reglab/housing_qa huggingface dataset:
MO Rev Stat § 376.393 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.393 - Pharmacy benefits manager, license required — definitions — complaints, procedure.

Effective - 28 Aug 2020   376.393. Pharmacy benefits manager, license required — definitions — complaints, procedure. — 1. As used in this section, the following terms shall mean:  (1) "Health carrier" or "carrier", the same meaning as is ascribed to such term in section 376.1350;  (2) "Pharmacy benefits manager", the same meaning as is ascribed to such term in section 376.388.  2. No entity subject to the jurisdiction of this state shall act as a pharmacy benefits manager without a license issued by the department. The department shall establish by rule the application process and license fee for pharmacy benefits managers.  3. The department may cause a complaint to be filed with the administrative hearing commission as provided in chapter 621 against any holder of a license issued under this section for:  (1) Violation of the laws or regulations of any state or of the United States, where the offense is reasonably related to the qualifications, functions, or duties of a pharmacy benefits* manager, including, but not limited to, where an essential element of the offense is fraud, dishonesty, or an act of violence, or where the offense involves moral turpitude, or where the offense involves failure to comply with a requirement of this chapter, whether or not sentence or penalty is imposed;  (2) Use of fraud, deception, misrepresentation, or bribery for any reason;  (3) Obtaining or attempting to obtain any fee, charge, tuition, or other compensation by fraud, deception, or misrepresentation;  (4) Incompetence, misconduct, gross negligence, or dishonesty in the performance of the functions or duties of a pharmacy benefits manager or other regulated profession or activity; or  (5) Disciplinary action taken against the holder of a license or other right to practice as a pharmacy benefits manager or other regulated profession. ­­After the filing of such complaint, the proceedings shall be conducted in accordance with the provisions of chapter 621. Upon a finding by the administrative hearing commission that grounds provided in this subsection for disciplinary action are met, the department may, singly or in combination, censure or place the person named in the complaint on probation with such terms and conditions as the department deems appropriate for a period not to exceed five years, or may suspend, for a period not to exceed three years, or revoke the license, certificate, or permit. An individual whose license has been revoked shall wait at least one year from the date of revocation to apply for relicensure. Relicensure shall be at the discretion of the department. ­­-------- (L. 2020 H.B. 1682)  *Word "benefit" appears in original rolls.
MO Rev Stat § 376.395 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.395 - Definitions for group health conversion policy requirements.

Effective - 01 Jan 1983   376.395. Definitions for group health conversion policy requirements. — As used in sections 376.395 to 376.404 the following terms shall mean:  (1) "Group policy", a group health insurance policy issued by an insurance company and a group contract issued by a health service corporation, a health maintenance organization or a similar corporation or organization;  (2) "Group policyholder", the entity purchasing the group policy from the insurer;  (3) "Individual policy" or "converted policy", an individual health insurance policy issued by an insurance company or an individual health services contract issued by a health service corporation, a health maintenance organization or a similar corporation or organization;  (4) "Insurer", the entity issuing a group policy or an individual or converted policy;  (5) "Medicare", Title XVIII of the United States Social Security Act as added by the Social Security Amendments of 1965 or as later amended or superseded;  (6) "Premium", any premium or other consideration payable for coverage under a group or individual policy. ­­-------- (L. 1981 S.B. 58 § 1)  Effective 1-01-83
MO Rev Stat § 376.398 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.398 - Application to all group policies — effective, when.

Effective - 01 Jan 1983   376.398. Application to all group policies — effective, when. — The provisions of sections 376.395 to 376.404 shall become effective January 1, 1983, and shall apply to all group policies delivered, issued for delivery or amended on or after January 1, 1983. ­­-------- (L. 1981 S.B. 58 § A)  Effective 1-01-83
MO Rev Stat § 376.401 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.401 - Conversion rights — retirees — dependents of insured.

Effective - 01 Jan 1983   376.401. Conversion rights — retirees — dependents of insured. — 1. In the event coverage would be continued under the group policy on an employee following his retirement, but prior to the time he is or could be covered by Medicare, the employee or member may elect, in lieu of such continuation of group insurance, to have the same conversion rights as would apply had that insurance terminated at retirement. The converted policy may provide for reduction or termination of coverage of any person upon his eligibility for coverage under Medicare or under any other state or federal law providing for benefits similar to those provided by the converted policy.  2. Subject to the conditions set forth in this section and section 376.397, the conversion privilege shall also be available to:  (1) The surviving spouse, if any, at the death of the employee or member, with respect to the spouse and such children whose coverage under the group policy terminates by reason of such death, or if the group policy provides for continuation of dependents coverage following the employee's or member's death, at the end of such continuation;  (2) The spouse of the employee or member upon termination of coverage of the spouse, while the employee or member remains insured under the group policy, with respect to the spouse and such children whose coverage under the group policy terminates at the same time; or  (3) A child, solely with respect to himself, upon termination of his coverage by reason of ceasing to be a qualified family member under the group policy, if a conversion privilege is not otherwise provided in sections 376.395 to 376.404 with respect to such termination. ­­-------- (L. 1981 S.B. 58 § 3)  Effective 1-01-83
MO Rev Stat § 376.403 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.403 - Benefit levels — group coverage may be provided in lieu of converted policy — delivery outside state, form.

Effective - 01 Jan 1983   376.403. Benefit levels — group coverage may be provided in lieu of converted policy — delivery outside state, form. — 1. If the benefit levels required in subdivision (9) of subsection 1 of section 376.397 exceed the benefit levels provided under the group policy, the converted policy may offer benefits which are substantially similar to those provided under the group policy in lieu of those required in subdivision (9) of subsection 1 of section 376.397.  2. The insurer may elect to provide group insurance coverage in lieu of the issuance of an individual converted policy.  3. A converted policy which is delivered outside this state may be on a form which could be delivered in such other jurisdiction as a converted policy had the group policy been issued in that jurisdiction. ­­-------- (L. 1981 S.B. 58 § 4)  Effective 1-01-83
MO Rev Stat § 376.404 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.404 - Specific requirement requests of policyholder may be met by alteration.

Effective - 01 Jan 1983   376.404. Specific requirement requests of policyholder may be met by alteration. — Upon written request by the group policyholder, the coverages required in section 376.397 may be changed or altered to meet the specific requirements of such group policyholder. ­­-------- (L. 1981 S.B. 58 § 5)  Effective 1-01-83
MO Rev Stat § 376.407 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.407 - Advance practice nurse, claims for service to be reimbursed, when.

Effective - 28 Aug 1998   376.407. Advance practice nurse, claims for service to be reimbursed, when. — Any health insurer, as defined in section 376.806, nonprofit health service plan or health maintenance organization shall reimburse a claim for services provided by an advance practice nurse, as defined in section 335.016, if such services are within the scope of practice of such nurse. ­­-------- (L. 1998 H.B. 1302 § 9)
MO Rev Stat § 376.410 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.410 - Insurance companies to maintain reserves — exemptions.

Effective - 28 Aug 1945   376.410. Insurance companies to maintain reserves — exemptions. — Except as provided in subdivision (6) of this section, all companies organized under the laws of this state, and engaged in writing policies of accident or health insurance, or combination policies of accident and health insurance, and all other companies transacting such kinds of business in this state, shall maintain reserves thereon in accordance with the following requirements:  (1) On all such policies actually written there shall be maintained an unearned gross premium reserve which reserve may be computed on a pro rata basis or such reserve may be computed at not less than fifty percent of the gross premiums in force;  (2) On all such policies written on a noncancellable plan and under the terms of which the company is obligated to renew or continue for a stated period, or to a stated age or for life, there shall be maintained active life reserves and reserves for losses in amounts not less than such minimum standards which the director of the department of commerce and insurance shall determine and prescribe after giving proper consideration to the terms and conditions of the policies involved;  (3) On all such policies other than those written on a noncancellable plan there shall be maintained reserves for losses in amounts not less than the minimum standards which the director of the department of commerce and insurance shall determine and prescribe after giving proper consideration to the terms and conditions of the policies involved;  (4) In the calculation of reserves required to be maintained under this section, proper credit shall be allowed for reinsurance in other companies licensed to do business in this state;  (5) In addition to the minimum reserves mentioned above the director of the department of commerce and insurance may also require such companies to maintain reserves for extraordinary losses in amounts not less than such minimum standards which the director of the department of commerce and insurance shall determine and prescribe after giving proper consideration to the terms and conditions of the policies involved;  (6) This section shall not be applicable to total and permanent disability benefits, or to accidental death benefits, contained in or supplementary to life insurance policies or other contracts and for which benefits the standard of valuation is prescribed by section 376.380. ­­-------- (L. 1945 p. 1000 § 6077a)
MO Rev Stat § 376.422 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 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.

Effective - 28 Aug 1985   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. — 1. As used in this section, the following terms shall mean:  (1) "Direct response solicitation", a solicitation through a sponsoring or endorsing entity or through the mails, telephone, or other mass communications medium;  (2) "Sponsoring or endorsing entity", an organization which has arranged for the offering of a program of insurance in a manner which communicates that eligibility for participation in the program is dependent upon affiliation with such organization or that it endorses participation in the program.  2. With respect to a program of insurance, whether issued on an individual basis or a group basis, which would not qualify under subdivisions (1), (2), (3), (4) and (6) of subsection 1 of section 376.421, if issued on a group basis, if compensation of any kind will or may be paid to a policyholder in the case of a group policy, or a sponsoring or endorsing entity in the case of individual, blanket or franchise policies marketed by means of direct response solicitation, the insurer shall cause to be distributed to prospective insureds a written notice that compensation will or may be paid. Such notice shall be distributed whether compensation is direct or indirect and whether such compensation is paid to or retained by the policyholder or sponsoring or endorsing entity or paid to or retained by a third party at the direction of the policyholder or sponsoring or endorsing entity or any entity affiliated therewith by way of ownership, contract or employment. The notice required by this subsection shall be placed on or shall accompany any application or enrollment form provided prospective insureds. ­­-------- (L. 1985 H.B. 623)
MO Rev Stat § 376.424 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.424 - Group health insurance policies may be extended to insure family members or dependents.

Effective - 28 Aug 1985   376.424. Group health insurance policies may be extended to insure family members or dependents. — Except for a policy issued under subdivision (2) of subsection 1 of section 376.421, a group health insurance policy may be extended to insure the employees and members with respect to their family members or dependents, or any class or classes thereof, subject to the following:  (1) The premium for the insurance shall be paid either from funds contributed by the employer, union, association or other person to whom the policy has been issued or from funds contributed by the covered persons, or from both. Except as provided in subdivision (2) of this section, a policy on which no part of the premium for the family members' or dependents' coverage is to be derived from funds contributed by the covered persons must insure all eligible employees or members with respect to their family members or dependents, or any class or classes thereof;  (2) An insurer may exclude or limit the coverage on any family member or dependent as to whom evidence of individual insurability is not satisfactory to the insurer, subject to sections 376.406 and 376.776 in a policy insuring fewer than ten employees or members and in a policy insuring ten or more employees or members if:  (a) Application is not made within thirty-one days after the date of eligibility for insurance; or  (b) The employee or member voluntarily terminated the insurance of the family member or dependent while such family member or dependent continues to be eligible for insurance under the policy; or  (c) After the expiration of an open enrollment period during which the family member or dependent could have been enrolled for the insurance or could have been enrolled for another level of benefits under the policy. ­­-------- (L. 1985 H.B. 623)
MO Rev Stat § 376.425 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.425 - Student accident policies, may not limit surgical benefits, when.

Effective - 01 Jan 1993   376.425. Student accident policies, may not limit surgical benefits, when. — 1. As used in this section, the following terms mean:  (1) "Institution of higher learning", any college or university, or "institution" as that term is defined in section 173.510;  (2) "Sponsoring or endorsing entity", the same as that term is defined in section 376.422;  (3) "Student accident policy", any individual, franchise, group or blanket policy of accident or health insurance which policy is offered to students of a sponsoring or endorsing entity which is an institution of higher learning and under which policy the insured person pays all or substantially all of the cost of his insurance.  2. No student accident policy issued or delivered for issuance in this state shall limit or exclude surgical benefits to one procedure when multiple procedures are done in one operating session. ­­-------- (L. 1992 S.B. 831 §§ A, 1)  Effective 1-01-93
MO Rev Stat § 376.428 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.428 - Federal COBRA provisions to apply to group health insurance policies.

Effective - 26 Jun 2009   376.428. Federal COBRA provisions to apply to group health insurance policies. — 1. A group policy delivered or issued for delivery in this state by a health carrier or health benefit plan, as defined in section 376.1350, which insures employees or members and their eligible dependents for hospital, surgical or major medical insurance on an expense-incurred or service basis, other than for specific diseases or for accidental injuries only, shall provide that employees or members whose coverage under the group policy, which includes coverage for their eligible dependents, would otherwise terminate because of termination of employment or membership shall be entitled to continue their hospital, surgical or major medical coverage, including coverage for their eligible dependents, under that group policy in the same manner as continuation of coverage is required under the continuation of coverage provisions set forth in the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), as amended.  2. The spouse of an employee or member whose coverage under the group policy would otherwise terminate due to dissolution of marriage or death of the employee or member shall have the same continuation privilege accorded under sections 376.421 to 376.442, 376.694 to 376.696, and 376.779 to the employee or member upon termination of employment or membership.  3. The right to a converted policy pursuant to sections 376.395 to 376.404 for an employee or member entitled to continuation of coverage under sections 376.421 to 376.442, 376.694 to 376.696, and 376.779 shall commence upon termination of the continued coverage provided for in sections 376.421 to 376.442, 376.694 to 376.696, and 376.779.  4. This section shall only apply to those persons who are not subject to the continuation and conversion provisions set forth in Title I, Subtitle B, Part 6 of the Employment Retirement Income Security Act of 1974 or Title XXII of the Public Health Service Act, as said acts were in effect on January 1, 1987. ­­-------- (L. 1985 H.B. 623, A.L. 1987 S.B. 337, A.L. 1988 H.B. 1242 Revision, A.L. 1991 H.B. 385, et al., A.L. 2009 H.B. 231)  Effective 6-26-09
MO Rev Stat § 376.431 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.431 - Employees or members of unions or associations, group or group-type basis coverage, sections 376.431 to 376.442 to apply.

Effective - 28 Aug 1999   376.431. Employees or members of unions or associations, group or group-type basis coverage, sections 376.431 to 376.442 to apply. — The provisions of sections 376.431 to 376.442 are applicable to all insurance policies and contracts issued or provided by an insurance company, health services corporation or health maintenance organization on a group or group-type basis covering persons as employees of employers or as members of unions or associations. ­­-------- (L. 1985 H.B. 623 § 376.430, A.L. 1999 H.B. 903)
MO Rev Stat § 376.432 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.432 - Group-type basis, defined.

Effective - 28 Aug 1999   376.432. Group-type basis, defined. — As used in sections 376.431 to 376.442, the term "group-type basis" means a benefit plan, other than salary budget plans utilizing individual insurance policies or contracts, which meets the following conditions:  (1) Coverage is provided through insurance policies or contracts to classes of employees or members defined in terms of conditions pertaining to employment or membership;  (2) The coverage is not available to the general public and can be obtained and maintained only because of the covered person's membership in or connection with the particular organization or group;  (3) There are arrangements for bulk payment of premiums or subscription charges to the insurer or health services corporation; and  (4) There is sponsorship of the plan by the employer, union or association. ­­-------- (L. 1985 H.B. 623, A.L. 1999 H.B. 903)
MO Rev Stat § 376.433 (2021)
2021 Missouri Revised Statutes|Title XXIV - Business and Financial Institutions|Chapter 376 - Life, Health and Accident Insurance|Section 376.433 - Self-insurance plans for health care, public entities — subject to Medicaid rights, obligations, and remedies.

Effective - 28 Aug 2004   376.433. Self-insurance plans for health care, public entities — subject to Medicaid rights, obligations, and remedies. — 1. Any public entity which provides, furnishes, or pays for hospital, medical, surgical, or other health care services under a plan of self-insurance to an employee or to any other person covered under the public entity's plan of self-insurance shall have the same rights and obligations, and be subject to the same remedies, as the department of social services has with Medicaid, as provided in section 208.215.  2. As used in this section, the term "public entity" shall have the same meaning ascribed to it in section 107.170.  3. This section shall not apply to limited benefit supplemental health insurance policies paid for entirely by an employee of the public entity. ­­-------- (L. 2004 H.B. 1233)