MO SB440

Repeals and replaces sections 383.015, 383.016, 383.035, 383.037, and 383.206 relating to medical malpractice insurance provided by assessable associations.

Requires assessable associations to maintain a minimum policyholder's surplus of $600,000, with a phased implementation for existing associations (starting at $200,000 on December 31, 2012, increasing to $600,000 by December 31, 2014).

Establishes new assessment types (initial, operating, regular, and special) and requires associations to specify assessment methods, payment timelines, and maximum amounts in their articles of association and bylaws.

Limits the ratio of net written premiums to policyholders' surplus to 3:1, with phased compliance for existing associations (4:1 by December 31, 2012, decreasing to 3:1 by December 31, 2014).

Specifies that special assessments cannot apply to former members more than five years after their coverage termination and requires director approval of rates to ensure they are not excessive, inadequate, or unfairly discriminatory.