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HEALTH SERVICES CORPORATIONS |
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354.010
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Definitions. (8/28/1983) |
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354.015
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Health services corporations, laws applicable to — exceptions. (8/28/1983) |
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354.020
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Preexisting health services corporation to amend articles, effect of. (8/28/1983) |
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354.025
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Corporate purposes and authority. (8/28/1983) |
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354.027
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Discrimination in coverage or reimbursement for covered service by licensed persons, prohibited. (8/28/1993) |
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354.030
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For-profit corporations excluded from act. (8/28/1983) |
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354.035
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Procedure for organization of corporation. (8/28/1983) |
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354.040
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Articles of incorporation, required information and contents. (8/28/1983) |
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354.045
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Issuance of certificate, effect of. (8/28/1983) |
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354.050
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General powers of corporation. (8/28/1983) |
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354.055
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Certificate of authority required — expiration of, extended how. (8/28/1983) |
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354.060
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Director to issue certificate, when. (8/28/1983) |
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354.065
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Articles of incorporation, how amended — copy to director, when. (8/28/2007) |
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354.070
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Certificate of authority automatically extended, when. (8/28/1983) |
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354.075
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Capital required to do business. (8/28/1983) |
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354.080
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Reserves required, how computed. (8/28/1973) |
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354.085
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Membership contract forms, approval by director, when — time for filing — time for disapproval. (8/28/2003) |
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354.090
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Health services corporation contracts, purposes, parties to. (8/28/1983) |
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354.095
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Limitation of membership and benefits — certain benefits to be provided, when. (8/28/1983) |
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354.105
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Annual report required, contents of. (8/28/1983) |
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354.115
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Member's grievance, how and where filed — director may investigate, court action not barred. (8/28/1983) |
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354.120
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Rules and regulations by director authorized — procedure, review. (8/28/1995) |
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354.125
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Corporation not liable for injuries resulting from medical services rendered members. (8/28/1973) |
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354.130
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Exemption from certain taxes, exceptions. (8/28/1983) |
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354.140
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Dissolution, liquidation or rehabilitation of corporation, procedure for. (8/28/1983) |
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354.145
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Appeal from director's actions or decisions, how taken. (8/28/1983) |
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354.150
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Fees — waiver, when. (1/1/2019) |
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354.152
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Premiums, dues or fees subject to restrictions — violation, hearing — order prohibiting. (8/28/1979) |
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354.155
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Disclaimer as to nonhealth services corporations. (8/28/1983) |
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354.165
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Certain organizations exempt. (8/28/1983) |
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354.175
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Wage continuation plans by employer exempt. (8/28/1983) |
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354.180
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Administrative order, director to issue, when. (8/28/2007) |
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354.190
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Examinations, procedures. (8/28/1983) |
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354.195
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Records of examination, duty to keep. (8/28/1983) |
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354.200
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Examinations, false testimony, penalty. (8/28/1983) |
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354.205
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Examinations — costs, how paid. (8/28/1983) |
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354.207
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Second medical opinion to be allowed by health services corporations, procedure, costs. (8/28/1998) |
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354.210
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Director may seek relief, when. (8/28/2007) |
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354.215
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Examiner's sick leave to apply to health services corporations. (8/28/1983) |
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354.220
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Director may bring suit to recover fees or sums. (8/28/1983) |
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354.225
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Enrollment representative, defined — annual report to furnish information — solicitors of members to be insurance agent or broker, exception. (8/28/1993) |
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354.230
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License required for enrollment representative. (8/28/1983) |
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354.235
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Enrollment representative — license issued when, qualifications. (8/28/1993) |
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354.240
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Nonresident may be licensed — examination waived, when. (8/28/1983) |
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354.265
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Nonrenewable temporary license issued, when. (8/28/1983) |
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354.275
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Violations by enrollment representatives, penalties. (8/28/1983) |
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354.280
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Officers of corporation found to be of known bad character or incompetent — authority to transact business, effect. (8/28/1983) |
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354.285
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Management agreements to control corporation, notice to department, when — examination requirements — violations. (8/28/1983) |
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354.290
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Examiner's duties — examination contents — hearing on reports allowed — publication of report, when. (8/28/1983) |
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354.295
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Certificate of authority not to be issued if controlling management involved in improper actions. (8/28/1983) |
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354.300
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Certificate of authority suspended or revoked, when. (8/28/1983) |
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354.305
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Corporation advertising assets also to show liabilities — penalties. (8/28/2008) |
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354.315
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Data processing system authorized, cost, amount allowed — amortization not to exceed ten years. (8/28/1983) |
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354.320
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Corporate funds and securities use for private gain by officers and employees prohibited, penalty. (1/1/2017) |
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354.325
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Investigation by director of investments — records to be kept by division — criminal action, when. (8/28/1983) |
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354.330
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Public official failing to perform duties as to investment violations, penalty. (8/28/1983) |
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354.335
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Damages allowed if corporation without reasonable cause refuses to pay. (8/28/1983) |
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354.340
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Unsatisfied judgments against corporation — suspension or revocation of certificate of authority until judgment satisfied. (8/28/1983) |
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354.345
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Court decree of specific performance — membership contract, failure of corporation to comply, procedure, effect. (8/28/1983) |
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354.350
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Fraudulent or bad faith conduct — investigation by division — hearing, procedure. (8/28/2007) |
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354.355
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Injunctions, permanent or temporary, grounds, procedure — dissolution of corporation or rehabilitation, procedure. (8/28/1983) |
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354.357
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Receivership, grounds, procedure. (8/28/1983) |
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354.362
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Newborn child coverage required — notice of birth, when, effect. (8/28/1983) |
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354.380
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Certain provisions of insurance law to be applicable. (8/28/1983) |
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HEALTH MAINTENANCE ORGANIZATIONS |
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Termination, coverage to continue for period after termination, 376.428
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354.400
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Definitions. (8/28/2007) |
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354.405
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Certificate of authority, who may make application — foreign corporation may qualify, requirements — procedure. (8/28/2003) |
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354.407
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PACE projects not deemed health maintenance organizations, when. (8/28/2002) |
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354.410
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Certificate issued, when — annual deposit, requirements — capital account, amount, contents. (8/28/2013) |
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354.415
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Powers of organization. (8/28/2013) |
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354.420
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Advisory panels to afford enrollees participation in policy decisions. (8/28/1983) |
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354.425
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Bonding of officers who disburse or invest funds — bond requirements. (8/28/1983) |
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354.430
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Evidence of coverage, requirements — rights of enrollee — toll-free telephone number required. (8/28/2013) |
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354.435
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Annual reports filed with director, when — content — forms. (8/28/2007) |
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354.440
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Information to be available to enrollees. (8/28/1983) |
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354.441
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Disclosures to subscribers shall not be prohibited or restricted. (8/28/1997) |
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354.442
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Disclosure information to enrollees required, when. (8/28/2010) |
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354.443
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Financial disclosures to the department required by health maintenance organizations, when. (8/28/1997) |
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354.444
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Administrative orders for violations — voluntary forfeitures, civil actions. (8/28/2007) |
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354.445
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Complaints by enrollees, organization to establish system. (8/28/1983) |
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354.450
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Investments authorized. (8/28/1983) |
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354.455
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Deposit required, how made. (8/28/2007) |
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354.460
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Advertising not to be untrue or misleading — deceptive solicitation — prohibited — how determined. (8/28/2007) |
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354.462
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Enrollee, grounds for disenrollment. (8/28/1983) |
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354.464
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Names not authorized for use, exceptions. (8/28/2007) |
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354.465
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Examinations by division, when — costs, how paid. (8/28/2014) |
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354.470
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Suspension or revocation, when — effect. (8/28/1997) |
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354.475
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Insurance companies or health service company may organize and operate a health maintenance organization. (8/28/2007) |
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354.480
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Rehabilitation, liquidation, or conservation, grounds, procedure — enrollee's priorities — claims, priority. (8/28/1983) |
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354.485
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Rules and regulations authorized. (8/28/2007) |
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354.490
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Certificate of authority, denial, suspension or revocation, grounds — procedure. (8/28/1997) |
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354.495
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Fees to be paid to director. (1/1/2019) |
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354.500
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Conferences called by director as to suspected or potential violations. (8/28/2007) |
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354.505
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Laws regulating insurance or health service corporations not to apply, exceptions. (8/28/1997) |
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354.510
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Public documents, all filings and required reports. (8/28/2007) |
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354.515
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Confidential information, diagnosis, treatment, health of enrollees or applicants, exceptions. (8/28/1997) |
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354.520
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Mergers, consolidations, control of organization, requirements. (8/28/1983) |
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354.525
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Health provision collective bargaining agreements or contracts — charge for coverage, how determined. (8/28/1983) |
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354.530
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Severability clause. (8/28/2007) |
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354.535
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Pharmacist, emergency situation, may take an assignment of enrollee's right to reimbursement — health maintenance organizations shall only contract with entities licensed by the board of pharmacy — requirements for drug prescriptions, exceptions. (8/28/1998) |
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354.536
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Continuation of dependent child coverage, when — dependent child defined. (1/1/2008) |
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354.540
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Health maintenance organization of bordering states may be admitted to do business — procedure. (8/28/2007) |
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354.545
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Exempt plans and companies. (8/28/2007) |
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354.546
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Second medical opinion to be allowed by health maintenance organizations, procedure, costs. (8/28/1998) |
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354.550
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Laws not applicable to community health companies. (8/28/2007) |
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354.551
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Health maintenance organizations may offer point of service (POS) riders, when. (8/28/1997) |
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COMMUNITY-BASED HEALTH MAINTENANCE ORGANIZATIONS |
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354.552
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Community-based health maintenance organizations, requirements. (8/28/1997) |
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354.554
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Standing referrals for certain members of community-based health maintenance organizations, when. (8/28/1997) |
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354.556
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Trustees, vacancies, elections. (8/28/1997) |
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354.558
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Materials provided to prospective purchasers. (8/28/1997) |
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354.559
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Disclosure to members, restrictions and prohibitions. (8/28/1997) |
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354.560
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Payment arrangements, department to adopt rules — disclosure of financial arrangements — confidentiality. (8/28/1997) |
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354.562
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Grievance procedures, rulemaking authority. (8/28/1997) |
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354.563
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Medicare rules to apply to community-based health maintenance organizations, when. (8/28/1997) |
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354.565
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Community-based health maintenance organization designation given, when — revocation. (8/28/1997) |
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354.567
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Community-based health maintenance organizations subject to other laws regarding health maintenance organizations. (8/28/1997) |
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354.570
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Rulemaking — procedure. (8/28/1997) |
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354.600
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Definitions. (8/28/2007) |
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354.603
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Sufficiency of health carrier network, requirements, criteria — access plan filed with the department, when. (8/28/2018) |
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354.606
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Providers notified of specific covered services, when — hold harmless provision — cessation of operations procedure — selection standards for health care professionals, filing with the department. (8/28/2001) |
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354.609
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Termination of a contract, procedure. (8/28/1997) |
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354.612
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Continuation of care after provider termination, when. (8/28/1997) |
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354.615
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Referrals to appropriate providers, when. (8/28/1997) |
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354.618
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Open referral health plans offered, when — definitions — obstetrician/ gynecologist services to be offered, when — eye care providers, discrimination against, prohibited — exemptions. (8/28/1999) |
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354.621
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Intermediary and participating provider requirements. (8/28/1997) |
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354.624
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Proposed provider contract forms filed with the director — contracts maintained at place of business, available for review, when. (8/28/1997) |
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354.627
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Liability of a health carrier, when. (8/28/1997) |
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354.636
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Contract requirements after January 1, 1998. (8/28/1997) |
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ESSENTIAL COMMUNITY PROVIDERS |
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354.650
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Definitions. (8/28/1998) |
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354.652
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Designation as essential community provider, procedure, qualifications. (8/28/1998) |
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354.654
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Department of health and senior services, duties — rulemaking authority. (8/28/1998) |
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354.656
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Inclusion of essential community providers in health care network, exceptions. (8/28/1998) |
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354.658
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Designation nontransferable, site specific — annual affidavit required — notice of certain changes, required when. (8/28/1998) |
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PREPAID DENTAL PLANS |
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354.700
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Definitions. (8/28/1992) |
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354.702
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Prepaid dental plans, who may offer — certificate of authority required — certain state laws not to apply. (8/28/1987) |
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354.703
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Director may order violators to cease and desist, hearing — noncompliance, director's remedies. (8/28/1989) |
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354.704
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Application for certificate of authority, content. (8/28/1987) |
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354.705
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Certificate of authority granted, when. (8/28/1987) |
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354.707
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Capital, surplus, security required — cash, securities, bond to be deposited or filed with director, director to return deposit, when — security subject to final judgments — security not required for prepaid dental plans funded by government — director may waive capital, surplus, security requirements, when. (8/28/1987) |
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354.710
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Reserve requirements — reserve not required for prepaid dental plans funded by government — surplus requirement for prepaid dental plans in existence January 1, 1987, additional time. (8/28/1997) |
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354.712
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Contract or contract certificate to be issued to enrollees, content, copy to be filed with director — newborn child to be covered, when, extent of coverage, notification of birth and additional premium, when, effect of. (8/28/1987) |
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354.715
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Providers of dental care, written contract with prepaid dental plan corporations, review and mediation procedures for enrollees required. (8/28/1987) |
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354.717
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Director, powers — financial examinations, when, by whom made and paid. (8/28/1987) |
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354.720
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Annual report, required, content. (8/28/1987) |
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354.721
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Agents, registration required — rules and regulations authorized. (8/28/1987) |
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354.722
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Revocation or suspension of certificate of authority, when — notice, civil suit authorized — suspension, revocation, activity permitted. (8/28/2007) |
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354.723
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Rulemaking authorized. (8/28/1987) |
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354.725
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Exclusion, labor organization's health plans. (8/28/1987) |
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