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2018 Missouri Revised Statutes
Title XXIV - Business and Financial Institutions
Chapter 376 - Life, Health and Accident Insurance

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Chapter Cross References

GENERAL PROVISIONS

GROUP LIFE INSURANCE

Section 376.691 Group life policies, eligible groups authorized for issue — premiums, how paid. (8/28/1987)
Section 376.693 Special group life policies, requirements — director's approval. (8/28/1982)
Section 376.694 Group life, definitions of direct response solicitation and sponsoring or endorsing entity — certain insurers required to give notice of compensation to policyholder or endorsing entity. (8/28/1985)
Section 376.695 Extension of policy to insure for loss due to death of spouse or dependent children, requirements, limitations. (8/28/1985)
Section 376.696 Political subdivisions purchasing any insurance policies to submit to competitive bidding, when — renewal between bidding periods deemed extension. (8/28/1985)
Section 376.697 Required provisions for group life policies. (8/28/1982)
Section 376.699 Person insured by group policy entitled to individual life policy, notice requirements. (8/28/1982)

BUYER'S GUIDE

Section 376.700 Purpose — use of additional material. (8/28/1979)
Section 376.702 Application of law — exceptions. (8/28/1979)
Section 376.704 Definitions. (8/28/1979)
Section 376.706 Delivery of guide and summary required, when. (8/28/1979)
Section 376.708 Required presentations and statements — company to maintain file. (8/28/1979)
Section 376.710 Effect of omission. (8/28/1979)
Section 376.712 Effective date. (8/28/1979)
Section 376.714 Contents and form of buyer's guide. (8/28/1979)

GUARANTY ASSOCIATION — LIFE AND HEALTH INSURANCE
Effective date of certain amendments, 376.758

INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE

EATING DISORDERS

Section 376.845 Definitions — eating disorders, coverage for diagnosis and treatment of — limitations on coverage. (8/28/2015)

MEDICARE SUPPLEMENT INSURANCE

SPOUSAL COVERAGE CONTINUATION

LIFE CARE CONTRACTS

Section 376.900 Definitions. (8/28/1981)
Section 376.905 Administration by department, powers, duties — fees. (8/28/1981)
Section 376.910 Certificate of authority required. (8/28/1981)
Section 376.915 Application for certificate, content — renewal, content, filed when — extensions, fee. (8/28/1981)
Section 376.920 Annual statement, form, contents. (8/28/1981)
Section 376.925 Seven-day rescission period, all money or property to be refunded. (8/28/1981)
Section 376.930 Insured to be furnished application for certificate and annual statement, when. (8/28/1981)
Section 376.935 Certificates issued for one year — nontransferable — not endorsement by department. (8/28/1981)
Section 376.940 Escrow account for entrance fees required, released when. (8/28/1981)
Section 376.945 Escrow account, amount required — principal, how released, investment. (8/28/1988)
Section 376.950 Board of directors, one member to be resident of facility. (8/28/1981)

HEALTH INSURANCE POOL

LIMITED MANDATE HEALTH INSURANCE

Section 376.995 Limited mandate health insurance policies defined — certain sections not to apply to limited mandate health insurance policies, exceptions — requirements to sell or issue — certain law to apply. (8/28/1997)

EXCEPTED BENEFIT PLANS

Section 376.998 Health insurance mandate exemption for excepted benefit plans — definitions — procedure to exempt. (8/28/2016)

MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS

DENTAL SERVICES

ADMINISTRATORS, CERTAIN INSURANCE POLICIES

LONG-TERM CARE

HEALTH BENEFIT EXCHANGES

Section 376.1186 State-based health benefit exchanges prohibited without statutory authority — executive order to establish prohibited — state agency restrictions — taxpayer standing — definitions. (11/6/2012)

HEALTH CARE MANDATE REVIEW

Section 376.1190 Health care mandates — review by oversight division — actuarial analysis. (8/28/2011)

WOMEN'S HEALTH

Section 376.1199 Coverage for certain obstetrical/gynecological services — exclusion of contraceptive coverage permitted, when — rulemaking authority. (10/12/2012)

BREAST CANCER, OFFER OF COVERAGE

MATERNITY BENEFITS, MANDATED HOSPITAL CARE

Section 376.1210 Maternity benefits, minimum hospital stays, exceptions — notice of benefits, contents — attending physician defined — rulemaking. (8/28/1996)

IMMUNIZATIONS, MANDATED COVERAGE

Section 376.1215 Immunizations, mandated coverage, exceptions, rulemaking. (8/28/1996)

PART C OF IDEA (FIRST STEPS PROGRAM) COVERAGE

Section 376.1218 Insurance coverage for children enrolled in the Part C early intervention system (First Steps). (8/28/2007)

PKU FORMULA, MANDATED COVERAGE

Section 376.1219 PKU formula and low protein modified food products covered by insurance, when — exceptions. (8/28/2002)

NEWBORN HEARING SCREENINGS, MANDATED COVERAGE

Section 376.1220 Insurance coverage for newborn hearing screenings mandated. (8/28/1999)

SCALP HAIR PROSTHESES

Section 376.1222 Prostheses and scalp prostheses to be provided for children under eighteen by Medicaid, children's health insurance and the consolidated plan — no additional insurance cost — amount allowable. (8/28/2003)

AUTISM SPECTRUM DISORDER

Section 376.1224 Definitions — insurance coverage required — limitations on coverage — maximum benefit amount, adjustments — reimbursements, how made — applicability to plans — waiver, when — report. (8/28/2010)

DENTAL CARE, ANESTHESIA AND HOSPITALIZATION, MANDATED COVERAGE

CHIROPRACTIC CARE

Section 376.1230 Chiropractic care coverage, rates, terms, conditions, limits, and exclusions. (8/28/2003)

PROSTHETICS, OFFER OF COVERAGE

Section 376.1232 Insurers to offer coverage for prosthetics. (8/28/2009)

PHYSICAL THERAPY SERVICES

Section 376.1235 No co-payments or coinsurance for physical or occupational therapy services, when — actuarial analysis of cost, when. (8/28/2016)

PRESCRIPTION EYE DROPS

Section 376.1237 Refills for prescription eye drops, required, when — definitions. (8/28/2018)

CANCER COVERAGE

BONE MARROW TRANSPLANTS

Section 376.1275 Coverage for human leukocyte antigen testing for bone marrow transplantation required, when — exceptions. (8/28/2002)

LEAD TESTING

Section 376.1290 Coverage for lead testing. (8/28/2001)

REORGANIZATION OF DOMESTIC MUTUAL LIFE INSURANCE COMPANY

HEALTH CARE UTILIZATION REVIEW

Section 376.1350 Definitions. (8/28/2018)
Section 376.1353 Utilization review activities monitored. (8/28/1997)
Section 376.1356 Utilization review organization monitored, when. (8/28/1997)
Section 376.1359 Written utilization program implemented, filed with the director. (8/28/1997)
Section 376.1361 Documented clinical review criteria used in a utilization program — medical director qualifications — compensation of utilization review services. (8/28/1997)
Section 376.1363 Utilization review decisions, procedures. (8/28/2014)
Section 376.1365 Reconsideration of an adverse determination, when. (8/28/1997)
Section 376.1367 Emergency services benefit determination, coverage required, when. (8/28/2018)
Section 376.1369 Certification of compliance, when. (8/28/1997)
Section 376.1372 Certification and member handbook to include utilization review procedures. (8/28/1997)
Section 376.1375 Registry of grievances maintained, procedures — definitions. (8/28/1997)
Section 376.1378 Grievances and certificate of compliance filed with the director, when. (8/28/1997)
Section 376.1382 First- and second-level grievance review for managed care plans, first-level procedures. (8/28/1997)
Section 376.1385 Second-level review procedures. (8/28/1997)
Section 376.1387 Appeals of grievances determined by the director. (8/28/1997)
Section 376.1389 Expedited grievance review procedure. (8/28/1997)

RULEMAKING AUTHORITY

Section 376.1399 Rules, effective, when — rules invalid and void, when. (8/28/2007)

STANDARDIZATION OF INFORMATION

DOCUMENTS AND MATERIALS

Section 376.1450 Enrollee's right to receive documents and materials in printed or electronic form, when. (8/28/2010)

DISCOUNT MEDICAL PLANS

Section 376.1500 Definitions. (8/28/2007)
Section 376.1502 Requirements for transaction of business. (8/28/2007)
Section 376.1504 Registration requirements — term of registration — renewal. (8/28/2007)
Section 376.1506 Violations, penalty. (8/28/2007)
Section 376.1508 Processing fee — cancellation of membership, effect of. (8/28/2007)
Section 376.1510 Prohibited acts. (8/28/2007)
Section 376.1512 Required disclosures. (8/28/2007)
Section 376.1514 Written agreement required, contents. (8/28/2007)
Section 376.1516 Written membership materials, required contents — forms to be filed with director, fee. (1/1/2008)
Section 376.1516 Written membership materials, required contents — forms to be submitted to director. (8/28/2007)
Section 376.1518 Net worth to be maintained, amount. (8/28/2007)
Section 376.1520 Notice of changes. (8/28/2007)
Section 376.1522 List of providers to be maintained on website. (8/28/2007)
Section 376.1524 Advertising and marketing materials, approval in writing required. (8/28/2007)
Section 376.1528 Rulemaking authority. (8/28/2007)
Section 376.1530 Denial and refusal to issue registrations, when. (8/28/2007)
Section 376.1532 Violations, penalties. (8/28/2007)

MENTAL HEALTH COVERAGE

Section 376.1550 Mental health coverage, requirements — definitions — exclusions. (8/28/2018)

CREDENTIALING OF PRACTITIONERS

Section 376.1575 Definitions (1/1/2014)
Section 376.1578 Credentialing procedure, health carrier duties — violations, mechanism for reporting. (1/1/2014)

HEALTH CARE SHARING MINISTRY

Section 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. (8/28/2007)

SERVICES RELATED TO PREGNANCY

Section 376.1753 Services related to pregnancy, persons holding ministerial or tocological certification may provide. (8/28/2007)

MEDICAL RETAINER AGREEMENTS

Section 376.1800 Definitions — medical retainer agreements not insurance — agreement requirements — use of health savings accounts for fees. (8/28/2015)

TELEHEALTH

Section 376.1900 Definitions — reimbursement for telehealth services, when. (1/1/2014)

HEALTH INSURANCE MARKETPLACE INNOVATION ACT

Section 376.2000 Citation of law — definitions. (7/12/2013)
Section 376.2002 Navigators, license required — permitted acts — prohibited acts — exemptions. (7/12/2013)
Section 376.2004 Application procedure. (7/12/2013)
Section 376.2006 Term of licensure — renewal — continuing education. (7/12/2013)
Section 376.2008 Consultation with licensed insurance producer, navigator to advise, when. (7/12/2013)
Section 376.2010 Sanction of license, when — restitution required, when — examination and investigation of records. (7/12/2013)
Section 376.2011 Violations, administrative orders, civil actions — penalty. (7/12/2013)
Section 376.2012 Navigators duty to report, when. (7/12/2013)
Section 376.2014 Applicability — severability — rulemaking authority. (7/12/2013)

DISCLOSURE OF COSTS

Section 376.2020 Contracts prohibiting disclosure of certain payments and costs are unenforceable. (10/14/2016)

STEP THERAPY

UNCLAIMED LIFE INSURANCE BENEFITS ACT

Section 376.2050 Citation of act. (8/28/2016)
Section 376.2051 Definitions. (8/28/2016)
Section 376.2052 Comparison of in-force policies to death master file — violation deemed an unfair trade practice. (8/28/2016)
Section 376.2053 Exemption from requirements, when. (8/28/2016)

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