Florida Administrative Code

(1) A marketing communication shall not contain statements that are untrue in fact, or misleading by implication, with respect to the assets, corporate structure, financial standing, age, or relative position of the small employer carrier in the insurance business. (2) A marketin…

If any section or portion of a section of these rules, or any amendment, or the applicability to any person or circumstance is held invalid by a court, the remainder of the rules or the applicability of the provision to other persons or circumstances shall not be affected. Rulema…

The purpose of this rule chapter is: (1) To implement the provisions of sections 626.9521, 626.9541, 626.9611 and 626.9641, F.S., and such other laws of this state as may be applicable, with respect to the replacement of life insurance and related matters; (2) To regulate the act…

"Replacement" means any transaction in which new life insurance is to be purchased, and it is known or should be known to the proposing agent that by reason of such transaction existing life insurance has been or is to be: (1) Lapsed, forfeited, surrendered, or otherwise terminat…

(1) "Existing Insurer" means the insurance company whose policy is or will be changed or terminated in such a manner as described within the definition of "replacement." (2) "Existing Life Insurance" means any life insurance in force including life insurance under a binding or co…

Rulemaking Authority 624.308, 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 7-9-81, Formerly 4-24.03, Amended 2-2-83, Formerly 4-24.13, 4-24.013, 4-151.004, Repealed 12-31-15.

Each agent shall submit to the insurer with or as a part of each application for life insurance: (1) A statement signed by the applicant as to whether or not such insurance will replace existing life insurance; and, (2) A signed statement as to whether or not the agent knows repl…

Where replacement is or may be involved, the agent shall: (1) Present to the applicant, not later than at the time of taking the application, a Form OIR-B2-312 "Notice to Applicant Regarding Replacement of Life Insurance" rev. 1-91 as described in Exhibit A adopted in rule 69B-15…

Rulemaking Authority 624.308, 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 7-9-81, Formerly 4-24.06, 4-24.19, 4-24.019, 4-151.009, Repealed 12-31-15.

The Form OIR-B2-312 "Notice to Applicant Regarding Replacement of Life Insurance," rev. 1-91, set forth in Exhibit A is hereby incorporated by reference and adopted herein. Copies of the above-mentioned form is available to the public through the Office of Insurance Regulation, B…

Rulemaking Authority 624.308, 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 7-9-81, Formerly 4-24.20, 4-24.020, 4-151.012, Repealed 12-31-15.

The purpose of these rules is to safeguard the interests of persons covered by accident and health insurance policies or plans who are considering replacement of their insurance by making available to them information regarding replacement, thereby reducing the opportunity for mi…

These rules apply to the solicitation of accident and health insurance covering residents of this state. They do not apply to the solicitation of the following accident and health insurance: (1) Group, blanket or franchise; (2) Accident only; (3) Single premium nonrenewable; (4) …

As used in these rules: (1) "Replacement" is any transaction wherein new accident and health insurance is to be purchased and it is known to the agent, broker or insurer at the time of application that, as a part of the transaction, existing accident and health insurance has been…

An application form for insurance subject to these rules shall contain a question to elicit information as to whether the insurance to be issued is to replace any insurance presently in force. If replacement of existing coverage is indicated the application shall state the Compan…

Rulemaking Authority 624.308(1), 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 2-1-79, Formerly 4-44.05, 4-44.005, 4-151.105, Repealed 12-31-15.

Rulemaking Authority 624.308(1), 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 2-1-79, Formerly 4-44.06, 4-44.006, 4-151.106, Repealed 12-31-15.

Rulemaking Authority 624.308(1), 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.9521, 626.9541, 626.9641 FS. History-New 2-1-79, Formerly 4-44.07, 4-44.007, 4-151.107, Repealed 12-31-15.

(1) The purpose of rules 69B-151.201 and 69B-151.202, F.A.C., is to implement the provisions of section 626.9541(1)(aa), F.S., with respect to churning rules 69B-151.201 and 69B-151.202, F.A.C., apply to all types of policies and annuity contracts which include a policy value fea…

(1)(a) Forms required to be completed by the insurer by its licensed and appointed agent and provided to the applicant prior to or contemporaneous with the time the applicant signs any application for the purchase of an additional life insurance policy or annuity contract to be f…

Rulemaking Authority 624.308(1), 626.9541(1)(aa)2. FS., Chapter 95-219, Laws of Florida. Law Implemented 624.307(1), 626.9541(1)(aa) FS., Chapter 95-219, Laws of Florida. History-New 2-19-96, Formerly 4-151.203, Repealed 6-4-18.

For purposes of this chapter: (1) The term "False Claim" means any written statement which is a part of or supports a claim for payment or other benefit pursuant to an insurance policy or health maintenance organization coverage document for commercial or personal insurance or he…

The preparation of a false claim for presentation to an insurer, health maintenance organization, or third party and the presentation of a false claim to an insurer, health maintenance organization, or third party by an agent, physician, claimant or other person are deceptive act…

The submission or presentation for payment to an insurer, health maintenance organization or third party of a claim form, bill, or other statement for services rendered, prepared or signed by a health care provider or health care facility which does not disclose a pre-provision o…

Rulemaking Authority 627.6742(1) FS. Law Implemented 627.6742 FS. History-New 12-9-90, Formerly 4-51.022, Amended 1-1-92, Formerly 4-156.013, Repealed 11-11-18.

Rulemaking Authority 624.308(1), 627.674(2) FS. Law Implemented 624.307(1), 627.674 FS. History-New 1-1-81, Formerly 4-51.06, Amended 9-4-89, 3-13-90, 12-9-90, Formerly 4-51.006, Amended 1-1-92, 7-14-96, 12-17-96, 7-26-99, Formerly 4-156.014, Repealed 11-11-18.

Rulemaking Authority 624.308(1), 627.674(2) FS. Law Implemented 624.307(1), 627.674 FS. History-New 1-1-81, Formerly 4-51.07, Amended 9-4-89, 12-9-90, Formerly 4-51.007, Amended 1-1-92, 7-14-96, Formerly 4-156.015, Repealed 11-11-18.

(1) An issuer, directly or through its producers, shall: (a) Establish marketing procedures to assure that any comparison of policies by its agents or other producers will be fair and accurate. (b) Establish marketing procedures to assure excessive insurance is not sold or issued…

(1) In recommending the purchase or replacement of any Medicare supplement policy or certificate an agent shall make reasonable efforts to determine the appropriateness of a recommended purchase or replacement. (2) Any sale of Medicare supplement coverage that will provide an ind…

Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 627, Part VIII FS. History-New 12-9-90, Formerly 4-51.030, 4-156.050, Repealed 11-11-18.

The purpose of these rules is to provide prospective purchasers with clear and unambiguous statements in the advertisement and direct solicitation and sale of Medicare Supplement Insurance, and to assure the clear and truthful disclosure of the benefits, limitations and exclusion…

(1) These rules shall apply to any Medicare Supplement Insurance "advertisement" or direct solicitation and sale made or disseminated in this State which the insurer knows or reasonably should know is intended for presentation, distribution or dissemination in this State when suc…

For the purpose of these rules, the terms below are defined as follows: (1) An "Advertisement" includes: (a) Printed and published material, audio visual material and descriptive literature used by or on behalf of an insurer in direct mail, newspapers, magazines, radio scripts, T…

All information required to be disclosed by these rules shall be set out conspicuously and in close conjunction with the statements to which such information relates or under appropriate captions of such prominence that it shall not be minimized, rendered obscure or presented in …

It shall be deemed an unfair or deceptive act or practice in the direct solicitation or sale of Medicare supplement insurance policies, to: (1) Make any representation by an agent to the effect that such person is a "Counselor," "Advisor" or similar designation, for any associati…

Rulemaking Authority 624.308(1), 626.9611, 626.9641 FS. Law Implemented 624.307(1), 626.830, 626.9541(1), (2), (3), (5), (11), (12), 626.9641(1)(a), (c), (e), (h) FS. History-New 7-1-79, Formerly 4-46.04, 4-46.004, 4-156.106, Repealed 11-15-22.

(1) The form and content of a Medicare Supplement Insurance advertisement shall be sufficiently complete and clear to avoid deception or the capacity or tendency to mislead or deceive. Whether an advertisement has a capacity or tendency to mislead or deceive shall be determined b…

(1) Deceptive Words, Phrases, or Illustrations Prohibited. (a) No advertisement shall omit information or use words, phrases, statements, references or illustrations if the omission of such information or use of such words, phrases, statements, references, or illustrations has th…

An advertisement which is an invitation to contract shall disclose the provisions relating to renewability, cancellability, and termination and any modification of benefits, losses covered or premiums because of age or for other reasons, in a manner which shall not minimize or re…

Rulemaking Authority 624.308(1), 626.9611 FS. Law Implemented 624.307(1), 626.062, 626.830, 626.9541(1)(a), (b), (e), (k), (l), 626.9641(1) FS. History-New 6-12-88, Formerly 4-46.009, 4-156.110, Repealed 11-15-22.

(1) An advertisement relating to the dollar amounts of claims paid, the number of persons insured, or similar statistical information relating to any insurer or policy or contract shall not use irrelevant facts, and shall not be used unless it accurately reflects all of the relev…

When a choice of the amount of benefits is referred to, an advertisement shall disclose that the amount of benefits provided depends upon the plan selected and that the premium will vary with the amount of the benefits selected. Rulemaking Authority 624.308(1), 626.9611 FS. Law I…

(1) An advertisement shall not directly or indirectly make unfair or incomplete comparisons of policies or contracts or benefits or comparisons of non-comparable policies or contracts of other insurers, and shall not disparage competitors, their policies or contracts, services or…

(1) An advertisement which is intended to be seen or heard beyond the limits of the jurisdiction in which the insurer is licensed shall not imply licensing beyond those limits. (2) An advertisement shall not create the impression directly or indirectly that the insurer, its finan…

(1) The name of the actual insurer shall be stated in all of its advertisements. The form number or numbers of the policy advertised shall be stated in any invitation to contract. An advertisement shall not use a trade name, any insurance group designation, name of the parent com…

(1) An advertisement of a particular policy shall not state or imply that prospective insureds become group or quasi-group members covered under a group policy and as such enjoy special rates or underwriting privileges, unless such is the fact. (2) No solicitation of a particular…

(1) An advertisement of an individual policy shall not directly or by implication represent that a contract or combination of contracts is an introductory, initial, or special offer, or that applicants will receive substantial advantages not available at a later date, or that the…