, no health m…

376.819. MO HealthNet division to have right to payment for health care services provided. — To the extent that payment has been made by the MO HealthNet division for health care items or services furnished to a Medicaid-eligible individual, the MO HealthNet division is considere…

376.820. Insurers may not deny coverage of child because of marital status of parents, residence or income tax dependency claim. — No individual or group insurance policy providing coverage on an expense-incurred basis, no individual or group service or indemnity contract issued …

376.821. Insurers may not cancel health or dental insurance solely because the insured is incarcerated — insurer, defined. — 1. As used in this section, the term "insurer" means any person, reciprocal exchange, interinsurer, Lloyds insurer, fraternal benefit society, and any othe…

376.823. Prohibition on kickbacks not applicable for rebates for certain chronic illnesses. — Section 191.905 shall not apply to programs established by pharmaceutical companies for the purposes of providing a partial rebate of private health insurance co-payments and coinsurance…

376.845. Definitions — eating disorders, coverage for diagnosis and treatment of — limitations on coverage. — 1. For the purposes of this section the following terms shall mean: (1) "Eating disorder", pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia …

376.850. Law, how cited. — Sections 376.850 to 376.890 may be cited as the "Missouri Medicare Supplement Insurance Act". ­­-------- (L. 1981 S.B. 347 § 1, A.L. 1989 H.B. 615 & 563)

376.854. Definitions. — As used in sections 376.850 to 376.890, the following terms mean: (1) "Applicant": (a) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and (b) In the case of a group Medicare supplement poli…

376.859. Medicare supplement law applicable to what policies — policies not included. — 1. Except as otherwise specifically provided, sections 376.850 to 376.890 shall apply to: (1) All Medicare supplement policies delivered or issued for delivery in this state on or after August…

376.864. Policies not to duplicate benefits provided by Medicare — preexisting conditions, limitations on — director to issue rules establishing standards. — 1. No Medicare supplement policy or certificate in force in the state shall contain benefits that duplicate benefits provi…

376.869. Standards for policies, minimum, director to adopt. — The director shall adopt reasonable regulations to establish minimum standards for benefits, claims payment, marketing practices, compensation arrangements and reporting practices for Medicare supplement policies. ­­-…

376.874. Requirements of policy, return to policyholders. — Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The director shall issue reasonable regulations to establish minimum standards for loss ratios …

376.879. Outline of coverage for fair disclosure — furnished to each applicant — format and content — rules and standards. — 1. In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate shall be deli…

376.881. Policy certificate front page to contain notice of right to return and receive premium refund. — Medicare supplement policies and certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance …

376.882. Cancellation of policy, refund required — notification. — 1. If a Medicare supplement policy issued, delivered, or renewed in this state on or after January 1, 2011, is cancelled for any reason, the insurer shall refund the unearned portion of any premium paid beyond the…

376.884. Advertisement to be reviewed by director. — Every issuer of Medicare supplement insurance policies or certificates in this state shall provide a copy of any Medicare supplement advertisement intended for use in this state whether through written, radio or television medi…

376.886. Regulations, requirements — rules, procedure. — Regulations adopted pursuant to sections 376.850 to 376.890 shall be subject to the provisions of section 376.982, section 536.021 and section 536.024. Any regulation adopted pursuant to sections 376.850 to 376.890 shall co…

376.889. Violations, penalty. — 1. If the director determines that a person has engaged, is engaging in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of sections 376.850 to 376.890 or a rule adopted or order is…

376.890. Invalidity of any section regulating Medicare supplement not to affect others. — If any provision of sections 376.850 to 376.890 or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of sections 376.850 to 376.890 an…

376.891. Definitions. — As used in sections 376.891 to 376.894, the following terms mean: (1) "Certificate holder", a person who receives health care benefits or services pursuant to a policy, contract or plan; (2) "Plan administrator": (a) The person designated as the plan admin…

376.892. Surviving spouse may continue coverage, when — divorced or separated spouse may continue coverage, when — services offered. — 1. Any policy, contract or plan offered, issued or renewed in this state after August 28, 1993, providing coverage for hospital or medical expens…

376.893. Divorced or separated spouse, continuation of coverage, notice — contents of notice — failure to elect, effect — application. — 1. Within sixty days of legal separation or the entry of a decree of dissolution of marriage or prior to the expiration of a thirty-six month f…

376.894. Amount of premium, date of payment — termination of right of continuation of coverage, grounds. — If a legally separated, divorced or surviving spouse elects continuation of coverage under section 376.893: (1) During the period of time covered by the federal Consolidated…

376.900. Definitions. — For the purpose of sections 376.900 to 376.950 the following words and terms mean: (1) "Care for a term of years", an agreement between a resident and a provider whereby the resident pays a fee for the right to occupy space in a designated facility, and to…

376.905. Administration by department, powers, duties — fees. — The administration of sections 376.900 to 376.950 is vested in the division, which shall: (1) Prepare and furnish all forms necessary under the provisions of sections 376.900 to 376.950 in relation to applications fo…

376.910. Certificate of authority required. — No provider shall engage in the business of providing continuing care in this state without a certificate of authority therefor obtained from the department as provided in sections 376.900 to 376.950. ­­-------- (L. 1981 S.B. 84 § 3)…

376.915. Application for certificate, content — renewal, content, filed when — extensions, fee. — 1. A provider shall file an application for a certificate of authority on a form prescribed by the department, and the application shall be accompanied by the annual statement and ot…