Golden Rule Insurance Co. v. Missouri Department of Insurance

FOREST W. HANNA, Judge.

Golden Rule Insurance Company submitted a group health insurance rider form entitled “Precertification Requirements Rider” to the Department of Insurance for its approval. The Department interpreted the rider form, as defined by § 376.1350(24), to be a “managed care plan” requiring compliance with §§ 376.1350-376.1390, RSMo 1997. Golden Rule disputed the Department’s interpretation, maintaining that these statutory provisions did not apply to its rider form because it was not a managed care plan. Golden Rule insisted that its rider form should be classified as a “health…