Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69B - Division of Insurance Agent and Agency Services › Chapter 69B-150 - LIFE AND HEALTH ADVERTISING REQUIREMENTS › Section 69B-150.206 - Marketing Communications of Benefits Payable, Losses Covered, and Premiums Payable

Current through Reg. 50, No. 138; July 16, 2024
(1) Deceptive
				Words, Phrases, or Illustrations Prohibited.
(a) A marketing communication shall not omit
				information or use words, phrases, statements, references, or illustrations
				that have the capacity, tendency, or effect of misleading or deceiving
				purchasers or prospective purchasers as to the nature or extent of any health
				benefit payable, loss covered, or premium payable. The fact that the plan
				offered is made available to the prospective plan purchaser for inspection
				prior to consummation of the sale, or that an offer is made to refund the
				premium if the purchaser is not satisfied, does not remedy misleading
				statements.
(b) A marketing
				communication shall not contain or use words or phrases such as "all," "full,"
				"complete," "comprehensive," "unlimited," "up to," "high as," "this plan will
				help pay your hospital and surgical bills," "this plan will help fill some of
				the gaps that your present insurance leaves out," or similar words and phrases,
				in a manner that exaggerates any benefits beyond the terms of the
				plan.
(c) A marketing communication
				shall not contain descriptions of a plan limitation or exclusion worded in a
				positive manner to imply that it is a benefit, such as, "even pre-existing
				conditions are covered after a limited period of time." Words and phrases used
				in a marketing communication to describe plan limitations and exclusions shall
				fairly and accurately describe the negative features of the limitations and
				exclusions of the plan offered.
(d)
				A marketing communication of a benefit for which payment is conditional upon
				confinement in a hospital or similar facility shall not use words or phrases
				such as "tax free," "extra cash," "extra income," "extra pay," or substantially
				similar words or phrases in a manner that would have the capacity, tendency, or
				effect of misleading the public into believing that the plan marketed will in
				some way enable them to make a profit from being hospitalized or
				disabled.
(e) When the plan
				marketed contains a limit on the number of days of coverage provided, the limit
				must appear in the marketing communication.
(f) A marketing communication of a plan
				covering only one disease or a list of specified diseases shall not imply
				coverage beyond the terms of the plan. Synonymous terms shall not be used to
				refer to any disease in order to imply broader coverage than is the
				fact.
(g) A marketing communication
				that is an invitation to contract and is intended to be used in the marketing
				of a standard, basic, or limited health benefit plan in this state must contain
				the disclosures stated in section 627.6699(9)(d)1., F.S.
(h)
1. A
				marketing communication for a plan providing benefits for either a basic or
				standard health benefit plan shall state clearly and conspicuously in a
				prominent type the kind of plan marketed.
2. A marketing communication for a health
				benefit plan providing limited benefits, such as specified diseases or
				specified accidents, shall state clearly and conspicuously in prominent type
				the limited nature of the plan.
3.
				The statement shall be worded in language identical to, or substantially
				similar to the following: "THIS IS A LIMITED SMALL EMPLOYER HEALTH BENEFIT
				PLAN", "THIS IS A BASIC SMALL EMPLOYER HEALTH BENEFIT PLAN", "THIS IS A
				STANDARD SMALL EMPLOYER HEALTH BENEFIT PLAN", whichever is
				applicable.
(i) A
				marketing communication of a health benefit plan sold by direct response shall
				not use in a misleading manner the phrases, "no salesman will call", "no agent
				will call", "by eliminating the agent and/or commission, we can offer this low
				cost plan" or similar wording.