Insurance company fined for violation of Mo. laws
Aetna Life Insurance Company has been fined $1.5 million by the state of Missouri for violating several state laws, including one that forbids health insurance policies from covering elective abortions.
The Missouri Department of Insurance, in a Sept. 26 statement, noted that it is the largest insurance fine in Missouri history. Aetna is Missouri's sixth largest health insurance company, with premium sales of $340 million in 2011.
In the settlement, Aetna admitted to several violations of Missouri law. They include:
• Aetna routinely provided coverage for elective abortions. A 1983 state law says that no health insurance policy "shall provide coverage for elective abortions except by an optional rider for which there must be paid an additional premium." An investigation by the Missouri Department of Insurance discovered that Aetna had been selling policies that included elective abortions as part of its coverage of maternity benefits.
• In some cases, Aetna provided coverage for contraceptives without allowing employers to opt out of coverage. A 2001 state law gives employers and employees the right to exclude this coverage. The law also allows an individual employee to be covered for contraceptives, if an employer excludes the coverage in the group plan.
• Aetna also excluded coverage for autism spectrum disorders, in violation of an autism insurance law signed by Gov. Jay Nixon in 2010;
The Missouri Catholic Conference, the public policy arm of the state's bishops, noted in a Sept. 27 statement that Aetna's practice of bundling elective abortion coverage into health plans came to light during a public hearing on SB 749, the religious liberty bill that recently was enacted into law over Nixon's veto.
During an April hearing before the Missouri House Insurance Committee, Kansas City attorney Woody Cozad noted that one of his clients was unaware that abortion coverage has been included in the policy sold to the company.
"When state insurance officials heard that testimony they undertook an investigation," said Mike Hoey, executive director of the MCC.
Under the terms of the settlement made with the Missouri Department of Insurance, Aetna has agreed to stop issuing health insurance policies in violation of Missouri law; pay a $1.5 million penalty; notify customers that they were entitled to coverage for treatment of autism and accept claims for treatments received since the 2010 law went into effect; and donate $250,000 to a Missouri nonprofit organization specializing in the care and treatment of autism spectrum disorders.
"When the Aetna situation came to light, we worked with legislators to add even stronger provisions to SB 749," said Hoey of the MCC. "Now under the new law, even if a company wants coverage for elective abortions and pays for it with an additional rider, employees of that company have a right to exclude and not pay for that coverage in their premium."
SB 749 also adds a provision that makes sure customers know beforehand whether a policy is proposed by a company is to include contraceptive coverage. "People have a right to know what the insurance company is trying to sell them," said Hoey.
"The new SB 749 law really completes the work of earlier law so that the moral and religious beliefs of all Missouri citizens are respected when they buy insurance," he said.
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