Section 376.998

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS

Chapter 376

Effective - 28 Aug 2016   

  376.998.  Health insurance mandate exemption for excepted benefit plans — definitions — procedure to exempt. — 1.  As used in this section, the following terms shall mean:

  (1)  "Excepted benefit plan", a policy or certificate of insurance extending the following coverages or any combination thereof:

  (a)  Coverage under short-term major medical policies;

  (b)  Coverage only for accident, including accidental death and dismemberment, insurance;

  (c)  Coverage only for disability income insurance;

  (d)  Credit-only insurance;

  (e)  Other similar insurance coverage under which benefits for medical care are supplemental to other insurance benefits;

  (f)  Coverage only for a specified disease or illness; or

  (g)  Hospital indemnity or other fixed indemnity insurance;

  (2)  "Health benefit plan", "health care services", "health carrier", and "health care provider", the same meaning as under section 376.1350;

  (3)  "Health insurance mandate", a requirement under state law for a health carrier to offer or provide coverage for:

  (a)  A treatment by a particular type of health care provider;

  (b)  A certain treatment or service, including procedures, medical equipment, or drugs that are used in connection with a treatment or service; or

  (c)  Screening, diagnosis, or treatment of a particular disease or condition;

  (4)  "Notice", a requirement under Missouri law to disclose information regarding the availability of certain benefits or services under a health benefit plan.

  2.  Excepted benefit plans shall be exempt from any health insurance mandate enacted on or after August 28, 2016, unless the statute enacting such mandate expressly declares that it is applicable to excepted benefit plans as defined in this section.

  3.  Notwithstanding the provisions of any other law to the contrary, the director may, by bulletin, exempt a type of excepted benefit plan from notice or disclosure requirements required by statute for specific services that by custom are not covered by the particular type of excepted benefit plans being exempted.

  4.  This section shall apply to an excepted benefit plan to the extent the excepted benefit plan does not materially change coverage to provide for the reimbursement of health care services which extend beyond the types of health care services customarily provided by the specific type of excepted benefit plan or where the combination of coverages and benefits would otherwise meet the definition of a health benefit plan.

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(L. 2016 S.B. 833)