376.879. Outline of coverage for fair disclosure--furnished to each applicant--format and content--rules and standards.

MISSOURI STATUTES AND CODES

376.879. Outline of coverage for fair disclosure--furnished to each applicant--format and content--rules and standards.

Outline of coverage for fair disclosure--furnished to eachapplicant--format and content--rules and standards.

376.879. 1. In order to provide for full and fair disclosure in thesale of Medicare supplement policies, no Medicare supplement policy orcertificate shall be delivered in this state unless an outline of coverageis delivered to the applicant at the time application is made.

2. The director shall prescribe the format and content of the outlineof coverage required by subsection 1 of this section. For purposes of thissection, "format" means style, arrangements and overall appearance,including such items as the size, color and prominence of type andarrangement of text and captions. Such outline of coverage shall include:

(1) A description of the principal benefits and coverage provided inthe policy;

(2) A statement of the renewal provisions, including any reservationby the issuer of a right to change premiums; and disclosure of theexistence of any automatic renewal premium increases based on thepolicyholder's age;

(3) A statement that the outline of coverage is a summary of thepolicy issued or applied for and that the policy should be consulted todetermine governing contractual provisions.

3. The director may prescribe by regulation a standard form and thecontents of an informational brochure for persons eligible for Medicare,which is intended to improve the buyer's ability to select the mostappropriate coverage and improve the buyer's understanding of Medicare.Except in the case of direct response insurance policies, the director mayrequire by regulation that the information brochure be provided to anyprospective insureds eligible for Medicare concurrently with delivery ofthe outline of coverage. With respect to direct response insurancepolicies, the director may require by regulation that the prescribedbrochure be provided upon request to any prospective insureds eligible forMedicare, but in no event later than the time of policy delivery.

4. The director may adopt regulations for captions or noticerequirements, determined to be in the public interest and designed toinform prospective insureds that particular insurance coverages are notMedicare supplement coverages, for all accident and sickness insurancepolicies sold to persons eligible for Medicare, other than:

(1) Medicare supplement policies;

(2) Disability income policies.

5. The director may adopt reasonable regulations to govern the fulland fair disclosure of the information in connection with the replacementof accident and sickness policies, subscriber contracts or certificates bypersons eligible for Medicare.