376.833. Inapplicability of section 376.827, when--waiver granted to policyholder, when. - Missouri Statutes

Inapplicability of section 376.827, when--waiver granted topolicyholder, when.

376.833. 1. The provisions of section 376.827 shall not be violatedif the insurer decides to apply different limits or exclude entirely fromcoverage the following:

(1) Marital, family, educational, or training services unlessmedically necessary and clinically appropriate;

(2) Services rendered or billed by a school or halfway house;

(3) Care that is custodial in nature;

(4) Services and supplies that are not medically necessary norclinically appropriate; or

(5) Treatments that are considered experimental.

2. The director shall grant a policyholder a waiver from theprovisions of section 376.827 if the policyholder demonstrates to thedirector by actual experience over any consecutive twenty-four-month periodthat compliance with sections 376.825 to 376.840 has increased the cost ofthe health insurance policy by an amount that results in a two percentincrease in premium costs to the policyholder.

(L. 1999 H.B. 191 § 376.829)

Expires 1-01-11