reglab/statecodes huggingface dataset:
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 123 - Modular Units › Section 20 CSR 4240-123.090 - Complaints and Review of Manager's Action(s)

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule provides for the manner in which
				  complaints may be filed and the procedure by which commission review of the
				  decisions, directives, and interpretations of the manager may be
				  obtained.
(1) Any person
				aggrieved by a violation of this chapter or Chapter 700, RSMo as it relates to
				modular homes and the manufacturers or dealers of modular homes, may file a
				formal or informal complaint with the commission under
				4 CSR
				240-2.070.
(2) Any person aggrieved by the manager's
				decisions, directives, and interpretations of the code, this chapter, or
				Chapter 700, RSMo as it relates to modular units, may file a written informal
				or formal complaint under
				4 CSR
				240-2.070. In such a complaint, the manager shall be
				denominated as the respondent.
*Original authority: 700.040, RSMo 1973, amended 1976,
					 1978, 1982, 1984, 1989, 1993, 1995,
					 1999.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 123 - Modular Units › Section 20 CSR 4240-123.095 - Re-Inspection and Re-Inspection Fee

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule outlines the procedure for the
				  re-inspection of modular homes and third party requests for inspections
				  pursuant to section
				  700.040,
				  RSMo.
(1) Re-inspections
				subsequent to routine inspections of new modular homes.
(A) The manager may conduct re-inspections of
				new modular homes to verify corrections have been made to address code
				violations identified on the initial routine inspection report.
(B) The manager shall not assess the dealer,
				installer, or the manufacturer, or each entity, a fee for the first
				re-inspection.
(C) The manager, in
				consultation with the commission staff director, after attempting to contact
				the entity at issue and documenting consideration of potential mitigating
				factors, including, but not limited to, the number of similar non-compliance
				issues, circumstances beyond the entity's control, and the entity's
				responsiveness to commission requirements, may assess a two hundred dollar
				($200) re-inspection fee(s) for any re-inspection subsequent to the first
				re-inspection. The fee is charged to the dealer, installer, or the manufacturer
				who was responsible for making the corrections and completing the corrections.
				The manager will track fees assessed or waived under this provision, along with
				any documented consideration, and compile a quarterly report summarizing such
				information for review by the commission.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.010 - Definitions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines the terms used in this
				  chapter.
(1) The following
				definitions, as well as those set out in section
				700.010, RSMo, and 4
				CSR 240-127 apply to this chapter:
(A)
				Approval means a written approval of a manufactured home tie-down system issued
				by the commission under section
				700.080,
				RSMo 2000;
(B) Anchoring standards
				means the manufactured home tie-down systems standards adopted by the
				commission under section
				700.076,
				RSMo.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.020 - Administration and Enforcement

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule delegates the responsibility for
				  administering and enforcing this chapter and Chapter 700, RSMo (1986) as it
				  relates to manufactured home tiedown systems.
(1) The following commission powers and
				responsibilities under Chapter 700, RSMo with respect to manufactured home
				tie-down systems are delegated to the manager:
(A) The ability to approve, prior to being
				sold, being offered for sale, or being installed, any anchor or tie-down system
				designed and intended for manufactured homes; and
(B) The authority to seek sanctions in the
				form of a complaint against parties in violation of rules and regulations
				promulgated under Chapter 700, RSMo or commission rules 4 CSR
				240-124.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.030 - Determination of Applicable Manufactured Home Systems Standards

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule describes how to determine which
				  standards apply to a particular manufactured home.
(1) All manufactured homes located in this
				state, subject to the exceptions set out in sections
				700.076
				and
				700.085,
				RSMo shall be tied down in accordance with applicable anchoring
				standards.
(2) A manufactured home
				located in this state which entered the first stage of production before
				November 23, 1976 shall be tied down in accordance with the anchoring standards
				in effect on November 23, 1976.
(3)
				A manufactured home located in this state which entered the first stage of
				production after November 22, 1976 shall be tied down in accordance with the
				anchoring standards in effect at the time it entered the first stage of
				production.
*Original authority: 700.076, RSMo 1976, amended 1978,
					 1982.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.045 - Anchoring Standards

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule applies to the anchoring of any
				  manufactured home purchased or relocated on or after the effective date of this
				  rule. This rule shall not be applicable to any manufactured home which has
				  previously been anchored at its existing location and which has not been
				  relocated subsequent to the effective date of this rule.
(1) Definitions. The following definitions,
				as well as those set out in section
				700.010, RSMo apply
				to this chapter:
(A) Anchor means any device
				designed to transfer wind loads imposed on a manufactured home to the
				ground;
(B) Anchoring equipment
				means straps, seals, cables, turnbuckles, and tensioning devices, which are
				used to secure a manufactured home to anchors;
(C) Anchoring systems means a combination of
				ties, anchoring equipment, and anchors that will, when properly designed and
				installed, resist overturning and lateral movement of the manufactured home
				from wind forces;
(D) Classified
				soil means soil that has been evaluated through the use of a standard soil
				torque probe or other approved method to determine anchor-holding
				capacity;
(E) Installed means the
				arrangement and assembly at the occupancy site of all portions of an anchoring
				system, in accordance with the manufacturer's design, that renders the
				anchoring system fit for its intended use;
(F) Stabilizing device means a lateral
				support device such as a steel plate or a concrete collar used in connection
				with an anchor to limit lateral movement of the anchor;
(G) Tie means straps, cable, or securing
				devices used to connect the manufactured home to the anchor; and
(H) Unclassified soil means soils that have
				not been evaluated to determine anchor-holding capacity.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.050 - Standards

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the manufactured home
				  tiedown systems standards for manufactured homes located in this state which
				  entered the first stage of production after November 22, 1976.
(1) The federal standards set forth in
				24 CFR section
				3280.306 constitute the manufactured home
				tie-down systems standards for manufactured homes located in this state which
				entered the first stage of production after November 22, 1976.
*Original authority: 700.076, RSMo 1976, amended 1978,
					 1982.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 124 - Manufactured Home Tie-Down Systems › Section 20 CSR 4240-124.060 - Complaints

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule provides for the manner in which
				  complaints may be filed and the procedure by which commission review of the
				  decisions, directives, and interpretations of the manager may be
				  obtained.
(1) Any person
				aggrieved by a violation of this chapter or Chapter 700, RSMo as it relates to
				manufactured home tie-down systems and the manufacturer of those systems may
				file a formal or informal complaint under
				4 CSR
				240-2.070.
(2) Any person aggrieved by the manager's
				decisions, directives, and interpretations of the standards, this chapter, or
				Chapter 700, RSMo as they relate to manufactured home tie-down systems may file
				a written formal or informal complaint under
				4 CSR
				240-2.070. In such a complaint, the manager shall be
				denominated as the respondent.
*Original authority: 700.076, RSMo 1976, amended 1978,
					 1982.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.010 - Definitions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines various terms as used in
				  this chapter and in chapters 120, 123, and 125.
(1) The following definitions, as well as
				those set out in section
				700.010, RSMo and 4
				CSR 240-127 apply to this chapter:
(A) Act
				means the Federal Manufactured Housing Improvement Act of 2000;
(B) Applicant is a person who applies to the
				commission for a license or limited use license to install manufactured
				homes;
(C) Application means a
				manufactured housing installer license application or renewal application as
				provided by the commission;
(D)
				Certificate means a document issued by a commission-approved educational
				provider reflecting the applicant for licensure has taken an approved
				manufactured housing installer training class or program and has received a
				passing grade;
(E) Code means the
				federal standards set out in 24 CFR section 3280 of the Manufactured Home
				Construction and Safety Standards, and 24 CFR section 3282 of the Manufactured
				Home Procedural and Enforcement Regulations, and 24 CFR section 3284 of the
				Federal Manufactured Housing Installation Standards which constitute the codes
				to be applied to new manufactured homes which entered the first stage of
				production after November 22, 1976 which are rented, leased, sold, or offered
				for rent; and
(F) Program means
				Title VI of
				P.L.
				106-569 and any federal regulations promulgated
				thereunder and as may be amended.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.020 - General Provisions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule describes the general guidelines
				  for the implementation of this chapter.
(1) Any person who engages in the business of
				installing new manufactured homes or who directs, supervises or controls
				installations, or who performs repairs as part of the initial installation
				shall have an appropriate, valid manufactured housing installer license issued
				under this program. Installers shall not install or set up the home if the site
				is not prepared as required by the manufacturer's installation
				manual.
(2) Any person whose
				installer license has been revoked may not apply for an installer license or
				limited use installer license within one (1) year after the date of
				revocation.
(3) No person shall
				engage in the business of installing manufactured homes or hold himself,
				herself, or itself out as a manufactured home installer in this state unless
				such person holds a valid installer license issued by the manager. Manufactured
				home dealers and manufacturers who do not subcontract with a licensed
				installer, but perform installations themselves, must have at least one (1)
				employee who is a licensed installer who is responsible for each
				installation.
*Original authority: 700.692, RSMo
					 2004.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.030 - Exceptions to Licensing Requirements

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule identifies the exceptions to
				  licensing requirements for manufactured home installers.
(1) Unless otherwise required by federal law
				or regulations, the following activities are exceptions to the licensing
				requirements found in this chapter:
(A)
				Installation of a manufactured home by a person on his or her property for his
				or her own occupancy pursuant to section 700.656.5, RSMo;
(B) Installation of additional perimeter
				blocking under a manufactured home for the exclusive support of awnings,
				carports or roof additions;
(C)
				Installation of a manufactured home when the manufactured home is installed
				temporarily on a dealer's or manufacturer's sales or storage lot or at a show
				and is not occupied or intended to be occupied. This exception does not include
				those manufactured homes that are permanently installed in a manufactured home
				park, mobile home park or manufactured home subdivision;
(D) Excavation, or concrete (flat) work for
				sidewalks, garages, etc.;
(E)
				Plumbing or electrical work, if the person performing such work holds a valid
				license from the local jurisdiction to perform such work;
(F) Installation of drywall or trim and
				finish work not covered by the act or the code; and
(G) Maintenance or repairs performed by
				manufacturers or dealers for the purpose of customer service.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.040 - Manufactured Home Installer License

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This proposed amendment updates fees for
				  installer licenses.
(1)
				Requirements for an Installer License.
(A) To
				be licensed as a manufactured home installer, an applicant shall meet all of
				the requirements of sections
				700.650 to
				700.692,
				RSMo, and submit to the manufactured housing and modular units program-
1. An application form and two hundred
				twenty-five dollar ($225) application fee;
2. The certificate issued by the educational
				provider; and
3. Proof of liability
				and workman's compensation insurance coverage as required pursuant to section
				700.659,
				RSMo.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.060 - Licensing

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes manufactured home
				  installer licensing, renewal, and disciplinary requirements.
(1) Issuance and Possession of License.
(A) A manufactured home installer license or
				a limited use installer license shall be issued to the person named on the
				application and shall not be transferable.
(B) The licensee shall notify the
				manufactured housing and modular units program in writing within thirty (30)
				days of any address change.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 125 - Manufactured Home Installers › Section 20 CSR 4240-125.070 - Installation Decals

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes installation decal
				  requirements and fees for manufactured home installers.
(1) Requirements for Installation Decals.
(A) An installation decal issued by the
				manufactured housing and modular units program shall be a permanent stick-on
				decal to be attached to the exterior of the home and shall also include a
				sign-off portion of the decal, which must be attached next to the data plate
				inside the home with the initials and license number of each installer involved
				with the initial setup and installation of the home.
(B) The primary installer who is responsible
				for the initial setup and installation of the manufactured home which includes
				site preparation and foundation and any portion of the blocking, leveling, or
				roof installation is responsible for affixing the installation decal and the
				sign-off portion of the decal to the manufactured home upon completion of
				blocking, leveling, or roof installation.
(C) A decal shall be affixed to the
				manufactured home in a permanent manner in a visible location within two feet
				(2') of the Housing and Urban Development (HUD) label.
(D) Decals may be purchased by licensed
				installers by submitting an application to the manufactured housing and modular
				units program, in duplicate together with the appropriate twenty-seven dollars
				($27) for each decal.
(E) Only
				licensed installers may be issued installation decals by the manufactured
				housing and modular units program and decals shall be affixed only by licensed
				installers upon completion of the blocking and leveling.
(F) The licensed installer purchasing decals
				from the manufactured housing and modular units program shall be responsible
				for decal security, use, and reporting.
(G) Decals assigned to licensed installers
				may only be transferred by the manufactured housing and modular units
				program.
(H) If an installer
				license is suspended, revoked, or expires, or the installer is no longer in
				business, all unused decals issued to that person shall be returned to the
				manufactured housing and modular units program. The decal fee may be refunded
				by the manufactured housing and modular units program, if a refund application
				is completed by the applicant as provided by the manufactured housing and
				modular units program.
(I) Primary
				installers who fail to attach the installation decal and/or the sign-off
				portion of the decal to the home immediately after the completion of the
				blocking and leveling of the home shall be subject to a two hundred dollar
				($200) inspection fee. The fee shall be paid and submitted to the manufactured
				housing and modular units program within ten (10) days after notification by
				the manager.
Missouri Code of State Regulations › Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE › Division 4240 - Public Service Commission › Chapter 126 - Manufactured Housing Consumer Recovery Fund › Section 20 CSR 4240-126.010 - Definitions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines various terms as used in
				  this chapter.
(1) The
				following definitions, as well as those set out in section
				700.010, RSMo, and 4
				CSR 240-127 apply to this chapter:
(A)
				Applicant is any consumer who completes a claim form; and
(B) Home means any new manufactured home
				built according to the federal standards 24 CFR Parts 3280 and 3282 and
				4 CSR
				240-120.100, and/or any modular unit used as a
				residential home and built according to the code for modular units as that code
				is defined in 4 CSR 240-123.080.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 1 - General Organization › Section 22 CSR 10-1.010 - General Organization

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment removes the language regarding a
				  chief operations officer from the rule as the chief operations officer is no
				  longer a position at MCHCP.
(1) The
				Missouri Consolidated Health Care Plan became effective January 1, 1994, under
				an Act of the general assembly. The plan offers health care cove rage for state
				employees, retirees, and their dependents. It also provides this benefit as an
				option to all other public entities within the state, as long as they meet
				admission criteria that may be established by the board of trustees.
(2) The responsibility for the proper
				operation of the plan and the direction of its policies is vested in a board of
				trustees. The administration of the detailed affairs of the plan is in the
				charge of an executive director.
(3) The statutory provisions relating to the
				establishment and operation of the plan of health care benefits is provided for
				in Chapter 103, RSMo. The rules in 22 CSR 10-2 and 22 CSR 10-3 delineate the
				terms of the plan established by the trustees of the Missouri Consolidated
				Health Care Plan.
(4) Anyone
				wishing to obtain information may do so by contacting the plan at-
(A) 832 Weathered Rock Court, Jefferson City,
				MO 65101;
(B) PO Box 104355,
				Jefferson City, MO 65110;
(C)
(573) 751-8881;
(D)
(800) 701-8881; or
(E) Online:
www.mchcp.org
.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 1 - General Organization › Section 22 CSR 10-1.020 - Public Records

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies MCHCP regular business
				  hours.
(1) All public records of the
				Missouri Consolidated Health Care Plan, except for those records closed
				pursuant to the Health Insurance Portability and Accountability Act and section
				610.021,
				RSMo, shall be open for inspection and copying at the plan's office during the
				plan's regular business hours. The plan's regular business hours are 8:00 a.m.
				until 4:30 p.m., Central Time Monday through Friday, excluding state holidays.
				All public meetings, records, votes, actions, and deliberation of the Missouri
				Consolidated Health Care Plan shall be open to the public, other than those
				meetings, records, and votes closed pursuant to provisions of section
				610.021,
				RSMo.
(2) The Missouri Consolidated
				Health Care Plan establishes the executive director as the custodian of its
				records as required by section
				610.023,
				RSMo. The executive director is responsible for maintaining the plan's records
				and for responding to requests for access to public records. The executive
				director may appoint deputy custodians as necessary for the efficient operation
				of the plan.
(3) When the
				custodian determines that requested access is not required under Chapter 610,
				RSMo, the custodian upon request shall inform the requestor of such
				determination citing the specific sections of Chapter 610, RSMo, under which
				the records are to remain closed.
(4) The custodian shall maintain a file
				containing copies of all written requests for access to records and responses
				to such requests. The requests shall be maintained on file with the board for a
				period of one (1) year and will be maintained as a public record of the board
				open for inspection by any member of the general public during the plan's
				regular business hours.
(5)
				Whenever a request for inspection of public records is made and the individual
				inspecting the records requests copies of such records, the plan may charge a
				reasonable fee for the cost of inspecting and copying the records. The fee
				charged by the plan shall be as follows:
(A) A
				fee for copying public records shall not exceed the actual cost of the document
				search, duplication, and any necessary postage; and
(B) The plan may require payment for these
				fees prior to making the copies.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 1 - General Organization › Section 22 CSR 10-1.030 - Board of Trustees Election Process

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to election of board members by the subscribers of
				  the Missouri Consolidated Health Care Plan.
(1) The subscribers of the Missouri
				Consolidated Health Care Plan (MCHCP) shall elect two (2) active employee
				members and one (1) retiree member to the board of trustees. Each member will
				serve a term of four (4) years from the first day of January following their
				election.
(2) Board Member
				Candidate Eligibility.
(A) Candidates must be
				a subscriber of the plan.
(B) A
				candidate who is running for a position on the board as an active employee
				member must be employed on the date the nominating petitions are due. Failure
				to be employed at that time will result in an automatic
				disqualification.
(C) A candidate
				who is running for a position on the board as a retiree member must be retired
				on the date that the nominating petitions are due. Failure to be retired at
				that time will result in an automatic disqualification.
(D) The following members are not eligible
				candidates:
1. Current employees of the
				plan;
2. Immediate relatives of
				persons employed by the plan. Immediate relatives include:
A. Employee's spouse;
B. Children of employee or spouse;
C. Parents of employee or spouse;
D. Brothers and sisters of employee,
				including brothers-in-law and sisters-in-law;
E. Grandchildren (including
				great-grandchildren) of employee or spouse;
F. Grandparents (including
				great-grandparents) of employee or spouse; and
G. Members of the employee's
				household.
(E)
				It will be automatic grounds for disqualification if it is determined that a
				candidate knowingly submitted false information in the election
				process.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.010 - Definitions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment revises the definitions of
				  diabetes education, essential benefits, Health Savings Account Plan, network,
				  and non-network; removes the definition of terminated vested subscriber because
				  it is duplicative of section (79); and renumbers as necessary.
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to the definitions of the Missouri Consolidated
				  Health Care Plan relative to state members.
(1) Accident. An unforeseen and unavoidable
				event resulting in an injury.
(2)
				Active employee. A benefit-eligible person employed by the state or agency of
				the state who meets the plan eligibility requirements. An eligible
				variable-hour employee is considered an active employee for the purposes of
				this chapter.
(3) Activities of
				daily living. Bathing, dressing, toileting, and associated personal hygiene;
				transferring (being moved in and out of a bed, chair, wheelchair, tub, or
				shower); mobility, eating (getting nourishment into the body by any means other
				than intravenous), and continence (voluntarily maintaining control of bowel
				and/or bladder function; in the event of incontinence, maintaining a reasonable
				level of personal hygiene).
(4)
				Administrative appeal. A written request submitted by or on behalf of a member
				involving plan-related administrative issues such as eligibility, effective
				dates of coverage, and plan changes.
(5) Adverse benefit determination. An adverse
				benefit determination means any of the following:
(A) A denial, reduction, or termination of,
				or a failure to provide or make payment (in whole or in part) for a benefit
				based on a determination of an individual's eligibility to participate in the
				plan;
(B) A denial, reduction, or
				termination of, or a failure to provide or make payment (in whole or in part)
				for a benefit resulting from the application of any utilization review, or a
				failure to cover an item or service for which benefits are otherwise provided
				because it is determined to be experimental, investigational, or not medically
				necessary or appropriate; or
(C)
				Rescission of coverage after an individual has been covered under the
				plan.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.020 - General Membership Provisions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment clarifies eligibility for
				  retiree coverage for Public Higher Education Entities and retirees employed
				  with a public entity and adds that retirees can cancel dental and vision
				  coverage when voluntarily canceling medical coverage.
(1) Terms and Conditions. This rule provides
				the terms and conditions for membership in the Missouri Consolidated Health
				Care Plan (MCHCP). Members are required to provide complete, true, and accurate
				information to MCHCP in connection with enrollment, change, or cancellation
				processes, whether by online, written, or verbal communication. MCHCP may rely
				on, but reserves the right to audit, any information provided by members and
				seek recovery and/or pursue legal action to the extent members have provided
				incomplete, false, or inaccurate information.
(2) Eligibility Requirements.
(A) Active Employee Coverage.
1. An active employee may enroll him/herself
				and his/her spouse/child(ren) in one (1) of MCHCP's plans if s/he is an
				employee whose position is covered by the Missouri State Employees' Retirement
				System (MOSERS) or another retirement system whose members are grandfathered
				for coverage under the plan by law or is an eligible variable-hour employee of
				a MOSERS participating department or agency. The active employee is eligible to
				enroll in medical, dental, or vision coverage.
2. An active employee employed by the
				Missouri Department of Conservation and whose position is covered by MOSERS or
				who is an eligible variable-hour employee may only enroll him/herself and
				his/her spouse/child(ren) in an MCHCP dental or vision plan.
3. An active employee employed by the
				Missouri Department of Transportation or Highway Patrol may only enroll
				him/herself and his/her spouse/child(ren) in an MCHCP dental or vision plan if
				s/he is an employee whose position is covered by the Missouri Department of
				Transportation and Highway Patrol Employees' Retirement System (MPERS) or is an
				eligible variable-hour employee.
4.
				If an active employee has been enrolled as a dependent of another MCHCP
				subscriber as allowed by these rules, and the subscriber dies before coverage
				as a dependent goes into effect, the active employee may elect coverage as a
				subscriber within thirty-one (31) days of the date of death.
5. An active employee cannot be covered as an
				employee and as a dependent.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.025 - Rule for Participating Higher Education Entity Entry into the Missouri Consolidated Health Care Plan

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to the procedures for Participating Higher
				  Education Entities joining the Missouri Consolidated Health Care
				  Plan
.
(1) Terms and
				Conditions for Joining. Participating Higher Education Entities (PHEE) shall be
				a state sponsored institution of higher learning. The PHEE shall provide a
				letter to the board stating their intent to join the Missouri Consolidated
				Health Care Plan (MCHCP) no later than August 1, for coverage beginning January
				1 of the following year.
(2)
				Eligibility Requirements. Notwithstanding any provision of rule to the
				contrary, eligibility of PHEE employees and retirees shall be solely determined
				by the PHEE. The PHEE shall be responsible for complying with all laws
				pertaining to employee benefits as to eligibility.
(A) The PHEE shall provide to MCHCP
				appropriate documentation of initial and ongoing eligibility of PHEE employees
				and retirees.
(B) Once provided by
				the PHEE, the employees and/or retirees of the PHEE submitted shall be included
				in the term state employee and/or state retiree used throughout this
				chapter.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.046 - PPO 750 Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment adds one hundred percent
				  (100%) coverage of diagnostic breast examinations and colorectal screenings at
				  a network provider.
(1)
				Deductible-per calendar year for network: per individual, seven hundred fifty
				dollars ($750); family, one thousand five hundred dollars ($1,500) and for
				non-network: per individual, one thousand five hundred dollars ($1,500);
				family, three thousand dollars ($3,000).
(A)
				Network and non-network deductibles are separate. Expenses cannot be shared or
				transferred between network and non-network benefits.
(B) Claims will not be paid until the
				applicable deductible is met.
(C)
				Services that do not apply to the deductible and for which applicable costs
				will continue to be charged include, but are not limited to: copayments,
				charges above the usual, customary, and reasonable (UCR) limit; the amount the
				member pays due to noncompliance; non-covered services and charges above the
				maximum allowed.
(D) The family
				deductible is an embedded deductible with two (2) parts: an individual
				deductible and an overall family deductible. Each family member must meet
				his/her own individual deductible amount until the overall family deductible
				amount is reached. Once a family member meets his/her own individual
				deductible, the plan will start to pay claims for that individual and any
				additional out-of-pocket expenses incurred by that individual will not be used
				to meet the family deductible amount. Once the overall family deductible is
				met, the plan will start to pay claims for the entire family even if some
				family members have not met his/her own individual deductible.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.047 - PPO 1250 Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment adds one hundred percent
				  (100%) coverage of diagnostic breast examinations and colorectal screenings at
				  a network provider.
(1)
				Deductible-per calendar year for network: per individual, one thousand two
				hundred fifty dollars ($1,250); family, two thousand five hundred dollars
				($2,500) and for non-network: per individual, two thousand five hundred dollars
				($2,500); family, five thousand dollars ($5,000).
(A) Network and non-network deductibles are
				separate. Expenses cannot be shared or transferred between network and
				non-network benefits.
(B) Claims
				will not be paid until the applicable deductible is met.
(C) Services that do not apply to the
				deductible and for which applicable costs will continue to be charged include,
				but are not limited to: copayments, charges above the usual, customary, and
				reasonable (UCR) limit; the amount the member pays due to noncompliance;
				non-covered services and charges above the maximum allowed.
(D) The family deductible is an embedded
				deductible with two (2) parts: an individual deductible and an overall family
				deductible. Each family member must meet his/her own individual deductible
				amount until the overall family deductible amount is reached. Once a family
				member meets his/her own individual deductible, the plan will start to pay
				claims for that individual and any additional out-of-pocket expenses incurred
				by that individual will not be used to meet the family deductible amount. Once
				the overall family deductible is met, the plan will start to pay claims for the
				entire family even if some family members have not met his/her own individual
				deductible.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.050 - Copay Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded June 30, 2011)
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.053 - Health Savings Account Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment makes a technical correction
				  for nutritional counseling to nutrition counseling, revises coverage of virtual
				  visits, adds one hundred percent (100%) coverage after deductible is met of
				  diagnostic breast examinations and colorectal screenings at a network provider,
				  and revises MCHCP Health Savings Account contribution amounts.
(1) Deductible-per calendar year for network:
				per individual, one thousand six hundred fifty dollars ($1,650); family, three
				thousand three hundred dollars ($3,300) and for non-network: per individual,
				three thousand three hundred dollars ($3,300); family, six thousand six hundred
				dollars ($6,600).
(A) Network and non-network
				deductibles are separate. Expenses cannot be shared or transferred between
				network and non-network benefits.
(B) Claims will not be paid until the
				applicable deductible is met.
(C)
				Services that do not apply to the deductible and for which applicable costs
				will continue to be charged include, but are not limited to: copayments,
				charges above the usual, customary, and reasonable (UCR) limit; the amount the
				member pays due to noncompliance; non-covered services and charges above the
				maximum allowed.
(D) The family
				deductible applies when two (2) or more family members are covered. The family
				deductible must be met before claim payment begins for any covered family
				member. Once the family deductible is met, the plan will start to pay claims
				for the entire family even if some family members have not met his/her own
				individual deductible.
(E) Medical
				and pharmacy expenses are combined to apply toward the network or non-network
				deductible amount, as appropriate.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.054 - Medicare Supplement Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded June 30, 2014)
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.055 - Medical Plan Benefit Provisions and Covered Charges

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment adds coverage of
				  cryopreservation cycles and infertility treatment, makes a technical correction
				  for nutritional counseling to nutrition counseling, and revises preventive
				  services.
(1) Benefit
				Provisions Applicable to the PPO 750 Plan, PPO 1250 Plan, and Health Savings
				Account (HSA) Plan. Subject to the plan provisions, limitations, and enrollment
				of the employee, the benefits are payable for covered charges incurred by a
				member while covered under the plans, provided the deductible requirement, if
				any, is met.
(2) Transition of
				Care. A transition of care option is available for members who seek to continue
				to remain under the care of an non-network provider who was treating them prior
				to the provider losing network status. A subscriber and his/her dependents may
				request to continue receiving care at the network benefit level. If approved,
				the member will be eligible to continue care with the current non-network
				provider at the network benefit level for a period of time until it is
				medically appropriate for the member to transfer care to a network provider.
				The rate of payment during the transitional period shall be the fee paid prior
				to leaving the network. The following benefits are eligible for transition of
				care as determined by the claims administrator:
(A) Upcoming surgery or prospective
				transplant;
(B) Services for women
				in their third trimester of pregnancy;
(C) Radiation therapy;
(D) Dialysis;
(E) Cancer treatment;
(F) Physical, speech, or occupational
				therapy;
(G) Hospice
				care;
(H) Inpatient hospitalization
				at the time of the network change; or
(I) Mental health services.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.060

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 103.059, RSMo 1992 and 103.080, RSMo
					 2007, amended 2011 .
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.063 - HMO/POS Premium Option Summary of Medical Benefits

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded June 30, 2003)
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.070 - Coordination of Benefits

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment revises effect on the
				  benefits of MCHCP when MCHCP is a secondary plan.
(1) If a member is also covered under any
				other plan (as defined here) and is entitled to benefits or other services for
				which benefits are also payable under Missouri Consolidated Health Care Plan
				(MCHCP), the bene fits under MCHCP will be adjusted as shown in this rule.
(A) This coordination of benefits (COB)
				provision applies to MCHCP when a member has health care coverage under more
				than one (1) plan.
(B) If this COB
				provision applies, the order of benefit determination rules should be looked at
				first. Those rules determine whether the benefits of MCHCP are determined
				before or after those of another plan. The benefits of MCHCP-
1. Shall not be reduced when, under the order
				of benefit determination rules, MCHCP determines its benefits before another
				plan; but
2. May be reduced when,
				under the order of benefits determination rules, another plan determines its
				benefits first.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.088 - Medicare Advantage Plan for Non-Active Medicare Primary Members

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to the Medicare Advantage Plan for Non-active
				  Medicare-primary members of the Missouri Consolidated Health Care
				  Plan.
(1) The medical benefit
				for non-Active Medicare primary members is provided through a fully-insured
				Group Medicare Advantage PPO Plan as regulated by the Centers for Medicare and
				Medicaid Services (CMS) herein after referred to as the Medicare Advantage
				Plan. For purposes of this rule non-Active Medicare primary members include:
				Medicare-eligible members who are eligible retirees, terminated vested
				subscribers, long-term disability subscribers, and their eligible dependents
				who have Medicare.
(A) Members must be
				enrolled in Medicare Parts A and B to be eligible for the Medicare Advantage
				Plan.
(B) Non-active subscribers
				that have Medicare and/or their dependents that have Medicare shall receive
				their medical benefit through the Medicare Advantage Plan.
(C) Subscribers enrolled in the Medicare
				Advantage Plan will choose another medical plan offered by MCHCP for their
				non-Medicare dependents.
(D)
				Beginning the first day of the month in which a non-active Medicare primary
				member turns sixty-five (65) years old, they shall be transferred to the
				Medicare Advantage Plan.
(E) A
				member who opts out of the Medicare Advantage Plan will lose MCHCP eligibility
				and will not be allowed to enroll in a medical plan at a later date unless
				otherwise provided for in these rules.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.092 - Dental Coverage

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to dental coverage for members of the Missouri
				  Consolidated Health Care Plan.
(1) The plan administrator may offer dental
				coverage through a vendor.
(A) Dental plan
				design is defined by the vendor.
(B) Dental plan eligibility, enrollment, and
				termination requirements are determined by the plan administrator and are
				defined in 22 CSR 10 2.020.
(C)
				Total dental premium costs for all coverage levels are fully paid by the member
				and collected by the plan administrator.
Missouri Code of State Regulations › Title 22 - MISSOURI CONSOLIDATED HEALTH CARE PLAN › Division 10 - Health Care Plan › Chapter 2 - State Membership › Section 22 CSR 10-2.093 - Vision Coverage

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the policy of the
				  board of trustees in regard to vision coverage for members of the Missouri
				  Consolidated Health Care Plan.
(1) The plan administrator may offer vision
				coverage through a vendor.
(A) Vision plan
				design is defined by the vendor.
(B) Vision plan eligibility, enrollment, and
				termination requirements are determined by the plan administrator and are
				defined in 22 CSR 10 2.020.
(C)
				Total vision premium costs for all coverage levels are fully paid by the member
				and collected by the plan administrator.