reglab/housing_qa huggingface dataset:
FL Stat § 641.309 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.309 - Standards for marketing to persons eligible for Medicare.

641.309 Standards for marketing to persons eligible for Medicare.—(1) Every health maintenance organization marketing coverage to Medicare participants or persons eligible for Medicare in this state, directly or through its agents, shall:(a) Establish marketing procedures to assure that any comparison of benefits between Medicare or any other health maintenance organization offering such coverage by its agents will be fair and accurate.(b) Establish marketing procedures to assure proper notification to the Medicare participant of enrollment or disenrollment from the health maintenance organization. Such notification shall be made in a timely manner.(c) Display prominently by type, stamp, or other appropriate means, on the first page of the application and contract, the following:“Notice to buyer: When you enroll in this health maintenance organization, you will be disenrolled from Medicare. The buyer should be aware that in order to receive payment or coverage for services such services must be rendered by physicians, hospitals, and other health care providers designated by the health maintenance organization. If the services are rendered by a nonparticipating physician, hospital, or other health care provider, the purchaser may be liable for payment for such services except in very limited circumstances.”(d) Inquire and otherwise make every reasonable effort to identify whether a prospective Medicare participant has previously been enrolled in either the same health maintenance organization as a Medicare participant or in another health maintenance organization as a Medicare participant.(2) In addition to the practices prohibited in s. 641.3903:(a) No health maintenance organization or person representing such health maintenance organization shall employ any method of marketing having the effect of or tending to induce the purchase of health care plans through fraud, deceit, force, fright, threat whether explicit or implied, intimidation, harassment, or undue pressure to purchase or recommend the purchase of a health maintenance organization contract.(b) No participating provider, employee, or agent of such participating provider shall be an agent for or conduct any sales activities for a health maintenance organization with whom they have a provider contract.History.—ss. 120, 188, ch. 91-108; s. 4, ch. 91-429.
FL Stat § 641.3101 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3101 - Additional contract contents.

641.3101 Additional contract contents.—A health maintenance contract may contain additional provisions not inconsistent with this part which are:(1) Necessary, on account 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 therein.History.—ss. 23, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.
FL Stat § 641.31015 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31015 - Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

1641.31015 Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.—Each health maintenance organization or exclusive provider organization shall provide prospective enrollees with written information about the terms and conditions of the plan in accordance with s. 641.31(4) so that the prospective enrollees can make informed decisions about accepting a managed-care system of health care delivery; however, information about where, in what manner, and from whom the comprehensive health care services or specific health care services can be obtained need be disclosed only upon request by the prospective enrollee. All marketing materials distributed by the health maintenance organization or exclusive provider organization must contain a notice in boldfaced type which states that the information required under this section is available to the prospective enrollee upon request.History.—s. 8, ch. 96-223.1Note.—Also published at s. 627.64725.
FL Stat § 641.3102 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3102 - Restrictions upon expulsion or refusal to issue or renew contract.

641.3102 Restrictions upon expulsion or refusal to issue or renew contract.—(1) A health maintenance organization that offers individual health maintenance contracts in this state may not decline to offer coverage to an eligible individual as required in s. 627.6487.(2) A health maintenance organization shall 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, marital status, sex, or national origin of the subscriber or individual. A health maintenance organization shall not expel or refuse to renew the coverage of any individual member of a subscriber group on the basis of the age, health status, health care needs, or prospective costs of health care services of the subscriber or individual. Nothing in this section shall prohibit a health maintenance 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 or that individuals entitled to have payments for health costs made under Title XVIII of the United States Social Security Act, as amended, be issued a health maintenance contract for Medicare beneficiaries so long as the health maintenance organization is authorized to issue health maintenance contracts for Medicare beneficiaries.History.—ss. 24, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 24, ch. 97-179.
FL Stat § 641.3103 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3103 - Charter, bylaw provisions.

641.3103 Charter, bylaw provisions.—No health maintenance contract shall contain any provision purporting to make any portion of the articles of incorporation, charter, bylaws, or other organizational document of the health maintenance 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.—ss. 25, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.
FL Stat § 641.3104 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3104 - Execution of contracts.

641.3104 Execution of contracts.—(1) Every health maintenance contract shall be executed in the name of and on behalf of the health maintenance 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 health maintenance contract which is otherwise valid shall be rendered invalid by reason of the apparent execution thereof on behalf of the health maintenance organization by the imprinted facsimile signature of an individual not authorized so to execute as of the date of the contract.History.—ss. 26, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.
FL Stat § 641.3105 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3105 - Validity of noncomplying contracts.

641.3105 Validity of noncomplying contracts.—(1) Any health maintenance contract, rider, endorsement, attachment, or addendum otherwise valid which contains any condition or provision not in compliance with the requirements of this part shall not be thereby rendered invalid, but shall be construed and applied in accordance with such conditions and provisions as would have applied had such contract, rider, endorsement, attachment, or addendum been in full compliance with this part. In the event an organization issues or delivers any contract for an amount which exceeds any limitations otherwise provided in this part, such organization shall be liable to the subscriber or her or his beneficiary for the full amount stated in the contract in addition to any other penalties that may be imposed under this part.(2) Any health maintenance contract delivered or issued for delivery in this state covering a subscriber, which subscriber, pursuant to the provisions of this part, the organization may not lawfully cover under the contract, shall be cancelable at any time by the organization, any provision of the contract to the contrary notwithstanding; and the organization shall promptly cancel the contract in accordance with the request of the office therefor. No such illegality or cancellation shall 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 provision does not relieve the organization from any penalty otherwise incurred by the organization under this part on account of any such violation.History.—ss. 27, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 489, ch. 97-102; s. 1579, ch. 2003-261.
FL Stat § 641.3106 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3106 - Construction of contracts.

641.3106 Construction of contracts.—Every health maintenance contract shall 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 therefor or any rider, endorsement, attachment, or addendum thereto.History.—ss. 28, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.
FL Stat § 641.3107 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3107 - Delivery of contract; definitions.

641.3107 Delivery of contract; definitions.—(1) A health maintenance contract, certificate of coverage, endorsements and riders, or member handbook shall be mailed, delivered, or otherwise provided to the subscriber or, in the case of a group health maintenance contract, to the employer or other person who will hold the contract on behalf of the subscriber group, as provided in s. 627.421.(2) As used in s. 627.421, the term:(a) “Insurance policies and endorsements,” “policy and endorsements,” “policy,” and “policy form and endorsement form” includes the health maintenance contract, endorsement and riders, certificate of coverage, or member handbook.(b) “Insured” includes a subscriber or, in the case of a group health maintenance contract, the employer or other person who will hold the contract on behalf of the subscriber group.(c) “Insurer” includes a health maintenance organization.(3) If the health maintenance organization elects to post health maintenance contracts on its Internet website in lieu of mailing or delivery to subscribers or the person who will hold the contract on behalf of a subscriber group, the health maintenance organization must comply with the requirements of s. 627.421(4). This section does not apply to the delivery of those contracts specified in s. 641.31(13).History.—ss. 29, 47, ch. 85-177; ss. 187, 188, ch. 91-108; s. 10, ch. 91-110; s. 4, ch. 91-429; s. 14, ch. 2018-131; s. 99, ch. 2019-3.
FL Stat § 641.31071 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31071 - Preexisting conditions.

641.31071 Preexisting conditions.—(1) As used in this section, the term:(a) “Enrollment date” means, with respect to an individual covered under a group health maintenance organization contract, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period of such enrollment.(b) “Late enrollee” means, with respect to coverage under a group health maintenance organization contract, a participant or beneficiary who enrolls under the contract other than during:1. The first period in which the individual is eligible to enroll under the plan.2. A special enrollment period, as provided under s. 641.31072.(c) “Waiting period” means, with respect to a group health maintenance organization contract and an individual who is a potential participant or beneficiary under the contract, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the contract.(2) Subject to the exceptions specified in subsection (4), a health maintenance organization that offers group coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if:(a) Such exclusion relates to a physical or mental condition, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date;(b) Such exclusion extends for a period of not more than 12 months, or 18 months in the case of a late enrollee, after the enrollment date; and(c) The period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage, as defined in s. 627.6562(3), applicable to the participant or beneficiary as of the enrollment date.(3) Genetic information shall not be treated as a condition described in paragraph (2)(a) in the absence of a diagnosis of the condition related to such information.(4)(a) Subject to paragraph (b), a health maintenance organization that offers group coverage may not impose any preexisting condition exclusion in the case of:1. An individual who, as of the last day of the 30-day period beginning with the date of birth, is covered under creditable coverage.2. A child who is adopted or placed for adoption before attaining 18 years of age and who, as of the last day of the 30-day period beginning on the date of the adoption or placement for adoption, is covered under creditable coverage. This provision shall not apply to coverage before the date of such adoption or placement for adoption.3. Pregnancy.(b) Subparagraphs (a)1. and 2. do not apply to an individual after the end of the first 63-day period during all of which the individual was not covered under any creditable coverage.History.—s. 25, ch. 97-179; s. 55, ch. 99-3; s. 1580, ch. 2003-261; s. 22, ch. 2016-194.
FL Stat § 641.31073 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31073 - Prohibiting discrimination against individual participants and beneficiaries based on health status.

641.31073 Prohibiting discrimination against individual participants and beneficiaries based on health status.—(1) Subject to subsection (2), a health maintenance organization that offers group health insurance coverage may not establish rules for eligibility, including continued eligibility, of an individual to enroll under the terms of the contract based on any of the following health-status-related factors in relation to the individual or a dependent of the individual:(a) Health status.(b) Medical condition, including physical and mental illnesses.(c) Claims experience.(d) Receipt of health care.(e) Medical history.(f) Genetic information.(g) Evidence of insurability, including conditions arising out of acts of domestic violence.(h) Disability.(2) Subsection (1) does not:(a) Require a health maintenance organization to provide particular benefits other than those provided under the terms of such plan or coverage.(b) Prevent such a plan or coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the plan or coverage.(3) For purposes of subsection (1), rules for eligibility to enroll under a contract include rules for defining any applicable affiliation or waiting periods of enrollment.(4)(a) A health maintenance organization that offers health insurance coverage may not require any individual, as a condition of enrollment or continued enrollment under the contract, to pay a premium or contribution that is greater than such premium or contribution for a similarly situated individual enrolled under the contract on the basis of any health-status-related factor in relation to the individual or to an individual enrolled under the contract as a dependent of the individual.(b) This subsection does not:1. Restrict the amount that an employer may be charged for coverage under a group health insurance contract.2. Prevent a health maintenance organization offering group health insurance coverage from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.History.—s. 27, ch. 97-179.
FL Stat § 641.31075 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31075 - Advanced practice registered nurse services.

641.31075 Advanced practice registered nurse services.—A health maintenance contract that is delivered, issued, or renewed in this state on or after January 1, 2021, may not require a subscriber to receive services from an advanced practice registered nurse registered under s. 464.0123 in place of a physician.History.—s. 32, ch. 2020-9.
FL Stat § 641.31077 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31077 - Coverage for organ transplants.

641.31077 Coverage for organ transplants.—A health maintenance contract issued or renewed on or after July 1, 2020, in this state by a health maintenance organization which provides coverage for organ transplants may not deny coverage for an organ transplant solely on the basis of a subscriber’s disability. This section may not be construed to require such health maintenance organization to provide coverage for an organ transplant that is not medically necessary. For purposes of this section, the term “organ transplant” has the same meaning as in s. 765.523.History.—s. 4, ch. 2020-139.
FL Stat § 641.3108 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.3108 - Notice of cancellation of contract.

641.3108 Notice of cancellation of contract.—(1) Except for nonpayment of premium or termination of eligibility, no health maintenance organization may cancel or otherwise terminate or fail to renew a health maintenance contract without giving the subscriber at least 45 days’ notice in writing of the cancellation, termination, or nonrenewal of the contract. The written notice shall state the reason or reasons for the cancellation, termination, or nonrenewal. All health maintenance contracts shall contain a clause which requires that this notice be given.(2) If cancellation is due to nonpayment of premium, the health maintenance organization may not retroactively cancel the contract to a date prior to the date that notice of cancellation was provided to the subscriber unless the organization mails notice of cancellation to the subscriber prior to 45 days after the date the premium was due. Such notice must be mailed to the subscriber’s last address as shown by the records of the organization and may provide for a retroactive date of cancellation no earlier than midnight of the date that the premium was due.(3) In the case of a health maintenance contract issued to an employer or person holding the contract on behalf of the subscriber group, the health maintenance organization may make the notification through the employer or group contract holder, and, if the health maintenance organization elects to take this action through the employer or group contract holder, the organization shall be deemed to have complied with the provisions of this section upon notifying the employer or group contract holder of the requirements of this section and requesting the employer or group contract holder to forward to all subscribers the notice required herein.History.—ss. 30, 47, ch. 85-177; ss. 122, 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 14, ch. 99-204; s. 8, ch. 99-275; s. 13, ch. 99-393.
FL Stat § 641.31085 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31085 - Disclosures to subscribers; coverage of behavioral health care services.

641.31085 Disclosures to subscribers; coverage of behavioral health care services.—(1) A health maintenance organization shall make all of the following information available on its website:(a) The federal and state requirements for coverage of behavioral health care services.(b) Contact information for the Division of Consumer Services of the department, including a hyperlink, for consumers to submit inquiries or complaints relating to health maintenance organization products or services regulated by the department or the office.(2) On an annual basis, a health maintenance organization shall provide a direct notice to subscribers which must include a description of the federal and state requirements for coverage of behavioral health care services. Such notice must also include the website address and statewide toll-free telephone number of the Division of Consumer Services of the department for receiving and logging complaints.History.—s. 3, ch. 2021-146.
FL Stat § 641.31094 (2021)
2021 Florida Statutes|Title XXXVII - Insurance|Chapter 641 - Health Care Service Programs|Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)|641.31094 - Nondiscrimination of coverage for certain surgical procedures involving bones or joints.

641.31094 Nondiscrimination of coverage for certain surgical procedures involving bones or joints.—No health maintenance contract or policy which provides coverage for any diagnostic or surgical procedure involving bones or joints of the skeleton shall discriminate against coverage for any similar diagnostic or surgical procedure involving bones or joints of the jaw and facial region, if, under accepted medical standards, such procedure or surgery is medically necessary to treat conditions caused by congenital or developmental deformity, disease, or injury. This section shall not be construed to affect any other coverage under this part or to restrict the scope of coverage under any policy, plan, or contract. Nothing in this section shall be construed to discourage appropriate nonsurgical procedures or to prohibit the continued coverage of nonsurgical procedures in the treatment of a bone or joint of the jaw and facial region. Furthermore, nothing in this subsection requires coverage for care or treatment of the teeth or gums, for intraoral prosthetic devices, or for surgical procedures for cosmetic purposes.History.—s. 5, ch. 96-361.