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Missouri - Compensation & Benefit Legislation

MISSOURI - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

MISSOURI - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.

 

Preventive care for children: Yes, employer option to age 12. Immunizations must be covered.

 

(Missouri Rev. Stat. Sections 376.406, 376.426, 376.801, 376.816, 376.995)

 

MISSOURI - ALCOHOLISM & DRUG ABUSE

Employer option.

 

Minimum yearly inpatient coverage: 21 days, plus 6 days for toxification.

 

Minimum yearly outpatient coverage: 26 days.

 

Minimum lifetime coverage: 10 episodes, not including detoxification in life threatening situations.

 

(Missouri Rev. Stat. Section 376-779, 376.811)

 

MISSOURI - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: Certain Missouri municipalities, including St. Louis and Kansas City, require employers to count cafeteria plan payments as wages for purposes of local income taxes. For state Unemployment Insurance purposes, employer contributions toward medical and hospital insurance are not taxable, even if provided under a cafeteria plan. Employer contributions toward other cafeteria plan benefits and all employee salary reductions are Unemployment Insurance taxable.

 

MISSOURI - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

MISSOURI - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Missouri Rev. Stat. 376.777)

 

MISSOURI - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

MISSIOURI - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

MISSOURI - GROUP HEALTH CODE ADDITIONS (MANDATED)

Alcoholism Treatment: Policies covering hospital treatment must cover inpatient alcoholism treatment on the same basis as other illnesses for at least 30 days per benefit period. (Missouri Rev. Stat. Section 376.779.)

 

Breast Cancer Treatment: All policies must cover breast cancer treatment by dose intensive chemotherapy/autologous bone marrow transplants or stem cell transplants, performed to nationally accepted peer review protocols. Such treatment may not be subjected to higher deductibles or co-payments, although policies may impose a lifetime benefit limit of $100,000 for the transplants. Such treatments may be administered through managed care or preferred providers, as long as the contracts with the providers hold the patient harmless for the cost of the treatment if it is later found to not qualify under the protocols, was not medically appropriate, or failed to meet utilization review requirements. (S27, 1995) (Missouri Rev. Stat. Section 376.1200.)

 

Coverage Continuation and Conversion: Group policies must provide continuation and conversion rights to employees terminating employment for themselves and their dependents. (Missouri Rev. Stat. Sections 376.397, 376.401, 376.403, 376.428.) Group policies must provide continuation rights to employees for a reasonable time upon discontinuance of the policy. (Missouri Rev. Stat. Section 376.438.) Notice of Dissolution of Marriage or Death of Spouse: A legally separate or divorced spouse, whose COBRA benefits have been maintained must give notice of separation or dissolution of marriage to a plan administrator within 60 days of change of marital status. Also, a plan administrator must be given written notice from a surviving spouse of death of a husband or wife, whose COBRA benefits have been maintained, within 30 days of death. After receipt of notification, a plan administrator must inform the legally separated, divorced, or surviving spouse within 14 days that a policy will be continued. Failure of a spouse to provide notification in a timely manner will terminate a right to continue benefits. (H1217, 1996) (Missouri Rev. Stat. Section 376.893.)

 

Disclosure of Terms: HMOs and Managed Care Plans: Coverage required under these plans must be supplied in writing and prominently positioned in policies for all policyholders, insured persons, and participants. (H1069, 794, 807, ,936, 1128, 1153, 1202, 1996.) (Missouri Rev. Stat. Section 376.3995, 376.1210.)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while a child is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Missouri Rev. Stat. Sections 376.776, 426(16).)

 

Mammography Screening: All policies must cover low dose mammography screening for any non-symptomatic woman, including: a baseline mammogram for women ages 35 to 39; a mammogram for women ages 40 to 49 every two years (or more frequently on physician recommendation); a mammogram every year for women age 50 and over; and a mammogram for any woman, upon the recommendation of a physician, where the woman's mother or sister has a prior history of breast cancer. (S27, 1995) (Missouri Rev. Stat. Section 376.782.)

 

Maternity Benefits: Health care insurers, including HMOs and managed health care plans, which provide benefits for maternity care must supply inpatient hospital coverage for a mother and her newly born child for a minimum of 48 hours following a vaginal delivery and for a minimum of 96 hours following a Caesarean section. Insurers may, however, authorize shorter lengths of hospital stay for these services if the attending physician gives approval after consultation with a mother. Post-discharge care must be provided for mothers and newborns who receive early discharges; this care must consist of a minimum of two visits by a physician or by a registered professional nurse, and at least one of the visits must be conducted in the home. (H1069, 794, 807, 936, 1128, 1153, 1202, 1996.) (Missouri Rev. Stat. Section 376.995, 376.1210.)

 

Mental Health: Insurers must offer at least 30 days inpatient treatment and outpatient treatment of at least $1,500 per year with 50 percent coinsurance. (Missouri Rev. Stat. Section 376.381.) Drug abuse treatment: Insurers must offer coverage of residential and non-residential treatment of at least 80 percent of reasonable charges up to $2,000 per benefit period. (Missouri Rev. Stat. Section 376.779.2.) Speech and hearing disorders: Insurers must offer coverage for treatment of such disorders on the same basis as other illnesses. (Missouri Rev. Stat. Section 376.781.) Child health supervision: Insurers must offer policyholders with family coverage such coverage for children through age 12, including 15 physician visits. (Missouri Rev. Stat. Section 376.801.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects and birth abnormalities.

 

Policies for Small Employers: Policies for employers with 50 or fewer employees not previously covered by health insurance are exempt from Sections 376.779, 375.936 on alcoholism treatment and providers. (Missouri Rev. Stat. Section 376.995.) Disclosure of Terms: Health care providers which provide coverage to small employers may offer limited mandated health insurance policies under which certain health care laws are not applicable. Laws which are not enforceable under these policies include those relating to coverage of particular health care benefits, and those regulating health care reimbursement, utilization, and inclusion of specific categories of licensed practitioners. In addition, insurers must fully and clearly disclose plan provisions to persons or groups enrolled in these plans and to those engaged in sales, promotional, and advertising endeavors. Those persons enrolled in these plans must be informed that the reason for the less expensive premium payments is due to coverage restrictions. (H1069, 794, 807, 936, 1128, 1153, 1202, 1996.) (Missouri Rev. Stat. Section 376.995, 376.1210.)

 

Providers: Optometrists, chiropractors, dentists, psychologists, pharmacists, and podiatrists. Cost for services must be covered if the provider is licensed, the service is within the scope of services, and the service is covered by the policy. (Missouri Rev. Stat. Section 375.936(11)(b).)

 

MISSOURI - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

MISSOURI - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%

 

Minimum number of employees in group plan: No statutory requirements.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Missouri Rev. Stat. Sections 376.691, 376.697)

 

MISSOURI - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Lincoln's Birthday, Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If holiday falls on Sunday, following Monday is a holiday. (Missouri Rev. Stat. Sections 9.010-9.100)

 

MISSOURI - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

MISSOURI - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Employee can bring civil action within 90 days of discharge for lost wages, reinstatement and reasonable attorney fees.

 

Other Requirements: None reported. (Missouri Ann. Stat. Section 494.460.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: None reported.

 

MISSOURI - LEAVES OF ABSENCE

Employers Subject to Leave Laws: State employers.

 

Criteria for Eligibility: State employee adoptive parents who are primarily responsible for furnishing care of a child.

 

Maximum length of leave: Same leave that is granted to biological parents by employer.

 

Paid Leave: Leave may be with or without pay.

 

Acceptable Reasons for Leave: Adoption of child.

 

Employment Guarantees After Leave: Employer may not penalize employee for exercising right to take leave.

 

Use of Vacation or other Time-off Benefits: Employee may first use sick leave, annual leave, and leave without pay.

 

Certification Required: State reports no statutory requirements.

 

Effect Of Leave on Other Benefits: State reports no statutory requirements.

 

Effect of Seniority Accrual During Leave: State reports no statutory requirements.

 

Minimum Requirements for Notification to Employer: State reports no statutory requirements.

 

Conditions for Denial of a Request For Leave: State reports no statutory requirements.

 

(Missouri Rev. Stat. Sections 105.271.)

 

See U.S. Federal Family and Medical Leave Act

 

MISSOURI - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

MISSOURI - MANDATED PROVIDERS

Advanced practice nurses. (Mo. Rev. Stat. Section 376.407)

 

MISSOURI - MENTAL HEALTH CARE

Employer option.

 

Minimum yearly inpatient coverage: Inpatient: 30 days.

 

Minimum yearly outpatient coverage: Coverage at 50% up to $1,500.

 

(Missouri Rev. Stat. Section 376-381)

 

MISSOURI - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain professional, agriculture workers, domestics, outside sales, apprentices and handicapped workers in special environments. (Missouri Rev. Stat. Sections 290.500, 290.502, 290.507, 290.515, 290.517)

 

See U.S. Minimum Wage

 

MISSOURI - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All employees and new hires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: Withholding form.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and EIN.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: $25 for each time employer fails to submit the required information; $350 if failure is due to a conspiracy between employer and employee.

 

(Missouri Ann. Stat. Sections 285.300 through 385.304, as amended by Senate Bill No. 361)

 

MISSOURI - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Yes, employer option to age 12. Immunizations must be covered. (Missouri Rev. Stat. Sections 376.406, 376.426, 376.801, 376.816, 376.995)

 

MISSOURI - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

MISSOURI - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, plan shall not deny or limit benefits for a covered individual for losses incurred over 12 months following the effective date due to a pre-existing condition. (Missouri Rev. Stat. Sections 379.930 et seq.)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

MISSOURI - PROTECTED CLASSIFICATIONS

Age:   Yes, between 40 and 70.

Race:   Yes.

Color:   Yes.

National Origin: Yes.

Ancestry: Yes.

Religion:  Yes.

Sex:  Yes.

Pregnancy: Yes.

Sexual Harassment: Yes.

 

(Mo. Rev. Stat. Sections 213.010, 213.055, 213.070, 213.125; Mo. Code Regs. tit. 4, Section 180-3.050; Mo. Code Regs. tit. 8, Sections 60-3.040, 60-3.050, 60-3.070.)

 

MISSOURI - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

MISSOURI - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

MISSOURI - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Immediately.

 

Date due if employee resigns: Not specified.

 

Wages: Yes.

 

Vacation Pay: Yes. (Case law requires payment of vacation on termination, if that is the employer's policy.)

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(Missouri Rev. Stat. Section 290-110. See Solter V. P.M. Place Stores Co., 748 S.W. 2d 919 (MO Ct. App. 1988)

 

MISSOURI - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. On or before January 15 of rate year.

 

(Missouri Rev. Stat. Sections 288.090, 288.120, 288.125, 288.126, 288.130.)

 

MISSOURI - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

MISSOURI - VOTING TIME OFF

3 hours, provided employee does not have 3 consecutive hours away from work while the polls are open. (Missouri Ann. Stat. Sections 115.635, 115.639.)

 

MISSOURI - WORKERS' COMPENSATION

Private Employers: Mandatory to all employers of 5 or more employees. Elective for partners and sole proprietors. Mandatory as to construction industry employers of 1 or more employees. (Note: Employers who do not elect coverage are liable to suit with defenses abrogated. Also, corporations with 2 owners may elect to be exempt.)

 

Public Employers: Mandatory as to all public employments, including elected and appointed state officials; contractors of a public corporation, state militia, sheriffs and deputy sheriffs. Mandatory for workers on state welfare projects under Federal Economic Opportunity Act.

 

Exceptions: Farm labor, domestic servants, occasional labor for private household and qualified real estate agents; members of employer's family by marriage or consanguinity; inmates confined to a state prison; penitentiary, county or municipal jail; residents of mental health facilities; and unpaid volunteers of a tax-exempt organization.

 

Special Coverage Provisions: Voluntary as to exempt employments, employers of less than 5 employees, and salaried officers of Missouri farm corporations.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)