Section 354.085

Title XXIII CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS

Chapter 354

Effective - 28 Aug 2003   

  354.085.  Membership contract forms, approval by director, when — time for filing — time for disapproval. — No corporation subject to the provisions of sections 354.010 to 354.380 shall deliver or issue for delivery in this state a form of membership contract, or any endorsement or rider thereto, until a copy of the form shall have been approved by the director.  The director shall not approve any policy forms which are not in compliance with the provisions of sections 354.010 to 354.380 of this state, or which contain any provision which is deceptive, ambiguous or misleading, or which do not contain such words, phraseology, conditions and provisions which are specific, certain and reasonably adequate to meet needed requirements for the protection of those insured.  If a policy form is disapproved, the reasons therefor shall be stated in writing; a hearing shall be granted upon such disapproval, if so requested; provided, however, that such hearing shall be held no sooner than fifteen days following the request.  The failure of the director of the department of commerce and insurance to take action approving or disapproving a submitted policy form within forty-five days from the date of filing shall be deemed an approval thereof.  The director shall not disapprove any deemed policy form for a period of twelve months thereafter.  If at any time during that twelve-month period the director determines that any provision of the deemed policy form is contrary to state law, the director shall notify the health services corporation of the specific provision that is contrary to state law, and any specific statute to which the provision is contrary to, and request that the health services corporation file, within thirty days of receipt of the request, an amendment form that modifies the provision to conform to state law.  Upon approval of the amendment form by the director, the health services corporation shall issue a copy of the amendment to each individual and entity to which the deemed policy form was previously issued and shall attach a copy of the amendment to the deemed policy form when it is subsequently issued.  Such amendment shall have the force and effect as if the amendment was in the original filing or policy.  The director of the department of commerce and insurance shall have authority to make such reasonable rules and regulations concerning the filing and submission of such policy forms as are necessary, proper or advisable.

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(L. 1973 S.B. 3 § 16, A.L. 1983 H.B. 127, A.L. 2003 H.B. 121)