HB 1964 -- Missouri Health Insurance Pool

Sponsor:  Ervin

This bill changes the laws regarding the Missouri Health
Insurance Pool (MHIP).  In its main provisions, the bill:

(1)  Specifies that a Missouri resident who has exhausted the
maximum benefits from his or her health insurer or who can only
obtain health insurance from a carrier at a rate that is more
expensive than the pool's eligibility rates as set by the board
will be eligible for coverage under the pool;

(2)  Specifies that an individual who has had prior creditable
coverage with a group, governmental, or church plan and is not
eligible for certain Social Security or Title XIX benefits; does
not have other health insurance coverage; and has exhausted
continuation of coverage through COBRA will be eligible for
coverage under the pool;

(3)  Specifies that any person on whose behalf the pool has paid
out $2 million in benefits will not be eligible for coverage
under the pool.  Currently, the limit is $1 million;

(4)  Requires all health insurers to notify an insured when he or
she has exhausted 85% of his or her total lifetime health
insurance benefits and of the person's eligibility for and the
methods of applying for coverage under the pool.  Notification
must be repeated when an insured has exhausted 100% of his or her
total lifetime health insurance benefits, and the insurer must
also notify the pool with the name and address of the affected
person;

(5)  Requires the board to offer other health benefit plans that
are in the best interest of the individuals covered under the
pool including, but not limited to, coverage for dental, vision,
and limited mandate plans or other similar flexible benefit plans
and allows the board to establish a premium rate load to allow
enrollees to buy down creditable coverage;

(6)  Specifies that an individual's premium rate for the pool
must be based on the individual's family size;

(7)  Removes the lower limit requirement for pool coverage for
applicants;

(8)  Prohibits pool coverage rates from exceeding 125% of those
applicable to individual standard risks for individuals who have
had prior creditable coverage with a group, governmental, or
church plan; are not eligible for certain Social Security or
Title XIX benefits; do not have other health insurance coverage;
and have exhausted continuation of coverage through COBRA.  Pool
coverage rates cannot exceed 125% of rates applicable to
individual standard risks for all others covered in the pool.
Currently, the rate limits are 150%; and

(9)  Requires an agent or broker selling or renewing a pool
policy to receive a 5% commission upon the approval or renewal of
the policy.

Missouri House of Representatives
95th General Assembly, 2nd Regular Session
Last Updated September 14, 2010 at 3:12 pm