Advertising not to be untrue or misleading--deceptivesolicitation--prohibited--how determined.
354.460. No health maintenance organization, or representativethereof, may cause or knowingly permit the use of advertising which isuntrue or misleading, solicitation which is untrue or misleading, or anyform of evidence of coverage which is deceptive. For purposes of sections354.400 to 354.636:
(1) A statement or item of information shall be deemed to be untrueif it does not conform to fact in any respect which is or may besignificant to an enrollee of, or person considering enrollment with, ahealth maintenance organization;
(2) A statement or item of information shall be deemed to bemisleading, whether or not it may be literally untrue, if, in the totalcontext in which such statement is made or such item of information iscommunicated, such statement or item of information may be reasonablyunderstood by a reasonable person, not possessing special knowledgeregarding health care coverage, as indicating any benefit or advantage orthe absence of any exclusion, limitation, or disadvantage of possiblesignificance to an enrollee of, or person considering enrollment in, ahealth maintenance organization plan, if such benefit, advantage, orabsence of limitation, exclusion, or disadvantage does not, in fact, exist;
(3) An evidence of coverage shall be deemed to be deceptive if theevidence of coverage, taken as a whole, is misleading.
Advertising not to be untrue or misleading--deceptivesolicitation--prohibited--how determined.
354.460. No health maintenance organization, or representativethereof, may cause or knowingly permit the use of advertising which isuntrue or misleading, solicitation which is untrue or misleading, or anyform of evidence of coverage which is deceptive. For purposes of sections354.400 to 354.636:
(1) A statement or item of information shall be deemed to be untrueif it does not conform to fact in any respect which is or may besignificant to an enrollee of, or person considering enrollment with, ahealth maintenance organization;
(2) A statement or item of information shall be deemed to bemisleading, whether or not it may be literally untrue, if, in the totalcontext in which such statement is made or such item of information iscommunicated, such statement or item of information may be reasonablyunderstood by a reasonable person, not possessing special knowledgeregarding health care coverage, as indicating any benefit or advantage orthe absence of any exclusion, limitation, or disadvantage of possiblesignificance to an enrollee of, or person considering enrollment in, ahealth maintenance organization plan, if such benefit, advantage, orabsence of limitation, exclusion, or disadvantage does not, in fact, exist;
(3) An evidence of coverage shall be deemed to be deceptive if theevidence of coverage, taken as a whole, is misleading.
Advertising not to be untrue or misleading--deceptivesolicitation--prohibited--how determined.
354.460. No health maintenance organization, or representativethereof, may cause or knowingly permit the use of advertising which isuntrue or misleading, solicitation which is untrue or misleading, or anyform of evidence of coverage which is deceptive. For purposes of sections354.400 to 354.636:
(1) A statement or item of information shall be deemed to be untrueif it does not conform to fact in any respect which is or may besignificant to an enrollee of, or person considering enrollment with, ahealth maintenance organization;
(2) A statement or item of information shall be deemed to bemisleading, whether or not it may be literally untrue, if, in the totalcontext in which such statement is made or such item of information iscommunicated, such statement or item of information may be reasonablyunderstood by a reasonable person, not possessing special knowledgeregarding health care coverage, as indicating any benefit or advantage orthe absence of any exclusion, limitation, or disadvantage of possiblesignificance to an enrollee of, or person considering enrollment in, ahealth maintenance organization plan, if such benefit, advantage, orabsence of limitation, exclusion, or disadvantage does not, in fact, exist;
(3) An evidence of coverage shall be deemed to be deceptive if theevidence of coverage, taken as a whole, is misleading.
