354.095. Limitation of membership and benefits — certain benefits to be provided, when.

308 words·~1 min read·/mo/chapter-354/354-095

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

354.095. Limitation of membership and benefits — certain benefits to be provided, when. — 1. A corporation subject to the provisions of sections 354.010 to 354.380 may, in the discretion of its board of directors, limit or define the classes of persons who shall be eligible to become members or beneficiaries, limit and define the benefits which it will furnish, and may define such benefits as it undertakes to furnish into classes or kinds. It may make available to its members or beneficiaries such health services, or reimbursement therefor, as the board of directors of any such corporation may approve; if maternity benefits are provided to any members of any plan, then maternity benefits shall be provided to any member of such plan without discrimination as to whether the member is married or unmarried, and if maternity benefits are provided to a beneficiary of any plan, then maternity benefits shall be provided to such beneficiary of such plan without discrimination as to whether the beneficiary is married or unmarried.

2. If an ambulatory surgical facility as defined by subdivision

(2)* of section 197.200 , has received a certificate of need as provided in chapter 197 , a health services corporation shall provide benefits to the facility on the same basis as it does to all other health care facilities, whether contracting members or noncontracting members. A health services corporation shall use the same standards that are applied to any other health care facility within the same health services area in defining the benefits that the corporation will furnish to the ambulatory surgical facility, the classes to which such benefits will be furnished, and the amount of reimbursement.

--------

(L. 1973 S.B. 3 § 18, A.L. 1981 S.B. 185, A.L. 1983 H.B. 127)

*In 2017 statutory reference to subdivision "(1)" changed to "(2)" in accordance with section 3.060.