Missouri Life and Health Insurance Guaranty Association

PURPOSE: This rule sets forth the forms for use in connection with the sale of policies or contracts which either are or are not covered by the Missouri Life and Health Insurance Guaranty Association. (1) Effective May 31, 1989 no insurer may deliver a policy or contract described in section 376.717.2, RSMo, to a policy or contract holder unless a copy of the notice set out in Appendix One is given to the policy or contract holder before or at the time of delivery. If the policy or contract is excluded under section 376.717.3, RSMo, the notice set out in Appendix One, which is included herein, does not need to be delivered to the policy or contract holder. (2) No insurer or insurance producer may deliver a contract or policy described in section 376.717.2, RSMo, and excluded under section 376.717.3, RSMo, from coverage under the provisions of sections 376.715—376.758, RSMo, unless the insurer or insurance producer, prior to or at the time of delivery, gives the policy or contract holder a copy of the notice set out in Appendix Two, included herein. AND INSURANCE This notice provides a brief summary of the Missouri Life and Health Insurance Guaranty Association (“the Association”) and the protection it provides for policyholders. This safety net was created under Missouri law, which determines who and what is covered and the amounts of coverage. The Association was established to provide protection in the unlikely event that your life, annuity, or health insurance company becomes financially unable to meet its obligations and is taken over by its insurance department. If this should happen, the Association will typically arrange to continue coverage and pay claims, in accordance with Missouri law, with funding from assessments paid by other insurance companies. (For purposes of this notice, the terms “insurance company” and “insurer” include health maintenance organizations (HMOs).) The basic protections provided by the Association are as follows: • Life Insurance • $300,000 in death benefits, but not more than $100,000 in net cash surrender and net cash withdrawal values • Health Insurance • $500,000 for health benefit plans • $300,000 in disability insurance benefits • $300,000 in long-term care insurance benefits • $100,000 in other types of health insurance benefits • Annuities • $250,000 in the present value of annuity benefits, including net cash surrender and net cash withdrawal values The maximum amount of protection for each individual, regardless of the number of policies or contracts, is as follows: • $300,000 in aggregate for all types of coverage listed above, with the exception of health benefit plans • $500,000 in aggregate for health benefit plans • $5,000,000 to one policy owner of multiple nongroup policies of life insurance, whether the policy owner is an individual, firm, corporation, or other person, and whether the persons insured are officers, managers, employees, or other persons “Health benefit plan” is defined in section 376.718, RSMo. Note: Certain policies and contracts may not be covered or fully covered. For example, coverage does not extend to any portion(s) of a policy or contract that the insurer does not guarantee, such as certain investment additions to the account value of a variable life insurance policy or a variable annuity contract. There are also various residency requirements and other limitations under Missouri law. Benefits provided by a long-term care (LTC) rider to a life insurance policy or annuity contract shall be considered the same type of benefits as the basic life insurance policy or annuity contract to which it relates. To learn more about the above protections, as well as protections relating to group contracts or retirement plans, please visit the Association’s website at www.mo-iga.org, or contact: Missouri Life and Health Missouri Department of Commerce Insurance Guaranty Association and Insurance 630 Bolivar Street, Suite 204 301 West High Street, Room 530 Jefferson City, Missouri 65101 Jefferson City, Missouri 65101 Ph.: 573-634-8455 Ph.: 573-522-6115 Fax: 573-634-8488 Insurance companies and agents are not allowed by Missouri law to use the existence of the Association or its coverage to encourage you to purchase any form of insurance or HMO coverage. When selecting an insurance company, you should not rely on Association coverage. If there is any inconsistency between this notice and Missouri law, then Missouri law will control. APPENDIX ONE NOTICE OF PROTECTION PROVIDED BY MISSOURI LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION This policy or contract is not covered by the Missouri Life and Health Insurance Guaranty Association. If the company providing this policy or contract is unable to meet its obligation by reason of insolvency or financial impairment, the fund(s) of the Missouri Life and Health Insurance Guaranty Association will not be available to protect the policy or contract holder or his/her beneficiaries, payees, or assignees. AND INSURANCE AUTHORITY: section 374.045.1(2), RSMo 2016, and section 376.756, RSMo Supp. 2020.* This rule was previously filed as 4 CSR 19013.290. Original rule filed Sept. 6, 1988, effective April 1, 1989. Amended: Filed Dec. 1, 1989, effective May 1, 1990. Emergency amendment filed April 30, 1990, effective May 10, 1990, expired Aug. 7, 1990. Amended: Filed April 30, 1990, effective Sept. 28, 1990. Amended: Filed Aug. 4, 1992, effective May 6, 1993. Amended: Filed July 12, 2002, effective Jan. 30, 2003. Amended: Filed July 29, 2005, effective Feb. 28, 2006. Amended: Filed Oct. 10, 2013, effective April 30, 2014. Amended: Filed Jan. 22, 2016, effective Aug. 30, 2016. Non-substantive change filed Sept. 11, 2019, published Oct. 31, 2019. Amended: Filed June 4, 2020, effective Jan. 30, 2021. Nonsubstantive change filed July 20, 2023, published Sept. 30, 2023. *Original authority: 374.045, RSMo 1967, amended 1993, 1995, 2008 and 376.756, RSMo 1988, amended 2018.