A health insurer has agreed to pay Missouri $4.5 million for covering certain elective abortions and failing to cover some autism treatments.

Gov. Jay Nixon on Tuesday announced the settlement with Aetna, which he says includes the largest fine ever for insurance law violations.

At issue is a 1983 law requiring that women buy additional riders in order for elective abortions to be covered. Aetna reported that it paid for nine abortions for women without riders after it had agreed in 2012 to not violate the law following similar violations.

The company also says it sometimes failed to cover treatments for autism as required by a 2010 law.

Aetna spokesman Rohan Hutchings says autism treatments now are covered in all policies. He says claims for abortions now undergo additional vetting.

governor.mo.gov