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Chapter 376 Life, Health and Accident Insurance

• 376.005. Definitions.
• 376.010. Who may form company--purposes.
• 376.015. Involuntary unemployment insurance may be issued in connection with extension of credit, requirements.
• 376.020. Various companies defined.
• 376.050. Declaration of corporators.
• 376.060. Stock companies--content of charter.
• 376.070. To be submitted to attorney general.
• 376.080. Director to examine, when.
• 376.090. To furnish certificate of deposit, when.
• 376.100. Mutual companies--contents of charter.
• 376.110. To be submitted to attorney general.
• 376.120. Director to examine and certify, when.
• 376.130. To furnish certificate of deposit, when.
• 376.142. Stock company may become mutual--procedure--policyholders' meeting--acquisition of stock.
• 376.143. Stock company may acquire its own shares to be held in trust for mutual--appointment, powers and duties of trustees.
• 376.144. Acquisition of shares of dissenting stockholders, procedure--abandonment of mutualization.
• 376.145. Officers of stock company to continue as officers of mutual.
• 376.146. Board of directors or trustees of mutual, membership qualifications, term of office.
• 376.147. Meetings of board of mutual, notice--executive committee of board, powers.
• 376.148. Policyholders are members of mutual--voting rights--directors may alter articles--additional assessments prohibited.
• 376.150. Stock and mutual companies--content of charter.
• 376.160. Formation of stock and mutual companies.
• 376.170. Special deposits for registered policies and annuity bonds.
• 376.180. Certificates as to registration and reserves on policy--policies exempt, exceptions.
• 376.190. Additional deposits required.
• 376.200. Definition of net value.
• 376.210. Excess deposits.
• 376.220. May use realty to secure notes and bonds.
• 376.230. Changing of securities on deposit.
• 376.240. Deposits to be held in trust by director.
• 376.250. Deposits to be kept separate.
• 376.260. Fees collected by director of revenue.
• 376.270. Director may proceed against depositary companies.
• 376.280. Capital necessary to do business--how invested.
• 376.290. Deposit and transfer of securities.
• 376.291. Applicability and inapplicability.
• 376.292. Definitions.
• 376.293. Permissible investments--written plan for investments required.
• 376.294. Prohibited acts.
• 376.295. Additional prohibited acts--authorized actions.
• 376.296. Value of investments, how calculated.
• 376.297. Investment subsidiaries not permitted, when.
• 376.298. Acquisition of rate credit instruments, when.
• 376.300. Equity interests permitted, when.
• 376.301. Tangible personal property interests permitted, when.
• 376.302. Mortgage interests, may be acquired, when--other real estate interests.
• 376.303. Lending and repurchase, permitted when.
• 376.304. Acquisition of foreign investments, when.
• 376.305. Rulemaking authority.
• 376.306. Cash surrender value, life insurer may lend to policyholder, when.
• 376.307. Limits on acquisition of certain investments.
• 376.308. Secondary mortgage market act, not to preempt health insurer, when.
• 376.309. Separate account defined--establishment of account and special voting or control rights authorized--approved investments--approval of director required.
• 376.310. Investment of surplus and reserve funds by foreign companies.
• 376.311. Investment of capital reserve and surplus of life insurance companies in investment pools--definitions--qualifications--requirements.
• 376.320. (Repealed L. 2007 S.B. 66 § A)
• 376.330. Securities may be changed.
• 376.350. Reports to director.
• 376.360. Distribution of surplus funds to participating policyholders--method.
• 376.370. Director to value reserves, methods.
• 376.380. Legal minimum standards for valuation--procedures--reserves required--life insurance company to submit opinion of actuary, contents.
• 376.383. Health care claims for reimbursement, how paid, when--definitions--interest on unpaid claims--effective, when--penalties for unpaid claims, when--fraudulent claims, notification to the depart
• 376.384. Reimbursement of claims, duties of health carriers--claims submitted in electronic format, when--compliance monitored by department--complaint procedures developed--standard medical code sets
• 376.385. Diabetes--insurance coverage for equipment, supplies and self-management training.
• 376.386. Prescription drugs, one co-payment for dosage prescribed.
• 376.390. Reserve liability for group insurance--how computed.
• 376.391. Co-payments for chiropractic services, cap.
• 376.392. Prescription drug formularies, enrollees to be notified of changes to, when.
• 376.395. Definitions for group health conversion policy requirements.
• 376.397. Converted policy to be offered on termination of group health coverage, when--exceptions--terms and conditions.
• 376.398. Application to all group policies--effective, when.
• 376.401. Conversion rights--retirees--dependents of insured.
• 376.403. Benefit levels--group coverage may be provided in lieu of converted policy--delivery outside state, form.
• 376.404. Specific requirement requests of policyholder may be met by alteration.
• 376.405. Group health and accident policies, approval required--exempt, when, director's powers.
• 376.406. Newborn child to be covered under health policies, extent of coverage--notification of birth, when, effect of--definitions.
• 376.407. Advance practice nurse, claims for service to be reimbursed, when.
• 376.410. Insurance companies to maintain reserves--exemptions.
• 376.421. Group health insurance, authorized categories.
• 376.422. Direct response solicitation and sponsoring or endorsing entity, defined--certain group or individual insurers paying compensation to policyholder or sponsoring entity to notify policyholders
• 376.423. Health insurance, claims for chiropractic services denial, qualified chiropractor to review, qualifications--investigation by department, when.
• 376.424. Group health insurance policies may be extended to insure family members or dependents.
• 376.425. Student accident policies, may not limit surgical benefits, when.
• 376.426. Group health policies, required provisions.
• 376.427. Assignment of benefits made by insured to provider--payment, how made--exceptions--all claims to be paid, when.
• 376.428. Federal COBRA provisions to apply to group health insurance policies.
• 376.429. Coverage for certain clinical trials for prevention, early detection and treatment of cancer, restrictions--definitions--exclusions.
• 376.431. Employees or members of unions or associations, group or group-type basis coverage, sections 376.431 to 376.442 to apply.
• 376.432. Group-type basis, defined.
• 376.433. Self-insurance plans for health care, public entities--subject to Medicaid rights, obligations, and remedies.
• 376.434. Carrier liable for claims incurred during grace period, when--exceptions.
• 376.435. Claim information to be reported, when--covered lives defined.
• 376.436. Discontinuance notice by carrier, contents--notice forms furnished by carrier for distribution to policyholders.
• 376.438. Group policies, modifying or amending benefits shall provide extension of benefits in event of total disability at date of termination or discontinuance.
• 376.441. Carrier contract replaced by similar benefit plan of another carrier--liability of prior carrier--succeeding carrier coverage requirements.
• 376.442. Rules and regulations, procedure.
• 376.450. Citation of law--definitions (MISSOURI HIPAA).
• 376.451. Standards prohibiting discrimination.
• 376.452. Large group market, renewal or continuation of coverage required--nonrenewal or discontinuation permitted, when--conditions for discontinuation.
• 376.453. Premium--only cafeteria plans required, when.
• 376.454. Individual market, renewal or continuation at option of individual--nonrenewal or discontinuation permitted, when--discontinuation of a type of coverage, procedure.
• 376.480. Domestic companies may assume risks of foreign companies--duties of director.
• 376.500. Discriminations, rebates and favors prohibited--contracts to conform to policy.
• 376.502. Life insurers not to discriminate based on lawful travel destinations--violations, penalty.
• 376.510. Penalty for violation of section 376.500.
• 376.530. (Repealed L. 2007 S.B. 613 Revision § A)
• 376.531. Life insurance policies, consent of insured required, exceptions--employers have insurable interest in employees, when, effects.
• 376.540. Policy, to whom payable.
• 376.550. (Repealed L. 2007 S.B. 613 Revision § A)
• 376.562. Charitable, benevolent, educational and religious organizations may be beneficiary or owner of policy, life insurance, when--fraud or coercion, exception.
• 376.570. Foreign executor or administrator.
• 376.580. Misrepresentation.
• 376.590. Misrepresentations, false estimates and circulars prohibited--agents--notes to be held until policy delivered.
• 376.600. Penalty for violating section 376.590.
• 376.610. Defense in case of suits.
• 376.620. Suicide, effect on liability--refund of premiums, when.
• 376.630. Life insurance policies not to be forfeited or become invalid, when.
• 376.640. Paid-up policy may be demanded, when.
• 376.650. Rules of payment on commuted policy.
• 376.660. Foregoing provisions inapplicable, when.
• 376.669. Annuity contract requirements--paid-up annuity benefits, how calculated--cash surrender benefits, how calculated--applicable, when.
• 376.670. Provisions which shall be contained in life insurance policies, exceptions.
• 376.671. Provisions which shall be contained in annuity contracts--expiration date.
• 376.672. (Repealed L. 2007 S.B. 66 § A)
• 376.673. Life insurance policies, regulations relative to.
• 376.674. Life insurance policies, no cash surrender value, regulations relative to.
• 376.675. Life insurance policies and annuity contracts to be approved--exemption, when--director's powers--judicial review of disapproval.
• 376.676. Regulation of the valuation of life insurance policies--may adopt NAIC model regulation.
• 376.677. Life policies may be issued that have no cash surrender value prior to death--no policy loans so law regulating not applicable--requirements to issue.
• 376.678. Life insurance policies and annuity contracts, annual statement to holder required--company to furnish policy or contract information to holder upon request.
• 376.679. Life insurance company may reinsure for risks involving aircraft, limitation.
• 376.680. Assignment of incidents of ownership, group life policy, effect of.
• 376.691. Group life policies, eligible groups authorized for issue--premiums, how paid.
• 376.693. Special group life policies, requirements--director's approval.
• 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.
• 376.695. Extension of policy to insure for loss due to death of spouse or dependent children, requirements, limitations.
• 376.696. Political subdivisions purchasing any insurance policies to submit to competitive bidding, when--renewal between bidding periods deemed extension.
• 376.697. Required provisions for group life policies.
• 376.699. Person insured by group policy entitled to individual life policy, notice requirements.
• 376.700. Purpose--use of additional material.
• 376.702. Application of law--exceptions.
• 376.704. Definitions.
• 376.706. Delivery of guide and summary required, when.
• 376.708. Required presentations and statements--company to maintain file.
• 376.710. Effect of omission.
• 376.712. Effective date.
• 376.714. Contents and form of buyer's guide.
• 376.715. Citation of law, purpose.
• 376.717. Coverages provided, persons covered--coverage not provided, when--maximum benefits allowable.
• 376.718. Definitions.
• 376.720. Association, created--accounts--director to supervise.
• 376.722. Board of directors, established, members, how selected--expense reimbursement.
• 376.724. Impaired insurers, association's options, duties--insolvent insurers, association's options, duties--alternative policies, requirements.
• 376.725. Terminated coverage, reissuance of, premium set, how.
• 376.726. Nonpayment of premiums, effect of.
• 376.728. Law not applicable, when.
• 376.730. Liens, association may impose, when.
• 376.732. Director to have association's powers and duties, when--association may appear in court, when.
• 376.733. Assignment of rights to association by persons receiving benefits, when.
• 376.734. Powers of association--legal counsel, who may be retained.
• 376.735. Assessments against members, when due, classes--amounts, how determined.
• 376.737. Deferment of assessment, how, when--maximum assessment--refund of, when--members may increase premiums to cover assessments.
• 376.738. Certificate of contribution, when issued.
• 376.740. Plan of operation, required, approval of director--provisions of plan.
• 376.742. Director, powers and duties.
• 376.743. Board of directors, powers--examinations by director, when.
• 376.745. Assessments, offset against tax liability, when, how.
• 376.746. Records of association meetings to be kept--association deemed creditor of insolvent or impaired insured.
• 376.747. Distribution of member insurer assets upon liquidation, priority of association.
• 376.748. Liquidation, recovery of distributions, when, exceptions, limitations.
• 376.750. Financial report, submitted to director, when--tax exempt status--immunity from liability.
• 376.752. Member insurer's deposit with director, exemption from, amount.
• 376.754. Stay of proceedings, insolvent insurer, when.
• 376.755. Advertising, use of guaranty association prohibited.
• 376.756. Summary document, association to prepare, when, contents--policy not covered by guaranty association to contain notice, form determined by director.
• 376.758. Law inapplicable to insolvent insurers on effective date of law.
• 376.770. Title of law.
• 376.773. Definitions.
• 376.775. Matters required in policies.
• 376.776. Hospital and medical expense provisions extended for certain handicapped and dependent children past normal coverage age.
• 376.777. Specifically required provisions--exemptions, when--director's powers.
• 376.778. Payment direct to public hospitals or clinics with or without assignment, when--provisions required in contracts.
• 376.779. Health insurance policies to offer coverage for treatment of alcoholism--exclusions.
• 376.780. Limits on provisions, effect of conflict of policy with law.
• 376.781. Speech and hearing disorders, companies to offer coverage, when--rules, procedure.
• 376.782. Mammography--low-dose screening, defined--health care policies to provide required coverage.
• 376.783. Insured bound only if copy of application attached to policy.
• 376.785. What does not constitute waiver of defenses.
• 376.787. Effect of age limit provision.
• 376.789. Definition of actual charge and actual fee.
• 376.790. Limits on applicability of law.
• 376.800. Misrepresentation made in obtaining individual accident and health policy no defense, exception.
• 376.801. Coverage for child health supervision services required--definitions--permitted limitations on benefits.
• 376.805. Elective abortion to be by optional rider and requires additional premium--elective abortion defined.
• 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.
• 376.807. Policies not to reduce or deny benefits to persons eligible for medical assistance--deemed primary contract.
• 376.810. Definitions for policy requirements for chemical dependency.
• 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 of
• 376.814. Rules and regulations authorized, department of mental health to advise department--procedure.
• 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.
• 376.818. Eligibility for Medicaid may not be considered by insurers.
• 376.819. Division of medical services to have right to payment for health care services provided.
• 376.820. Insurers may not deny coverage of child because of marital status of parents, residence or income tax dependency claim.
• 376.821. Insurers may not cancel health or dental insurance solely because the insured is incarcerated--insurer, defined.
• 376.823. Prohibition on kickbacks not applicable for rebates for certain chronic illnesses.
• 376.825. Title.
• 376.826. Definitions.
• 376.827. Requirements for mental illness coverage--parity with coverage provided for physical conditions.
• 376.830. Services administered and delivered by whom--contracted services permitted, when.
• 376.833. Inapplicability of section 376.827, when--waiver granted to policyholder, when.
• 376.836. Effective date--study conducted by director, contents, report to general assembly--exclusions--expiration date.
• 376.840. (Repealed L. 2004 H.B. 855 § A)
• 376.850. Law, how cited.
• 376.854. Definitions.
• 376.859. Medicare supplement law applicable to what policies--policies not included.
• 376.864. Policies not to duplicate benefits provided by Medicare--preexisting conditions, limitations on--director to issue rules establishing standards.
• 376.869. Standards for policies, minimum, director to adopt.
• 376.874. Requirements of policy, return to policyholders.
• 376.879. Outline of coverage for fair disclosure--furnished to each applicant--format and content--rules and standards.
• 376.881. Policy certificate front page to contain notice of right to return and receive premium refund.
• 376.884. Advertisement to be reviewed by director.
• 376.886. Regulations, requirements--rules, procedure.
• 376.889. Violations, penalty.
• 376.890. Invalidity of any section regulating Medicare supplement not to affect others.
• 376.891. Definitions.
• 376.892. Surviving spouse may continue coverage, when--divorced or separated spouse may continue coverage, when--services offered.
• 376.893. Divorced or separated spouse, continuation of coverage, notice--contents of notice--failure to elect, effect--application.
• 376.894. Amount of premium, date of payment--termination of right of continuation of coverage, grounds.
• 376.900. Definitions.
• 376.905. Administration by department, powers, duties--fees.
• 376.910. Certificate of authority required.
• 376.915. Application for certificate, content--renewal, content, filed when--extensions, fee.
• 376.920. Annual statement, form, contents.
• 376.925. Seven-day rescission period, all money or property to be refunded.
• 376.930. Insured to be furnished application for certificate and annual statement, when.
• 376.935. Certificates issued for one year--nontransferable--not endorsement by department.
• 376.940. Escrow account for entrance fees required, released when.
• 376.945. Escrow account, amount required--principal, how released, investment.
• 376.950. Board of directors, one member to be resident of facility.
• 376.951. (Transferred 2002; now 376.1100)
• 376.952. (Transferred 2002; now 376.1103)
• 376.953. (Transferred 2002; now 376.1106)
• 376.955. (Transferred 2002; now 376.1109)
• 376.956. (Transferred 2002; now 376.1112)
• 376.957. (Transferred 2002; now 376.1115)
• 376.958. (Transferred 2002; now 376.1118)
• 376.960. Definitions.
• 376.961. Missouri health insurance pool created--members to be all health insurers in state--board of directors, members, terms, qualifications.
• 376.962. Plan of operation to be submitted by board--effective when--failure to submit, director's duty to develop rules--plan content.
• 376.964. Board, powers and duties--including providing for issuing policies and reinsuring risks--staff appointment--rulemaking authority.
• 376.965. Board members not civilly liable for performance of duties, exception.
• 376.966. No employee to lose coverage by enrolling in pool--eligibility for pool coverage, ineligibility--medical underwriting considerations, notification required, when.
• 376.968. Administration of pool by insurer or insurers by competitive bids--insurer's qualifications--board to establish criteria for bid content.
• 376.970. Administering insurer to serve for three years subject to removal for cause--duties--reports.
• 376.973. Administering insurer at close of fiscal year to make accounting and assessment--how calculated--excess to be held at interest for future losses or to reduce premiums--future losses, defined.
• 376.975. Member's proportion of participation in pool to be determined annually--deficits to be recouped by proportioned assessment--amount of assessment to be offset against certain taxes.
• 376.978. Director of revenue to determine reduced amount in county foreign insurance tax fund, state treasurer to reimburse fund by reducing amount to general revenue.
• 376.980. Pool member exempt from taxation of financial institution, may be allowed to offset against sales or use tax, when--excess of assessment over sales or use tax payable in any one year a credit
• 376.982. Rulemaking procedure.
• 376.984. Abatement or deferring all or part of assessment of member, when--amount abated or deferred may be assessed against other members--deficiency liability.
• 376.986. Pool to offer medical coverage--premiums, how established--standard risk rate, how calculated--director to approve rates--exclusions--benefits reduced by other insurance or workers' compe
• 376.987. High deductible health plans and establishment of health savings plans to be offered as options--definitions--rulemaking authority.
• 376.989. No liability, criminal or civil, for participation in pool by members.
• 376.990. Study to be conducted on financing of the state health insurance pool, contents, report.
• 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.
• 376.1000. Multiple employer self-insured health plan, defined.
• 376.1002. Certificate of authority required--penalty for noncompliance--law inapplicable, when--exempt organizations.
• 376.1005. Application for certificate of authority, form--fee--policy or other evidence of coverage provided to employees, form.
• 376.1007. Plan to file copy of bylaws, coverage and agreements with director.
• 376.1010. Excess stop-loss coverage maintained by plan.
• 376.1012. Funds collected from employers held in trust--requirements--board of trustees, elected, duties--annual report, filed when.
• 376.1015. Department not to grant approval, when.
• 376.1017. Plan to establish loss reserves--plan to establish surplus account, amount.
• 376.1020. Plan to maintain principal place of business in Missouri, exception.
• 376.1022. Dissolution of plan, application, procedure, granted when--distribution of assets, procedures.
• 376.1025. Director may adopt rules.
• 376.1027. Plan in unsound condition, powers of director.
• 376.1030. Agreement of employer to pay benefits, requirements, form--copy filed with director--no excuse from liability.
• 376.1032. Plan considered insurer, when.
• 376.1035. Chapter 376 applicable to plan.
• 376.1037. Plan subject to premium taxes.
• 376.1040. Plan not to be offered to general public--marketing restrictions.
• 376.1042. Marketing by agent, agency or broker violation of law.
• 376.1045. Injunctive relief, director may seek, when--procedures.
• 376.1075. Definitions.
• 376.1077. Administrator to have agreement with insurer, form, contents--termination, how.
• 376.1080. Payments of premiums and claims deemed paid, when.
• 376.1082. Records maintained by administrator for insurer--director may examine records--records owned by insurer, transfer allowed, when.
• 376.1083. Advertising restrictions for administrator.
• 376.1084. Insurer responsible for benefits and underwriting practices--insurer to conduct review of administrator, when.
• 376.1085. Premiums held in fiduciary capacity, duties--financial records, duties--withdrawals from fiduciary account by agreement only, contents--payment of claims.
• 376.1087. Commissions not to be contingent on savings in payment of claims--may be based on premiums collected.
• 376.1088. Notice to policyholder of administrator, contents, required--disclosure of receipts to insurer.
• 376.1090. Materials delivered to administrator for insured to be promptly delivered.
• 376.1092. Certificate of authority, required, application, contents, fee--refusal to issue, when--renewal--bond, required when.
• 376.1093. Annual report filed with director, when--contents--filing fee, amount.
• 376.1094. Certificate of authority, suspension or revocation, grounds--civil action, when.
• 376.1095. Rules and regulations, promulgation.
• 376.1100. Law, how cited--definitions.
• 376.1103. Laws applicable, Medicare supplement laws not applicable--purpose--policies or riders must be in compliance.
• 376.1106. Policies issued in other states may be issued to residents of Missouri if in compliance with Missouri regulations.
• 376.1109. Policies, content requirements, provisions prohibited--rules authorized.
• 376.1112. Director to provide buyer's guide--content--advertising of long-term care policies to contain notice of availability of guide.
• 376.1115. Coverage outline to be delivered to applicants, when, content.
• 376.1118. Benefits funded by a life insurance death benefit acceleration, reports to policyholder required, content.
• 376.1121. Denial of claim, long-term care insurance, duties of issuer.
• 376.1124. Rescinding of a long-term care policy, permitted when--grounds for contesting--no field issuance, when.
• 376.1127. Nonforfeiture benefit option required for long-term care insurance policies, requirements of offer--rulemaking authority.
• 376.1130. Rulemaking authority.
• 376.1199. Coverage for certain obstetrical/gynecological services--exclusion of contraceptive coverage permitted, when--rulemaking authority.
• 376.1200. Certain policies to offer coverage for treatment of breast cancer--limitation on deductible, lifetime maximum benefit--administration of benefits--application, effect.
• 376.1209. Mastectomy--mandatory insurance coverage for prosthetic devices and reconstructive surgery--no time limit to be imposed.
• 376.1210. Maternity benefits, minimum hospital stays, exceptions--notice of benefits, contents--attending physician defined--rulemaking.
• 376.1215. Immunizations, mandated coverage, exceptions, rulemaking.
• 376.1218. Insurance coverage for children enrolled in the Part C early intervention system (First Steps).
• 376.1219. PKU formula and low protein modified food products covered by insurance, when--exceptions.
• 376.1220. Insurance coverage for newborn hearing screenings mandated.
• 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 allowa
• 376.1225. Mandated coverage for general anesthesia and hospital charges for dental care, when--prior authorization required, when--exceptions.
• 376.1230. Chiropractic care coverage, rates, terms, conditions, limits, and exclusions.
• 376.1232. Insurers to offer coverage for prosthetics.
• 376.1250. Cancer screening, health insurance coverage required, when, types--department of health and senior services duties.
• 376.1253. Second opinion, right of newly diagnosed cancer patients, attending physician to inform--insurance coverage for such second opinions required, when.
• 376.1275. Coverage for human leukocyte antigen testing for bone marrow transplantation required, when--exceptions.
• 376.1290. Coverage for lead testing.
• 376.1300. Reorganization of a domestic mutual life insurance company, authority.
• 376.1305. Formation of holding company, application--shareholder approval.
• 376.1307. Issuance of shares.
• 376.1309. Member's interest--nontransference of membership--immunity from liability--assessments, not imposed--security, membership interest.
• 376.1312. Nonapplicability of certain provisions of insurance holding companies law.
• 376.1315. Incorporation of mutual holding company, authority, approval.
• 376.1318. Powers of mutual holding company, engaging in business of insurance, no authority, affiliation and merger agreements.
• 376.1322. Mutual holding company subject to supervision of director, dissolution or liquidation--demutualization.
• 376.1350. Definitions.
• 376.1353. Utilization review activities monitored.
• 376.1356. Utilization review organization monitored, when.
• 376.1359. Written utilization program implemented, filed with the director.
• 376.1361. Documented clinical review criteria used in a utilization program--medical director qualifications--compensation of utilization review services.
• 376.1363. Utilization review decisions, procedures.
• 376.1365. Reconsideration of an adverse determination, when.
• 376.1367. Emergency services benefit determination, coverage required, when.
• 376.1369. Certification of compliance, when.
• 376.1372. Certification and member handbook to include utilization review procedures.
• 376.1375. Registry of grievances maintained, procedures--definitions.
• 376.1378. Grievances and certificate of compliance filed with the director, when.
• 376.1382. First- and second-level grievance review for managed care plans, first-level procedures.
• 376.1385. Second-level review procedures.
• 376.1387. Appeals of grievances determined by the director.
• 376.1389. Expedited grievance review procedure.
• 376.1399. Rules, effective, when--rules invalid and void, when.
• 376.1400. Explanation of benefits, standardized information used, contents, when.
• 376.1403. Referrals, standardized information used, content, when.
• 376.1450. Waiver of enrollee's right to receive documents and materials in printed form, when.
• 376.1500. Definitions.
• 376.1502. Requirements for transaction of business.
• 376.1504. Registration requirements--term of registration--renewal.
• 376.1506. Violations, penalty.
• 376.1508. Processing fee--cancellation of membership, effect of.
• 376.1510. Prohibited acts.
• 376.1512. Required disclosures.
• 376.1514. Written agreement required, contents.
• 376.1516. Written membership materials, required contents--forms to be filed with director, fee.
• 376.1518. Net worth to be maintained, amount.
• 376.1520. Notice of changes.
• 376.1522. List of providers to be maintained on web site.
• 376.1524. Advertising and marketing materials, approval in writing required.
• 376.1528. Rulemaking authority.
• 376.1530. Denial and refusal to issue registrations, when.
• 376.1532. Violations, penalties.
• 376.1550. Mental health coverage, requirements--definitions--exclusions.
• 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.
• 376.1753. Services related to pregnancy, persons holding ministerial or tocological certification may provide.