reglab/housing_qa huggingface dataset:
FL Stat § 627.6474 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VI - Health Insurance Policies (Ss. 627.601-627.64995)|627.6474 - Provider contracts.

627.6474 Provider contracts.—(1) A health insurer may not require a contracted health care practitioner as defined in s. 456.001(4) to accept the terms of other health care practitioner contracts with the insurer or any other insurer, or health maintenance organization, under common management and control with the insurer, including Medicare and Medicaid practitioner contracts and those authorized by s. 627.6471, s. 627.6472, s. 636.035, or s. 641.315, except for a practitioner in a group practice as defined in s. 456.053 who must accept the terms of a contract negotiated for the practitioner by the group, as a condition of continuation or renewal of the contract. Any contract provision that violates this section is void. A violation of this subsection is not subject to the criminal penalty specified in s. 624.15.(2) A contract between a health insurer and a dentist licensed under chapter 466 for the provision of services to an insured may not contain a provision that requires the dentist to provide services to the insured under such contract at a fee set by the health insurer unless such services are covered services under the applicable contract. As used in this subsection, the term “covered services” means dental care services for which a reimbursement is available under the insured’s contract, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation.(3)(a) A health insurer may not require an ophthalmologist licensed pursuant to chapter 458 or chapter 459 or an optometrist licensed pursuant to chapter 463 to join a network solely for the purpose of credentialing the licensee for another insurer’s vision network. This paragraph does not prevent a health insurer from entering into a contract with another insurer’s vision care plan to use the vision network.(b) A health insurer may not restrict an ophthalmologist licensed pursuant to chapter 458 or chapter 459, an optometrist licensed pursuant to chapter 463, or an optician licensed pursuant to part I of chapter 484 to specific suppliers of materials or optical laboratories. This paragraph does not restrict a health insurer in determining specific amounts of coverage or reimbursement for the use of network or out-of-network suppliers or laboratories.(c) A health insurer’s online vision care network provider directory must be updated monthly to reflect the vision care providers currently participating in the health insurer’s network.(d) A knowing violation of paragraph (a) or paragraph (b) constitutes an unfair insurance trade practice under s. 626.9541(1)(d).History.—s. 1, ch. 2001-107; s. 1, ch. 2014-64; s. 1, ch. 2016-69.
FL Stat § 627.64741 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VI - Health Insurance Policies (Ss. 627.601-627.64995)|627.64741 - Pharmacy benefit manager contracts.

627.64741 Pharmacy benefit manager contracts.—(1) As used in this section, the term:(a) “Maximum allowable cost” means the per-unit amount that a pharmacy benefit manager reimburses a pharmacist for a prescription drug, excluding dispensing fees, prior to the application of copayments, coinsurance, and other cost-sharing charges, if any.(b) “Pharmacy benefit manager” means a person or entity doing business in this state which contracts to administer or manage prescription drug benefits on behalf of a health insurer to residents of this state.(2) A contract between a health insurer and a pharmacy benefit manager must require that the pharmacy benefit manager:(a) Update maximum allowable cost pricing information at least every 7 calendar days.(b) Maintain a process that will, in a timely manner, eliminate drugs from maximum allowable cost lists or modify drug prices to remain consistent with changes in pricing data used in formulating maximum allowable cost prices and product availability.(3) A contract between a health insurer and a pharmacy benefit manager must prohibit the pharmacy benefit manager from limiting a pharmacist’s ability to disclose whether the cost-sharing obligation exceeds the retail price for a covered prescription drug, and the availability of a more affordable alternative drug, pursuant to s. 465.0244.(4) A contract between a health insurer and a pharmacy benefit manager must prohibit the pharmacy benefit manager from requiring an insured to make a payment for a prescription drug at the point of sale in an amount that exceeds the lesser of:(a) The applicable cost-sharing amount; or(b) The retail price of the drug in the absence of prescription drug coverage.(5) This section applies to contracts entered into or renewed on or after July 1, 2018.History.—s. 4, ch. 2018-91.
FL Stat § 627.64995 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 627 - Insurance Rates and Contracts|Part VI - Health Insurance Policies (Ss. 627.601-627.64995)|627.64995 - Restrictions on use of state and federal funds for state exchanges.

627.64995 Restrictions on use of state and federal funds for state exchanges.—(1) A 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 health insurance policy.(2) This section does not prohibit a 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. 1, ch. 2011-111.
FL Stat § 627.651 (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)|627.651 - Group contracts and plans of self-insurance must meet group requirements.

627.651 Group contracts and plans of self-insurance must meet group requirements.—(1) Except as otherwise provided by law, a group health insurance policy or certificate insuring more than one individual delivered or issued for delivery in this state must be delivered or issued for delivery to one of the groups provided for in ss. 627.653-627.656. A plan of self-insurance providing health coverage benefits to residents of this state must comply with s. 627.419 and the applicable provisions of this part relating to the rights of individuals to specified benefits and coverages.(2) Subsection (1) does not apply to health insurance policies or plans of self-insurance:(a) Insuring or providing benefits only to individuals related by blood, marriage, or legal adoption.(b) Insuring or providing benefits only to individuals who have a common interest through ownership of a business enterprise, or a substantial legal interest or equity in the business enterprise, and who are actively engaged in the management of the business enterprise.(c) Insuring or providing benefits only to individuals otherwise having an insurable interest in each other’s lives.(d) Issued as blanket insurance pursuant to s. 627.659.(3) A nongovernmental self-insurance plan for health benefits may not be contributory by participants.(4) This section does not apply to any plan which is established or maintained by an individual employer in accordance with the Employee Retirement Income Security Act of 1974, Pub. L. No. 93-406, or to a multiple-employer welfare arrangement as defined in s. 624.437(1), except that a multiple-employer welfare arrangement shall comply with ss. 627.419, 627.657, 627.6575, 627.6578, 627.6579, 627.6612, 627.66121, 627.66122, 627.6615, 627.6616, and 627.662(7). This subsection does not allow an authorized insurer to issue a group health insurance policy or certificate which does not comply with this part.History.—s. 584, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 4, 10, ch. 80-341; ss. 2, 3, ch. 81-318; ss. 498, 500, 523, 809(2nd), ch. 82-243; ss. 62, 79, ch. 82-386; s. 6, ch. 83-203; s. 1, ch. 83-213; s. 17, ch. 83-288; s. 1, ch. 84-50; s. 4, ch. 86-122; s. 1, ch. 90-255; ss. 61, 114, ch. 92-318; s. 26, ch. 95-211; s. 5, ch. 97-48; s. 82, ch. 2000-154; s. 6, ch. 2002-389.
FL Stat § 627.6512 (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)|627.6512 - Exemption of certain group health insurance policies.

627.6512 Exemption of certain group health insurance policies.—Sections 627.6561, 627.65615, 627.65625, and 627.6571 do not apply to any group insurance policy in relation to its provision of benefits described in s. 627.6513(1)-(14).History.—s. 7, ch. 97-179; s. 14, ch. 2016-194.
FL Stat § 627.6513 (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)|627.6513 - Scope.

627.6513 Scope.—Section 641.312 and the provisions of the Employee Retirement Income Security Act of 1974, as implemented by 29 C.F.R. s. 2560.503-1, relating to internal grievances, apply to all group health insurance policies issued under this part. This section does not apply to:(1) Coverage only for accident insurance, or disability income insurance, or any combination thereof.(2) Coverage issued as a supplement to liability insurance.(3) Liability insurance, including general liability insurance and automobile liability insurance.(4) Workers’ compensation or similar insurance.(5) Automobile medical payment insurance.(6) Credit-only insurance.(7) Coverage for onsite medical clinics, including prepaid health clinics under part II of chapter 641.(8) Other similar insurance coverage, specified in rules adopted by the commission, under which benefits for medical care are secondary or incidental to other insurance benefits. To the extent possible, such rules must be consistent with regulations adopted by the United States Department of Health and Human Services.(9) Limited scope dental or vision benefits, if offered separately.(10) Benefits for long-term care, nursing home care, home health care, or community-based care, or any combination thereof, if offered separately.(11) Other similar, limited benefits, if offered separately, as specified in rules adopted by the commission.(12) Coverage only for a specified disease or illness, if offered as independent, noncoordinated benefits.(13) Hospital indemnity or other fixed indemnity insurance, if offered as independent, noncoordinated benefits.(14) Benefits provided through a Medicare supplemental health insurance policy, as defined under s. 1882(g)(1) of the Social Security Act, coverage supplemental to the coverage provided under 10 U.S.C. chapter 55, and similar supplemental coverage provided to coverage under a group health plan, which are offered as a separate insurance policy and as independent, noncoordinated benefits.History.—s. 12, ch. 2012-44; s. 15, ch. 2016-194; s. 108, ch. 2018-24.
FL Stat § 627.652 (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)|627.652 - Group health insurance; definitions.

627.652 Group health insurance; definitions.—As used in this part:(1) Group health insurance is that form of health insurance covering groups of persons under a master group health insurance policy issued to any one of the groups listed in ss. 627.653-627.656.(2)(a) The terms “policy,” “insurance policy,” “health insurance policy,” “group health policy,” and “group health insurance policy” include plans of self-insurance providing health insurance benefits.(b) The terms “amount of insurance” and “insurance” include the benefits provided under a plan of self-insurance.(c) The term “insurer” includes any person or governmental unit providing a plan of self-insurance.History.—s. 585, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 500, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 92-318.
FL Stat § 627.6525 (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)|627.6525 - Short-term health insurance.

627.6525 Short-term health insurance.—(1) For purposes of this part, the term “short-term health insurance” means a group, blanket, or franchise policy of health insurance coverage provided by an issuer with an expiration date specified in the contract that is less than 12 months after the original effective date of the contract and, taking into account renewals or extensions, has a duration not to exceed 36 months in total.(2) All contracts for short-term health insurance entered into by an issuer and a party seeking coverage shall include the following disclosure:“This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Patient Protection and Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your policy might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.”History.—s. 6, ch. 2019-129.
FL Stat § 627.653 (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)|627.653 - Employee groups.

627.653 Employee groups.—(1)(a) A group of individual employees of an employer, or employees and their dependents, may be insured, for the benefit of persons other than the employer, under a policy issued to the employer or to the trustees of a fund established by an employer, which employer or board of trustees is deemed to be the policyholder, insuring employees of the employer for the benefit of persons other than the employer.(b) Employees insured under a policy issued pursuant to this section may include any of the following:1. Directors of a corporate employer, former employees, or retired employees.2. The individual proprietor or partners if the employer is a proprietor or partnership.3. Elected or appointed officials if the policy is issued to insure employees of a public body.(c) A policy issued pursuant to this section may insure the employees of one or more subsidiary or affiliated corporations, proprietors, and partnerships if the business of the employer and the subsidiary or affiliated corporations, proprietors, or partnerships are under common control.(2) A policy may not be issued pursuant to this section unless all employees of the employer are declared eligible and acceptable to the insurer at the time of issuance of the policy, or unless all members of any class or classes of the employees, determined by conditions pertaining to their employment, but not determined so as to exclude those in the more hazardous employment solely because of their hazardous employment, are declared eligible and acceptable to the insurer at the time of issuance of the policy.(3) A policy issued pursuant to this section may insure the spouse or dependent children with or without the employee being insured.(4) This section does not affect the provisions of ss. 112.08-112.14.History.—s. 586, ch. 59-205; s. 1, ch. 63-218; s. 1, ch. 72-17; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 501, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; ss. 63, 114, ch. 92-318.Note.—Former s. 627.0602.
FL Stat § 627.654 (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)|627.654 - Labor union, association, and small employer health alliance groups.

627.654 Labor union, association, and small employer health alliance groups.—(1)(a) A bona fide group or association of employers, as defined in 29 C.F.R. part 2510.3-5, or a group of individuals may be insured under a policy issued to an association, including a labor union, which association has a constitution and bylaws and which has been organized for purposes in addition to that of obtaining insurance, or to the trustees of a fund established by such an association, which association or trustees shall be deemed the policyholder, insuring at least 15 individual members of the association for the benefit of persons other than the officers of the association, the association, or trustees.(b) A small employer, as defined in s. 627.6699 and including the employer’s eligible employees and the spouses and dependents of such employees, may be insured under a policy issued to a small employer health alliance by a carrier as defined in s. 627.6699.(2) No such policy of insurance as defined in subsection (1) may be issued to any such association or alliance, unless all individual members of such association, or all small employer members of an alliance, or all of any class or classes thereof, are declared eligible and acceptable to the insurer at the time of issuance of the policy.(3) Any such policy issued under paragraph (1)(a) may insure the spouse or dependent children with or without the member being insured.(4) A single master policy issued to an association, labor union, or small employer health alliance may include more than one health plan from the same insurer or affiliated insurer group as alternatives for an employer, employee, or member to select.History.—s. 587, ch. 59-205; s. 1, ch. 61-368; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 502, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 92-318; s. 35, ch. 2000-256; s. 2, ch. 2000-296; s. 7, ch. 2019-129.
FL Stat § 627.655 (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)|627.655 - Debtor groups.

627.655 Debtor groups.—A group of individual debtors of a creditor may be insured under a policy issued to a creditor under which the debtors are indemnified in connection with a specific loan or credit transaction against loss of time resulting from bodily injury or sickness. The creditor is deemed the policyholder of a policy issued pursuant to this section. Two types of insurance may be used to insure against the occurrence of disability of the lives of a group of individual debtors pursuant to this section as follows:(1) Credit disability insurance as defined in s. 627.677. The debtors eligible for insurance under this section are all of the debtors of the creditor, or all members of any class or classes of debtors of the creditor, determined by conditions pertaining to the indebtedness or to the credit transaction giving rise to the indebtedness. A policy issued pursuant to this section may insure the debtors of one or more subsidiary or affiliated corporations, proprietors, or partnerships, if the business of the creditor and of such subsidiary or affiliated corporations, proprietors, or partnerships is under common control. A policy may be issued pursuant to this section only if the group of eligible debtors is then receiving new entrants at the rate of at least 100 persons yearly, or may reasonably be expected to receive at least 100 new entrants during the first policy year, and only if the policy reserves to the insurer the right to require evidence of individual insurability if less than 75 percent of the new entrants become insured.(2) Mortgage insurance as defined in s. 627.982. The debtors eligible for insurance under the policy are all of the debtors of the creditor, or all of any class or classes of debtors of the creditor. The term “debtors” includes borrowers of money in connection with an indebtedness of more than 10 years’ duration, which indebtedness is secured by a first real estate mortgage and which indebtedness is not subject to part IX.History.—s. 588, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; ss. 64, 114, ch. 92-318.
FL Stat § 627.6551 (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)|627.6551 - Teacher and student groups.

627.6551 Teacher and student groups.—A group of teachers or students of an institution of learning may be insured under a policy issued by an insurer authorized under chapter 624 or a health maintenance organization authorized under chapter 641 to a school, district school systems, college, university, or other institution of learning. Any policy or contract issued may insure the spouse, dependent children, parents, or siblings of the insured student or teacher.History.—ss. 6, 7, ch. 89-190; s. 114, ch. 92-318.
FL Stat § 627.656 (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)|627.656 - Additional groups.

627.656 Additional groups.—(1) A group of individuals, other than the groups defined in s. 627.556, may be insured under a policy issued to any person or organization to which a policy of group life insurance may be issued or delivered in this state to insure any class or classes of individuals for health insurance that could be insured under such group life policy. Any such policy may insure the spouse and dependent children with or without the employee being insured.(2) A credit union group, as defined in s. 627.556, may purchase health insurance for its members under a policy issued to the credit union. The benefits shall be limited to a maximum of $10,000.History.—s. 1, ch. 61-377; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 503, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 92-318.