2012 Missouri Revised Statutes
TITLE XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376 Life, Health and Accident Insurance
Section 376.833 Inapplicability of section 376.827, when--waiver granted to policyholder, when.

376.833. 1. The provisions of section 376.827 shall not be violated if the insurer decides to apply different limits or exclude entirely from coverage the following:

(1) Marital, family, educational, or training services unless medically necessary and clinically appropriate;

(2) Services rendered or billed by a school or halfway house;

(3) Care that is custodial in nature;

(4) Services and supplies that are not medically necessary nor clinically appropriate; or

(5) Treatments that are considered experimental.

2. The director shall grant a policyholder a waiver from the provisions of section 376.827 if the policyholder demonstrates to the director by actual experience over any consecutive twenty-four-month period that compliance with sections 376.825 to 376.840 has increased the cost of the health insurance policy by an amount that results in a two percent increase in premium costs to the policyholder.

(L. 1999 H.B. 191 376.829)

Expires 1-01-11

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