§ 354.165 — Certain organizations exempt.

Missouri § 354.165

• Jurisdiction: Missouri
• Title XXIII: CORPORATIONS, ASSOCIATIONS AND PARTNERSHIPS
• Ch. 354: Health Services Corporations — Health Maintenance Organizations — Prepaid Dental Plans

Text

The provisions of sections 354.010 to 354.380 or of any law relating to insurance shall not apply to any labor organization's health plan providing services established and maintained solely for its members and their immediate families, or to any health plan or services established and maintained by a trust in which a labor organization is interested as that term is defined in, and which trust is subject to the provisions and regulations of, the Federal Labor-Management Reporting and Disclosure Act, 29 U.S.C. 401-531.  The administrator of any other plan or program to provide health service or benefits, or to pay or indemnify for the payment of their cost, which is maintained by any employer or jointly by any employer and employees and/or labor organizations exclusively for employees and their families, hereinafter referred to as "plan or program" , shall make and file annually with the director on or before the first day of March of each year a report under oath, upon a form to be prescribed by the director, setting out the income and expenses of the plan or program for the preceding year and its financial condition as of the end of that year.  In lieu of filing such prescribed form the administrator of any such plan or program may file with the director a duplicate set of documents, records, reports, booklets and other instruments as may have been filed by it within the preceding twelve months pursuant to the Federal Welfare and Pension Plans Disclosure Act, 29 U.S.C. 301-309, the Federal Labor-Management Reporting and Disclosure Act, 29 U.S.C. 151-168, 401-531 or the Labor Management Relations Act, 29 U.S.C. 186.  Any labor organization member or any employee claiming to be aggrieved under the terms of any such plan or program may file a complaint with respect thereto with the director.  The authority of the director under the insurance laws of this state and sections 354.010 to 354.380 to prohibit or regulate such a plan or program shall be limited to the following:

(1)  Compelling the filing of the annual reports referred to above;

(2)  Investigating the complaints of members or employees;

(3)  Examining the financial conditions, affairs and management of the plan or program;

(4)  Instituting judicial proceedings to enjoin the continuation of any act or practices which he believes to be unfair and deceptive with respect to such members. ­­ ­ This section shall not be construed as exempting from regulation by the department of commerce and insurance any insurance contract or health services contract which provides for the payment of benefits or the supplying of health services under the labor organization, union-employer-employee or employer-employee plans referred to in this section which are purchased from insurance companies or health-services corporations subject to regulation by the department of commerce and insurance.

Legislative History

(L. 1973 S.B. 3 § 32, A.L. 1983 H.B. 127)