reglab/housing_qa huggingface dataset:
FL Stat § 627.666 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.666 - Liability of succeeding insurer on replacement of group, blanket, or franchise health insurance policy.

627.666 Liability of succeeding insurer on replacement of group, blanket, or franchise health insurance policy.—Upon replacement of a group, blanket, or franchise health insurance policy:(1) Each person who was covered by the prior insurer must be covered by the succeeding insurer; however, the prior insurer is liable for any extension of benefits in accordance with s. 627.667.(2) The succeeding insurer, in applying any deductible, out-of-pocket limitation, or waiting period in its plan, shall give credit for the satisfaction or partial satisfaction of the same or similar provisions under a prior plan. As to deductible provisions, the credit applies for expenses actually incurred and applied against the deductible provisions of the prior insurer’s plan during the 90 days preceding the effective date of the succeeding insurer’s plan, but only to the extent that the expenses actually incurred are recognized under the terms of the succeeding insurer’s plan and are subject to a similar deductible provision.(3) If a determination of the prior insurer’s benefit is required by the succeeding insurer, the prior insurer shall, at the succeeding insurer’s request, furnish a statement of the benefits available or pertinent information sufficient to permit verification of the benefit determination, or the determination itself, by the succeeding insurer. For the purposes of this subsection, benefits of the prior plan must be determined in accordance with all of the definitions, conditions, and covered expense provisions of the prior plan, rather than in accordance with the comparable provisions of the succeeding plan. The benefit determination must be made as if coverage had not been replaced by the succeeding insurer.(4) This section also applies upon the issuance of an insurance policy to a group whose benefits had previously been self-insured or to a self-insurer providing coverage to a group that had been previously covered by an insurer or another self-insurer.History.—s. 5, ch. 75-279; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 5, 6, 10, ch. 80-341; ss. 2, 3, ch. 81-318; ss. 517, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; ss. 68, 114, ch. 92-318.
FL Stat § 627.669 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.669 - Optional coverage required for substance abuse impaired persons; exception.

627.669 Optional coverage required for substance abuse impaired persons; exception.—(1) Insurers, health maintenance organizations, and nonprofit health care services plans transacting group health insurance or providing prepaid health care in this state shall make available to the policyholder as part of the application for any such policy of insurance issued or delivered in this state or contract executed or operative in this state the level of benefits specified in subsection (2) for the necessary care and treatment of substance abuse impaired persons, subject to the right of the applicant for a group policy or contract to select any alternative benefits or level of benefits as may be offered by the insurer, health maintenance organization, or plan. For the purposes of this section, the term “substance abuse impaired” has the same meaning ascribed in s. 397.311.(2) Inpatient benefits or outpatient benefits shall consist of:(a) Basic benefit.—Intensive treatment program for the treatment of substance abuse impaired persons.(b) Limitations.—1. Benefits shall be available only to covered individuals in a group health plan.2. There shall be a minimum lifetime benefit of $2,000.3. There shall be allowable a maximum of 44 outpatient visits.4. The maximum benefit payable for an outpatient visit shall not exceed $35.5. Detoxification shall not be considered as a benefit under the outpatient program.(3) The benefits provided under this section are applicable only if treatment is provided by, or under the supervision of, or is prescribed by, a licensed physician or licensed psychologist and if services are provided in a program that is accredited by an accrediting organization whose standards incorporate comparable regulations required by this state or that is approved by this state.History.—ss. 1, 2, 3, ch. 79-392; s. 2, ch. 81-318; ss. 522, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 83-216; s. 114, ch. 92-318; s. 35, ch. 93-39; s. 13, ch. 2013-93.
FL Stat § 627.6691 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.6691 - Coverage for osteoporosis screening, diagnosis, treatment, and management.

627.6691 Coverage for osteoporosis screening, diagnosis, treatment, and management.—Any group, blanket, or franchise health insurance policy that covers a resident of this state and that is issued, amended, delivered, or renewed in this state after October 1, 1996, must provide coverage for the medically necessary diagnosis and treatment of osteoporosis for high-risk individuals, including, but not limited to, estrogen-deficient individuals who are at clinical risk for osteoporosis, individuals who have vertebral abnormalities, individuals who are receiving long-term glucocorticoid (steroid) therapy, individuals who have primary hyperparathyroidism, and individuals who have a family history of osteoporosis. This section does not apply to specified-accident, specified-disease, hospital-indemnity, Medicare supplement, or long-term-care health insurance policies or to the state employee health insurance program.History.—s. 3, ch. 96-282.
FL Stat § 627.66911 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.66911 - Required coverage for cleft lip and cleft palate.

627.66911 Required coverage for cleft lip and cleft palate.—A health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for the child. The coverage must include medical, dental, speech therapy, audiology, and nutrition services only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to treatment of the cleft lip or cleft palate. The coverage required by this section is subject to terms and conditions applicable to other benefits. This section does not apply to specified-accident, specified-disease, hospital indemnity, limited benefit disability income, or long-term care insurance policies.History.—s. 3, ch. 98-66.
FL Stat § 627.6698 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.6698 - Attorney’s fees.

627.6698 Attorney’s fees.—(1) Upon the rendition of a judgment by any of the courts of this state against an insurer and in favor of any resident of this state who is one of a group of persons insured under a master group health insurance policy executed by the insurer and covering residents of this state, whether issued or delivered inside or outside this state, the trial court or, in the event of an appeal in which the insured prevails, the appellate court shall award the insured a reasonable attorney’s fee. However, attorney’s fees shall not be allowed if the suit was commenced prior to the expiration of 60 days after proof of the claim was duly filed with the insurer.(2) When so awarded, the attorney’s fee shall be included in the judgment or decree rendered in the case.History.—ss. 2, 3, ch. 87-278; s. 114, ch. 92-318.
FL Stat § 627.66996 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.66996 - Restrictions on use of state and federal funds for state exchanges.

627.66996 Restrictions on use of state and federal funds for state exchanges.—(1) A group, franchise, or blanket health insurance policy under which coverage is purchased in whole or in part with any state or federal funds through an exchange created pursuant to the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, may not provide coverage for an abortion as defined in s. 390.011(1), except if the pregnancy is the result of an act of rape or incest, or in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, which would, as certified by a physician, place the woman in danger of death unless an abortion is performed. Coverage is deemed to be purchased with state or federal funds if any tax credit or cost-sharing credit is applied toward the group, franchise, or blanket health insurance policy.(2) This section does not prohibit a group, franchise, or blanket health insurance policy from offering separate coverage for an abortion if such coverage is not purchased in whole or in part with state or federal funds.(3) As used in this section, the term “state” means this state or any political subdivision of the state.History.—s. 2, ch. 2011-111.
FL Stat § 627.66997 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)|627.66997 - Stop-loss insurance.

627.66997 Stop-loss insurance.—(1) A self-insured health benefit plan established or maintained by a small employer, as defined in s. 627.6699(3)(v), is exempt from s. 627.6699 and may use a stop-loss insurance policy issued to the employer. For purposes of this subsection, the term “stop-loss insurance policy” means an insurance policy issued to a small employer which covers the small employer’s obligation for the excess cost of medical care on an equivalent basis per employee provided under a self-insured health benefit plan.(a) A small employer stop-loss insurance policy is considered a health insurance policy and is subject to s. 627.6699 if the policy has an aggregate attachment point that is lower than the greatest of:1. Two thousand dollars multiplied by the number of employees;2. One hundred twenty percent of expected claims, as determined by the stop-loss insurer in accordance with actuarial standards of practice; or3. Twenty thousand dollars.(b) Once claims under the small employer health benefit plan reach the aggregate attachment point set forth in paragraph (a), the stop-loss insurance policy authorized under this section must cover 100 percent of all claims that exceed the aggregate attachment point.(2) A self-insured health benefit plan established or maintained by an employer with 51 or more covered employees is considered health insurance if the plan’s stop-loss coverage, as defined in former s. 627.6482(14), has an aggregate attachment point that is lower than the greater of:(a) One hundred ten percent of expected claims, as determined by the stop-loss insurer in accordance with actuarial standards of practice; or(b) Twenty thousand dollars.(3) Stop-loss insurance carriers shall use a consistent basis for determining the number of an employer’s covered employees. Such basis may include, but is not limited to, the average number of employees employed annually or at a uniform time.History.—s. 2, ch. 2015-121; s. 21, ch. 2016-11.
FL Stat § 627.671 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.671 - Medicare supplement reform; short title.

627.671 Medicare supplement reform; short title.—Sections 627.671-627.675 may be cited as the “Alonzo Mourning Access to Care Act.”History.—s. 4, ch. 80-156; s. 2, ch. 81-318; ss. 527, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 92-318; s. 1, ch. 2009-141.
FL Stat § 627.672 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.672 - Definitions.

627.672 Definitions.—For the purposes of ss. 627.671-627.675:(1) A “Medicare supplement policy” is a health insurance policy or other health benefit plan offered by a private entity to individuals who are entitled to have payments for health care costs made under Medicare, Title XVIII of the Social Security Act (“Medicare”), as presently constituted and as may later be amended, which provides reimbursement for expenses incurred for services and items for which payment may be made under Medicare but which expenses are not reimbursable by reason of the applicability of deductibles, coinsurance amounts, or other limitations imposed by Medicare. The term does not include any such policy or plan of one or more labor organizations, or of the trustees of a fund established by one or more labor organizations, or a combination thereof, for employees or former employees, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations.(2) The term “policy” includes a certificate issued or delivered in this state under a group Medicare supplement policy which has been effectuated within or outside this state.(3) “Applicant” means:(a) In the case of an individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and(b) In the case of a group Medicare supplement policy or subscriber contract, the proposed certificateholder.History.—s. 5, ch. 80-156; s. 2, ch. 81-318; ss. 524, 527, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 5, ch. 86-271; s. 1, ch. 88-338; s. 114, ch. 92-318; s. 1, ch. 2000-202.
FL Stat § 627.673 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.673 - Designation as Medicare supplement policy; penalties for violations.

627.673 Designation as Medicare supplement policy; penalties for violations.—(1) An individual, group, blanket, or franchise health insurance policy may not be delivered or issued for delivery in this state as a Medicare supplement policy unless it complies with this part.(2) A violation of this part is punishable under s. 624.4211. In addition, the office may require insurers violating this part to cease marketing any Medicare supplement policy in this state which is related directly or indirectly to a violation of this part, or the office may require the insurer to take any action necessary to comply with this part.(3) This part does not prohibit or apply to insurance policies or health care benefit plans, including group conversion policies, provided to Medicare eligible persons if the policies are not marketed or held to be Medicare supplement policies or benefit plans.(4) The loss ratio requirement applicable to Medicare supplement policies that was in effect at the time of issuance of the policy applies to policies that were issued as Medicare supplement policies and have been redefined as limited benefit policies.History.—s. 6, ch. 80-156; s. 2, ch. 81-318; ss. 525, 527, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 2, ch. 88-338; s. 1, ch. 90-257; ss. 139, 149, ch. 92-33; s. 114, ch. 92-318; s. 1171, ch. 2003-261.
FL Stat § 627.6735 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.6735 - Order to discontinue certain advertising.

627.6735 Order to discontinue certain advertising.—An insurer must file with the office all advertisements for Medicare supplement policies pursuant to rules adopted by the commission. If, in the opinion of the office, any advertisement by a Medicare supplement policy insurer violates any of the provisions of part IX of chapter 626 or any rule of the commission, the office may enter an immediate order requiring that the use of the advertisement be discontinued. If requested by the insurer, the office shall conduct a hearing within 10 days of the entry of such order. If, after the hearing or by agreement with the insurer, a final determination is made that the advertising was in fact violative of any provision of part IX of chapter 626 or of any rule of the commission, the office may, in lieu of revocation of the certificate of authority, require the publication of a corrective advertisement; impose an administrative penalty of up to $10,000; and, in the case of an initial solicitation, require that the insurer, prior to accepting any application received in response to the advertisement, provide an acceptable clarification of the advertisement to each individual applicant.History.—ss. 6, 7, ch. 86-271; s. 93, ch. 89-360; s. 114, ch. 92-318; s. 61, ch. 2001-63; s. 1172, ch. 2003-261.
FL Stat § 627.6736 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.6736 - Filing requirements for out-of-state group policies.

627.6736 Filing requirements for out-of-state group policies.—An insurer providing group Medicare supplement insurance benefits to a resident of this state shall file a copy of the master policy and any certificate used in this state in accordance with ss. 627.410 and 627.411, as if the policy were to be issued in this state.History.—s. 3, ch. 88-338; s. 1, ch. 89-296; s. 2, ch. 90-257; ss. 140, 149, ch. 92-33; s. 114, ch. 92-318.
FL Stat § 627.6737 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.6737 - Reporting of multiple policies.

627.6737 Reporting of multiple policies.—(1) On or before March 1, every insurer or other entity providing Medicare supplement insurance coverage in this state shall report the following information for every individual resident of this state for which the insurer or entity has in force more than one Medicare supplement insurance policy or certificate:(a) Policy and certificate number.(b) Date of issuance.(2) The items set forth above must be grouped by individual policyholder.History.—s. 3, ch. 90-257; s. 114, ch. 92-318.
FL Stat § 627.6742 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.6742 - Permitted compensation arrangements.

627.6742 Permitted compensation arrangements.—(1) The commission shall adopt rules governing the permitted compensation arrangements between insurers and agents with respect to Medicare supplement policies.(2) The rules shall be based upon the format, interrelationships, and parameters relating to compensation arrangements as set forth in the NAIC Medicare Supplement Insurance Minimum Standards Model Act and Regulations adopted by the National Association of Insurance Commissioners on July 31, 1991.History.—s. 6, ch. 90-257; s. 18, ch. 91-201; ss. 143, 149, ch. 92-33; s. 114, ch. 92-318; s. 1175, ch. 2003-261.
FL Stat § 627.6743 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VIII - Medicare Supplement Policies (Ss. 627.671-627.675)|627.6743 - Standards for marketing.

627.6743 Standards for marketing.—(1) Every insurer, health care service plan, or other entity marketing Medicare supplement insurance coverage in this state, directly or through its producers, shall:(a) Establish marketing procedures to assure that any comparison of policies by its agents or other producers will be fair and accurate.(b) Establish marketing procedures to assure excessive insurance is not sold or issued.(c) Display prominently by type, stamp, or other appropriate means, on the first page of the outline of coverage and policy, the following:“Notice to buyer: This policy may not cover all of the costs associated with medical care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations.”(d) Inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee for Medicare supplement insurance already has accident and sickness insurance and the types and amounts of any such insurance.(2) Every insurer or entity marketing Medicare supplement insurance shall establish auditable procedures for verifying compliance with this subsection.(3) In addition to the practices prohibited in s. 626.9541, the following acts and practices are prohibited:(a) Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance policies or insurers for the purpose of inducing, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on, or convert any insurance policy or to take out a policy of insurance with another insurer.(b) Employing any method of marketing having the effect of or tending to induce the purchase of insurance through force, fright, threat whether explicit or implied, or undue pressure to purchase or recommend the purchase of insurance.(c) Making use directly or indirectly of any method of marketing which fails to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contact will be made by an insurance agent or insurance company.History.—s. 7, ch. 90-257; s. 18, ch. 91-20; s. 114, ch. 92-318.