CCS/HCS/SB 551 - This act modifies provisions relating to insurance. RECIPIENTS OF DONATED ORGANS (Section 194.320) Under this act, no hospital, physician, procurement organization, or other person shall determine the ultimate recipient of an anatomical gift based upon a potential recipient's physical or mental disability or congenital condition, except to the extent that the disability or condition has been found by a physician, following a case-by-case evaluation of the potential recipient, to be medically significant to the provision of the anatomical gift. A person with a disability or congenital condition shall not be required to demonstrate post-operative independent living abilities in order to have access to a transplant if there is evidence that the person will have sufficient, compensatory support and assistance. A court shall accord priority on its calendar and handle expeditiously any action brought to seek a remedy for purposes of enforcing compliance with this act. This act shall not be deemed to require referrals or recommendations for or the performance of medically inappropriate organ transplants. These provisions are similar to SB 712 (2020), and to provisions in SB 466 (2015). MISSOURI AUTOMOBILE INSURANCE PLAN (Section 303.200) This act modifies existing law regarding apportionment of substandard insurance risks to create the Missouri Automobile Insurance Plan ("MOAIP"). Under the act, MOAIP is authorized to issue motor vehicle insurance policies to applicants who are unable to procure motor vehicle liability policies through ordinary methods, rather than funding issuance of the policies through other insurers. The act further specifies that the Director of the Department of Commerce and Insurance (the "Director") shall consult with insurance companies "having a certificate of authority to do business in the state and actively writing motor vehicle liability policies" regarding the plan, rather than insurance companies "authorized to issue automobile liability policies". (Section 303.200.1). MOAIP shall perform its functions under a plan of operation, approved by the Director, and through a governing committee as prescribed in the plan of operation. (Section 303.200.2). The plan of operation shall prescribe the issuance of motor vehicle insurance policies, which may include the administration of the policies by a third party, as specified in the act. (Section 303.200.3). The act requires MOAIP to obtain approval from the Director before using forms, rates, or manuals. (Section 303.200.4). MOAIP is subject to the applicable insurance laws of this state unless specifically exempted (Section 303.200.5), is required to file annual financial reports and to be subject to examination by the Director, and shall have the authority to make assessments on member insurance companies in proportion to their market share. (Section 303.200.6). Member insurers and members of the governing committee shall be immune from liability for omissions and actions taken in the performance of their powers and duties under the act. (Section 303.200.7) These provisions are identical to provisions in HB 1648 (2020), and substantially similar to provisions in SB 779 (2020) and provisions in the truly agreed to and finally passed SS#3/SCS/HB 1963 (2020). INSURANCE COVERAGE FOR BREAST CANCER (Section 376.782) This act modifies an insurance mandate relating to breast cancer screening and evaluation. In addition to existing coverage requirements, the act adds "detectors" to the X-ray equipment specifically listed as being covered under the mandate. The act also specifies that coverage for certain breast cancer screening and evaluation services shall be provided to any woman deemed by her physician to have an above-average risk for breast cancer in accordance with American College of Radiology (ACR) guidelines, rather than specifically to women with a personal or family history of breast cancer. The act also requires coverage of any additional or supplemental imaging, such as breast MRI or ultrasound, deemed medically necessary by a treating physician for proper screening or evaluation in accordance with applicable ACR guidelines. Furthermore, the act requires coverage of ultrasound or MRI services when determined by a treating physician to be medically necessary for the screening or evaluation of breast cancer for any woman deemed by the treating physician to have an above-average risk of breast cancer in accordance with ACR guidelines for breast cancer screening. Lastly, language relating to out-of-pocket expenditures is modified to apply to the additional modalities required to be covered under the act. These provisions are identical to SB 841 (2020) and HB 2468 (2020), and to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 1682 (2020). INSURANCE FOR LIVING ORGAN DONORS (Section 376.1590) This act specifies that a person's status as a living organ donor shall not be the sole factor in the offering, issuance, cancellation, price, or conditions of an insurance policy, nor in the amount of coverage provided. The Department of Commerce and Insurance shall provide information to the public on the access of a living organ donor to insurance as specified in the act. If the Department of Commerce and Insurance or the Department of Health and Senior Services receives materials related to live organ donation from a recognized live organ donation organization, the materials may be made available to the public. These departments may seek or accept gifts, grants, or donations from public or private sources for purposes of this act. These provisions are identical to HCS/HB 1709 (2020), and to provisions in HCS/SS/SB 580 (2020). INDUCEMENTS TO INSURANCE (Sections 379.402 and 379.404) This act specifies that insurers and insurance producers may provide products or services in conjunction with a policy of property and casualty insurance for free, at a discount, or at market value, if the products or services are intended to prevent or mitigate loss, provide loss control, reduce rates or claims, educate about risk of loss, monitor or assess risk, identify sources of risk, develop strategies for the elimination or reduction of risk, or provide post-loss services. (Section 379.402.1) Insurers or producers of insurance may offer gifts, goods, or merchandise that contain advertising or promotion of the insurer or producer to policyholders, prospective policyholders, and members of the public. (Section 379.402.2) Products or services provided as specified in this act shall not be considered an inducement to insurance, a rebate, nor any other impermissible consideration prohibited by law. The products or services described in this act shall not be required to be included in the contract or policy form filings. (Section 379.402.3) The Director of the Department of Commerce and Insurance may promulgate rules to exempt, but not restrict, additional categories of products or services with regard to the prohibitions against inducements to insurance. (Section 379.402.4) The act also exempts commercial property and casualty insurers from the prohibitions against inducements to insurance, except with regard to any producer commission reduction not included in the insurer's rate filings. (Section 376.404) These provisions are identical to SB 900 (2020) and to provisions in HCS/HB 1634 & 2085 (2020). MISSOURI BASIC PROPERTY INSURANCE INSPECTION AND PLACEMENT PROGRAM (Section 379.860) This act also modifies the Missouri Basic Property Insurance Inspection and Placement Program. Under the act, ten of the members of the program's governing committee shall be elected as specified in the program's plan of operation, rather than prescribing entities from which the members shall be elected. (Section 379.860.2). Member insurers and members of the governing committee shall be immune from liability for omissions and actions taken in the performance of their powers and duties under the act. (Section 379.860.4) These provisions are identical to provisions in HB 1648 (2020) and substantially similar to provisions in SB 779 (2020). MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION (Sections 383.155, 383.160, and 383.175) The act modifies the authority to create a medical malpractice insurance joint underwriting association by specifying that the composition of the association's board of directors shall be established by its plan of operation (Section 383.155.6), and provides that member insurers and members of the board of directors shall be immune from liability for omissions and actions taken in the performance of their powers and duties under the act. (Section 383.155.9). Under the act, all policies of insurance written by the association shall be written to "provide medical malpractice insurance coverage as provided in the plan of operation", rather than to "apply to injury which results from acts or omissions occurring during the policy period." (Section 383.160.1). Lastly, the act specifies that the association's board of directors shall be established by its plan of operation, rather than prescribing entities from which the members shall be elected. (Section 383.175) These provisions are identical to provisions in HB 1648 (2020), and similar to provisions in SB 779 (2020). ERIC VANDER WEERD