reglab/statecodes huggingface dataset:
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1516 - Written membership materials, required contents — forms to be submitted to director.

There are multiple enactments of 376.1516
Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007, 2 histories
*376.1516. Written membership materials, required contents — forms to be submitted to director. —
1. Each benefit under the discount medical plan shall be included in the written membership materials between the discount medical plan organization and the member. The written membership materials shall also include a statement notifying the members of their right to cancel under section 376.1508, and such materials shall also list all of the disclosures required by section 376.1512.
2. Upon request by the director, any forms used by a discount medical plan organization, including written membership materials, shall be submitted to the director.
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(L. 2007 S.B. 66)
*This section was enacted by H.B. 818 and S.B. 66 during the First Regular Session of the 94th General Assembly, 2007. Due to possible conflict, both versions of this section are printed here.
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1518 - Net worth to be maintained, amount.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1518. Net worth to be maintained, amount. —
1. Each discount medical plan organization registered pursuant to sections
*
376.1500 to 376.1532 shall at all times maintain a net worth of at least one hundred fifty thousand dollars.
2. The director may not allow a registration unless the discount medical plan organization has a net worth of at least one hundred fifty thousand dollars.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
*Word "sections" appears twice in original rolls of S.B. 66, 2007.
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1520 - Notice of changes.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1520. Notice of changes. —
Each discount medical plan organization required to be registered pursuant to this section shall provide the director at least thirty days' advance notice of any change in the discount medical plan organization's name, address, principal business address, or mailing address.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1522 - List of providers to be maintained on website.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1522. List of providers to be maintained on website. —
Each discount medical plan organization shall maintain a current list of the names and addresses of the providers with which it has contracted on a website page, the address of which shall be prominently displayed on all its advertisements, marketing materials, brochures, and discount cards. This section applies to those providers with whom the discount medical plan organization has contracted directly, as well as those who are members of a provider network with which the discount medical plan organization has contracted.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1524 - Advertising and marketing materials, approval in writing required.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1524. Advertising and marketing materials, approval in writing required. —
1. All advertisements, marketing materials, brochures and discount cards used by marketers shall be approved in writing for such use by the discount medical plan organization.
2. The discount medical plan organization shall have an executed written agreement with a marketer prior to the marketer's marketing, promoting, selling, or distributing the discount medical plan.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1528 - Rulemaking authority.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1528. Rulemaking authority. —
The director under the provisions of section 374.045 may promulgate rules to administer and interpret the provisions of sections 376.1500 to 376.1532.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1530 - Denial and refusal to issue registrations, when.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1530. Denial and refusal to issue registrations, when. —
1. The director may deny a registration to an applicant or refuse to renew, suspend, or revoke the registration of a registrant if the applicant or registrant, or an officer, director, or employee of the applicant or registrant:
(1) Makes a material misstatement or misrepresentation in an application for registration;
(2) Fraudulently or deceptively obtains or attempts to obtain a registration for the applicant or registrant or for another;
(3) Has advertised, merchandised or attempted to merchandise its services in such a manner as to misrepresent its services or capacity for service or has engaged in deceptive, misleading or unfair practices with respect to advertising or merchandising;
(4) In connection with the advertisement, offer, sale or administration of a health care discount program, makes any untrue statement of material fact, conceals any material fact, uses any deception or commits fraud or engages in any dishonest activity;
(5) Is not fulfilling its obligations as a discount medical plan organization;
(6) Does not have the minimum net worth as required by sections 376.1500 to 376.1532; or
(7) Violates any provision of sections 376.1500 to 376.1532, or any law or regulation of this state relating to insurance or the provision of medical care.
2. If the director has cause to believe that grounds for the suspension or revocation of a registration exist, the director shall notify the discount medical plan organization in writing, specifically stating the grounds for suspension or revocation, and shall provide opportunity for a hearing on the matter before the director.
3. When the registration of a discount medical plan organization is surrendered or revoked, such organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs transacted under the registration. The organization may not engage in any further advertising, solicitation, collecting of fees, or renewal of contracts.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1532 - Violations, penalties.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2007
376.1532. Violations, penalties. —
1. If the director determines that a person has engaged, is engaging, or has taken a substantial step toward engaging in a violation of sections 376.1500 to 376.1532, 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 376.1500 to 376.1532 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 sections 376.1500 to 376.1532 is a level two violation under section 374.049. The director of the department of commerce and insurance may also suspend or revoke the license or certificate of authority of such person for any willful violation.
2. If the director believes that a person has engaged, is engaging, or has taken a substantial step toward engaging in a violation of sections 376.1500 to 376.1532 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 376.1500 to 376.1532 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 sections 376.1500 to 376.1532 is a level two violation under section 374.049.
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(L. 2007 H.B. 818 merged with S.B. 66)
Effective 8-28-07 (S.B. 66); 1-01-08 (H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1551 - Federal mental health parity and addiction equity requirements — inapplicable, when — rulemaking authority.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
Effective - 28 Aug 2021
376.1551. Federal mental health parity and addiction equity requirements — inapplicable, when — rulemaking authority. —
1. As used in this section, the following terms mean:
(1)
"Health benefit plan"
, the same meaning given to the term in section 376.1350;
(2)
"Health carrier"
, the same meaning given to the term in section 376.1350;
(3)
"Mental health condition"
, the same meaning given to the term in section 376.1550.
2. Notwithstanding any other provision of law to the contrary, each health carrier that offers or issues health benefit plans that are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2022, and that provide coverage for a mental health condition shall meet the requirements of the Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. Section 300gg-26, as amended, and the regulations promulgated thereunder. The director may enforce such requirements subject to the provisions of this section.
3. The provisions of this section shall not apply to a supplemental insurance policy, including a life care contract, accident-only policy, specified disease policy, hospital policy providing a fixed daily benefit only, Medicare supplement policy, long-term care policy, hospitalization-surgical care policy, short-term major medical policy of twelve months' or less duration, a health benefit plan in the small group market that was issued before January 1, 2014, or a health benefit plan in the individual market that was purchased before January 1, 2014, or any other supplemental policy as determined by the director of the department of commerce and insurance.
4. The director may promulgate rules to effectuate the provisions of this section. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2021, shall be invalid and void.
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(L. 2021 H.B. 432 merged with H.B. 604)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1575 - Definitions.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2022, 2 histories
376.1575. Definitions. —
As used in sections 376.1575 to 376.1580
*
, the following terms shall mean:
(1)
"Completed application"
, a practitioner's application to a health carrier that seeks the health carrier's authorization for the practitioner to provide patient care services as a member of the health carrier's network and does not omit any information which is clearly required by the application form and the accompanying instructions;
(2)
"Credentialing"
, a health carrier's process of assessing and validating the qualifications of a practitioner to provide patient care services and act as a member of the health carrier's provider network;
(3)
"Health carrier"
, the same meaning as such term is defined in section 376.1350. The term health carrier shall also include any entity described in subdivision (4) of section 354.700;
(4)
"Practitioner"
:
(a) A physician or physician assistant eligible to provide treatment services under chapter 334;
(b) A pharmacist eligible to provide services under chapter 338;
(c) A dentist eligible to provide services under chapter 332;
(d) A chiropractor eligible to provide services under chapter 331;
(e) An optometrist eligible to provide services under chapter 336;
(f) A podiatrist eligible to provide services under chapter 330;
(g) A psychologist or licensed clinical social worker eligible to provide services under chapter 337; or
(h) An advanced practice nurse eligible to provide services under chapter 335.
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(L. 2013 S.B. 262, A.L. 2022 S.B. 710)
*Section 376.1580 does not exist.
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1590 - Status as living organ donor not sole factor for insurance coverage.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
Effective - 28 Aug 2020
376.1590. Status as living organ donor not sole factor for insurance coverage. —
1. As used in this section, the term
"insurance policy"
means a policy or other contract of life insurance as such term is defined in section 376.365, a policy of accident and sickness insurance as such term is defined in section 376.773, or a long-term care insurance policy as such term is defined in section 376.1100.
2. Notwithstanding any provision of law to the contrary, a person's status as a living organ donor shall not be the sole factor in the offering, issuance, cancellation, price, or conditions of an insurance policy, nor in the amount of coverage provided under an insurance policy.
3. (1) The department of commerce and insurance shall provide information to the public on the access of a living organ donor to insurance as specified in this section. If the department of commerce and insurance receives materials related to live organ donation from a recognized live organ donation organization, the department of commerce and insurance may make the materials available to the public.
(2) If the department of health and senior services receives materials related to live organ donation from a recognized live organ donation organization, the department of health and senior services may make the materials available to the public.
(3) The department of commerce and insurance and the department of health and senior services may seek and accept gifts, grants, or donations from private or public sources for the purposes of this subsection.
4. The director of the department of commerce and insurance may promulgate rules as necessary for the implementation of this section. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable, and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2020, shall be invalid and void.
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(L. 2020 S.B. 551)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.1753 - Services related to pregnancy, persons holding ministerial or tocological certification may provide.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
Effective - 28 Aug 2007
376.1753. Services related to pregnancy, persons holding ministerial or tocological certification may provide. —
Notwithstanding any law to the contrary, any person who holds current ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance (NOCA) may provide services as defined in 42 U.S.C. 1396r-6(b)(4)(E)(ii)(I).
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(L. 2007 H.B. 818)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2000 - Citation of law — definitions.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2000. Citation of law — definitions. —
1. Sections 376.2000 to 376.2014 shall be known and may be cited as the "Health Insurance Marketplace Innovation Act of 2013".
2. As used in sections 376.2000 to 376.2014, the following terms mean:
(1)
"Department"
, the department of commerce and insurance;
(2)
"Director"
, the director of the department of commerce and insurance;
(3)
"Exchange"
, any health benefit exchange established or operating in this state, including any exchange established or operated by the United States Department of Health and Human Services;
(4)
"Navigator"
, a person that, for compensation, provides information or services in connection with eligibility, enrollment, or program specifications of any health benefit exchange operating in this state, including any person that is selected to perform the activities and duties identified in 42 U.S.C. 18031(i) in this state, any person who receives funds from the United States Department of Health and Human Services to perform any of the activities and duties identified in 42 U.S.C. 18031(i), or any other person certified by the United States Department of Health and Human Services, or a health benefit exchange operating in this state, to perform such defined or related duties irrespective of whether such person is identified as a navigator, certified application counselor, in-person assister, or other title. A "navigator" does not include any not-for-profit entity disseminating to a general audience public health information.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2004 - Application procedure.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2004. Application procedure. —
1. An individual applying for a navigator license shall make application to the department on a form developed by the director and declare under penalty of refusal, suspension, or revocation of the license that the statements made in the application are true, correct, and complete to the best of the individual's knowledge and belief. Before approving the application, the director shall find that the individual:
(1) Is eighteen years of age or older;
(2) Resides in this state or maintains his or her principal place of business in the state;
(3) Is not disqualified for having committed any act that would be grounds for refusal to issue, renew, suspend, or revoke an insurance producer license under section 375.141;
(4) Has successfully passed the written examination prescribed by the director;
(5) When applicable, has the written consent of the director under 18 U.S.C. 1033 or any successor statute regulating crimes by or affecting persons engaged in the business of insurance whose activities affect interstate commerce;
(6) Has identified the entity with which he or she is affiliated and supervised; and
(7) Has paid the fees prescribed by the director.
2. An entity that acts as a navigator, supervises the activities of individual navigators, or receives funding to perform such activities shall obtain a navigator entity license. An entity applying for an entity navigator license shall make application on a form containing the information prescribed by the director.
3. The director may require any documents deemed necessary to verify the information contained in an application submitted in accordance with subsections 1 and 2 of this section.
4. Entities licensed as navigators shall, in a manner prescribed by the director, provide a list of all individual navigators that are employed by or in any manner affiliated with the navigator entity and shall report any changes in employment or affiliation within twenty days of such change.
5. Prior to any exchange becoming operational in this state, the director shall prescribe initial training, continuing education, and written examination standards and requirements for navigators.
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(L. 2013 S.B. 262)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2006 - Term of licensure — renewal — continuing education.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2006. Term of licensure — renewal — continuing education. —
1. A navigator license shall be valid for two years.
2. A navigator may file an application for renewal of a license and pay the renewal fee as prescribed by the director. Any navigator who fails to timely file for license renewal shall be charged a late fee in an amount prescribed by the director.
3. Prior to the filing date for an application for renewal of a license, an individual licensee shall comply with any ongoing training and continuing education requirements established by the director. Such navigator shall file with the director, by a method prescribed by the director, proof of satisfactory certification of completion of the continuing education requirements. Any failure to fulfill the ongoing training and continuing education requirements shall result in the expiration of the license.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2008 - Consultation with licensed insurance producer, navigator to advise, when.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2008. Consultation with licensed insurance producer, navigator to advise, when. —
Upon contact with a person who acknowledges having existing health insurance coverage obtained through an insurance producer, a navigator shall advise the person to consult with a licensed insurance producer regarding coverage in the private market.
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(L. 2013 S.B. 262)
Effective 7-12-13
(2016) Provision requiring state navigators to refer certain persons to consult with licensed insurance producers was preempted by the federal Patient Protection and Affordable Care Act. St. Louis Effort for AIDS v. Huff, 170 F.Supp.3d 1219 (W.D.Mo.).
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2010 - Sanction of license, when — restitution required, when — examination and investigation of records.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2010. Sanction of license, when — restitution required, when — examination and investigation of records. —
1. The director may place on probation, suspend, revoke, or refuse to issue, renew, or reinstate a navigator license or may levy a fine not to exceed one thousand dollars for each violation, or any combination of actions, for any one or more of the causes listed in section 375.141, 375.936 or for other good cause. In the event that the action by the director is not to renew or to deny an application for a license, the director shall notify the applicant or licensee in writing and shall advise the applicant or licensee of the reason for the denial or nonrenewal. Appeal of the nonrenewal or denial of the application for a navigator license shall be made under the provisions of chapter 621.
2. In addition to imposing the penalties authorized by subsection 1 of this section, the director may require that restitution be made to any person who has suffered financial injury because of a violation of this section.
3. The director shall have the power to examine and investigate the business affairs and records of any navigator to determine whether the individual or entity has engaged or is engaging in any violation of this section.
4. The navigator license held by an entity may be suspended or revoked, renewal or reinstatement thereof may be refused, or a fine may be levied, with or without a suspension, revocation, or refusal to renew a license, if the director finds that an individual licensee's violation was known or should have been known by the employing or supervising entity and the violation was not reported to the director and no corrective action was undertaken on a timely basis.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2011 - Violations, administrative orders, civil actions — penalty.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2011. Violations, administrative orders, civil actions — penalty. —
1. If the director determines that a person has engaged, is engaging, or has taken a substantial step toward engaging in an act, practice, omission, or course of business constituting a violation of sections 376.2000 to 376.2014 or a rule adopted or order issued pursuant thereto, or a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation in sections 376.2000 to 376.2014 or a rule adopted or order issued pursuant thereto, the director may issue such administrative orders as authorized under section 374.046.
2. If the director believes that a person has engaged, is engaging, or has taken a substantial step toward engaging in an act, practice, omission, or course of business constituting a violation of sections 376.2000 to 376.2014 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 in sections 376.2000 to 376.2014 or a rule adopted or order issued pursuant thereto, the director may maintain a civil action for relief authorized under section 374.048.
3. A violation of sections 376.2000 to 376.2014 is a level two violation under section 374.049.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2012 - Navigators duty to report, when.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2012. Navigators duty to report, when. —
1. Each licensed navigator shall report to the director within thirty calendar days of the final disposition of the matter of any administrative action taken against him or her in another jurisdiction or by another governmental agency in this state. This report shall include a copy of the order, consent to order, or other relevant legal documents.
2. Within thirty days of the initial pretrial hearing date, a navigator shall report to the director any criminal prosecution of the navigator in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.
3. An entity that acts as a navigator that terminates the employment, engagement, affiliation, or other relationship with an individual navigator shall notify the director within twenty days following the effective date of the termination, using a format prescribed by the director if the reason for termination is one of the reasons set forth in section 375.141 or 375.936 or if the entity has knowledge that the navigator was found by a court or governmental body to have engaged in any such activities. Upon the written request of the director, the entity shall provide additional information, documents, records, or other data pertaining to the termination or activity of the individual.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2014 - Applicability — severability — rulemaking authority.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 12 Jul 2013, see footnote
376.2014. Applicability — severability — rulemaking authority. —
1. The requirements of sections 379.930 to 379.952 and chapters 375, 376, 407 and any related rules shall apply to navigators. The activities and duties of a navigator shall be deemed to constitute transacting the business of insurance.
2. If any provision of sections 376.2000 to 376.2014 or its application to any person or circumstance is held invalid by a court of competent jurisdiction or by federal law, the invalidity does not affect other provisions or applications of sections 376.2000 to 376.2014 that can be given effect without the invalid provision or application. The provisions of sections 376.2000 to 376.2014 are severable, and the valid provisions or applications shall remain in full force and effect.
3. The director may promulgate rules and regulations to implement and administer the provisions of sections 376.2000 to 376.2014. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in sections 376.2000 to 376.2014 shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. Sections 376.2000 to 376.2014 and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2013, shall be invalid and void.
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(L. 2013 S.B. 262)
Effective 7-12-13
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2020 - Contracts prohibiting disclosure of certain payments and costs are unenforceable.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
Effective - 14 Oct 2016, see footnote
*376.2020. Contracts prohibiting disclosure of certain payments and costs are unenforceable. —
1. For purposes of this section, the following terms shall mean:
(1)
"Contractual payment amount"
or
"payment amount"
, shall mean the total amount a health care provider is to be paid for providing a given health care service pursuant to a contract with a health carrier, and includes both the portions to be paid by the patient and by the health carrier. It is commonly referred to as the allowable amount;
(2)
"Enrollee"
, shall have the same meaning ascribed to it in section 376.1350;
(3)
"Health care provider"
, shall have the same meaning ascribed to it in section 376.1350;
(4)
"Health care service"
, shall have the same meaning ascribed to it in section 376.1350;
(5)
"Health carrier"
, shall have the same meaning ascribed to it in section 376.1350.
2. No provision in a contract in existence or entered into, amended, or renewed on or after August 28, 2016, between a health carrier and a health care provider shall be enforceable if such contractual provision prohibits, conditions, or in any way restricts any party to such contract from disclosing to an enrollee, or such person's parent or legal guardian, the contractual payment amount for a health care service if such payment amount is less than the health care provider's usual charge for the health care service, and if such contractual provision prevents the determination of the potential out-of-pocket cost for the health care service by the enrollee, parent, or legal guardian.
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(L. 2016 S.B. 608)
*Effective 10-14-16, see § 21.250. S.B. 608 was vetoed July 5, 2016. The veto was overridden on September 14, 2016.
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2030 - Definitions.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2016
376.2030. Definitions. —
As used in sections 376.2030 to 376.2036, the following terms mean:
(1)
"Health benefit plan"
, the same meaning as such term is defined in section 376.1350;
(2)
"Health care provider"
, the same meaning as such term is defined in section 376.1350;
(3)
"Health carrier"
, the same meaning as such term is defined in section 376.1350;
(4)
"Step therapy override exception determination"
, a determination as to whether a step therapy protocol should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the health care provider's preferred prescription drug. This determination is based on a review of the patient's health care provider's request for an override, along with supporting rationale and documentation;
(5)
"Step therapy override exception request"
, a written request from the patient's health care provider for the step therapy protocol to be overridden in favor of immediate coverage of the health care provider's preferred prescription drug. The manner and form of the written request shall be disclosed to the patient and the health care provider as described in subsection 1 of section 376.2034;
(6)
"Step therapy protocol"
, a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient are to be prescribed and covered by a health carrier or health benefit plan;
(7)
"Utilization review organization"
, an entity that conducts utilization review other than an insurer or health carrier performing utilization review for its own health benefit plans.
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(L. 2016 H.B. 2029)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2034 - Restriction on step therapy protocol, patient to have access to override exception determination — procedure.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2021, 2 histories
376.2034. Restriction on step therapy protocol, patient to have access to override exception determination — procedure. —
1. If coverage of a prescription drug for the treatment of any medical condition is restricted for use by a health carrier, health benefit plan, or utilization review organization via a step therapy protocol, a patient, through his or her health care provider, shall have access to a clear, convenient, and readily accessible process to request a step therapy override exception determination. A health carrier, health benefit plan, or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care provider, which shall include the necessary documentation needed to process such request and be made available on the health carrier plan or health benefit plan website.
2. A step therapy override exception determination shall be granted if the patient has tried the step therapy required prescription drugs while under his or her current or previous health insurance or health benefit plan, and such prescription drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event, or if the patient's treating health care provider attests that coverage of the prescribed prescription drug is necessary to save the life of the patient. Pharmacy drug samples shall not be considered trial and failure of a preferred prescription drug in lieu of trying the step therapy required prescription drug.
3. The health carrier, health benefit plan, or utilization review organization may request relevant documentation from the patient or provider to support the override exception request.
4. Upon the granting of a step therapy override exception request, the health carrier, health benefit plan, or utilization review organization shall authorize dispensation of and coverage for the prescription drug prescribed by the patient's treating health care provider, provided such drug is a covered drug under such policy or contract.
5. This section shall not be construed to prevent:
(1) A health carrier, health benefit plan, or utilization review organization from requiring a patient to try a generic equivalent or other brand name drug prior to providing coverage for the requested prescription drug; or
(2) A health care provider from prescribing a prescription drug he or she determines is medically appropriate.
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(L. 2016 H.B. 2029, A.L. 2021 H.B. 432)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2036 - Enforcement — applicability to health insurance plans, when.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2016
376.2036. Enforcement — applicability to health insurance plans, when. —
Notwithstanding any law to the contrary, the department of commerce and insurance shall enforce sections 376.2030 to 376.2036. The provisions of sections 376.2030 to 376.2036 shall apply to health insurance and health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2018.
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(L. 2016 H.B. 2029)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2050 - Citation of act.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2016
376.2050. Citation of act. —
Sections 376.2050 to 376.2053 shall be known and may be cited as the "Unclaimed Life Insurance Benefits Act".
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(L. 2016 H.B. 2150)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2053 - Exemption from requirements, when.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
• Effective - 28 Aug 2016
376.2053. Exemption from requirements, when. —
An insurer that has not engaged in any asymmetric conduct prior to January 1, 2018, shall not be required to comply with the requirements of sections 376.2050 to 376.2053 with respect to any policies, contracts, or retained asset accounts that are issued and delivered in this state and that are issued or entered into prior to January 1, 2018; provided, however, that an insurer, regardless of whether it has engaged in asymmetric conduct, shall comply with the requirements of sections 376.2050 to 376.2053 for all policies, annuities, or retained asset accounts that are issued and delivered in this state and that are issued or entered into on or after January 1, 2018.
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(L. 2016 H.B. 2150)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 376 - Life, Health and Accident Insurance › Section 376.2080 - Funding agreement defined — authority to issue — rulemaking authority.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 376
Effective - 28 Aug 2021
376.2080. Funding agreement defined — authority to issue — rulemaking authority. —
1. As used in this chapter and chapter 375, the term
"funding agreement"
means an agreement for an insurer to accept and accumulate funds and to make one or more payments at future dates in amounts that are not based on mortality or morbidity contingencies of the person to whom the funding agreement is issued. A funding agreement shall not be deemed to constitute a security, as such term is defined in section 409.1-102.
2. A life insurance company formed under this chapter may issue funding agreements. The issuance of a funding agreement shall be deemed to be doing insurance business.
3. The director may promulgate rules as necessary for the implementation of this section. Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2021, shall be invalid and void.
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(L. 2021 H.B. 604 merged with S.B. 6)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 377 - Assessment Plan and Stipulated Premium Plan Life Insurance › Section 377.005 - Definitions.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 377
Effective - 28 Aug 2008
377.005. Definitions. —
As used in this chapter, unless otherwise clearly indicated by the context, the following words mean:
(1)
"Department"
, the department of commerce and insurance; and
(2)
"Director"
, the director of the department of commerce and insurance.
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(L. 2008 S.B. 788)
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 377 - Assessment Plan and Stipulated Premium Plan Life Insurance › Section 377.010 - Assessment plan insurance defined.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 377
• Effective - 28 Aug 1939
377.010. Assessment plan insurance defined. —
Every contract whereby a benefit is to accrue to a person or persons named therein, upon the death or physical disability of a person also named therein, the payment of which said benefit is in any manner or degree dependent upon the collection of an assessment upon persons holding similar contracts, shall be deemed a contract of insurance upon the assessment plan, and the business involving the issuance of such contracts shall be carried on in this state only by duly organized corporations which shall be subject to the provisions and requirements of sections 377.010 to 377.190.
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(RSMo 1939 § 5856)
Prior revisions: 1929 § 5745; 1919 § 6155; 1909 § 6950
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 377 - Assessment Plan and Stipulated Premium Plan Life Insurance › Section 377.030 - Release of beneficiary fund — replacement — exemptions.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 377
• Effective - 28 Aug 1939
377.030. Release of beneficiary fund — replacement — exemptions. —
1. On written application by the board of directors, the director of the department of commerce and insurance shall release to said company from the beneficiary fund the amount herein stated for the purpose of paying policy beneficiaries as provided later herein.
2. The board of directors shall certify the names of the beneficiaries and amounts in claims to the director of the department of commerce and insurance and that the money so released is for no other purpose than to pay the claims so certified.
3. However, the amount released from this fund by the said director shall not exceed twelve thousand dollars, which shall be used solely for the purpose of paying beneficiaries.
4. Such funds so released shall be replaced on deposit by the company within twelve months in four equal installments, in three, six, nine and twelve months from the date of release. The director of the department of commerce and insurance at his own discretion may extend time of replacement of said funds, if, in his judgment it is to the best interest of the policyholders.
5. This section and section 377.020 shall not apply to companies already incorporated and existing under the laws of the state of Missouri. Nothing in sections 377.010 to 377.190 shall prevent any such company or association from engaging in both life and casualty insurance and placing both a life and casualty clause in the same policy.
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(RSMo 1939 § 5857)
Prior revisions: 1929 § 5746; 1919 § 6156; 1909 § 6951
2023 Missouri Revised Statutes › Title XXIV - Business and Financial Institutions › Chapter 377 - Assessment Plan and Stipulated Premium Plan Life Insurance › Section 377.040 - Qualifications to do business.

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS
Chapter 377
• Effective - 28 Aug 1939
377.040. Qualifications to do business. —
1. Any association, society or company duly incorporated under the laws of this state, having a bona fide membership of not less than five hundred persons in good standing, and who hold policies or certificates of insurance therein in the aggregate of not less than five hundred thousand dollars, may either reincorporate, as herein provided for incorporation, or become entitled to do business in this state under the provisions of sections 377.010 to 377.190 in the manner following: A declaration duly authorized by such corporation, attested by its president and secretary, and with its corporate seal attached, accompanied by a copy of its charter, bylaws, rules and regulations, shall be filed in the office of the director of the department of commerce and insurance showing the number of its members in good standing, the aggregate amount of insurance held by them, and that it has the amount of one full assessment upon its members paid in and deposited to its credit in bank, and that it accepts fully and unconditionally the provisions and requirements of sections 377.010 to 377.190, and will conform to and abide by the same in good faith.
2. The said director shall thereupon issue his certificate to such corporation, setting out the fact that, having complied with the provisions of sections 377.010 to 377.190 in all respects, it is then permitted and authorized to do business in this state under the supervision and control of said department, and subject to the provisions of sections 377.010 to 377.190.
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(RSMo 1939 § 5866)
Prior revisions: 1929 § 5755; 1919 § 6165; 1909 § 6960