reglab/housing_qa huggingface dataset:
MO Rev Stat § 354.355 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.355 - Injunctions, permanent or temporary, grounds, procedure — dissolution of corporation or rehabilitation, procedure.

Effective - 28 Aug 1983   354.355. Injunctions, permanent or temporary, grounds, procedure — dissolution of corporation or rehabilitation, procedure. — Whenever it shall appear to the director of the department of commerce and insurance, from any examination made by himself, or from the report of a person or persons appointed by him, or from the statements of the corporation subject to the provisions of sections 354.010 to 354.380, or from any knowledge or information in his possession  (1) That the corporation has refused to submit its books, papers, accounts or affairs to the reasonable inspection of the director or his deputy or his examiner; or  (2) That the corporation has, by contract of reinsurance or otherwise, transferred or attempted to transfer substantially its entire property or business, or entered into any transaction, the effect of which is to merge substantially its entire property or business in the property or business of any other corporation, association, society, order, partnership or individual without first having obtained the written approval of the director of the department of commerce and insurance as provided by law; or  (3) That the corporation is found, after an examination, to be in such condition that its further transaction of business will be hazardous to its policyholders or to its creditors or to the public; or  (4) That the corporation has an officer who has refused to be examined under oath touching its affairs; or  (5) That the corporation has ceased to transact the business of insurance for a period of one year; ­­the director may institute a suit or proceedings in the circuit court in the county or city in which the corporation was organized or in which it has or last had its principal or chief office or place of business or in the county of Cole, to enjoin the corporation from further prosecution of its business, either temporarily or perpetually, or for a judgment dissolving the corporation or for both; and after the entry of the decree or judgment, the court upon the motion of the director of the department of commerce and insurance may order the liquidation, settlement and winding up of the affairs of such corporation or the rehabilitation of the corporation as provided in section 354.140 together with such other decrees and orders in connection therewith as the court shall deem advisable. ­­-------- (L. 1983 H.B. 127 § 354.355 subsec. 1)
MO Rev Stat § 354.357 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.357 - Receivership, grounds, procedure.

Effective - 28 Aug 1983   354.357. Receivership, grounds, procedure. — 1. Whenever the director institutes proceedings under section 354.355, he may also institute proceedings in the same case for receivership for any organization or corporation having the exclusive or dominant right to manage or control the corporation subject to the provisions of sections 354.010 to 354.380 which is the subject of the main case, when it appears that a receiver is necessary for the preservation of the assets of the corporation or that a receiver is necessary to determine the assets of the corporation held by the organization or corporation. The duration of the receivership and the duties of the receiver shall be in the discretion of the court.  2. The director may apply to the circuit court of Cole County, Missouri, for an order appointing him as receiver or ancillary receiver, and directing him to conserve the assets within this state of any foreign or alien corporation subject to the provisions of sections 354.010 to 354.380 upon any of the following grounds:  (1) Upon any of the grounds specified in section 354.355; or  (2) That the corporation has been placed in conservatorship or receivership in its domiciliary state or sovereignty or elsewhere. The institution of and the operation of the receivership shall be in accordance with chapter 355. ­­-------- (L. 1983 H.B. 127 § 354.355 subsecs. 2, 3)
MO Rev Stat § 354.362 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.362 - Newborn child coverage required — notice of birth, when, effect.

Effective - 28 Aug 1983   354.362. Newborn child coverage required — notice of birth, when, effect. — The provisions of section 376.406 shall apply to all health services corporations subject to the provisions of sections 354.010 to 354.380. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.380 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.380 - Certain provisions of insurance law to be applicable.

Effective - 28 Aug 1983   354.380. Certain provisions of insurance law to be applicable. — The provisions of sections 375.936 and 376.770 to 376.800 shall apply to all health services corporations subject to the provisions of sections 354.010 to 354.380. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.407 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.407 - PACE projects not deemed health maintenance organizations, when.

Effective - 28 Aug 2002   354.407. PACE projects not deemed health maintenance organizations, when. — Notwithstanding the provisions of section 354.405 to the contrary, a program for all-inclusive care for the elderly (PACE) project sponsored by a religious or charitable organization that is itself or is controlled by an entity organized under Section 501(c)(3) of the Internal Revenue Code and which has had its application for the operation of a PACE program approved by the Center for Medicare and Medicaid Services of the federal Department of Health and Human Services and is operating under such approval shall not be deemed to be engaged in any business required to be licensed pursuant to section 354.405. Such exemption shall apply only to business conducted pursuant to the approved PACE contract and not to any other business that such organization may conduct. ­­-------- (L. 2002 S.B. 1094)
MO Rev Stat § 354.420 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.420 - Advisory panels to afford enrollees participation in policy decisions.

Effective - 28 Aug 1983   354.420. Advisory panels to afford enrollees participation in policy decisions. — The governing body of each health maintenance organization shall establish a mechanism to afford the enrollees an opportunity to participate in matters of policy and operation through the establishment of advisory panels, the use of advisory referenda on major policy decisions, or the use of other mechanisms. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.425 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.425 - Bonding of officers who disburse or invest funds — bond requirements.

Effective - 28 Aug 1983   354.425. Bonding of officers who disburse or invest funds — bond requirements. — Any director, officer or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of such organization shall be fiduciaries of such funds. Every health maintenance organization shall maintain in force a surety bond on such officers and employees in an amount of not less than one hundred thousand dollars, or such other sum as may be prescribed by the director. All such bonds shall be written with at least a one-year discovery period and, if written with less than a three-year discovery period, shall contain a provision that no cancellation or termination of the bond, whether by or at the request of the insured or by the underwriter, shall take effect prior to the expiration of ninety days after written notice of such cancellation or termination has been filed with the director, unless an earlier date of such cancellation or termination is approved by the director. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.430 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.430 - Evidence of coverage, requirements — rights of enrollee — toll-free telephone number required.

Effective - 28 Aug 2013   354.430. Evidence of coverage, requirements — rights of enrollee — toll-free telephone number required. — 1. Every enrollee residing in this state is entitled to evidence of coverage. If the enrollee obtains coverage through an insurance policy or a contract issued by a health services corporation, whether by option or otherwise, the insurer or the health services corporation shall issue the evidence of coverage. Otherwise the health maintenance organization shall issue the evidence of coverage.  2. No evidence of coverage, or amendment thereto, shall be issued or delivered to any person in this state until a copy of the form of the evidence of coverage, or amendment thereto, has been filed with the director.  3. An evidence of coverage shall contain:  (1) No provisions or statements which are unjust, unfair, inequitable, misleading, or deceptive, or which encourage misrepresentation, or which are untrue, misleading, or deceptive as defined in subsection 1 of section 354.460; and  (2) A clear and complete statement, if a contract, or a reasonably complete summary, if a certificate, of:  (a) The health care services and the insurance or other benefits, if any, to which the enrollee is entitled;  (b) Any limitations on the services, kind of services, benefits or kinds of benefits to be provided, including any deductible or co-payment, coinsurance, or other cost-sharing feature as requested by the group contract holder or, in the case of nongroup coverage, the individual certificate holder;  (c) Where and in what manner information is available as to how services may be obtained;  (d) The total amount of payment for health care services and the indemnity or service benefits, if any, which the enrollee is obligated to pay with respect to individual contracts; and  (e) A clear and understandable description of the health maintenance organization's method for resolving enrollee complaints, including the health maintenance organization's toll-free customer service number and the department of commerce and insurance's consumer complaint hot line number.  4. Any subsequent change in an evidence of coverage may be made in a separate document issued to the enrollee.  5. A copy of the form of the evidence of coverage to be used in this state, and any amendment thereto, shall be subject to the filing of subsection 2 of this section unless it is subject to the jurisdiction of the director under the laws governing health insurance or health services corporations, in which event the filing provisions of those laws shall apply. ­­-------- (L. 1983 H.B. 127, A.L. 1997 H.B. 335, A.L. 2013 S.B. 262)
MO Rev Stat § 354.435 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.435 - Annual reports filed with director, when — content — forms.

Effective - 28 Aug 2007   354.435. Annual reports filed with director, when — content — forms. — 1. Every health maintenance organization shall annually, on or before March first, file a report, verified by at least two principal officers, with the director, covering its preceding calendar year.  2. Such report shall be on forms prescribed by the director and shall include:  (1) A financial statement of the organization, including its balance sheet for the preceding calendar year;  (2) Any material changes in the information submitted pursuant to subsection 3 of section 354.405;  (3) The number of persons enrolled during the year, the number of enrollees, as of the end of the year, and the number of enrollments terminated during the year;  (4) A statement setting forth the amount of uncovered and covered expenses that are payable and are more than ninety days past due for the period of August first through December thirty-first of the preceding year;  (5) Such other information relating to the performance of the organization as is necessary to enable the director to carry out his duties under sections 354.400 to 354.636. ­­-------- (L. 1983 H.B. 127, A.L. 2007 S.B. 66)  CROSS REFERENCE:  Forms approval required, RSMo 37.340; failure to obtain, personal liability, 37.390
MO Rev Stat § 354.440 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.440 - Information to be available to enrollees.

Effective - 28 Aug 1983   354.440. Information to be available to enrollees. — Every health maintenance organization shall make available to its enrollees:  (1) The most recent annual statement of financial condition, including a balance sheet and summary of receipts and disbursements;  (2) A description of the organizational structure and operation of the health care plan and a summary of any material changes since the issuance of the last report;  (3) A description of services and information as to where and how to secure them; and  (4) A clear and understandable description of the health maintenance organization's method for resolving enrollee complaints. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.441 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.441 - Disclosures to subscribers shall not be prohibited or restricted.

Effective - 28 Aug 1997   354.441. Disclosures to subscribers shall not be prohibited or restricted. — No health maintenance organization plan, medical group/staff model, independent practice association or any other entity shall prohibit or restrict any provider from disclosing to any subscriber, enrollee or member any information that such provider deems appropriate regarding the nature of treatment, risks or alternatives thereto, the availability of other therapy, consultation or test, the decision of any plan to authorize or deny services, or the process that the plan or any person contracting with the plan uses or proposes to use, to authorize or deny health care services or benefits. Any such prohibition or restriction contained in a contract with a provider entered into after August 28, 1997, shall be void and unenforceable. ­­-------- (L. 1997 H.B. 335)
MO Rev Stat § 354.443 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.443 - Financial disclosures to the department required by health maintenance organizations, when.

Effective - 28 Aug 1997   354.443. Financial disclosures to the department required by health maintenance organizations, when. — 1. A health maintenance organization shall disclose to the department of commerce and insurance all financial arrangements, financial interest in, or contractual provisions with utilization review companies or any other health care provider that would encourage or limit the type, amount, duration and scope of services offered, restrict or limit referral or treatment to patients, including but not limited to financial incentives to limit, restrict or deny access to or delivery of medical or other services prior to the delivery of such services. Capitation arrangements between health maintenance organizations and health care providers shall not be considered an inducement to limit, restrict or deny access to medical services. The director shall review all financial arrangements filed with the department of commerce and insurance to determine if such arrangements offer an inducement to a provider to provide less than medically necessary services to an enrollee.  2. The capitation rate to be paid from the health maintenance organization to the health care provider is not required to be included with the financial arrangements to be filed with the department of commerce and insurance pursuant to subsection 1 of this section. ­­-------- (L. 1997 H.B. 335)
MO Rev Stat § 354.444 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.444 - Administrative orders for violations — voluntary forfeitures, civil actions.

Effective - 28 Aug 2007   354.444. Administrative orders for violations — voluntary forfeitures, civil actions. — 1. If the director determines that a person has engaged, is engaged in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of sections 354.400 to 354.636, or a rule adopted or order issued pursuant thereto or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of sections 354.400 to 354.636 or a rule adopted or order issued pursuant thereto, the director may issue such administrative orders as authorized under section 374.046. A violation of any of these sections is a level one violation under section 374.049.  2. If the director believes 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 354.400 to 354.636, or a rule adopted or order issued pursuant thereto or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of sections 354.400 to 354.636 or a rule adopted or order issued pursuant thereto, the director may maintain a civil action for relief authorized under section 374.048. A violation of any of these sections is a level one violation under section 374.049. ­­-------- (L. 1997 H.B. 335, A.L. 2007 S.B. 66)
MO Rev Stat § 354.445 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.445 - Complaints by enrollees, organization to establish system.

Effective - 28 Aug 1983   354.445. Complaints by enrollees, organization to establish system. — Every health maintenance organization shall establish and maintain a complaint system which provides reasonable procedures for the resolution of written complaints initiated by enrollees. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.450 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.450 - Investments authorized.

Effective - 28 Aug 1983   354.450. Investments authorized. — With the exception of investments made in accordance with subdivisions (1) and (2) of subsection 1 of section 354.415 and subsection 2 of section 354.415, the investable funds of a health maintenance organization shall be invested only in securities or other investments permitted by the laws of this state for the investment of assets constituting the legal reserves of life insurance companies, or such other securities or investments as the director may permit. ­­-------- (L. 1983 H.B. 127)
MO Rev Stat § 354.455 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.455 - Deposit required, how made.

Effective - 28 Aug 2007   354.455. Deposit required, how made. — Unless otherwise provided in sections 354.400 to 354.636, each health maintenance organization shall deposit with the director, or with any organization or trustee acceptable to him through which a custodial or controlled account is utilized, cash, securities, or any combination of these or other measures acceptable to him, in the amount set forth in section 354.410. ­­-------- (L. 1983 H.B. 127, A.L. 2007 S.B. 66)
MO Rev Stat § 354.460 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.460 - Advertising not to be untrue or misleading — deceptive solicitation — prohibited — how determined.

Effective - 28 Aug 2007   354.460. Advertising not to be untrue or misleading — deceptive solicitation — prohibited — how determined. — No health maintenance organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of sections 354.400 to 354.636:  (1) A statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment with, a health maintenance organization;  (2) A statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation, or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health maintenance organization plan, if such benefit, advantage, or absence of limitation, exclusion, or disadvantage does not, in fact, exist;  (3) An evidence of coverage shall be deemed to be deceptive if the evidence of coverage, taken as a whole, is misleading. ­­-------- (L. 1983 H.B. 127 § 354.460 subsec. 1, A.L. 2007 S.B. 66)
MO Rev Stat § 354.462 (2021)
2021 Missouri Revised Statutes|Title XXIII - Corporations, Associations and Partnerships|Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans|Section 354.462 - Enrollee, grounds for disenrollment.

Effective - 28 Aug 1983   354.462. Enrollee, grounds for disenrollment. — An enrollee may not be disenrolled nor denied renewal except for the failure to pay the charge for such coverage, for fraudulent misuse of the system, for abusive conduct, for failure to establish a proper patient-physician relationship, or for such other reasons as may be allowed in rules promulgated by the director. ­­-------- (L. 1983 H.B. 127 § 354.460 subsec. 2)