reglab/statecodes huggingface dataset:
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.295 - Certificate of authority not to be issued if controlling management involved in improper actions.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.295. Certificate of authority not to be issued if controlling management involved in improper actions. —
The director shall not approve any declaration of organization or articles of incorporation or issue a certificate of authority to any company until he has found that there is no good reason to believe that the incorporators, directors and proposed officers are affiliated, directly or indirectly, through ownership, control, management, reinsurance transactions or other insurance or business relations with any person or persons known to have been involved in the improper manipulation of assets, accounts or reinsurance.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.300 - Certificate of authority suspended or revoked, when.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.300. Certificate of authority suspended or revoked, when. —
Other provisions of law notwithstanding, the director may suspend or revoke, after a hearing, the certificate of authority or license of any corporation subject to the provisions of sections 354.010 to 354.380 for the same reasons and upon the same grounds as set forth in section 354.355.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.305 - Corporation advertising assets also to show liabilities — penalties.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2008
354.305. Corporation advertising assets also to show liabilities — penalties. —
1. Whenever any corporation subject to the provisions of sections 354.010 to 354.380 doing business in this state advertises its assets, either in any newspaper or periodical, or by any sign, circular, card, policy of insurance or certificate of renewal thereof, it shall, in the same connection, equally conspicuously advertise its liabilities, the same to be determined in the manner required in making statement to the department, and all advertisements purporting to show the amount of capital of the company shall show only the amount of capital actually paid up in cash.
2. Any corporation subject to the provisions of sections 354.010 to 354.380 or enrollment representative violating the provisions of this section shall, upon conviction thereof, be guilty of a class B misdemeanor, punishable as provided by law.
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(L. 1983 H.B. 127, A.L. 2008 S.B. 788)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.315 - Data processing system authorized, cost, amount allowed — amortization not to exceed ten years.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.315. Data processing system authorized, cost, amount allowed — amortization not to exceed ten years. —
Notwithstanding any prohibitions or restrictions contained in the statutes, any corporation subject to the provisions of sections 354.010 to 354.380 may acquire by purchase electronic or mechanical machines constituting a data processing system, and thereafter may hold the system as an admitted asset for use in connection with the business of the company if
(1) The system shall have an aggregate cost of not less than twenty-five thousand dollars and its aggregate cost shall not exceed five percent of the admitted assets of the company;
(2) The cost of the component machines constituting the system shall be fully amortized over a period not to exceed ten calendar years. If a data processing system consists of separate component machines which are acquired at different times, then the cost of each component shall be fully amortized over a period not to exceed ten calendar years commencing with the date of acquisition of each component.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.320 - Corporate funds and securities use for private gain by officers and employees prohibited, penalty.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 01 Jan 2017, 2 histories, see footnote
354.320. Corporate funds and securities use for private gain by officers and employees prohibited, penalty. —
No officer, enrollment representative or employee of any corporation subject to the provisions of sections 354.010 to 354.380, formed under the laws of this state, or doing business herein, shall, directly or indirectly, use or employ, or permit others to use or employ, any of the money, funds or securities of such corporation for private profit or gain, except for reasonable compensation for services performed and reimbursement for expenses incurred, and any such use shall, upon conviction thereof, be a class E felony.
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(L. 1983 H.B. 127, A.L. 2014 S.B. 491)
Effective 1-01-17
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.325 - Investigation by director of investments — records to be kept by division — criminal action, when.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.325. Investigation by director of investments — records to be kept by division — criminal action, when. —
1. The director of the department of commerce and insurance shall, as often as he may deem proper, make careful inquiry and investigation as to the manner in which the money, funds or securities of corporations subject to the provisions of sections 354.010 to 354.380, doing business in this state, are invested or employed, and record the result of such inquiry or investigation in records kept in his office for the inspection of members and public officials.
2. In the event of a violation of this section or of section 354.320, the prosecuting attorney of the proper county, or in the city of St. Louis, the circuit attorney, shall proceed at once by information or indictment against the offenders.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.330 - Public official failing to perform duties as to investment violations, penalty.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.330. Public official failing to perform duties as to investment violations, penalty. —
Any public official failing, neglecting or refusing to comply with any of the provisions of sections 354.320 and 354.325 shall be deemed guilty of a misdemeanor, and, upon conviction, shall be fined not less than five hundred dollars and forfeit his office.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.335 - Damages allowed if corporation without reasonable cause refuses to pay.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.335. Damages allowed if corporation without reasonable cause refuses to pay. —
In any action against any corporation subject to the provisions of sections 354.010 to 354.380 to recover the amount of any loss under a policy of health insurance, if it appears from the evidence that such corporation has refused to pay such loss without reasonable cause or excuse, the court or jury may, in addition to the amount thereof and interest, allow the plaintiff damages not to exceed twenty percent of the first fifteen hundred dollars of the loss, and ten percent of the amount of the loss in excess of fifteen hundred dollars and a reasonable attorney's fee; and the court shall enter judgment for the aggregate sum found in the verdict.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.340 - Unsatisfied judgments against corporation — suspension or revocation of certificate of authority until judgment satisfied.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.340. Unsatisfied judgments against corporation — suspension or revocation of certificate of authority until judgment satisfied. —
Whenever any judgment shall be obtained in any of the courts of this state against any corporation subject to the provisions of sections 354.010 to 354.380 doing business in this state, and said judgment shall remain unsatisfied for fifteen days after execution shall have been lawfully issued thereon, the certificate of authority or license to do business issued or granted to such corporation shall immediately be suspended or revoked by the director of the department of commerce and insurance, upon said director being notified thereof, and such insurance company shall, after such suspension or revocation, be prohibited from transacting any business in this state until such judgment shall be satisfied.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.345 - Court decree of specific performance — membership contract, failure of corporation to comply, procedure, effect.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.345. Court decree of specific performance — membership contract, failure of corporation to comply, procedure, effect. —
Any person, who has heretofore obtained or may hereafter obtain, in any of the courts of this state, a decree against any corporation subject to the provisions of sections 354.010 to 354.380 doing business in this state, commanding or directing said corporation to specifically perform a membership contract, may, if the corporation against which said decree is obtained, fails, for a period of fifteen days after the rendition of said decree, to comply with the same, obtain a copy of said decree, certified to under the hand and seal of the clerk of the court in which said decree was rendered, and transmit the same, together with the certificate of said clerk, reciting therein the failure of such corporation to comply with said decree, and transmit the same to the director of the department of commerce and insurance of the state of Missouri, and immediately upon receipt thereof, the said director of the department of commerce and insurance shall cause such corporation to be notified of the fact of the filing of such certified copy of said decree and certificate, and if such corporation fails for a period of thirty days thereafter to comply with said decree, the certificate of authority or license to do business issued or granted to such corporation shall immediately be suspended or revoked by the director of the department of commerce and insurance, until such decree shall be satisfied; provided, however, the foregoing shall not be applicable while an appeal is pending if a supersedeas bond shall have been given.
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(L. 1983 H.B. 127)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.350 - Fraudulent or bad faith conduct — investigation by division — hearing, procedure.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2007
354.350. Fraudulent or bad faith conduct — investigation by division — hearing, procedure. —
1. It is unlawful for any corporation subject to the provisions of sections 354.010 to 354.380 transacting business in this state to:
(1) Conduct its business fraudulently;
(2) Fail to carry out its contracts in good faith; or
(3) Habitually and as a matter of business practice compel claimants under policies or liability judgment creditors of its members to either accept less than the amount due under the terms of the policy or resort to litigation against the corporation to secure payment of the amount due.
2. If the director determines 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 this section 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 this section or a rule adopted or order issued pursuant thereto, the director may issue such administrative orders as authorized under section 374.046. Each practice in violation of this section is a level two violation under section 374.049. Each act as a part of a practice does not constitute a separate violation under section 374.049. The director may also suspend or revoke the license or certificate of authority of a corporation subject to the provisions of sections 354.010 to 354.380 or enrollment representative for any such willful violation.
3. 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 this section 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 this section or a rule adopted or order issued pursuant thereto, the director may maintain a civil action for relief authorized under section 374.048. Each practice in violation of this section is a level two violation under section 374.049. Each act as a part of a practice does not constitute a separate violation under section 374.049.
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(L. 1983 H.B. 127, A.L. 2007 S.B. 66)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127 § 354.355 subsec. 1)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127 § 354.355 subsecs. 2, 3)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 2002 S.B. 1094)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127, A.L. 1997 H.B. 335, A.L. 2013 S.B. 262)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(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
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1997 H.B. 335)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1997 H.B. 335)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1997 H.B. 335, A.L. 2007 S.B. 66)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127, A.L. 2007 S.B. 66)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127 § 354.460 subsec. 1, A.L. 2007 S.B. 66)
2023 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.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• 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.
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(L. 1983 H.B. 127 § 354.460 subsec. 2)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.464 - Names not authorized for use, exceptions.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2007
354.464. Names not authorized for use, exceptions. —
No health maintenance organization, unless licensed as an insurer, may use in its name, contracts, or literature any of the words "insurance", "casualty", "surety", "mutual", or any other words descriptive of the insurance, casualty, or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this state when such words are deceptive or misleading. No person, if not in possession of a valid certificate of authority issued pursuant to sections 354.400 to 354.636, may use the phrase "health maintenance organization" or "HMO" in the course of its operation.
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(L. 1983 H.B. 127 § 354.460 subsec. 3, A.L. 2007 S.B. 66)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.465 - Examinations by division, when — costs, how paid.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2014
354.465. Examinations by division, when — costs, how paid. —
1. The director, or any duly appointed representative, may make an examination of the affairs of any health maintenance organization as often as he deems it necessary for the protection of the interests of the people of this state, but not less frequently than once every five years.
2. All costs incurred by the state as a result of making examinations under this section shall be paid by the organization being examined and remitted as provided in section 374.160.
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(L. 1983 H.B. 127, A.L. 2014 H.B. 1968)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.475 - Insurance companies or health service company may organize and operate a health maintenance organization.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2007
354.475. Insurance companies or health service company may organize and operate a health maintenance organization. —
1. An insurance company licensed in this state, or a health services corporation authorized to do business in this state, may directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of sections 354.400 to 354.636 so long as they comply with the provisions of section 354.410 as applicable thereto. Notwithstanding any other law to the contrary, any two or more such insurance companies, health services corporations, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization.
2. Notwithstanding any other provision of law pertaining to insurance and health services corporations to the contrary, an insurer or a health services corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. The enrollees of a health maintenance organization shall be deemed to constitute a permissible group under such laws. Among other things, under such contracts, the insurer or health services corporation may make benefit payments to health maintenance organizations for health care services rendered by providers.
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(L. 1983 H.B. 127, A.L. 2007 S.B. 66)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.480 - Rehabilitation, liquidation, or conservation, grounds, procedure — enrollee's priorities — claims, priority.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1983
354.480. Rehabilitation, liquidation, or conservation, grounds, procedure — enrollee's priorities — claims, priority. —
1. Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the director pursuant to the laws governing the rehabilitation, liquidation, or conservation of an insurance company. The director may apply for an order directing him to rehabilitate, liquidate, or conserve a health maintenance organization upon any one or more grounds set out in section
*
354.355, or section 375.560, or when, in his opinion, the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation granted the policyholders of an insurer.
2. A claim by a health care provider for any uncovered expenditures has priority over claims of other health care providers, provided such provider of services agrees not to assert such claim against any enrollee of the health maintenance organization.
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(L. 1983 H.B. 127)
*Word "chapter" appears in original rolls.
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.485 - Rules and regulations authorized.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 2007
354.485. Rules and regulations authorized. —
The director may promulgate such reasonable rules and regulations in accordance with chapter 536 as are necessary or proper to carry out the provisions of sections 354.400 to 354.636.
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(L. 1983 H.B. 127, A.L. 2007 S.B. 66)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.490 - Certificate of authority, denial, suspension or revocation, grounds — procedure.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 28 Aug 1997
354.490. Certificate of authority, denial, suspension or revocation, grounds — procedure. —
1. When the director has cause to believe that grounds for the denial of an application for a certificate of authority exist, that grounds for the suspension or revocation of a certificate of authority exist, or that grounds for the imposition of restrictions or conditions on a certificate of authority exist, the director shall notify the health maintenance organization in writing, specifically stating the grounds for denial, suspension, revocation, or conditions or restrictions and fixing a time of at least twenty days thereafter for a hearing on the matter.
2. After such hearing, or upon the failure of the health maintenance organization to appear at such hearing, the director shall take action as is deemed advisable, on the basis of written findings, which shall be mailed to the health maintenance organization. The action of the director shall be subject to review by the circuit court having jurisdiction. The court may, in disposing of the issue before it, modify, affirm, or reverse the order of the director in whole or in part.
3. The provisions of chapter 536 shall apply to proceedings pursuant to this section to the extent they are not in conflict with subsections 1 and 2 of this section.
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(L. 1983 H.B. 127, A.L. 1997 H.B. 335)
2023 Missouri Revised Statutes › Title XXIII - Corporations, Associations and Partnerships › Chapter 354 - Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans › Section 354.495 - Fees to be paid to director.

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
Chapter 354
• Effective - 01 Jan 2019, 2 histories, see footnote
354.495. Fees to be paid to director. —
Every health maintenance organization subject to sections 354.400 to 354.636 shall pay to the director the fees specified in section 374.230.
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(L. 1983 H.B. 127, A.L. 2007 S.B. 66, A.L. 2018 S.B. 982)
Effective 1-01-19