354.165. Certain organizations exempt. - Missouri Statutes

Certain organizations exempt.

354.165. The provisions of sections 354.010 to 354.380 or of any lawrelating to insurance shall not apply to any labor organization's health planproviding services established and maintained solely for its members and theirimmediate families, or to any health plan or services established andmaintained by a trust in which a labor organization is interested as that termis defined in, and which trust is subject to the provisions and regulationsof, the Federal Labor-Management Reporting and Disclosure Act, 29 U.S.C.401-531. The administrator of any other plan or program to provide healthservice 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 employeesand/or labor organizations exclusively for employees and their families,hereinafter referred to as "plan or program", shall make and file annuallywith the director on or before the first day of March of each year a reportunder oath, upon a form to be prescribed by the director, setting out theincome and expenses of the plan or program for the preceding year and itsfinancial condition as of the end of that year. In lieu of filing suchprescribed form the administrator of any such plan or program may file withthe director a duplicate set of documents, records, reports, booklets andother instruments as may have been filed by it within the preceding twelvemonths pursuant to the Federal Welfare and Pension Plans Disclosure Act, 29U.S.C. 301-309, the Federal Labor-Management Reporting and Disclosure Act, 29U.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 underthe terms of any such plan or program may file a complaint with respectthereto with the director. The authority of the director under the insurancelaws of this state and sections 354.010 to 354.380 to prohibit or regulatesuch 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 theplan or program;

(4) Instituting judicial proceedings to enjoin the continuation of anyact or practices which he believes to be unfair and deceptive with respect tosuch members. This section shall not be construed as exempting from regulation by thedepartment of insurance, financial institutions and professional registrationany insurance contract or health services contract which provides for thepayment of benefits or the supplying of health services under the labororganization, union-employer-employee or employer-employee plans referred toin this section which are purchased from insurance companies orhealth-services corporations subject to regulation by the department ofinsurance, financial institutions and professional registration.

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