reglab/housing_qa huggingface dataset:
FL Stat § 636.018 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.018 - Changes in rates and benefits; material modifications; addition of limited health services.

636.018 Changes in rates and benefits; material modifications; addition of limited health services.—(1)(a) No prepaid limited health services contract, certificate of coverage, application, enrollment form, rider, endorsement, and applicable rates to be charged may be delivered in this state unless the forms and rates have been filed with the office by or on behalf of the prepaid limited health service organization and have been approved by the office. Every form filed shall be identified by a unique form number placed in the lower left corner of each form. If a prepaid limited health service organization desires to amend any contract with its subscribers or any certificate or member handbook, or desires to change any rate charged for the contract or to change any basic prepaid limited health services contract, certificate, grievance procedure, or member handbook form, or application form where written application is required and is to be made a part of the contract, or printed amendment, addendum, rider, or endorsement form or form renewal certificate, it must file such changes 30 days prior to the effective date of the proposed change. At least 30 days’ written notice must be provided to the subscriber before application of any approved change in rates. In the case of a group enrollee, there may be a contractual agreement with the prepaid limited health service organization to have the contract holder provide the required notice to the individual enrollees of the group. Any proposed change must contain information as required by s. 636.017.(b) The prepaid limited health service organization’s certification must be prepared by an independent actuary or a qualified employee. The chief executive officer of the prepaid limited health service organization must review and sign the certification indicating her or his agreement with its conclusions. Following receipt of notice of any disapproval or withdrawal of approval, no prepaid limited health service organization may issue or use any form disapproved by the office or as to which the office has withdrawn approval.(2) If such filings are disapproved, the office shall notify the prepaid limited health service organization and shall specify the reasons for disapproval in the notice. The prepaid limited health service organization has 21 days from the date of receipt of notice to request a hearing before the office pursuant to chapter 120.History.—s. 15, ch. 93-148; s. 486, ch. 97-102; s. 1531, ch. 2003-261.
FL Stat § 636.019 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.019 - Additional contract contents.

636.019 Additional contract contents.—A prepaid limited health services contract may contain additional provisions not inconsistent with this act which are:(1) Necessary because of the manner in which the organization is constituted or operated in order to state the rights and obligations of the parties to the contract; or(2) Desired by the organization and neither prohibited by law nor in conflict with any provisions required to be included.History.—s. 16, ch. 93-148.
FL Stat § 636.0201 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.0201 - Genetic information restrictions.

636.0201 Genetic information restrictions.—A prepaid limited health service organization must comply with the provisions of s. 627.4301.History.—s. 4, ch. 97-182.
FL Stat § 636.022 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.022 - Restrictions upon expulsion or refusal to issue or renew contract.

636.022 Restrictions upon expulsion or refusal to issue or renew contract.—A prepaid limited health service organization may not expel or refuse to renew the coverage of or refuse to enroll any individual member of a subscriber group on the basis of the race, color, creed, handicap, marital status, sex, or national origin of the subscriber or individual. A prepaid limited health service organization may not expel or refuse to renew the coverage of any individual member of a subscriber group on the basis of the age or health status of the subscriber or individual. For group solicitations, a prepaid limited health service organization may preunderwrite to determine group acceptability. However, once a contract is issued, a prepaid limited health service organization must provide coverage to all existing enrollees and their dependents, and newly employed enrollees and their dependents who have enrolled within 30 days of eligibility or membership. Late enrollees who apply during other than an open enrollment period may be subject to evidence of insurability requirements of the prepaid limited health service organization. Nothing in this section prohibits a prepaid limited health service organization from requiring that, as a condition of continued eligibility for membership, dependents of a subscriber upon reaching a specified age convert to a converted contract. Coverage must continue to be provided to handicapped children who are incapable of self-sustaining employment by reason of mental or physical handicap, and substantially dependent upon the enrollee for support and maintenance.History.—s. 17, ch. 93-148.
FL Stat § 636.023 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.023 - Charter; bylaw provisions.

636.023 Charter; bylaw provisions.—No prepaid limited health services contract may contain any provision purporting to make any portion of the articles of incorporation, charter, bylaws, or other organizational document of the prepaid limited health service organization a part of the contract unless the provision is set forth in full in the contract. Any contract provision in violation of this section is invalid unless the provision operates to the benefit of the subscriber.History.—s. 18, ch. 93-148.
FL Stat § 636.024 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.024 - Execution of contracts.

636.024 Execution of contracts.—(1) Every prepaid limited health services contract must be executed in the name of and on behalf of the prepaid limited health service organization by its officer, attorney in fact, employee, or representative duly authorized by the organization.(2) A facsimile signature of any executing individual may be used in lieu of an original signature.(3) No prepaid limited health services contract which is otherwise valid is rendered invalid by reason of the apparent execution thereof on behalf of the prepaid limited health service organization by the imprinted facsimile signature of an individual not authorized so to execute as of the date of the contract.History.—s. 19, ch. 93-148.
FL Stat § 636.025 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.025 - Validity of noncomplying contracts.

636.025 Validity of noncomplying contracts.—(1) Any prepaid limited health services contract rider, endorsement, attachment, or addendum otherwise valid which contains any condition or provision not in compliance with the requirements of this act is not thereby rendered invalid, but must be construed and applied in accordance with such conditions and provisions as they would have applied had such contract, rider, endorsement, attachment, or addendum been in full compliance with this act. If an organization issues or delivers any contract for an amount which exceeds any limitations otherwise provided in this act, such organization is liable to the subscriber or his or her beneficiary for the full amount stated in the contract in addition to any other penalties that may be imposed under this act.(2) Any prepaid limited health services contract delivered or issued for delivery in this state covering a subscriber, which subscriber pursuant to the provisions of this act the organization may not lawfully cover under the contract, is cancelable at any time by the organization, any provision of the contract to the contrary notwithstanding, and the organization must promptly cancel the contract in accordance with the request of the office therefor. No such illegality or cancellation may be deemed to relieve the organization of any liability incurred by it under the contract while in force or to prohibit the organization from retaining the pro rata earned premium or rate thereon. This subsection does not relieve the organization from any penalty otherwise incurred by the organization under this act for any such violation.History.—s. 20, ch. 93-148; s. 487, ch. 97-102; s. 1532, ch. 2003-261.
FL Stat § 636.026 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.026 - Construction of contracts.

636.026 Construction of contracts.—Every prepaid limited health services contract must be construed according to the entirety of its terms and conditions as set forth in the contract and as amplified, extended, or modified by any application, endorsement, attachment, or addendum.History.—s. 21, ch. 93-148.
FL Stat § 636.027 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.027 - Delivery of contract.

636.027 Delivery of contract.—Unless delivered upon execution or issuance, a prepaid limited health services contract, certificate of coverage, or member handbook must be mailed or delivered to the subscriber or, in the case of a group prepaid limited health services contract, to the employer or other person who will hold the contract on behalf of the subscriber group, prior to the effective date of coverage by the prepaid limited health service organization. However, if the employer who will hold the contract on behalf of the subscriber group requires retroactive enrollment of a subscriber, the organization must deliver the contract certificate or member handbook to the subscriber within 10 days after receiving notice from the employer of the retroactive enrollment.History.—s. 22, ch. 93-148.
FL Stat § 636.028 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.028 - Notice of cancellation of contract.

636.028 Notice of cancellation of contract.—Except for nonpayment of premium or termination of eligibility, a prepaid limited health service organization may not cancel or otherwise terminate or fail to renew a prepaid limited health services contract without giving the subscriber at least 45 days’ notice in writing of the cancellation, termination, or nonrenewal of the contract. The written notice must state the reason or reasons for the cancellation, termination, or nonrenewal. The only reasons for cancellation at such time other than the renewal period shall be as follows:(1) The subscriber’s behavior is disruptive, unruly, abusive, unlawful, fraudulent, or uncooperative to the extent that the subscriber’s continuing participation seriously impairs the organization’s ability to provide services to other subscribers.(2) Fraud or material misrepresentation in applying for or presenting any claim for benefits under the contract.(3) Misuse of the documents provided as evidence of benefits available pursuant to the contract.(4) Furnishing to the organization, by the subscriber, incorrect or incomplete information for the purposes of fraudulently obtaining services.Prior to disenrollment, the organization must make an effort to resolve the problem through the grievance procedure and must determine that the subscriber’s behavior is not due to use of the services provided or mental illness. All prepaid limited health services contracts must contain a clause which requires that this notice be given. In the case of a prepaid limited health services contract issued to an employer holding the contract on behalf of the subscriber group, the prepaid limited health service organization may make the notification through the employer, and, if the prepaid limited health service organization elects to take this action through the employer, the organization shall be deemed to have complied with the provisions of this section upon notifying the employer of the requirements of this section and requesting the employer to forward the required notice to all subscribers.History.—s. 23, ch. 93-148.
FL Stat § 636.029 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.029 - Construction and relationship with other laws.

636.029 Construction and relationship with other laws.—(1) No other provision of the insurance code applies to a prepaid limited health service organization unless such an organization is specifically mentioned therein.(2) Except as provided in this act, the insurance code does not apply to prepaid limited health service organizations certificated under this act. Any person, entity, or prepaid limited health service organization operating without a subsisting certificate of authority in violation of this act or rules adopted thereunder, in addition to being subject to the provisions of this act, is subject to the provisions of the insurance code.(3) The department and office are vested with all powers granted to them under the insurance code with respect to the investigation of any violation of this act within their respective regulatory jurisdictions.History.—s. 24, ch. 93-148; s. 1533, ch. 2003-261; s. 131, ch. 2004-5.
FL Stat § 636.032 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.032 - Acceptable payments.

636.032 Acceptable payments.—Each prepaid limited health service organization may accept from government agencies, corporations, groups, or individuals payments covering all or part of the cost of contracts entered into between the prepaid limited health service organization and its subscribers.History.—s. 25, ch. 93-148.
FL Stat § 636.033 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.033 - Certain words prohibited in name of organization.

636.033 Certain words prohibited in name of organization.—(1) No entity certificated as a prepaid limited health service organization, other than a licensed insurer or health maintenance organization insofar as its name is concerned, may use in its name, contracts, or literature any of the words “insurance,” “casualty,” “surety,” “mutual,” or “HMO,” or any other words descriptive of the insurance, casualty, HMO, or surety business or deceptively similar to the name or description of any insurance, HMO, or surety corporation doing business in the state.(2) No person, entity, or health care plan not certificated under the provisions of this act may use in its name, logo, contracts, or literature the phrase “prepaid limited health services contract” or the initials “PLHSC” to imply, directly or indirectly, that it is a prepaid limited health service organization or hold itself out to be a prepaid limited health service organization.History.—s. 26, ch. 93-148.
FL Stat § 636.034 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.034 - Extension of benefits.

636.034 Extension of benefits.—Every prepaid limited health services contract must provide that termination of the contract by the prepaid limited health service organization is without prejudice to any continuous loss which commenced while the contract was in force. Extension of benefits beyond the period the contract was in force must be until the specific treatment or procedure undertaken upon any subscriber has been completed or for 90 days, whichever is the lesser period of time.History.—s. 27, ch. 93-148.
FL Stat § 636.036 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.036 - Administrative, provider, and management contracts.

636.036 Administrative, provider, and management contracts.—(1) The office may require a prepaid limited health service organization to submit any contract for administrative services, contract with a provider physician, contract for management services, or contract with an affiliated entity to the office if the office has information that the prepaid limited health service organization has entered into a contract which requires it to pay a fee which is unreasonably high in relation to the service provided.(2) After review of a contract, the office may order the prepaid limited health service organization to cancel the contract if it determines that the fees to be paid by the prepaid limited health service organization under the contract are so unreasonably high as compared with similar contracts entered into by the prepaid limited health service organization in similar circumstances that the contract is detrimental to the subscribers, stockholders, investors, or creditors of the prepaid limited health service organization.(3) All contracts for administrative services, management services, or provider services or contracts with affiliated entities, entered into or renewed by a prepaid limited health service organization on or after October 1, 1993, must contain a provision that the contract will be canceled upon issuance of an order by the office pursuant to this section.History.—s. 29, ch. 93-148; s. 1534, ch. 2003-261.
FL Stat § 636.037 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.037 - Contract providers.

636.037 Contract providers.—Each prepaid limited health service organization must, upon the request of the office, file financial statements for all contract providers of limited health care services who have assumed through capitation or other means more than 10 percent of the health care risks of the prepaid limited health service organization.History.—s. 30, ch. 93-148; s. 1535, ch. 2003-261.
FL Stat § 636.038 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.038 - Complaint system; annual report.

636.038 Complaint system; annual report.—(1) Every prepaid limited health service organization must establish and maintain a complaint system providing reasonable procedures for resolving written complaints initiated by enrollees and providers. This section does not preclude an enrollee or a provider from filing a complaint with the department or office or limit the department’s or office’s ability to investigate such complaints.(2) Every prepaid limited health service organization shall report annually to the department and office the total number of grievances handled, a categorization of the cases underlying the grievances, and the final disposition of the grievances.History.—s. 31, ch. 93-148; s. 2, ch. 98-156; s. 1536, ch. 2003-261.
FL Stat § 636.039 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.039 - Examination by the office.

636.039 Examination by the office.—The office shall examine the affairs, transactions, accounts, business records, and assets of any prepaid limited health service organization, in the same manner and subject to the same terms and conditions that apply to insurers under part II of chapter 624, as often as it deems it expedient for the protection of the people of this state, but not less frequently than once every 3 years. In lieu of making its own financial examination, the office may accept an independent certified public accountant’s audit report prepared on a statutory accounting basis consistent with this act. However, except when the medical records are requested and copies furnished pursuant to s. 456.057, medical records of individuals and records of physicians providing service under contract to the prepaid limited health service organization are not subject to audit, but may be subject to subpoena by court order upon a showing of good cause. For the purpose of examinations, the office may administer oaths to and examine the officers and agents of a prepaid limited health service organization concerning its business and affairs. The expenses of examination of each prepaid limited health service organization by the office are subject to the same terms and conditions as apply to insurers under part II of chapter 624. Expenses of all examinations of a prepaid limited health service organization may never exceed a maximum of $20,000 for any 1-year period.History.—s. 32, ch. 93-148; s. 160, ch. 98-166; s. 221, ch. 2000-160; s. 1537, ch. 2003-261.
FL Stat § 636.042 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations|Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)|636.042 - Assets, liabilities, and investments.

636.042 Assets, liabilities, and investments.—Section 641.35 applies in its entirety to determine what assets, liabilities, and investments are acceptable for a prepaid limited health service organization.History.—s. 33, ch. 93-148.