reglab/statecodes huggingface dataset:
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.140 - Transportation and Storage

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Sections 1 and 2 of the
				  Missouri Constitution, the Department of Health and Senior Services has the
				  authority to regulate and control the storage of, warehouses for, and
				  transportation of marijuana product. This rule explains what regulations apply
				  to all medical and marijuana facility licensees that transport and store
				  marijuana product.
(1) Any
				licensee transporting or storing marijuana product shall comply with the
				provisions of this section.
(2)
				Transfer of marijuana product, generally.
(A)
				A medical or marijuana licensee shall be allowed to transfer marijuana product
				between facilities, in compliance with the requirements and prohibitions
				provided in this chapter.
(B)
				Marijuana product may only be transferred as follows:
1. From a medical facility to another medical
				facility or testing facility;
2.
				From a comprehensive facility to another comprehensive facility, medical
				facility, or testing facility;
3.
				From a microbusiness facility to another microbusiness facility or testing
				facility; and
4. Marijuana facility
				licensees not specifically identified above may transfer marijuana product with
				department approval, in compliance with the requirements and prohibitions of
				this chapter.
(C) Testing
				licensees may only transport marijuana product that they intend to
				test.
(D) The agent transferring
				marijuana product must-
1. Ensure accuracy of
				the transportation manifest;
2.
				Ensure marijuana product is stored and transported in a way that prevents
				contamination and degradation; and
3. Ensure a secure handoff.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.150 - Marijuana Waste Disposal

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Sections 1 and 2 of the
				  Missouri Constitution, the Department of Health and Senior Services is
				  authorized to regulate and control the operations of medical and marijuana
				  facilities. This rule explains how licensed and certified facilities, with the
				  exception of transportation facilities, should dispose of any excess or
				  unusable marijuana waste, unwanted marijuana product, or any waste from the
				  facility.
.
(1) Unused
				marijuana product and any solid and liquid wastes generated during marijuana
				product production and processing must be stored, managed, and disposed of in
				accordance with applicable state, tribal, local, and municipal laws and
				regulations. Licensees must keep records of the final disposition of all such
				wastes for at least five (5) years or longer if required by federal, state,
				local law.
(2) Each licensee shall
				maintain a marijuana waste disposal log indicating the date and time, location,
				video camera names that captured the two (2) angles of destruction, method of
				destruction, mixing medium, and agent ID(s) of the employee(s) who destroyed
				the marijuana product.
(3)
				Wastewater generated during marijuana product production and processing must be
				disposed of in compliance with applicable state, tribal, local, and municipal
				laws and regulations.
(4) Marijuana
				waste must be stored securely before final disposition, which can be done
				within the facility in areas designated for disposal activities or, if
				necessary, outside the facility in a locked, tamper-resistant
				receptacle.
(5) Wastes from the
				production and processing of marijuana plants must be evaluated against state
				hazardous waste regulations to determine if those wastes qualify as hazardous
				waste. It is the responsibility of each licensee to properly evaluate their
				waste to determine if it is a hazardous waste per
				40 CFR
				262.11.
(A)
				All solid waste, as defined by
				40 CFR
				261.2, must be evaluated under the hazardous
				waste regulations, including:
1. Waste from
				marijuana flowers, trim, and solid plant material used to create an
				extract;
2. Waste solvents,
				pesticides, and other similar materials used in the cultivation, infused
				product manufacturing, or testing process;
3. Discarded plant waste, spent solvents, and
				laboratory wastes from any marijuana processing or quality assurance testing;
				and
4. Marijuana extract that fails
				to meet quality testing.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.160 - Cultivation Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Sections 1 and 2 of the
				  Missouri Constitution, the Department of Health and Senior Services has the
				  authority to regulate and control medical and marijuana facilities and
				  licensees. This rule explains what regulations apply to facilities licensed to
				  cultivate marijuana
.
(1)
				Cultivation facilities, generally.
(A) A
				cultivation licensee's authority to engage in the process of cultivating
				marijuana includes the ability to-
1. Acquire
				and transfer marijuana, marijuana seeds, and clones from another cultivation
				facility;
2. Acquire and transfer
				marijuana seeds from entities not licensed under this chapter if doing so does
				not violate state or federal law;
3. Acquire and transfer marijuana product
				from a manufacturing facility or dispensary facility;
4. Cultivate marijuana;
5. Process, package, and store (on- or
				off-site) marijuana product;
6.
				Transfer marijuana product to or from its own warehouse storage facility,
				another cultivation facility, manufacturing facility, or dispensary
				facility;
7. Transfer marijuana
				product to a testing facility; and
8. Sell marijuana product to another
				cultivation facility, manufacturing facility, dispensary facility, or testing
				facility.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.170 - Manufacturing Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Sections 1 and 2 of the
				  Missouri Constitution, the Department of Health and Senior Services has the
				  authority to regulate and control medical and marijuana facilities. This rule
				  explains what regulations apply to facilities that manufacture marijuana
				  product.
(1) Manufacturing
				facilities, generally.
(A) A manufacturing
				licensee's authority to engage in the process of manufacturing
				marijuana-infused products includes the ability to-
1. Acquire and transfer marijuana from a
				cultivation facility;
2. Acquire
				and transfer marijuana product from another manufacturing facility to further
				process;
3. Acquire and transfer
				marijuana product from a dispensary facility;
4. Process and store (on- or off-site)
				marijuana product;
5. Manufacture
				and package marijuana-infused products and prerolls;
6. Transfer marijuana product to or from its
				own warehouse storage facility, another manufacturing facility, cultivation
				facility, or dispensary facility;
7. Transfer marijuana product to a testing
				facility; and
8. Sell marijuana
				product to another manufacturing facility, cultivation facility, dispensary
				facility, or testing facility.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.180 - Dispensary Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Sections 1 and 2 of the
				  Missouri Constitution, the Department of Health and Senior Services has the
				  authority to regulate and control medical and marijuana facilities and
				  licensees. This rule explains what regulations apply to dispensary facilities
				  and licensees.
(1) Dispensary
				facilities, generally.
(A) A dispensary
				licensee's authority to engage in the process of dispensing marijuana product
				includes the ability to-
1. Acquire and
				transfer marijuana, marijuana seeds, clones, and prerolls from a cultivation
				facility;
2. Acquire and transfer
				marijuana-infused products and prerolls from a manufacturing
				facility;
3. Acquire and transfer
				marijuana product from another dispensary facility;
4. Create and sell prerolls, which does not
				include the grinding of marijuana for use in prerolls or manufacture of
				marijuana-infused products;
5.
				Package and store (on- or off-site) marijuana product and drug paraphernalia
				used to administer marijuana product;
6. Transport and sell or distribute marijuana
				product and drug paraphernalia to another dispensary facility, manufacturing
				facility, cultivation facility, testing facility, or individuals authorized to
				purchase marijuana product for personal or medical use, as follows:
A. A medical dispensary licensee may only
				sell or distribute to individuals who are qualifying patients or primary
				caregivers; and
B. A comprehensive
				or microbusiness dispensary licensee may sell or distribute to individuals who
				are consumers, qualifying patients, or primary caregivers; and
7. Transfer marijuana product to
				or from its own warehouse.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 100 - Division of Cannabis Regulation › Chapter 1 - Marijuana › Section 19 CSR 100-1.190 - Microbusinesses

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: Under Article XIV, Section 2, of the
				  Missouri Constitution, the Department of Health and Senior Services has the
				  authority to regulate and control marijuana microbusiness facilities and
				  licensees. This rule explains what regulations apply only to microbusiness
				  facilities and licensees.
(1)
				Microbusiness facilities, generally.
(A)
				Entities must obtain a license to cultivate, manufacture, and dispense
				marijuana product in Missouri as a marijuana microbusiness. Application
				requirements are outlined in the application section of this chapter.
1. An entity may apply for and obtain only
				one (1) license to operate a microbusiness facility, which may be either a
				microbusiness dispensary facility or a microbusiness wholesale facility. If an
				entity, which includes an individual, holds an ownership interest in more than
				one microbusiness license applicant in the same microbusiness application
				period, all microbusiness applications where the entity holds an ownership
				interest will be denied.
2. An
				entity may be an owner of only one (1) license to operate a microbusiness
				facility, which may be either a microbusiness dispensary facility or a
				microbusiness wholesale facility.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 10 - General Administration › Chapter 2 - Public Meetings and Records › Section 20 CSR 10-2.100 - Custodian of Records

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule complies with sections
				  610.023
				  and
				  610.028,
				  RSMo regarding appointing a custodian of records.
(1) Records of the director and the consumer
				affairs, insurance market regulation, insurance company regulation and resource
				administration divisions. Pursuant to section
				610.023,
				RSMo, the director is the custodian of records of the department, except those
				records that are required by statute to be maintained by the director of
				finance, director of credit unions, director of professional registration, or
				any agency, board or commission assigned to those divisions. The department
				director has delegated to the director of the Resource Administration Division
				the task of acting as the custodian who is to be responsible for the
				maintenance of the records of the department relating to the director's powers
				and duties under Chapters 354, and 374 through 385, RSMo, or any other
				provision relating to the business of insurance, or duties, powers or functions
				delegated to the Consumer Affairs Division, the Insurance Company Regulation
				Division, the Insurance Market Regulation Division, or the Resource
				Administration Division. The director of resource administration is located at
				PO Box 690, Truman Building, Room 530, 301 West High Street, Jefferson City, MO
				65102. Further information regarding the organization of the department is
				contained in
				20 CSR
				10-1.010.
(2) Division of Finance Records. Pursuant to
				section
				610.023,
				RSMo, the director of finance is the custodian of records of the Division of
				Finance and the State Banking Board. The director of finance is located at PO
				Box 716, Truman Building, Room 630, 301 West High Street, Jefferson City, MO
				65102.
(3) Division of Credit Union
				Records. Pursuant to section
				610.023,
				RSMo, the director of credit unions is the custodian of records of the Division
				of Credit Unions and the Credit Union Commission. The director of credit unions
				is located at PO Box 1607, Truman Building, Room 720, 301 West High Street,
				Jefferson City, MO 65102.
(4)
				Division of Professional Registration Records. Pursuant to section
				610.023,
				RSMo, the director of professional registration is the custodian of records of
				the Division of Professional Registration. Each board and commission assigned
				to the Division of Professional Registration may designate an executive
				director in the division as the custodian of records for that particular board
				or commission. The director of professional registration is located at PO Box
				1335, 3605 Missouri Boulevard, Jefferson City, MO 65102.
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 10 - General Administration › Chapter 2 - Public Meetings and Records › Section 20 CSR 10-2.200 - Release of Information

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule complies with sections
				  610.023
				  and
				  610.028,
				  RSMo regarding release of information.
(1) Release of Information. Pursuant to
				section
				610.028,
				RSMo, the provisions of 20 CSR 10-2 constitute the department's reasonable
				written policy in compliance with sections 610.010-610.030, RSMo, open to
				public inspection, regarding the release of information on any meeting, record
				or vote. This policy must be applied in a manner consistent with other state
				and federal laws placing restrictions on the records of the department and its
				divisions, boards and commissions.
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 10 - General Administration › Chapter 2 - Public Meetings and Records › Section 20 CSR 10-2.500 - Votes

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule complies with sections
				  610.023
				  and
				  610.028,
				  RSMo regarding release of information.
(1) Department Administration. The provisions
				of Chapter 621, RSMo, relating to votes do not apply to administrative
				decisions made in the department which relate to the director's executive
				powers and duties because rules, policies and decisions of the department and
				its divisions are decided by the department director or the division directors
				individually and a single member body cannot have votes.
(2) Boards and Commissions. The provisions of
				Chapter 621, RSMo relating to votes apply to decisions of various boards and
				commissions in the department.
*Original authority: 374.045, RSMo 1967, amended 1993, 1995
					 and 610.028, RSMo 1982, amended 1987,
					 2004.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 10 - General Administration › Chapter 2 - Public Meetings and Records › Section 20 CSR 10-2.600 - Effective Date

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule complies with sections
				  610.023
				  and
				  610.028,
				  RSMo regarding release of information.
Effective Date. As a written policy under section
				  610.028,
				  RSMo, the provisions of 20 CSR 10-2 are effective November 15, 1989. As rules,
				  the provisions of 20 CSR 10-2 are effective February 25,
				  1990.
*Original authority: 374.045, RSMO 1967 and 610.028, RSMo
					 1982, amended 1987,
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 10 - General Administration › Chapter 3 - Internal Affairs › Section 20 CSR 10-3.400 - Reinsurance Analyst Qualifications

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets comparable standards to those
				  stated in section
				  374.120,
				  RSMo relating to the qualifications of the department's reinsurance
				  analyst.
(1) The following
				standards are the minimum standards for the position of reinsurance analyst.
				The reinsurance analyst shall-
(A) Have
				knowledge of the state's insurance laws;
(B) Have a bachelor's degree from an
				accredited college or university, with the major field of study in one (1) or
				more of the following:
1.
				Accounting;
2. Insurance or risk
				management;
3. Business
				administration; and
4.
				Economics;
(C) Obtain
				the designation of an Associate in Reinsurance of the American Institute of
				Property and Liability Underwriters within two (2) years of appointment;
				and
(D) Have at least three (3)
				years' experience in insurance or reinsurance matters.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.020 - Misrepresentation of Policy Provisions in Claims Settlement

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule effectuates or aids in the
				  interpretation of section
				  375.1007(1),
				   RSMo.
(1) An insurer who engaged in one or more of
				the following acts or practices shall be deemed to be engaged in
				"misrepresenting policy provisions" as used in section
				375.1007(1),
				RSMo. This rule is not intended to be all inclusive and acts or practices not
				enumerated in this rule may also be deemed misrepresentation.
(A) No insurer shall fail to fully disclose
				to first-party claimants all pertinent benefits, coverages or other provisions
				of an insurance policy under which a claim is presented.
(B) No insurance producer shall conceal from
				any first-party claimant the benefits, coverages or other provisions of any
				insurance policy when these benefits, coverages or other provisions are
				pertinent to a claim.
(C) No
				insurer shall deny any claim for failure to exhibit the property without proof
				of demand and unfounded refusal by a claimant to do so.
(D) No insurer shall deny any claim based
				upon the insured's failure to submit a written notice of loss within a
				specified time following any loss, unless this failure operates to prejudice
				the rights of the insurer.
(E) No
				insurer shall request a first-party claimant to sign a release that extends
				beyond the subject matter that gave rise to the claim payment.
(F) No insurer shall issue any draft in
				partial settlement of a claim under a specific coverage, when endorsement of
				the draft would totally release the insurer or its insured from
				liability.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.030 - Failure to Acknowledge Pertinent Communication

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment restructures the rule to
				  provide greater clarity in interpreting the provisions of section
				  375.1007(2),
				   RSMo regarding the handling and processing
				  of claims.
(1) The following
				conduct by an insurer is deemed to be the type of conduct set forth in section
				375.1007(2).
(A) Failing to acknowledge the receipt of a
				notification of claim from a first party claimant. For the purposes of this
				subsection, acknowledgment of receipt by an insurer may be made by either:
1. Making payment within ten (10) working
				days of receipt;
2. Sending the
				first party claimant a written acknowledgment within ten (10) working days of
				receipt and maintaining a copy of the written acknowledgment in the claim file
				of the insurer; or
3. Providing the
				first party claimant with an oral acknowledgment within ten (10) working days
				of receipt and making an appropriate notation of the date of this
				acknowledgment in the claim file of the insurer.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.060 - Standards for Prompt, Fair, and Equitable Settlements under Health Benefit Plans (Rescinded)

Current through Register Vol. 49, No. 14, July 15, 2024
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.070 - Identification Cards Issued by Health Carriers

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets forth the require-ments for
				  an identification card issued to insureds or enrollees by health carriers
				  offer-ing health benefit plans.
(1) Applicability.
(A) This rule applies to all health carriers
				offering or providing a plan of health insurance, health benefits, or health
				services to individuals and groups.
(B) The provisions of this rule do not apply
				to identification cards issued to individuals or groups that relate solely to
				the provision of prescription drug benefits.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.100 - Claims Involving Public Adjusters or Solicitors

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule effectuates or aids in the
				  interpretation of section
				  375.1007(4),
				   RSMo as applied to claims involving a public
				  adjuster or solicitor.
(1) No
				insurance company authorized to do the business of insurance in Missouri shall
				make payment of any insurance claim, or any portion of a claim, to a public
				adjuster or solicitor on account of services rendered by a public adjuster or
				solicitor to an insured unless the name of the insured is added as a joint
				payee on any claim check or draft. The payment, whether by check, draft or
				otherwise, should be sent to the address designated by the insured.
*Original authority: 374.045, RSMo 1967, amended 1993, 1995
					 and 375.1000-375.1018, see RSMo 2000 and RSMo Supp.
					 2007.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.200

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993, 1995
					 and 375.445, RSMo 1967, amended 2007.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 1 - Improper or Unfair Claims Settlement Practices › Section 20 CSR 100-1.300

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967; 376.778, RSMo
					 1983; and 376.427, RSMo 1990.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 2 - Unfair Trade Practices › Section 20 CSR 100-2.100

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 2 - Unfair Trade Practices › Section 20 CSR 100-2.200 - Unfair Discrimination on the Basis of Blindness, Partial Blindness or Physical or Mental Impairment

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This regulation identifies specific acts or
				  practices which are prohibited by section
				  375.936,
				  RSMo. It follows the National Association of Insurance Commissioners model
				  regulation dealing with discrimination based on blindness or partial blindness
				  and its model regulation dealing with discrimination based on physical or
				  mental impairment.
(1)
				Unfairly Discriminatory Acts or Practices Regarding Blindness or Partial
				Blindness. The following are identified as acts or practices which constitute
				unfair discrimination between individuals of the same class: refusing to
				insure, or refusing to continue to insure, or limiting the amount, extent or
				kind of coverage available to an individual or charging an individual a
				different rate for the same coverage solely because of blindness or partial
				blindness.
(A) With respect to all other
				conditions, including the underlying cause of blindness, persons who are blind
				or partially blind shall be subject to the same standards of sound actuarial
				principles or actual or reasonably anticipated experience as are sighted
				persons.
(B) Refusal to insure
				includes denial by an insurer of disability insurance coverage on the grounds
				that the policy defines disability as being presumed in the event that the
				insured loses his/her eyesight. However, an insurer may exclude from coverage
				disabilities consisting solely of blindness or partial blindness when this
				condition existed at the time the policy was issued.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 3 - Fraudulent Insurance Claims and Acts › Section 20 CSR 100-3.100

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995; 375.991, RSMo 1990, amended 1992, 1994, 2005; 375.992, RSMo 1990;
					 375.993, RSMo 1990; and 375.994, RSMo 1990, amended 1993,
					 2007.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 4 - General › Section 20 CSR 100-4.100 - Response to Inquiries by the Consumer Affairs Division

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment incorporates the definitions
				  from rule 20 CSR 100-4.010 and clarifies
				  the terms of the rule.
PURPOSE: This rule sets forth with greater
				  specificity the [statutory requirements] standards for responding to inquiries
				  from the Division of Consumer Affairs, [required of all persons in this state,]
				  pursuant to sections
				  354.190,
				  354.465,
				  354.717,
				  374.085, 374.110, 374.190, 375.938, 375.1009, 376.1375 and 384.015,
				  RSMo.
(1) As used in this
				rule, the following terms mean:
(A) "Adequate
				response," a written response answering each inquiry with reasonable
				specificity. A person's acknowledgment of the division's inquiry is not an
				adequate response;
(B)
				"Department," the Department of Insurance, Financial Institutions and
				Professional Registration;
(C)
				"Division," the Division of Consumer Affairs;
(D) "Inquiry," each and every question or
				request for information submitted in writing to a person by the division
				concerning subjects which are within the division's authority to regulate or
				investigate; and
(E) "Person," any
				person as that term is defined in sections 374.046.17,
				375.932(4),
				and
				375.1002(3),
				RSMo, including "insurers" as that term is defined in sections
				375.932(3) and
				375.1002(2), RSMo, and any other entity,
				association, or individual, whether or not the director has granted a license
				or certificate of authority to the entity, association, or
				individual.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 5 - Health Care Consumer Procedures › Section 20 CSR 100-5.010 - Notice Requirements of an Adverse Determination

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets forth with greater
				  specificity the requirements of written notification when a health carrier
				  informs an enrollee of a health plan that includes a managed care component of
				  an adverse determination. This rule is promulgated pursuant to section
				  376.1399,
				  RSMo, and implements section 376.1363.5, RSMo.
(1) A written notification of an adverse
				determination shall be printed in clear legible type of at least twelve
				(12)-point font.
(2) The notice
				shall explain the principal reason for the adverse determination in language
				easily understood by a person with an eighth grade reading level. A health
				carrier may determine the reading level of a notice without including medical
				terminology which describes an enrollee's medical condition, proper names,
				telephone numbers and addresses.
(3) The notice shall explain how an enrollee
				initiates a grievance review. If an enrollee is eligible for an expedited
				review pursuant to section
				376.1389,
				RSMo, then the notice shall explain how an enrollee initiates an expedited
				review.
(4) The notice shall
				explain how an enrollee as defined in section
				376.1350(14),
				RSMo initiates a grievance review of the adverse determination with the
				director. The notice shall explain that an enrollee may file a grievance with
				the director at any time. The notice shall also list the Consumer Affairs
				Division's toll-free telephone number.
(5) The notice shall describe how the
				enrollee can request a written statement of the clinical rationale and clinical
				review criteria used to make the adverse determination.
(6) If the Health Care Financing
				Administration's Medicare or Medicaid plans have notification requirements for
				grievance procedures, those notification requirements shall satisfy the
				requirements of this rule for notification of enrollees in those plans if the
				notices comply with all Missouri statutory requirements.
(7) The notice shall inform enrollees that
				they have a right to have a relative, friend, lawyer, the department or other
				representative help them with a grievance.
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995; 376.1363, RSMo 1997; and 376.1399, RSMo 1997, amended 1997,
					 2007.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 5 - Health Care Consumer Procedures › Section 20 CSR 100-5.020 - Grievance Review Procedures

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets forth with greater
				  specificity the procedures by which the department will process a grievance
				  concerning an adverse determination by a health carrier or its designee for a
				  health plan that has a managed care component. This rule is promulgated
				  pursuant to section
				  376.1399,
				  RSMo, and implements section
				  376.1387,
				  RSMo.
(1) As used in this
				rule, "division" means the Consumer Affairs Division.
(2) As used in this rule, "enrollee's
				representative" or "representative" means-
(A) A person to whom an enrollee has given
				express written consent to represent the enrollee in an external
				review;
(B) A person authorized by
				law to provide substituted consent for an enrollee; or
(C) A family member of the enrollee or the
				enrollee's treating health care professional only when the enrollee is unable
				to provide consent.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 6 - Privacy of Consumer Information › Section 20 CSR 100-6.110 - Standards for Safeguarding Customer Information

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes standards for
				  developing and implementing administrative, technical, and physical safeguards
				  to protect the security, confidentiality, and integrity of customer
				  information, pursuant to sections 501, 505(b), and 507 of the
				  Gramm-Leach-Bliley Act, codified at
				  15 U.S.C.
				  6801,
				  6805(b),
				  and
				  6807, and
				  as authorized by section
				  362.422,
				  RSMo Supp. 2001. This rule requires that the safeguards established pursuant to
				  this rule shall apply to nonpublic personal information and nonpublic personal
				  financial information.
(1)
				Definitions. For purposes of this rule, the following definitions apply:
(A) "Customer" means a customer of the
				licensee as the term customer is defined in subsection
				20 CSR
				100-6.100(1)(I);
(B) "Customer information" means non-public
				personal information as defined in
				20 CSR
				100-6.100 about a customer, whether in paper,
				electronic, or other form, that is maintained by or on behalf of the
				licensee;
(C) "Customer information
				systems" means the electronic or physical methods used to access, collect,
				store, use, transmit, protect, or dispose of customer information;
(D) "Licensee" means a licensee as that term
				is defined in 20 CSR
				100-6.100(1)(N), except that
				"licensee" shall not include: a purchasing group; or an unauthorized insurer in
				regard to the surplus line business conducted pursuant to
				20 CSR
				200-6.100 to
				20 CSR
				200-6.500 and Chapter 384, RSMo;
(E) "Service provider" means a person that
				maintains, processes, or otherwise is permitted access to customer information
				through its provision of services directly to the licensee.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 7 - Market Conduct Analysis › Section 20 CSR 100-7.005 - Uniform Analysis and Continuum of Actions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies and modernizes the
				  rule by removing unnecessary language. This amendment also adds statutory
				  references, clarifies actions that may be taken as a result of market analysis,
				  and provides the insurer with the opportunity to resolve market conduct
				  concerns through an informal conference.
(1) The division will apply the following
				standards in utilizing market analysis:
(A)
				The division will gather information from data currently available to the
				division;
(B) Such information will
				be analyzed in order to develop a baseline understanding of the marketplace and
				to identify for further review insurers or practices that deviate significantly
				from the norm or that may pose a potential risk to the insurance consumer; and
(C) The NAIC Market Regulation
				Handbook, and other handbooks adopted by the NAIC, will be used by the division
				as a guide in performing this analysis.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 7 - Market Conduct Analysis › Section 20 CSR 100-7.010

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.008 - Hearing on Examination Warrants

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies the rule by
				  correctly referencing statutory authority, expands the grounds upon which an
				  insurer may challenge an examination warrant, and provides that a reviewing
				  court may stay the execution of an examination warrant upon judicial appeal of
				  an administrative ruling affirming the issuance of an examination
				  warrant.
PURPOSE: This rule establishes procedures for a
				  hearing conducted to review cause to issue a market conduct examination warrant
				  pursuant to sections
				  374.202
				  to
				  374.207,
				  RSMo.
(1) Any insurer or
				other company served with an examination warrant may request a hearing before
				the director within fifteen (15) days of the date of service of the examination
				warrant. If a hearing is requested, the director will schedule an expedited
				hearing within twenty (20) days of the request to review whether the director
				a) had a reasonable belief of cause to issue the examination warrant; or b) had
				a reasonable belief supporting the time period set forth in the examination
				warrant, if longer than three (3) years. The director may issue orders
				necessary to protect the identity of a confidential source. The director may
				vacate, set aside, modify, or affirm the examination warrant.
(2) If the director fails to make a final
				determination within twenty (20) days of the hearing, the examination warrant
				is deemed affirmed and may be executed, and the administrative determination is
				final for purposes of review. Any final determination of the director is
				subject to judicial review pursuant to section
				536.100,
				RSMo, but during the pendency of judicial review, the execution of the
				examination warrant shall not be delayed and is enforceable, unless stayed by a
				reviewing court pursuant to section
				536.120,
				RSMo.
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995; 374.055, RSMo 2007; and 374.205, RSMo 1992, amended 1997,
					 1999.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.010

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.012

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995; 374.185, RSMo 2007; and 374.205, RSMo 1992, amended 1997,
					 1999.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.014 - Collaborative Actions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies and simplifies the
				  language.
(1) To provide
				uniform standards designed to avoid arbitrary or capricious use of discretion
				in issuing warrants for market conduct examinations, the director will apply
				the following standards in evaluating factual support for a warrant when
				another jurisdiction is considering conducting a market conduct examination or
				has issued a market conduct report for an examination that has been conducted
				within the last three (3) years:
(A) In lieu
				of issuing an examination warrant for a market conduct examination, the
				director may delegate responsibility for conducting an examination of a
				domestic company, foreign company, or an affiliate of a company to the
				insurance commissioner of another jurisdiction if that insurance commissioner
				agrees to accept the delegated responsibility for the examination, and the
				domestic company, foreign company, or affiliate has a significant number of
				policies or significant premium volume in that jurisdiction. If the director
				elects to delegate responsibility for examining a company, the division will
				accept a report of the examination prepared by the insurance commissioner to
				whom the responsibility has been delegated;
(B) In lieu of requesting an examination
				warrant by the director and conducting a market conduct examination of a
				company, the division will accept a report of a market conduct examination on
				such company prepared by the insurance commissioner of the company's
				jurisdiction or state of domicile or another jurisdiction state if the director
				has determined-
1. The laws of that
				jurisdiction applicable to the subject of the examination are substantially
				similar to those of this state;
2.
				The examining jurisdiction has a market conduct analysis and examination system
				comparable to the system set forth under Chapter 7 of this division;
				and
3. The examination from the
				other jurisdiction's commissioner has been conducted within the past three (3)
				years; and
(C)
				Notwithstanding the above provisions, if the insurance commissioner to whom the
				examination responsibility was delegated, or the report of a market conduct
				examination prepared by the insurance commissioner of another jurisdiction, did
				not evaluate the specific area or issue of concern to the director or a
				specific requirement of Missouri law, the director may issue an examination
				warrant for a targeted examination to evaluate that specific area or issue of
				concern.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.015 - Notice of Examination

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment restructures the rule adding
				  clarity and simplicity to information provided to an insurance company subject
				  to a market conduct examination warrant.
PURPOSE: This rule implements the purposes of section
				  374.185,
				  RSMo, and establishes uniform standards for providing notice of a market
				  conduct examination to the insurer and reporting the examination warrant to the
				  National Association of Insurance Commissioners (NAIC).
(1) The notice of examination and the
				examination warrant issued under
				20 CSR
				100-8.005 will be provided to the insurer at least
				sixty (60) days before the estimated commencement of the examination. The
				director may reduce the sixty (60) day notice if the director has determined
				that the company has engaged in or is engaging in any practice or course of
				business in violation of Chapter 287, Chapter 354, or Chapters 374 to 385,
				RSMo, and the sixty (60) day notice would result in continuing injury to
				consumers. In the event that the notice period is reduced to less than sixty
				(60) days, the company is entitled to an expedited hearing as allowed by
				20 CSR
				100-8.008.
(2) The notice of examination will contain-
(A) The name and address of the insurer or
				company being examined;
(B) The
				name and contact information of the audit manager;
(C) The reason for and the scope of the
				examination;
(D) The date the
				examination is scheduled to begin;
(E) Identification of any personnel not
				employed by the department who will assist in the examination, if known at the
				time the notice is prepared;
(F) A
				time estimate for the examination;
(G) A budget and work plan for the
				examination and identification of reasonable and necessary costs and fees that
				will be included in the bill, if the cost of the examination is billed to the
				insurer company; and
(H) A request
				for the insurer company to name its examination coordinator.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.016 - Examination Procedures

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment removes language that is
				  duplicative of language in other regulations and adds a new provision giving
				  insurance companies the opportunity to address issues relating to examination
				  costs or data requests.
PURPOSE: This rule implements the purposes of section
				  374.185,
				  RSMo, and establishes uniform standards for the director in applying the
				  discretion authorized in issuing examination warrants for market conduct
				  examinations pursuant to sections
				  374.202
				  to
				  374.207,
				  RSMo
(1) Market conduct
				examinations will be conducted in accordance with the provisions set forth in
				the National Association of Insurance Commissioners (NAIC) Market Regulation
				Handbook, or in department regulations, if inconsistent with the NAIC Market
				Regulation Handbook, for the type of examination being conducted.
(2) The examiner-in-charge will conduct a
				pre-examination conference with the company examination coordinator and key
				personnel to clarify expectations approximately thirty (30) days prior to
				commencement of the examination.
(3) If the insurer or company believes there
				is a significant increase from the original work plan's estimates of cost or a
				significant increase in the amount of data requested, the insurer or company
				may submit a request, in writing, for a review of the examination costs or data
				requests. Such request shall be submitted to the market regulation division
				director or chief examiner. The market regulation division director or chief
				examiner will provide a written response to the request within twenty (20)
				business days. Any request or response under this section shall be considered
				examination workpapers, subject to the confidentiality provisions of section
				374.205,
				RSMo.
(4) If an examination is
				expanded beyond the scope of the examination warrant the director will modify
				the examination warrant or issue a new examination warrant and provide written
				notice to the company explaining the extent of the expansion and the reasons
				for the expansion. The division will provide a revised work plan to the company
				before the beginning of any significantly expanded examination, unless
				extraordinary circumstances indicate immediate action is necessary to avoid a
				risk to consumers.
(5) Prior to the
				conclusion of a market conduct examination, the examiner-in-charge will
				schedule and conduct an exit conference with the company as outlined by the
				NAIC Market Regulation Handbook.
*Original authority: 374.045, RSMo 1967, amended 1993,
					 1995; 374.185, RSMo 2007; and 374.205, RSMo 1992, amended 1997,
					 1999.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 100 - Insurer Conduct › Chapter 8 - Market Conduct Examination › Section 20 CSR 100-8.017 - Contract Examiners

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule implements the purposes of section
				  374.185,
				  RSMo, and establishes uniform standards for the director appointing contract
				  examiners to perform or assist in market conduct examinations pursuant to
				  sections
				  374.202
				  to
				  374.207,
				  RSMo.
(1) In any contract
				with qualified examiners necessary to perform a market conduct examination, the
				director shall specify-
(A) The functions to
				be subject to the outsourcing;
(B)
				The timelines for completion of the outsourced review;
(C) Requirements for disclosure of the
				examiners' recommendations; and
(D)
				Requirements for disclosure of the terms of the contracts with the outside
				consultants participating in the examination, including costs and fees/rates to
				be assessed to the company.