HB 2282 -- Health Insurance

Sponsor:  Ervin

This bill changes the laws regarding health insurance.

HEALTH MAINTENANCE ORGANIZATIONS (HMOs)

The bill requires proof that a dependent child is incapable of
maintaining employment due to a mental or physical handicap to be
submitted to the insured's HMO within 31 days after the child has
attained the age when the child's coverage is to be terminated
instead of the current at least 31 days.

GROUP HEALTH INSURANCE POLICIES

Currently, group health insurance policies must contain a
provision that specifies any exclusions and limitations to the
policy in regard to a disease or physical condition that an
individual was treated for during the 12 months prior to the
effective date of an individual's policy.  The bill limits the
exclusions and limitations to the prior six months before an
individual becomes covered under the policy.  Exclusions and
limitations cannot apply to a loss or disability that occurred
after the effective date or during the 18-month period thereafter
in the case of a late enrollee.

The bill requires proof that a dependent child is incapable of
maintaining employment due to a mental or physical handicap and
is dependent upon the policy holder for support and maintenance
to be submitted to the health insurer within 31 days after the
dependent child has attained the age when coverage is to be
terminated in order to sustain coverage instead of the current at
least 31 days.

MISSOURI HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT

A health insurance issuer providing group health insurance must
provide special enrollment periods for eligible employees who
have involuntarily lost their individual health plan coverage
because the health plan carrier withdrew from the market.

INDIVIDUAL HEALTH INSURANCE POLICIES

The bill requires proof that a dependent child is incapable of
maintaining employment due to a mental or physical handicap and
is dependent upon the policy holder for support and maintenance
to be submitted to the health insurer within 31 days after the
dependent child has attained the age when coverage is to be
terminated in order to sustain coverage instead of the current at
least 31 days.

MISSOURI HEALTH INSURANCE POOL (MHIP)

Currently, if an individual pays more than 150% of the standard
insurance premium rates, he or she is eligible for insurance
coverage through the Missouri Health Insurance Pool.  The MHIP
board is required to establish the eligibility limits, but the
bill specifies that the limit cannot be in excess of 200% of the
standard rates for individual health insurance coverage.

SMALL EMPLOYER HEALTH INSURANCE AVAILABILITY ACT

The definition of "dependent" is revised as it relates to
insurance coverage to be a person that is a spouse, an unmarried
child who resides in Missouri and is younger than 25 years of age
and is not covered by an individual health benefit plan or
entitled to federal Social Security assistance benefits, or a
disabled person who is dependent upon his or her parent.

A small employer can make a defined contribution to its employees
with individual health insurance plans by establishing a
cafeteria plan according to the laws regulating the Missouri
Health Insurance Portability and Accountability Act.

A small employer insurance carrier must reasonably compensate an
agent or broker for the sale of any small employer health benefit
plan.

Currently, a small employer insurance carrier will not be in
violation of any unfair trade practice if the small employer
charges a lesser premium or deductible for employees who do not
use tobacco products.  The bill changes the definition of "unfair
trade practice" by using the provisions that apply to all
insurance carriers in Missouri instead of only health and
accident insurance companies.

Missouri House of Representatives
94th General Assembly, 2nd Regular Session
Last Updated October 15, 2008 at 3:12 pm