Missouri Department of Insurance

Jessica Hill / AP

Missouri became the first state to go on record opposing a proposed merger of insurance giants Humana and Aetna, saying the combination would create an anticompetitive market in the state for various lines of insurance.

A ruling late Tuesday by the Missouri Department of Insurance gives the two companies 30 days to address the department’s concerns. Otherwise, it said it would block them from offering individual, small-group and group Medicare Advantage plans in Missouri if the merger goes through.

Humana Insurance has agreed to pay a $161,800 fine for misleading policyholders, the Missouri Department of Insurance said Tuesday.

It’s the second time in less than a year that the department has slapped Humana with a penalty.

The latest fine stems from notices Humana sent to 1,618 policyholders, according to the department. The notices stated that, due to Missouri legislation, Humana was required to terminate their policies on Dec. 31, 2013, and replace them with new ones with 2014 benefits under the Affordable Care Act.

There is no such Missouri legislation.

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Saturday marks the last chance for Missouri residents to enroll in the federal high risk insurance pool.

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The Missouri Department of Insurance has issued its largest penalty to date, to health insurance company, Aetna.