20 CSR 400-3.200 - Medicare Supplement Insurance Minimum Standards
PURPOSE: This rule provides for the reasonable standardization of coverage and simplification of terms and benefits of Medicare supplement policies; facilitates public understanding and comparison of these policies; eliminates provisions contained in the policies which may be misleading or confusing in connection with the purchase of the policies or with the settlement of claims; and provides for full disclosure in the sale of accident and sickness insurance coverages to persons eligible for Medicare by reason of age.
(1)
Applicability and Scope. Except as otherwise specifically provided, this rule
shall-
(A) Apply to all Medicare supplement
policies and subscriber contracts delivered or issued for delivery in this
state on or after November 1, 1989;
(B) Apply to all certificates issued under
group Medicare supplement policies or subscriber contracts, which certificates
have been delivered or issued for delivery in this state; and
(C) Not apply to a policy or contract of one
(1) or more employers or labor organizations, or of the trustees of a fund
established by one (1) or more employers or labor organizations or combination
of them, for employees or former employees or a combination of them, or for
members or former members or combination of them of the labor
organizations.
(2)
Definitions. For the purposes of this rule-
(A) Applicant means-
1. In the case of an individual Medicare
supplement policy or subscriber contract, the person who seeks to contract for
insurance benefits; and
2. In the
case of a group Medicare supplement policy or subscriber contract, the proposed
certificate holder;
(B)
Certificate means any certificate issued under a group Medicare supplement
policy, which certificate had been delivered or issued for delivery in this
state; and
(C) Medicare supplement
policy means a group or individual policy of accident and sickness insurance or
a subscriber contract of a health services corporation or health maintenance
organization (HMO) which is advertised, marketed or designed primarily as a
supplement to reimbursements under Medicare for the hospital, medical or
surgical expenses of persons eligible for Medicare by reason of age.
(3) Policy Definitions and Terms.
No insurance policy or subscriber contract may be advertised, solicited or
issued for delivery in this state as a Medicare supplement policy unless that
policy or subscriber contract contains definitions or terms which substantially
conform to the requirements of this section.
(A) Accident or accidental injury shall be
defined to employ result language and shall not include words which establish
an accidental means test or use words such as external, violent, visible wounds
or similar words of description or characterization.
1. The definition shall not be more
restrictive than the following: Injury(ies) for which benefits are provided
means accidental bodily injury sustained by the insured person which is the
direct result of an accident, independent of disease or bodily infirmity or any
other cause, and occurs while insurance coverage is in force.
2. The definition may provide that injuries
shall not include injuries for which benefits are provided or available under
any Workers' Compensation, employer's liability or similar law or motor vehicle
no-fault plan, unless prohibited by law.
(B) Benefit period or Medicare benefit period
shall not be defined as more restrictive than that defined in the Medicare
program.
(C) Convalescent nursing
home, extended care facility or skilled nursing facility shall be defined in
relation to its status, facilities and available services.
1. A definition of such home or facility
shall not be more restrictive than one requiring that it-
A. Be operated pursuant to law;
B. Be primarily engaged in providing, in
addition to room and board accommodations, skilled nursing care under the
supervision of a duly licensed physician;
C. Provide continuous twenty-four (24)
hour-a-day nursing service by care under the supervision of a registered
graduate professional nurse (RN); and
D. Maintain a daily medical record of each
patient.
2. The
definition of such home or facility may provide that the term not be inclusive
of-
A. Any home, facility or part of it used
primarily for rest;
B. A home or
facility used for the aged or for the care of drug addicts or alcoholics;
or
C. A home or facility primarily
used for the care and treatment of mental diseases or disorders, or custodial
or educational care.
(D) Health care expenses means expenses of
HMOs associated with the delivery of health care services which are analogous
to incurred losses of insurers. These expenses shall not include:
1. Home office or overhead costs;
2. Advertising costs;
3. Commissions and other acquisition
costs;
4. Taxes;
5. Capital costs;
6. Administrative costs; or
7. Claims processing costs.
(E) Hospital may be defined in
relation to its status, facilities and available services or to reflect its
accreditation by the Joint Commission on Accreditation of Hospitals.
1. The definition of the term hospital shall
not be more restrictive than one requiring that the hospital-
A. Be an institution operated pursuant to
law;
B. Be primarily and
continuously engaged in providing or operating, either on its premises or in
facilities available to the hospital on a prearranged basis and under the
supervision of a staff of duly licensed physicians, medical, diagnostic and
major surgical facilities for the medical care and treatment of sick or injured
persons on an inpatient basis for which charge is made; and
C. Provide twenty-four (24) hour nursing
service by or under the supervision of RNs.
2. The definition of the term hospital may
state that the term shall not be inclusive of-
A. Convalescent homes or convalescent, rest
or nursing facilities;
B.
Facilities primarily affording custodial, educational or rehabilitative
care;
C. Facilities for the aged,
drug addicts or alcoholics; or
D.
Any military or veterans' hospital or soldiers' home or any hospital contracted
for or operated by any national government or agency of it for the treatment of
members or ex-members of the armed forces, except for services rendered on an
emergency basis where a legal liability exists for charges made to the
individual for those services.
(F) Medicare shall be defined in the policy.
Medicare may be substantially defined as The Health Insurance for the Aged Act,
Title XVIII of the Social Security Amendments of 1965 or Title I, Part I of
P.L. 89-97, as enacted by the Eighty-Ninth Congress of the United States of
America and popularly known as the Health Insurance for the Aged Act, or words
of similar import.
(G)
Medicare-eligible expenses shall mean health care expenses of the kinds covered
by Medicare, to the extent recognized as reasonable by Medicare. Payment of
benefits by insurers for Medicare-eligible expenses may be conditioned upon the
same or less restrictive payment conditions, including determinations of
medical necessity as are applicable to Medicare claims.
(H) Mental or nervous disorders shall not be
defined more restrictively than a definition including neurosis,
psychoneurosis, psychopathy, psychosis or mental or emotional disease or
disorder of any kind.
(I) Nurses
may be defined so that the description of nurse is restricted to a type of
nurse, such as an RN, a licensed practical nurse (LPN) or a licensed vocational
nurse (LVN). If the words nurse, trained nurse or registered nurse are used
without specific instruction, then the use of the terms requires the insurer to
recognize the services of any individual who qualifies under the terminology in
accordance with the applicable statutes or administrative rules of the
licensing or registry board of the state.
(J) Physician may be defined by including
words such as duly qualified physician or duly licensed physician. The use of
these terms requires an insurer to recognize and to accept, to the extent of
its obligation under the contract, all providers of medical care and treatment
when these services are within the scope of the provider's licensed authority
and are provided pursuant to applicable laws.
(K) Sickness shall not be defined to be more
restrictive than the following: sickness means sickness or disease of an
insured person which first manifests itself after the effective date of
insurance and while the insurance is in force. The definition may be further
modified to exclude sickness or diseases for which benefits are provided under
any Workers' Compensation, occupational disease, employer's liability or
similar law.
(4)
Prohibited Policy Provisions.
(A) No insurance
policy or subscriber contract may be advertised, solicited or issued for
delivery in this state as a Medicare supplement policy if the policy or
subscriber contract limits or excludes coverage by type of illness, accident,
treatment or medical condition, except as follows:
1. Foot care in connection with corns,
calluses, flat feet, fallen arches, weak feet, chronic foot strain or
symptomatic complaints of the feet;
2. Mental or emotional disorders, alcoholism
and drug addiction;
3. Illness,
treatment or medical condition arising out of-
A. War or act of war (whether declared or
undeclared); participation in a felony, riot or insurrection; or service in the
armed forces or auxiliary units of it;
B. Suicide or attempted suicide (while sane)
or intentionally self-inflicted injury; and
C. Aviation;
4. Cosmetic surgery, except that cosmetic
surgery shall not include reconstructive surgery when that service is
incidental to or follows surgery resulting from trauma, infection or other
diseases of the involved part;
5.
Care in connection with the detection and correction by manual or mechanical
means of structural imbalance, distortion or subluxation in the human body for
purposes of removing nerve interference and the effect of it, where that
interference is the result of or related to distortion, misalignment or
subluxation of or in the vertebral column;
6. Treatment provided in a governmental
hospital; benefits provided under Medicare or other governmental program
(except Medi-caid), any state or federal Workers' Compensation, employer's
liability or occupational disease law or any motor vehicle no-fault law;
services rendered by employees of hospitals, laboratories or other
institutions; services performed by a member of the covered person's immediate
family and services for which no charge is normally made in the absence of
insurance;
7. Dental care or
treatment;
8. Eyeglasses, hearing
aids and examination for the prescription or fitting of these;
9. Rest cures, custodial care, transportation
and routine physical examinations; and
10. Territorial limitations outside the
United States. Provided, however, supplemental policies may not contain, when
issued, limitations or exclusions of the type enumerated in paragraph (4)(A)1.,
2., 5., 9. or 10. that are more restrictive than those of Medicare. Medicare
supplement policies may exclude coverage for any expense to the extent of any
benefit available to the insured under Medicare.
(B) No Medicare supplement policy may use
waivers to exclude, limit or reduce coverage or benefits for specifically named
or described preexisting diseases or physical conditions.
(C) The terms Medicare supplement, Medigap
and words of similar import shall not be used unless the policy is issued in
compliance with this rule.
(D) No
Medicare supplement insurance policy, contract or certificate in force in the
state shall contain benefits which duplicate benefits provided by
Medicare.
(5) Minimum
Benefit Standards. No insurance policy or subscriber contract may be
advertised, solicited or issued for delivery in this state as a Medicare
supplement policy which does not meet the following minimum standards. These
are minimum standards and do not preclude the inclusion of other provisions or
benefits which are not inconsistent with these standards:
(A) General Standards. The following
standards apply to Medicare supplement policies and are in addition to all
other requirements of this rule:
1. A
Medicare supplement policy may not deny a claim for losses incurred more than
six (6) months from the effective date of coverage for a preexisting condition.
The policy may not define a preexisting condition more restrictively than a
condition for which medical advice was given or treatment was recommended by or
received from a physician within six (6) months before the effective date of
coverage;
2. A Medicare supplement
policy may not indemnify against losses resulting from sickness on a different
basis than losses resulting from accidents;
3. A Medicare supplement policy shall provide
that benefits designed to cover cost sharing amounts under Medicare will be
changed automatically to coincide with any changes in the applicable Medicare
deductible amount and copayment percentage factors. Premiums may be modified to
correspond with these changes;
4. A
noncancelable, guaranteed renewable or noncancelable and guaranteed renewable
Medicare supplement policy shall not-
A.
Provide for termination of coverage of a spouse solely because of the
occurrence of an event specified for termination of coverage of the insured,
other than the nonpayment of premium; or
B. Be cancelled or nonrenewed by the insurer
solely on the grounds of deterioration of health; and
5. Termination of a Medicare supplement
policy shall be without prejudice to any continuous loss which commenced while
the policy was in force, but the extension of benefits beyond the period during
which the policy was in force may be predicted upon the continuous total
disability of the insured, limited to the duration of the policy benefit
period, if any, or payment of the maximum benefits;
(B) Minimum Benefit Standards.
1. Coverage for either all or none of the
Medicare Part A inpatient hospital deductible amount.
2. Coverage for the daily copayment amount of
Medicare Part A eligible expenses for the first eight (8) days per calendar
year incurred for skilled nursing facility care.
3. Coverage for the reasonable cost of the
first three (3) pints of blood (or equivalent quantities of packed red blood
cells, as defined under federal regulations) under Medicare Part A unless
replaced in accordance with federal regulations.
4. Until January 1, 1990, coverage for twenty
percent (20%) of the amount of Medicare-eligible expenses under Part B
regardless of hospital confinement, subject to a maximum calendar year
out-of-pocket deductible of two hundred dollars ($200) of expenses and to a
maximum benefit of at least five thousand dollars ($5000) per calendar year.
Effective January 1, 1990 coverage for the copayment amount of
Medicare-eligible expenses excluding outpatient prescription drugs under
Medicare Part B regardless of hospital confinement up to the maximum
out-of-pocket amount for Medicare Part B after the Medicare deductible
amount.
5. Effective January 1,
1990, coverage under Medicare Part B for the reasonable cost of the first three
(3) pints of blood (or equivalent quantities of packed red blood cells as
defined under federal regulations) unless replaced in accordance with federal
regulations.
6. Effective January
1, 1990, coverage for the copayment amount of Medicare-eligible expenses for
covered home intravenous (I.V.) therapy drugs (as determined by the secretary
of Health and Human Services) subject to the Medicare outpatient prescription
drug deductible amount, if applicable.
7. Effective January 1, 1990, coverage for
the copayment amount of Medicare-eligible expenses for outpatient drugs used in
immunosuppressive therapy subject to the Medicare outpatient prescription drug
deductible if applicable; and
(C) Medicare-Eligible Expenses.
Medicare-eligible expenses shall mean health care expenses of the kinds covered
by Medicare to the extent recognized as reasonable by Medicare. Payment of
benefits by insurers for Medicare-eligible expenses may be conditioned upon the
same or less restrictive payment conditions, including determinations of
medical necessity as are applicable to Medicare claims.
(6) Standards for Claims Payment.
(A) Every entity providing Medicare
supplement policies or contracts shall comply with all provisions of Section
4081 of the Omnibus Budget Reconciliation Act of 1987 ( P.L. 100-203
).
(B) Compliance with the
requirements set forth in subsection (6)(A) must be certified on the Medicare
Supplement Insurance Experience exhibit attached to the annual
statement.
(C) No policy or
certificate may contain a provision reducing benefit payments due to the
existence of other Medicare supplement coverage. Coverage must provide that
insureds are entitled to a return of all premiums paid for duplicate coverage
with the same insurer.
(7) Loss Ratio Standards.
(A) Medicare supplement policies shall return
to policyholders in the form of aggregate benefits under the policy, for the
entire period for which rates are computed to provide coverage, on the basis of
incurred claims experience or incurred health care expenses where coverage is
provided by an HMO on a service rather than reimbursement basis and earned
premiums for that period and in accordance with accepted actuarial principles
and practices-
1. At least seventy-five
percent (75%) of the aggregate amount of premiums earned in the case of group
policies, or direct response policies issued on or after January 1, 1990;
and
2. At least sixty percent (60%)
of the aggregate amount of premiums earned in the case of individual
policies.
(B) All
filings of rates and rating schedules shall demonstrate that actual and
expected losses in relation to premiums comply with the requirements of this
section.
(C) Every entity providing
Medicare supplement policies in this state annually shall file its rates,
rating schedule and any supporting documentation requested by the director,
including ratios of incurred losses to earned premiums by number of years of
policy duration, demonstrating that it is in compliance with the previously
mentioned applicable loss ratio standards and that the period for which the
policy is rated is reasonable in accordance with accepted actuarial principles
and experience. For the purposes of this section, policy forms shall be deemed
to comply with the loss ratio standards if-i) for the most recent year, the
ratio of the incurred losses to earned premiums for policies or certificates
which have been in force for three (3) years or more is greater than or equal
to the applicable percentages contained in this section and ii) the expected
losses in relation to premiums over the entire period for which the policy is
rated comply with the requirements of this section. An expected third-year loss
ratio which is greater than or equal to the applicable percentage shall be
demonstrated for policies or certificates in force less than three (3)
years.
(D) In determining
compliance with the loss ratio standards in subsections (7)(A)- (C) actual and
expected incurred losses shall not include:
1. Loss adjustment expense incurred in
settling claims; or
2. Claim
reserves that would be found unreasonably excessive or unacceptable by
actuarial standards, procedures and practices.
(E) As soon as practicable, but no later than
sixty (60) days prior to the effective date of Medicare benefit changes
required by the Medicare Catastrophic Coverage Act of 1988, every insurer,
health care service plan or other entity providing Medicare supplement
insurance or contracts in this state (except employers subject to the
requirements of Section 421 of the Medicare Catastrophic Coverage Act of 1988)
shall file with the director in accordance with the applicable filing
procedures of this state-
1. Appropriate
premium adjustments necessary to produce loss ratios as originally anticipated
for the applicable policies or contracts. These supporting documents, as
necessary to justify the adjustment, shall accompany the filing. Every insurer,
health care service plan or other entity providing Medicare supplement
insurance or benefits to a resident of this state pursuant to Section 2 of the
Medicare Supplement Insurance Minimum Standards Model Act shall make whatever
premium adjustments are necessary to produce an expected loss ratio under the
policy or contract that will conform with minimum loss ratio standards for
Medicare supplement policies and which are expected to result in a loss ratio
at least as great as that originally anticipated in the rates used to produce
current premiums by the insurer, health care service plan or other entity for
those Medicare supplement insurance policies or contracts. No premium
adjustment which would modify the loss ratio experience under the policy other
than the adjustments described in this rule should be made with respect to a
policy at any time other than upon its renewal date or anniversary date.
Premium adjustments shall be in the form of refunds or premium credits and
shall be made no later than upon renewal if a credit is given, or within sixty
(60) days of the renewal date or anniversary date if a refund is provided to
the premium payer. Premium adjustments shall be calculated for the period
commencing with Medicare benefit changes; and
2. Any appropriate riders, endorsements or
policy forms needed to accomplish the Medicare supplement insurance
modifications necessary to eliminate benefit duplications with Medicare. Any
such riders, endorsements or policy forms shall provide a clear description of
the Medicare supplement benefits provided by the policy or contract.
(8) Filing Requirements
for Out-of-State Group Policies. Every insurer providing group Medicare
supplement insurance benefits to a resident of this state pursuant to Section 2
of the Medicare Supplement Insurance Minimum Standards Model Act shall file a
copy of the master policy and any certificate used in this state in accordance
with the filing requirements and procedures applicable to group Medicare
supplement policies issued in this state; provided, however, that no insurer
shall be required to make a filing earlier than thirty (30) days after
insurance was provided to a resident of this state under a master policy issued
for delivery outside this state.
(9) Prohibited Compensation for Replacement
with the Same Company. No entity shall provide compensation to its agents or
other producers which is greater than the renewal compensation which would have
been paid on an existing policy if the existing policy is replaced by another
policy with the same company where the new policy benefits are substantially
similar to the benefits under the old policy and the old policy was issued by
the same insurer or insurer group.
(10) Required Disclosure Provisions.
(A) General Rules.
1. Medicare supplement policies shall include
a renewal, continuation or nonrenewal provision. The language or specifications
of the provision must be consistent with the type of contract to be issued. The
provision shall be appropriately captioned, shall appear on the first page of
the policy and clearly shall state the duration, where limited or renewability
and the duration of the term of coverage for which the policy is issued and for
which it may be renewed.
2. Except
for riders or endorsements by which the insurer effectuates a request made in
writing by the insured or exercises a specifically reserved right under a
Medicare supplement policy, or is required to reduce or eliminate benefits to
avoid duplication of Medicare benefits, all riders or endorsements added to a
Medicare supplement policy after the date of issue or at reinstatement or
renewal which reduce or eliminate benefits or coverage in the policy shall
require a signed acceptance by the insured. After the date of policy issue, any
rider or endorsement which increases benefits or coverage with a concomitant
increase in premium during the policy term must be agreed to in writing signed
by the insured unless the benefits are required by the minimum standards for
Medicare supplement insurance policies or if the increased benefits or coverage
is required by law. Where a separate additional premium is charged for benefits
provided in connection with riders or endorsements, the premium charge shall be
set forth in the policy.
3. A
Medicare supplement policy which provides for the payment of benefits based on
standards described as usual and customary, reasonable and customary or words
of similar import shall include definitions and explanations of the terms in
its accompanying outline of coverage.
4. If a Medicare supplement policy contains
any limitations with respect to pre-existing conditions, the limitations must
appear as a separate paragraph of the policy and be labeled as preexisting
condition limitations.
5. Medicare
supplement policies or certificates shall have a notice prominently printed on
the first page of the policy or certificate, or attached to it stating in
substance that the policyholder or certificate holder shall have the right to
return the policy or certificate within thirty (30) days of its delivery and to
have the premium refunded if, after examination of the policy or certificate,
the insured person is not satisfied for any reason.
6. Insurers issuing accident and sickness
policies, certificates or subscriber contracts which provide hospital or
medical expense coverage on an expense-incurred or indemnity basis, other than
incidentally, to a per-son(s) eligible for Medicare by reason of age shall
provide to all applicants a Medicare supplement Buyer's Guide in the form
developed jointly by the National Association of Insurance Commissioners and
the Health Care Financing Administration. Delivery of the Buyer's Guide shall
be made whether or not the policies, certificates or subscriber contracts are
advertised, solicited or issued as Medicare supplement policies as defined in
this regulation. Except in the case of direct response insurers, delivery of
the Buyer's Guide shall be made to the applicant at the time of application and
acknowledgment of receipt of the Buyer's Guide shall be obtained by the
insurer. Direct response insurers shall deliver the Buyer's Guide to the
applicant upon request but not later than at the time the policy is
delivered.
(B) Notice
Requirements.
1. As soon as practicable, but
no later than thirty (30) days prior to the annual effective date of any
Medicare benefit changes, every insurer, health care service plan or other
entity providing Medicare supplement insurance or benefits to a resident of
this state shall notify its policyholders, contract holders and certificate
holders of modifications it has made to Medicare supplement insurance policies
or contracts in a format acceptable to the director. For the years 1989 and
1990, and if prescription drugs are covered in 1991, the notice shall be in a
format prescribed by the director or in the format prescribed in Appendices A,
B and C if no other format is prescribed by the director. In addition, the
notice shall-
A. Include a description of
revisions to the Medicare program and a description of each modification made
to the coverage provided under the Medicare supplement insurance policy or
contract; and
B. Inform each
covered person as to when any premium adjustment is to be made due to changes
in Medicare.
2. The
notice of benefit modifications and any premium adjustments shall be in outline
form and in clear and simple terms to facilitate comprehension.
3. The notices shall not contain or be
accompanied by any solicitation.
(C) Outline of Coverage Requirements for
Medicare Supplement Policies.
1. Insurers
issuing Medicare supplement policies or certificates for delivery in this state
shall provide an outline of coverage to all applicants at the time application
is made and, except for direct response policies, shall obtain an
acknowledgment of receipt of the outline from the applicant .
2. If an outline of coverage is provided at
the time of application and the Medicare supplement policy or certificate is
issued on a basis which would require revision of the outline, a substitute
outline of coverage properly describing the policy or certificate must
accompany the policy or certificate when it is delivered, and contain the
following statement, in no less than twelve (12)-point type, immediately above
the company name: NOTICE: Read this outline of coverage carefully. It is not
identical to the outline of coverage provided upon application and the coverage
originally applied for has not been issued.
(D) Notice Regarding Policies or Subscriber
Contracts Which Are Not Medicare Supplement Policies. Any accident and sickness
insurance policy or subscriber contract other than a Medicare supplement
policy, disability income policy, basic, catastrophic or major medical expense
policy, single premium nonrenewable policy or other policy identified in
subsection (1)(B) of this rule, issued for delivery in this state to persons
eligible for Medicare by reason of age shall notify insureds under the policy
or subscriber contract that the policy or subscriber contract is not a Medicare
supplement policy. The notice shall either be printed or attached to the first
page of the outline of coverage delivered to insureds under the policy or
subscriber contract or, if no outline of coverage is delivered, to the first
page of the policy, certificate or subscriber contract delivered to insureds.
The notice shall be in no less than twelve (12)-point type and shall contain
the following language: "THIS (POLICY, CERTIFICATE OR SUBSCRIBER CONTRACT) IS
NOT A MEDICARE SUPPLEMENT (POLICY OR CONTRACT). If you are eligible for
Medicare, review the Medicare Supplement Buyer's Guide available from the
company."
(11)
Requirements for Replacement.
(A) Application
forms shall include a question designed to elicit information as to whether a
Medicare supplement policy or certificate is intended to replace any other
accident and sickness policy or certificate presently in force. A supplementary
application or other form to be signed by the applicant containing such a
question may be used.
(B) Upon
determining that a sale will involve replacement, an insurer, other than a
direct response insurer or its agent, shall furnish the applicant , prior to
issuance or delivery of the Medicare supplement policy or certificate, a notice
regarding replacement of accident and sickness coverage. One (1) copy of the
notice shall be provided to the applicant and an additional copy signed by the
applicant shall be retained by the insurer. A direct response insurer shall
deliver to the applicant at the time of the issuance of the policy the notice
regarding replacement of accident and sickness coverage. In no event, however,
will this notice be required in the solicitation of accident-only and single
premium nonrenewable policies.
(C)
The notice required by subsection (11)(B) for an insurer, other than a direct
response insurer, shall be provided in substantially the form as indicated in
Appendix B.
(D) The notice required
by subsection (11)(B) for a direct response shall be as indicated in Appendix
C.
(12) Filing
Requirements for Advertising. Every insurer, health care service plan or other
entity providing Medicare supplement insurance or benefits in this state shall
provide a copy of any Medicare supplement advertisement intended for use in
this state whether through written, radio or television medium to the
(director) of insurance of this state for review or approval by the (director)
to the extent it may be required under state law.
(13) Separability. If any provision of this
rule or the application of it to any person or circumstance is for any reason
held to be invalid, the remainder of the rule and the application of that
provision to other persons or circumstances shall not be affected by
it.
(14) Effective Date. This rule
shall be effective on November 1, 1989.
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Notes
*Original authority: 376.864, RSMo (1989), amended 1992; 376.869 and 376.874, RSMo (1989); and 376.879, RSMo (1989), amended 1992.
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