376.781. Speech and hearing disorders, companies to offer coverage, when--rules, procedure.
Speech and hearing disorders, companies to offer coverage,when--rules, procedure.
376.781. 1. All group health insurance policies providing coverage onan expense-incurred basis, all group service or indemnity contracts issued bya not-for-profit health service corporation, all self-insured group healthbenefit plans of any type or description, and all such health plans orpolicies that are individually underwritten or provide for such coverage forspecific individuals and the members of their families as nongroup policies,which provide for hospital treatment, shall offer coverage for the necessarycare and treatment of loss or impairment of speech or hearing subject to thesame durational limits, dollar limits, deductibles and coinsurance factors asother covered services in such policies or contracts. All Missouri groupcontracts issued or renewed on or after December 31, 1984, shall be subject tothis section. Notwithstanding any construction or relationship ofinterdependent contracts or plans affecting coverage and payment ofreimbursement prerequisites under the policy or contract, coverage required bythis section shall be included in the policy or contract and payment providedas for other coverage in the same policy or contract.
2. The offer of benefits under subsection 1 of this section shall be inwriting and may be rejected by the individual or group policyholder.
3. Nothing in this section shall prohibit the insurance company ornot-for-profit health service corporation from including any coverage for lossor impairment of speech, language or hearing as standard coverage in theirpolicies or contracts, but same shall not contain terms contrary to thissection.
4. The phrase "loss or impairment of speech or hearing" shall includethose communicative disorders generally treated by a speech pathologist,audiologist or speech/language pathologist licensed by the state board ofhealing arts or certified by the American Speech-Language and HearingAssociation (ASHA), or both, and which fall within the scope of his or herlicense or certification.
5. Any provision in a health insurance policy contrary to or in conflictwith the provisions of this section shall, to the extent of the conflict, bevoid, but such invalidity shall not offset the validity of the otherprovisions of such policy.
6. The department of insurance, financial institutions and professionalregistration may issue rules necessary to carry out the provisions of thissection. No rule or portion of a rule promulgated under the authority of thissection shall become effective unless it has been promulgated pursuant to theprovisions of section 536.024, RSMo.
(L. 1984 S.B. 522 § 1, A.L. 1995 S.B. 3)