Missouri Revised Statutes













Chapter 376

Life, Health and Accident Insurance

←376.1083

Section 376.1084.1

376.1085→

August 28, 2015

Insurer responsible for benefits and underwriting practices--insurer to conduct review of administrator, when.

376.1084. 1. If an insurer uses the services of an administrator, the

insurer shall be responsible for determining the benefits, premium rates,

underwriting criteria and claims payment procedures applicable to such

coverage and for securing reinsurance, if any. The rules pertaining to these

matters shall be provided, in writing, by the insurer to the administrator.

The responsibilities of the administrator as to any of these matters shall be

set forth in the written agreement between the administrator and the insurer.



2. It is the sole responsibility of the insurer to provide for competent

administration of its programs.



3. In cases where an administrator administers benefits for more than

one hundred certificate holders on behalf of an insurer, the insurer shall,

at least semiannually, conduct a review of the operations of the

administrator. At least one such review shall be an on-site audit of the

operations of the administrator.



(L. 1993 H.B. 709 § 46)







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