MO SB403

Repeals and replaces eight sections of Missouri health insurance law relating to health maintenance organizations (HMOs), group health insurance policies, network adequacy, and utilization review procedures.

Allows health carriers to offer managed care plans requiring all health care services be delivered by participating providers in their network, except for emergency services and certain other services, with this provision disclosed in the policy form.

Establishes the "Health Insurance Marketplace Innovation Act of 2013" requiring individuals and entities performing navigator services in health benefit exchanges to obtain a navigator license from the Department of Insurance, with specific training, examination, and continuing education requirements.

Prohibits unlicensed navigators from providing plan recommendations or comparative advice about health plans; only licensed insurance producers may sell health insurance or recommend specific plans.

Modifies policy form approval timelines, requiring the director to provide specific reasons for disapproval within forty-five days and establishing procedures for post-approval amendments to comply with state law without retroactive enforcement.