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SECOND REGULAR SESSION
SENATE BILL NO. 1500
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR SCHROER.
6243S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to long -term care
insurance.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto 1
one new section, to be known as section 376.1135, to read as 2
follows:3
376.1135. 1. For purposes of this section, the 1
following terms mean: 2
(1) "Department", the department of commerce and 3
insurance; 4
(2) "Director", the director of the department or his 5
or her designee; 6
(3) "Long-term care insurance", as such term is 7
defined in section 376.1100. 8
2. (1) The provisions of this section shall apply to 9
all policies delivered or issued for delivery in this state 10
for long-term care insurance on or after August 28, 2026. 11
(2) To the extent a conflict arises between the 12
provisions in this chapter relating to the filing and 13
submission of policy forms for approval by the director and 14
this section relating to the long-term care insurance 15
premium rates filed with the director, the provisions of 16
this section and rules promulgated hereunder shall govern 17
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all policies delivered or issued in this state for long-term 18
care insurance, on or after August 28, 2026. 19
(3) This section is not intended to supersede the 20
obligations of entities subject to the provisions of 21
sections 376.1100 to 376.1130 to comply with the substance 22
of other applicable insurance laws insofar as they do not 23
conflict with the provisions of sections 376.1100 to 24
376.1130 and this section, except that laws and regulations 25
designed and intended to apply to Medicare supplement 26
insurance policies shall not be applied to long-term care 27
insurance. 28
(4) Any policy or rider advertised, marketed, or 29
offered as long-term care or nursing home insurance on or 30
after August 28, 2026, shall comply with the provisions of 31
sections 376.1100 to 376.1130 and this section. 32
3. (1) All premium rate schedules for long-term care 33
insurance shall be filed by the insurer with the department 34
and shall be subject to the prior approval of the director 35
before such rates can be implemented by the insurer. 36
(2) An insurer shall not charge a premium to an 37
insured under a policy or contract of long-term care 38
insurance before the applicable premium rate is filed with 39
and approved by the director. 40
(3) An insurer shall not change the premium charged to 41
an insured under a policy or contract of long-term care 42
insurance until the applicable premium rate change has been 43
filed with and approved by the director. 44
4. (1) The director shall disapprove or modify 45
premium rates submitted by an insurer if: 46
(a) It is determined that the benefits provided are 47
unreasonable in relation to the premiums charged; 48
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(b) The premium rates appear to be inadequate, 49
unfairly discriminatory, or excessive in relation to 50
benefits; or 51
(c) The premium rate appears to be based on 52
assumptions that are unreasonable in the aggregate or for 53
each assumption individually. 54
(2) When requesting a rate increase, insurers shall 55
submit their distribution of business rate increase data 56
approved to date, including, but not limited to, policy 57
count, annualized premiums, and paid claims, for each 58
referenced series, for all states. If the annualized rate 59
increase for this state is found to be higher than that of 60
other states, then the rate increase shall be denied, even 61
if such increase is actuarially justified. 62
(3) The director shall notify the insurer of his or 63
her decision in writing as soon as is practicable but not 64
later than ninety days from the date of receiving the filing 65
of the premium rate for long-term care insurance. 66
(4) If the director disapproves the premium rate filed 67
by the insurer, the notice shall contain the director's 68
reasons for disapproval and inform the insurer that the 69
insurer is entitled to appeal the decision or determination 70
of disapproval by filing an appeal in the same manner as 71
appeals are filed under the insurance laws of this state. 72
5. If no action is taken by the director within ninety 73
days to approve or disapprove the premium rates after they 74
have been filed by the insurer, the premium rates shall be 75
deemed to be approved. 76
6. (1) If additional time is needed to review and 77
make a determination on the premium rate filing, the 78
director shall provide written notice to the insurer that an 79
additional time period or periods, not to exceed ninety days 80
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per period, are needed to complete a review of the premium 81
rate filing. 82
(2) Upon written application by the insurer, the 83
director may authorize a premium rate filing that has been 84
reviewed to become effective before the expiration of the 85
additional time period indicated in subdivision (1) of this 86
subsection. 87
7. The director may disapprove a previously approved 88
premium rate filing at any time after providing written 89
notice to the insurer and as provided in rules promulgated 90
by the department. 91
8. Any applicable premium rate or premium rate change 92
of an insurer shall be filed with the director in accordance 93
with the guidance issued by the director by bulletin, 94
regulation, or other method. 95
9. In addition to the factors set forth in this 96
chapter and applicable regulations, and subsection 4 of this 97
section, the director shall consider the following to the 98
extent appropriate when determining whether to disapprove or 99
modify a premium rate filing of an insurer: 100
(1) Past and prospective loss experience within and 101
outside the state; 102
(2) Underwriting practice and judgment; 103
(3) A reasonable margin for reserve needs; 104
(4) Past and prospective expenses, both nationwide and 105
those specifically applicable to this state; 106
(5) Prior approved rate changes; and 107
(6) Any other relevant factors necessary, including 108
the factors set forth in the regulation. 109
10. (1) The director shall hold a public hearing or 110
solicit public comments as a part of the process to review 111
long-term care insurance rate filings submitted by insurers 112
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under this section. The director shall provide all persons 113
present at a public hearing held under this section an 114
opportunity to offer testimony or written comments. The 115
director may place time limits on the testimony. 116
(2) Notwithstanding the provisions of subdivision (1) 117
of this subsection to the contrary, if the director holds a 118
public hearing or solicits public comments on a premium rate 119
filing under this subsection, some or all portions of the 120
filing that are subject to disclosure as a part of the 121
public hearing or solicitation of public comments may be 122
open to public inspection as authorized by applicable 123
federal and state law. 124
11. Each premium rate decision of the director made 125
under this section is subject to judicial review in 126
accordance with the insurance laws of this state. 127
12. The director shall promulgate all necessary rules 128
and regulations for the administration of this section. Any 129
rule or portion of a rule, as that term is defined in 130
section 536.010, that is created under the authority 131
delegated in this section shall become effective only if it 132
complies with and is subject to all of the provisions of 133
chapter 536 and, if applicable, section 536.028. This 134
section and chapter 536 are nonseverable and if any of the 135
powers vested with the general assembly pursuant to chapter 136
536 to review, to delay the effective date, or to disapprove 137
and annul a rule are subsequently held unconstitutional, 138
then the grant of rulemaking authority and any rule proposed 139
or adopted after August 28, 2026, shall be invalid and void. 140
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