reglab/statecodes huggingface dataset:
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-198 - SERVICE WARRANTY ASSOCIATIONS › Section 69O-198.011 - Application for and Issuance of License and License Continuance

Current through Reg. 50, No. 138; July 16, 2024
(1) Application for License as a Service
				Warranty Association
(a) An application for a
				person applying for a license as a service warranty association consists of the
				following:
1. Form OIR-C1-997, "Application
				for License Service Warranty Association," effective 07/23, hereby incorporated
				by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16314
;
2. Form OIR-A3-455, "Home or Service Warranty
				Association Surety Bond," effective 5/20, hereby incorporated by reference and
				available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-13040
;
3. Form OIR-C1-144, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
4. Form OIR-C1-905, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
5. Form OIR-C1-938, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
6. Form OIR-C1-995, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
7. Form OIR-C1-1423, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
8. Form OIR-C1-0500, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
9. Form OIR-C1-0501, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
10. Form OIR-C1-0502, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
11. Form OIR-C1-0503, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
12. Form OIR-C1-0504, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
13. Form OIR-C1-0505, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
14. Form OIR-C1-0506, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
15. Form OIR-C1-0507, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
16. Form OIR-C1-0509, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
				and
17. Form OIR-C1-2221,
				incorporated by reference in Rule
				69O-136.100,
				F.A.C.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-198 - SERVICE WARRANTY ASSOCIATIONS › Section 69O-198.012 - Annual Statement

Current through Reg. 50, No. 138; July 16, 2024
Annual Statements are required to be filed with the Office,
				  on or before March 1 of each year, on Form OIR-A3-456, "Annual Statement for
				  Service Warranty Association," effective 5/20, hereby incorporated by reference
				  and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-13038
,
				  and Form OIR-A3-458, "Annual Filing Statement for Publicly Held Corporations -
				  SEC Filings," effective 07/23, hereby incorporated by reference and available
				  at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16191
.
				  The filings shall be submitted electronically via the Office's system at
https://www.floir.com/iportal
. If
				  the Annual Statements are not complete to include all information requested in
				  the format provided, they will not be deemed filed until all deficiencies are
				  corrected.
Rulemaking Authority 634.402 FS. Law Implemented 624.424,
					 634.415, 634.516(1) FS.
New 12-26-88, Amended 4-26-90, Formerly 4-67.012,
					 4-198.012, Amended 7-30-17, 5-25-21,
					 1-4-24.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-198 - SERVICE WARRANTY ASSOCIATIONS › Section 69O-198.013 - Change in Corporate or Business Name

Current through Reg. 50, No. 138; July 16, 2024
Service warranty associations are required to notify the
				  Office in writing in accordance with Section
				  634.404, F.S., of any change in
				  the corporate name or business name.
Rulemaking Authority 634.402 FS. Law Implemented 624.404
					 FS.
New 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-198 - SERVICE WARRANTY ASSOCIATIONS › Section 69O-198.015 - Forms Incorporated by Reference (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.402 FS. Law Implemented 634.405,
					 634.407, 634.408, 634.4085, 634.415
					 FS.
New 12-26-88, Amended 5-28-90, Formerly 4-67.015, Amended
					 3-28-93, Formerly 4-198.015, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.001 - Purpose and Scope (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.302 FS. Law Implemented 634, Part
					 II FS.
New 7-15-90, Formerly 4-118.001, 4-199.001, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.005 - Financial Requirements Regarding the Funded, Unearned Premium Reserve Account

Current through Reg. 50, No. 138; July 16, 2024
(1)
(a) "Gross premium" means the total amount of
				premium paid by the consumer, inclusive of commissions.
(b) "Gross Written Premiums" means the total
				amount of premiums paid by the consumer, paid for the entire period of the home
				warranty, inclusive of commissions, for which the association is obligated
				under home warranties issued.
(c)
				"Obligated" means outstanding warranties in force which have not expired or
				been canceled and a refund made to the consumer.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.008 - Application for License and License Renewal

Current through Reg. 50, No. 138; July 16, 2024
(1) Application for License as a Home
				Warranty Association.
(a) An application for
				a person applying for a license as a home warranty association consists of the
				following:
1. Form OIR-C1-490, "Application
				for License Home Warranty Association," effective 07/23, hereby incorporated by
				reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16188
;
2. Form OIR-A3-455, "Home or Service Warranty
				Association Surety Bond," effective 6/20, hereby incorporated by reference and
				available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-13052
;
3. Form OIR-C1-144, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
4. Form OIR-C1-905, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
5. Form OIR-C1-938, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
6. Form OIR-C1-995, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
7. Form OIR-C1-1423, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
8. Form OIR-C1-0500, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
9. Form OIR-C1-0501, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
10. Form OIR-C1-0502, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
11. Form OIR-C1-0503, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
12. Form OIR-C1-0504, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
13. Form OIR-C1-0505, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
14. Form OIR-C1-0506, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
15. Form OIR-C1-0507, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
16. Form OIR-C1-0509, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
				and
17. Form OIR-C1-2221,
				incorporated by reference in Rule
				69O-136.100,
				F.A.C.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.010 - License Renewal (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.302 FS. Law Implemented 624.424,
					 634.307 FS.
New 7-16-92, Amended 4-3-94, Formerly 4-199.010, Amended
					 7-30-17, Repealed 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.012 - Annual Statement

Current through Reg. 50, No. 138; July 16, 2024
(1)
(a) An Annual Statement shall be filed with
				the Office, on or before March 1 of each year, on Form OIR-A3-491, "Annual
				Statement for Home Warranty Association," effective 6/20, hereby incorporated
				by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-13051
.
				The filings shall be submitted electronically via the Office's system at
https://www.floir.com/iportal
.
(b) If the Annual Statement does not include
				all information requested in the format provided, it will not be deemed filed
				until all deficiencies are corrected.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-199 - HOME WARRANTY ASSOCIATIONS › Section 69O-199.015 - Forms Incorporated by Reference (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.302 FS. Law Implemented 624.424,
					 634.306, 634.3073, 634.3077, 634.313, 634.315
					 FS.
New 7-15-90, Formerly 4-118.015, Amended 7-16-92, Formerly
					 4-199.015, Amended 7-30-17, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.001 - Purpose and Scope (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented
					 624.307(1), 634, Part I FS.
New 6-25-90, Formerly 4-114.001, 4-200.001, Repealed
					 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.002 - Definitions (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.011
					 FS.
New 5-26-93, Formerly 4-200.002, Repealed
					 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.003 - Licensing of Companies that Administer and Market Service Agreements

Current through Reg. 50, No. 138; July 16, 2024
(1) Companies that administer service
				agreements as defined in subsection (2), or market service agreements must
				obtain a license as a service agreement company under chapter 634, Part I,
				F.S., and are subject to all applicable regulatory requirements of chapter 634,
				part I, F.S.
(2) An administering
				company is a company, other than an authorized property and casualty insurer,
				that performs substantially all of the claims adjusting and adjudication
				functions; performs substantially all of the functions of processing premium
				dollars and applications; or performs substantially all of the bookkeeping and
				accounting functions, computer processing, and other administrative functions
				on behalf of a service agreement company.
(3) The licensing provisions of section
				634.031, F.S., do not apply to
				companies which are "running off" service agreements for an authorized property
				and casualty insurer which is fulfilling its responsibility under a contractual
				liability insurance policy.
Rulemaking Authority 634.021 FS. Law Implemented 634.031,
					 634.041 FS.
New 5-26-93, Formerly
					 4-200.003.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.004 - Application for License and License Renewal

Current through Reg. 50, No. 138; July 16, 2024
(1) Application for License as a Motor
				Vehicle Service Agreement Company.
(a) An
				application for a license as a motor vehicle service agreement company consists
				of the following:
1. Form OIR-C1-994,
				"Application for License Motor Vehicle Service Agreement Company," effective
				07/23, hereby incorporated by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16226
;
2. Form OIR-C1-144, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
3. Form OIR-C1-905, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
4. Form OIR-C1-938, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
5. Form OIR-C1-995, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
6. Form OIR-C1-1423, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
7. Form OIR-C1-0500, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
8. Form OIR-C1-0501, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
9. Form OIR-C1-0502, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
10. Form OIR-C1-0503, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
11. Form OIR-C1-0504, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
12. Form OIR-C1-0505, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
13. Form OIR-C1-0506, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
14. Form OIR-C1-0507, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
15. Form OIR-C1-0509, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
				and
16. Form OIR-C1-2221,
				incorporated by reference in Rule
				69O-136.100,
				F.A.C.;
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.005 - Use of the Statutory Deposit

Current through Reg. 50, No. 138; July 16, 2024
The deposit required under section
				  634.052, F.S., may be used in
				  the funding of the 15% reserve deposit required under section 634.041(8)(a)3.,
				  F.S.
Rulemaking Authority 634.021 FS. Law Implemented 634.052
					 FS.
New 5-26-93, Formerly 4-200.005, Amended
					 8-13-12.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.006 - Contractual Liability Insurers (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.041
					 FS.
New 5-26-93, Formerly 4-200.006, Amended 8-13-12, Repealed
					 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.009 - Form Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) The name of the
				motor vehicle service agreement company must be stated, with sufficient
				prominence and placement to clearly identify the service agreement company that
				is obligated on the agreement, on any service agreement form.
(2) Every service agreement issued in this
				state shall contain at least the following:
(a) A space for the selling price;
(b) A space for the purchaser's
				signature;
(c) A space for
				identifying the salesperson licensed under Section
				634.171, F.S.;
(d) A space for a unique identifying
				number;
(e) A space for an issue
				and expiration date; and
(f) A
				space for the name and address of purchaser.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.011 - Disapproval of Forms (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.1213
					 FS.
New 5-26-93, Formerly 4-200.011, Repealed
					 10-16-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.013 - Rate Filings (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.1216
					 FS.
New 5-26-93, Formerly 4-200.013, Repealed by Section 40,
					 Chapter 2010-175, Laws of Florida,
					 6-1-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.014 - Exemption From Financial Examination (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.141,
					 634.416 FS.
New 5-26-93, Formerly 4-200.014, Amended 8-13-12, Repealed
					 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.015 - Forms Incorporated by Reference (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 634.021 FS. Law Implemented 634.041,
					 634.061, 634.071, 624.501, 634.161, 634.252
					 FS.
New 6-25-90, Formerly 4-114.015, Amended 5-26-93, 6-6-94,
					 Formerly 4-200.015, Amended 8-13-12, Repealed
					 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-200 - MOTOR VEHICLE SERVICE AGREEMENT COMPANIES › Section 69O-200.017 - Annual Reports

Current through Reg. 50, No. 138; July 16, 2024
Annual Reports are to be filed with the Office, on or before
				  March 1 of each year, on Form OIR-A3-467, "Annual Report for Motor Vehicle
				  Service Agreement Company," effective 5/21, hereby incorporated by reference
				  and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-14737
,
				  and Form OIR-A3-1984, "Annual Report for Motor Vehicle Manufacturers,"
				  effective 5/21, hereby incorporated by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-14738
.
				  The forms may be obtained from
https://www.floir.com/iportal
. The
				  filings shall be submitted electronically at
https://www.floir.com/iportal
. If
				  the Annual Report is not completed to include all information requested in the
				  format provided, then it will not be deemed filed until all deficiencies are
				  corrected.
Rulemaking Authority 634.021, 634.137(1), (5) FS. Law
					 Implemented 634.137 FS.
New 9-28-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.001 - Purpose and Scope (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 642 FS.
New 6-25-90, Formerly 4-115.001, 4-201.001, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.005 - Financial Requirements Regarding the Unearned Premium Reserve Liability Account and the Deposit or Bond

Current through Reg. 50, No. 138; July 16, 2024
(1) "Gross
				Written Premiums" means the total amount of premiums paid by the consumer for
				the entire period of the legal expense insurance contract, including
				commission.
(2) "Obligated" means
				outstanding contracts in force which have not expired or been canceled and a
				refund made to the consumer.
(3)
				The unearned premium reserve account is calculated as follows:
(a) For all one year policies, the minimum
				reserve for all legal expense insurance corporations shall be 50% of the gross
				written premium for which the corporation is obligated on all policies issued
				in any state.
(b) A legal expense
				insurance corporation may count as one-month policies those policies which are
				paid by the month and can be cancelled by either party with 30 days notice. The
				reserve amount required on monthly policies is one-half of the total monthly
				gross written premium. The legal expense insurance corporation must specify if
				the reserve is calculated on a monthly basis.
(c)
1. For
				all multiyear policies issued in any state the reserve shall initially be
				calculated at 50% of the gross written premium for the first year premium, and
				100% for each subsequent year's premium, for all gross written premiums for
				which the legal expense insurance corporation is obligated.
2. As each subsequent year becomes current,
				50 percent of that current year's premium is earned and shall be subtracted
				from the reserve.
3. The reserve is
				maintained until the expiration of the multiyear
				policy.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.008 - Application for Certificate Authority and Annual Renewal

Current through Reg. 50, No. 138; July 16, 2024
(1) Application for Certificate of Authority
				as a Legal Expense Insurance Corporation.
(a)
				An application for a person applying for a certificate of authority as a legal
				expense insurance corporation consists of the following:
1. Form OIR-C1-480, "Application for
				Certificate of Authority Legal Expense Insurance," effective 07/23, available
				at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16224
;
2. Form OIR-A3-478, "Legal Expense Insurance
				Corporation Surety Bond," effective 07/23, available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16220
;
3. Form OIR-C1-144, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
4. Form OIR-C1-905, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
5. Form OIR-C1-938, incorporated by reference
				in Rule 69O-136.100, F.A.C.;
6. Form OIR-C1-1423, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
7. Form OIR-C1-0500, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
8. Form OIR-C1-0501, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
9. Form OIR-C1-0502, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
10. Form OIR-C1-0503, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
11. Form OIR-C1-0504, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
12. Form OIR-C1-0505, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
13. Form OIR-C1-0506, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
14. Form OIR-C1-0507, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
				and
15. Form OIR-C1-2221
				incorporated by reference in Rule
				69O-136.100,
				F.A.C.;
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.010 - License Continuance (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.416, 624.424, 642.0301, 642.032
					 FS.
New 6-23-92, Formerly 4-201.010, Amended 7-30-17, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.012 - Annual Statement and Quarterly Statements

Current through Reg. 50, No. 138; July 16, 2024
(1)
(a) An
				Annual Statement and a $100 filing fee shall be filed with the Office, on or
				before March 1 of each year on Form OIR-A3-479, "Annual Statement Legal Expense
				Insurance Corporation," effective 07/23, hereby incorporated by reference and
				available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16221
.
(b) If the Annual Statement does not include
				all information requested in the format provided, it will not be deemed filed
				until all deficiencies are corrected.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-201 - LEGAL EXPENSE INSURANCE CORPORATIONS › Section 69O-201.015 - Forms Incorporated by Reference (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 642.021, 642.023, 642.032
					 FS.
New 6-25-90, Amended 6-23-92, Formerly 4-201.015, Repealed
					 5-25-21.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-202 - DONOR ANNUITY ORGANIZATIONS › Section 69O-202.001 - Purpose and Scope (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 627.481 FS.
New 7-15-90, Formerly 4-117.001, Amended 1-7-97, Formerly
					 4-202.001, Repealed 7-21-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-202 - DONOR ANNUITY ORGANIZATIONS › Section 69O-202.005 - Notification of Acquisition, Merger and Name Change (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.321(1), 627.481 FS.
New 1-7-97, Formerly 4-202.005, Repealed
					 7-21-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-202 - DONOR ANNUITY ORGANIZATIONS › Section 69O-202.008 - General Eligibility Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) Any
				person engaging in the business of issuing donor annuity agreements must submit
				Form OIR-C1-1208 to the Office electronically at
https://www.floir.com/iportal
on
				the date on which the person enters into the first of these annuity agreements.
				Form OIR-C1-1208, "Notification to the Office of Insurance Regulation as a
				Qualifying Issuer of Donor Annuity Agreements Pursuant to section
				627.481, F.S.," effective 6/20,
				is hereby incorporated by reference and available at
https://www.flrules.org/Gateway/reference.asp?No=Ref-14417
.
				The form may be obtained from
https://www.floir.com/iportal
.
(2) Any person subject to section
				627.481, F.S., that fails to
				submit the required notification form is subject to penalty as provided in
				section 626.9521,
				F.S.
Rulemaking Authority 624.308(1), 627.481(11) FS. Law
					 Implemented 624.307(1), 627.481 FS.
New 6-23-92, Amended 1-7-97, 12-24-03, Formerly 4-202.008,
					 Amended 7-21-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-202 - DONOR ANNUITY ORGANIZATIONS › Section 69O-202.012 - Annual Statement

Current through Reg. 50, No. 138; July 16, 2024
(1) Within 60 days
				of the end of each fiscal year, each qualifying issuer of donor annuity
				agreements in this state must submit Form OIR-A3-1209, "Sworn Statement in Lieu
				of Annual Statements for Issuers of Donor Annuity Agreements," effective 6/20,
				which is hereby incorporated by reference and available at
https://www.flrules.org/Gateway/reference.asp?No=Ref-14419
,
				attesting that the issuer has met all requirements of law. Form OIR-A3-1209
				shall be submitted to the Office electronically at
https://www.floir.com/iportal
. The
				form may be obtained from
https://www.floir.com/iportal
.
(2) Issuers that fail to submit the sworn
				statement in subsection (1) shall submit audited financial statements, and any
				information relating to the operations of the issuer necessary to determine
				compliance.
Rulemaking Authority 624.308(1), 627.781(11) FS. Law
					 Implemented 624.307, 624.307(1), 627.481
					 FS.
New 6-23-92, Amended 1-7-97, 12-24-03, Formerly 4-202.012,
					 Amended 7-21-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-202 - DONOR ANNUITY ORGANIZATIONS › Section 69O-202.015 - Forms Incorporated by Reference (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.424, 627.481 FS.
New 7-15-90, Formerly 4-117.015, Amended 6-23-92, 1-7-97,
					 12-24-03, Formerly 4-202.015, Amended 7-30-17, Repealed
					 7-21-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.010 - Scope (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 636.067 FS. Law Implemented Chapter
					 636 FS.
New 11-15-94, Formerly 4-203.010, Repealed
					 9-29-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.013 - Definitions for the Purpose of These Rules

Current through Reg. 50, No. 138; July 16, 2024
(1) All terms defined in the Prepaid Limited
				Health Service Organization Act, Chapter 636, F.S., which are used in these
				rules shall have the same meaning as in the Act.
(2) Advertising. This includes printed and
				published material, descriptive literature and sales aids, sales talks and
				sales materials, booklets, forms and pamphlets, illustrations, depictions and
				form letters, newspaper, radio, television, or direct mail advertising. This
				includes any material or information intended to solicit or induce membership
				or the purchase of a limited health service plan.
(3) Co-payment. A specific dollar amount or
				percentage discount as specified in a subscriber contract, except as otherwise
				provided for by statute, that the subscriber must pay upon receipt of covered
				health care services.
(4) Emergency
				Services. Services which are needed immediately because of an injury or
				unforeseen medical condition as provided for in the Subscriber
				Contract.
(5) PLHSO. Prepaid
				Limited Health Service Organization shall be abbreviated as PLHSO in these
				rules.
(6) Premium. The contracted
				sum paid by or on behalf of a subscriber or group of subscribers on a prepaid
				per capita or a prepaid aggregate basis for limited health services rendered by
				or through the PLHSO.
(7) Waiting
				Period. Waiting period shall relate to that period of time which may be
				specified in the contract and which must follow the date a person is initially
				covered under the contract before coverage shall become effective as to such
				person.
(8) Pre-Existing Condition
				or Illness. A condition, or symptoms thereof, which was diagnosed and for which
				the individual received medical advice or treatment from a physician within a 3
				month period preceding the effective date of coverage.
(9) Prepayment. Any premium paid by or on
				behalf of a subscriber which entitles the subscriber to access to limited
				health services.
Rulemaking Authority 636.067 FS. Law Implemented 636.003,
					 636.008, 636.009, 636.015, 636.016 FS.
New 11-15-94, Formerly 4-203.013, Amended
					 9-29-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.020 - Prepaid Limited Health Service Organization Application

Current through Reg. 50, No. 138; July 16, 2024
(1) A person applying for a certificate of
				authority as a prepaid limited service organization shall submit the following:
(a) Form OIR-C1-1119, "Application for
				Certificate of Authority Prepaid Limited Health Service Organization,"
				effective 07/23, hereby incorporated by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16241
;
(b) Form OIR-C1-905, "incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(c) Form OIR-C1-938 incorporated by reference
				in Rule 69O-136.100, F.A.C.;
(d) Form OIR-C1-1423, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(e) Form OIR-C1-0500, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(f) Form OIR-C1-0501, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(g) Form OIR-C1-0502, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(h) Form OIR-C1-0503, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(i) Form OIR-C1-0504, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(j) Form OIR-C1-0505, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(k) Form OIR-C1-0506, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
(l) Form OIR-C1-0507, incorporated by
				reference in Rule 69O-136.100, F.A.C.;
				and
(m) Form OIR-C1-0509,
				incorporated by reference in Rule
				69O-136.100,
				F.A.C.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.021 - Standards for Fingerprint Cards for New Applicants and Acquisition Applications (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 636.067 FS. Law Implemented 636.007,
					 636.008 FS.
New 11-15-94, Formerly 4-203.021, Repealed
					 9-29-22.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.022 - Co-payment

Current through Reg. 50, No. 138; July 16, 2024
If required by the PLHSO, co-payments will be paid when
				  health care services and benefits are rendered. The PLHSO or contracted
				  provider may assess a usual co-payment, as provided for in the benefits
				  schedule, when a subscriber fails to appear for an office visit or appointment,
				  provided this is a standard procedure.
Rulemaking Authority 636.067 FS. Law Implemented 636.016
					 FS.
New 11-15-94, Formerly
					 4-203.022.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.023 - Governing Body

Current through Reg. 50, No. 138; July 16, 2024
(1) Each PLHSO
				shall have a governing body that sets policy and has overall responsibility for
				the organization, including the following:
(a)
				Adopting organizational by-laws, rules and regulations, or similar form of
				document which provides a clear, concise statement of the mission, goals, and
				objectives of the organization.
(b)
				Adopting a quality assurance program that monitors the key areas of the health
				care delivery, to identify problems and opportunities to improve the delivery
				of quality health care services.
(c) Maintaining an ongoing quality assurance
				credentialing program.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.025 - Human Immunodeficiency Virus Infection (HIV) and Acquired Immune Deficiency Syndrome (AIDS) for Contract Purposes

Current through Reg. 50, No. 138; July 16, 2024
(1) A PLHSO may inquire whether a person has
				been tested positive for exposure to the HIV infection or been diagnosed as
				having AIDS or ARC caused by the HIV infection or other sickness or medical
				condition derived from such infection. A PLHSO shall not inquire whether a
				person has been tested for or has received a negative result from a specific
				test for exposure to the HIV infection or for a sickness or medical condition
				derived from such infection.
(2) A
				PLHSO contract shall not exclude coverage of a member of a subscriber group
				because of a positive test result for exposure to the HIV infection or a
				specific sickness or medical condition derived from such infection, either as a
				condition for or subsequent to the issuance of the contract, provided that this
				prohibition shall not apply to persons applying for enrollment where individual
				underwriting is otherwise allowed by law.
(3) No PLHSO contract shall exclude or limit
				coverage for exposure to the HIV infection or a specific sickness or medical
				condition derived from such infection.
Rulemaking Authority 636.067 FS. Law Implemented 636.016,
					 636.019, 636.022 FS.
New 11-15-94, Formerly
					 4-203.025.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.026 - Standards for Subscriber Contracts

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Group and nongroup subscriber contracts shall include all elements contained in
				this section.
(a) Definitions;
(b) Effective date and term of
				contract;
(c) Space for rate to be
				charged;
(d) Mode of payment
				(monthly, quarterly, etc. with provision for change of mode if
				applicable);
(e) Eligibility
				requirements for enrollment, including waiting periods for receiving services
				and any other restrictions;
(f)
				Grace period for late payment;
(g)
				Co-payment features, if any;
(h)
				Renewal, re-enrollment, termination, cancellation and disenrollment
				conditions;
(i) Services to be
				furnished and how the medical personnel will be made available;
(j) The contract, certificate, or handbook
				shall state where and in what manner the health care services may be
				obtained;
(k) Factors pertaining to
				pre-existing conditions, if applicable;
(l) All limitations, exclusions and
				exceptions, limitations on length of stay, and all other qualifying or limiting
				features which shall state coverage for pre-existing conditions cannot be
				excluded longer than two years;
(m)
				Provisions regarding in and out of area emergencies, which includes a
				definition of emergency, if applicable;
(n) Provisions for adding new family members
				including newborn and adopted children;
(o) Subscriber grievance procedures, formal
				and informal;
(p) Any other factors
				necessary for complete understanding of what is covered and what is excluded by
				the contract;
(q) Provisions
				relating to coordination of benefits if applicable;
(r) Provisions relating to subrogation, if
				applicable;
(s) Any applicable
				arbitration provision which shall state that any arbitration is voluntary and
				shall be conducted pursuant to chapter 682, F.S.; and,
(t) Conversion and extension of benefit
				privileges.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.028 - Certificate and Member Handbook Standards

Current through Reg. 50, No. 138; July 16, 2024
When certificates or member handbooks are given to the
				  subscriber in lieu of a subscriber contract, the certificate or member handbook
				  shall contain a description of the following:
(1) Definition;
(2) Eligibility requirements for enrollment,
				including waiting periods for receiving services and any other
				limitations;
(3) Health care
				services to be provided;
(4)
				Renewal, re-enrollment, termination, cancellation, and disenrollment
				conditions;
(5) Provisions for
				adding new family members;
(6)
				Benefits for newborn and adopted children;
(7) Grace period;
(8) Limitations, exceptions, or exclusions,
				such as waiting periods, specific conditions not covered, and limitations on
				length of stay and all other qualifying or limiting features;
(9) Provisions relating to pre-existing
				conditions, if applicable; NOTE: Pre-existing conditions cannot be excluded for
				longer than two years;
(10)
				Provisions relating to coordination of benefits;
(11) Provisions relating to
				subrogation;
(12) Any applicable
				arbitration provisions which shall state that any arbitration is voluntary and
				shall be conducted pursuant to chapter 682, F.S.;
(13) Conversion and extension of benefits
				privileges;
(14) Subscriber
				grievance procedures, formal and informal; and,
(15) Any applicable
				co-payments.
Rulemaking Authority 636.067 FS. Law Implemented 636.016,
					 636.027, 636.028 FS.
New 11-15-94, Formerly
					 4-203.028.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.035 - Reasons for Cancellation of Eligibility of a Subscriber Member

Current through Reg. 50, No. 138; July 16, 2024
Upon 45 days notice, a PLHSO may cancel or terminate the
				  coverage of a subscriber for the following reasons:
(1) The PLHSO may disenroll a subscriber for
				cause if the subscriber's behavior is disruptive, unruly, abusive, unlawful,
				fraudulent, or uncooperative to the extent that the subscriber's continuing
				participation in the PLHSO seriously impairs the PLHSO's ability to provide
				services to either the subscriber or other subscribers. The PLHSO may also
				cancel or terminate the coverage of a subscriber for the other reasons
				enumerated in section
				636.028, F.S. Prior to
				disenrolling a member, the following are required:
(a) An effort to resolve the problem. The
				PLHSO shall make a reasonable effort to resolve the problem presented by the
				subscriber, including the use or attempted use of subscriber grievance
				procedures.
(b) Consideration of
				extenuating circumstances. The PLHSO should ascertain that the subscriber's
				behavior is not related to the use of medical services or mental illness to the
				extent possible.
(c) Documentation.
				The PLHSO shall document the problems, efforts, and medical conditions as
				described in this rule chapter;
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.036 - Cancellation of Subscriber Contracts

Current through Reg. 50, No. 138; July 16, 2024
(1) If
				the subscriber group contract is not renewed due to claim experience, the
				subscriber group shall be entitled to receive the loss experience of the group.
				If requested by a subscriber group, a detailed claim experience record may be
				provided at a reasonable expense. The record shall maintain subscriber
				confidentiality.
(2) Any subscriber
				contract which is terminated or cancelled in accordance with section
				636.028, F.S., must identify
				clearly the reason(s) in writing to the subscriber.
Rulemaking Authority 636.067 FS. Law Implemented 636.028
					 FS.
New 11-15-94, Formerly
					 4-203.036.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.042 - Filing, Approval of Subscriber Contract and Related Forms

Current through Reg. 50, No. 138; July 16, 2024
(1) Every group or individual subscriber
				contract and every rider, endorsement, certificate, application, or other form
				to be used or issued in connection with any subscriber contract shall be filed
				by the PLHSO for approval by the Office before it may be delivered in this
				state, pursuant to the criteria in section
				636.018, F.S.
(2) Every form required to be filed by the
				PLHSO shall be identified by a unique form number, placed in the lower left
				hand corner of each form.
(3)
				Filing Format for All Forms. PLHSOs in possession of a Certificate of Authority
				shall submit contract filings to the Office electronically through
				http://www.floir.com/iportal. A filing shall consist of one copy of each of the
				following items:
(a) A brief letter
				explaining the type and nature of the filing. The letter shall indicate if the
				filing is for a new product, or a resubmission. If the filing is a
				resubmission, the letter shall indicate when the previous filing was submitted,
				the Florida filing number, and the date of the disapproval.
(b) Form OIR-B2-1507, "Office of Insurance
				Regulation, Life and Health Forms and Rates Universal Standardized Data Letter"
				as adopted in rule 69O-149.022, F.A.C., completely
				filled out in accordance with Form OIR-B2-1507A, "Office of Insurance
				Regulation, Life and Health Forms and Rates Universal Standardized Data Letter
				Instruction Sheet," as adopted by rule
				69O-149.022, F.A.C.
(c) The form being submitted by the PLHSO for
				approval.
(d) An actuarial
				memorandum consistent with the requirements of rule
				69O-203.045, F.A.C.
(e) Rate pages that define all proposed
				rates, rating factors, and methodologies for determining rates applicable in
				the state.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.045 - Rates

Current through Reg. 50, No. 138; July 16, 2024
(1) Before charging premiums to subscribers,
				a PLHSO shall file the rating methodology by which those premiums were
				determined with the Office. The Office must approve the methodologies and
				premium rates before use. Filings of rating methodologies shall provide
				adequate information, so that the Office, in accordance with generally accepted
				actuarial principles as applied to Prepaid Limited Health Service
				Organizations, may verify that the rating methodology does not produce
				inadequate, excessive, or unfairly discriminatory premiums. The Office will
				consider the limited services provided, the method in which services are
				provided, and the method of provider payment to determine whether a rate is in
				compliance.
(2) All rate
				classifications should be clearly identified, and the formulas and/or methods
				of calculating premiums adequately described.
(3) An actuarial memorandum shall be provided
				for each new product filing, rate revision or justification of existing rates.
				The pricing assumptions shall reflect organizational experience to the degree
				credible and industry experience where organizational experience is not
				credible, available or appropriate. All such items shall be actuarially
				justified by supporting data. In reviewing these assumptions, the Office will
				use, as an initial point of reference, comparisons of the assumptions with
				those from similar products of the same organization, similar products of other
				organizations and independent studies. The memorandum must contain the
				following items:
(a) Morbidity. This section
				shall describe the morbidity basis for the plan, including the source or
				sources used. The relationship between the morbidity assumptions and the
				benefits provided by the contract must be clearly demonstrated.
(b) Expenses. This section shall include a
				description of any expense assumptions used, including, but not limited to, per
				policy and percentage of premium expenses for acquisition, maintenance,
				commissions and state premium taxes.
(c) Contingency and Risk Margins. This
				section shall describe the margins anticipated for the contract at the time of
				the filing.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-203 - PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS AND DISCOUNT MEDICAL PLAN ORGANIZATIONS › Section 69O-203.048 - Standards for Marketing

Current through Reg. 50, No. 138; July 16, 2024
All sales people or representatives of the PLHSO engaged in
				  soliciting subscribers are bound by the advertising rules set forth in rule
				  69O-203.050, F.A.C. The PLHSO is
				  initially, and continues to be, as long as they hold a Certificate of
				  Authority, responsible for the acts of its representatives in soliciting
				  subscribers.
Rulemaking Authority 636.067 FS. Law Implemented 636.044
					 FS.
New 11-15-94, Formerly
					 4-203.048.