95-01: New Mandated Benefit and Required Offer of Coverage

* This bulletin was repealed by 08-05

From:      Jay Angoff, Director

Re:          New Mandated Benefit and Required Offer of Coverage

Date:       September 18, 1995

Senate Bill 27 was passed in Missouri's last legislative session and signed into law by Governor Mel Carnahan. This law expands the mandated mammography benefits required by statute section 376.782 RSMo and requires the offer of coverage for certain breast cancer treatments as set forth in statute section 376.1200 RSMo. The new language added to section 376.782 RSMo and the text of 376.1200 RSMo appear below.

Your company must receive approval of forms to accommodate these laws. Offer and acceptance forms, insert pages and amendments will be given expedited review by this department to assist you with compliance. Please follow standard filing procedures. The filing fee for filings made solely to comply with this law is $50.00.

Section 376.782.2(4) RSMo was added to section 376.782 RSMo. Subdivision (4) mandates additional coverage as follows:

(4) A mammogram for any woman, upon the recommendation of a physician, where such woman, her mother or her sister has a prior history of breast cancer.

Section 376.1200 reads as follows:

By use of the term "continued" in section 376.1200.1 RSMo, the statute requires that insurers offer all policyholders this coverage effective January 1, 1996. The statute requires that an offer be made, and therefore precludes exclusion of policyholders based on medical underwriting or any other method.