Florida Administrative Code

(1) "Worksite" for purposes of this rule means a place in Florida where an employer conducts business operations. (2) Upon service of a Stop-Work Order on an employer, the Stop-Work Order shall be effective upon all employer worksites in the state for which the employer is not in…

(1) When an investigation commenced by the Department pursuant to Section 440.107, F.S., reflects that, on the date the investigation commences, the employer is failing to secure the payment of workers' compensation, is materially understating or concealing payroll, is materially…

(1) Under Section 440.107(7)(b), F.S., Stop-Work Orders or Orders of Penalty Assessment issued against a corporation, limited liability company, partnership, or sole proprietorship shall be in effect against any successor corporation or business entity that has one or more of the…

(1) In order for a contractor who is not securing the payment of compensation pursuant to Section 440.38(1)(a), F.S., to satisfy its obligation to obtain evidence of workers' compensation insurance or a Certificate of Election to Be Exempt from a subcontractor pursuant to Section…

(1) For purposes of determining payroll for calculating a penalty pursuant to Section 440.107(7)(d)1., F.S., the Department must when applicable, include the following as remuneration to employees based upon evidence received in its investigation: (a) Wages or salaries paid to em…

(1) Pursuant to Section 440.107, F.S., the Division will reduce the final assessed penalty by 15% if: (a) The employer has not been previously issued a Stop-Work Order or Order of Penalty Assessment; and (b) The employer takes an online workers' compensation coverage and complian…

(1) The Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2024 Edition (HCP RM), is incorporated by reference as part of this rule. The HCP RM establishes reimbursement policies, guidelines, and procedures for services provided by health care providers. Als…

(1) The Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASC RM), 2020 Edition, effective 07/23 is incorporated herein by reference. The policy, procedures, principles, and standards in the ASC RM supplement the requirements and responsibilities…

(1) The Florida Workers' Compensation Reimbursement Manual for Hospitals, (Hospital RM), 2020 Edition, effective 06/23, is incorporated herein by reference The policy, procedures, principles and standards in the Hospital RM supplement the requirements and responsibilities establi…

Health care providers and health care facilities shall upon demand furnish an injured employee or his attorney a copy of his office chart, records and reports. The health care provider or health care facility furnishing the records may charge the employee for copying the records …

Rulemaking Authority 440.13(4), 440.15(3)(b), (d), (f), 440.185(5), 440.20(6)(b), 440.525(2), 440.591, 440.593(5) FS. Law Implemented 440.09, 440.13(2)(a), (3), (4), (6), (11), (12), (14), (16), 440.15(3)(b), (d), (f), (5), 440.185(5), (9), 440.20(6), 440.525(2), 440.593 FS. Hist…

(1) Determination of Physical Impairment Rating. The American Medical Association's Guide to the Evaluation of Permanent Impairment, 3rd Edition, (AMA Guide) (Copyright 1988 by the American Medical Association) is adopted as the schedule for determining the existence and degree o…

(1) As used in this chapter: (a) "Accurately Complete" or "Accurately Completed" means the form submitted contains the information necessary to meet the requirements of Chapter 440, F.S., and this rule. (b) "Adjust" or "Adjusted" means payment is made with modification to the inf…

(1) The following forms, including form completion instructions, are incorporated for use with rules adopted under this rule chapter. (a) Form DFS-F5-DWC-9/CMS-1500 Health Insurance Claim Form, Rev. 02/12; Completion Instructions for Form DFS-F5-DWC-9 are comprised of three sets.…

(1) Bill Submission/Filing and Reporting Requirements. (a) All health care providers are responsible for meeting their obligations, under this rule, regardless of any business arrangement with any entity under which claims are prepared, processed or submitted to the insurer. (b) …

(1) An insurer is responsible for meeting its obligations under this rule regardless of any business arrangements with any claim administrator or any entity acting on behalf of an insurer under which medical bills are paid, adjusted, disallowed, denied, or otherwise processed or …

(1) Effective 3/16/05, all required medical reports shall be electronically filed with the Division by all insurers. (2) Required data elements shall be submitted in compliance with the MEIG. (3) The Division will notify the Sender on the "Medical Bill Acknowledgement" of the cor…

(1) The following materials are incorporated by reference: (a) Rule 69L-7.710, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06181; (b) Rule 69L-7.720, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06182; (c) Rule 69L-7.730, F.A.C., http://www.flrules.…

(1) The following materials are incorporated by reference: (a) Rule 69L-7.710, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06181; (b) Rule 69L-7.720, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06182; (c) Rule 69L-7.730, F.A.C., http://www.flrules.…

(1) The following materials are incorporated by reference: (a) Rule 69L-7.710, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06181; (b) Rule 69L-7.720, F.A.C., http://www.flrules.org/Gateway/reference.asp?No=Ref-06182; (c) Rule 69L-7.730, F.A.C., http://www.flrules.…

(1) The following materials are incorporated by reference: (a) The HCPCS Level II Professional Edition, as adopted in rules 69L-8.071 and 69L-8.073, F.A.C. (b) The Current Procedural Terminology (CPT®), as adopted in rules 69L-8.071, 69L-8.072 and 69L-8.073, F.A.C. (c) The CDT, D…

Rulemaking Authority 440.09(7), 440.101, 440.102(10) FS. Law Implemented 440.09(7), 440.101, 440.102, 627.0915 FS. History-New 4-30-96, Formerly 38F-9.015, 4L-9.015, Repealed 12-12-11.

(1) Under the Commissioner of the Office are hereby established a chief of staff, a general counsel, and deputy commissioners as follows: (a) Deputy commissioner for property and casualty; and, (b) Deputy commissioner for life and health. (c) Deputy commissioner for market regula…

Rulemaking Authority 120.53, 624.308 FS. Law Implemented 119.01, 119.031, 119.041, 119.07, 120.53, 624.307(1), 624.311, 624.501, 627.919 FS. History-New 1-1-75, Formerly 4-38.07, 4-38.007, Amended 2-5-87, 6-4-92, 5-30-95, Formerly 4-121.007, Repealed 10-25-16.

Rulemaking Authority 120.533, 120.533(1)(b), (e), (i), (j), 624.501 FS. Law Implemented 119.041(2), 120.53(2)(a)1.-5., (d), (3), (4), 120.53 FS., Chapter 91-30, Section 10, Laws of Florida. History-New 6-4-92, Amended 3-1-93, 9-19-94, Formerly 4-121.010, Repealed 10-25-16.

(1) Informal Conferences Authorized. The Office head or a hearing officer designated by the Office may order an informal conference prior to a formal or informal proceeding. (2) Procedures for Conferences Held Pursuant to Section 624.319(1), F.S. (a) Every insurer will receive a …

Each set of fingerprints filed with the Office of Insurance Regulation shall be accompanied by a processing fee. The processing fee shall be the total of the following amounts: $25.00 for processing by the Office; and the fee charged to the Office by the Florida Department of Law…

Rulemaking Authority 624.308(1) FS. Law Implemented 119.07(1)(b), 624.307, 624.313(3) FS. History-New 9-29-92, Amended 4-25-00, Formerly 4-127.001, Repealed 4-27-26.

Rulemaking Authority 624.308 FS. Law Implemented 624.307, 624.313(3) FS. History-New 9-29-92, Amended 3-8-94, 4-25-00, Formerly 4-127.002, Repealed 4-27-26.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.001, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.002, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.003, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.004, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.005, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205 FS. History-New 4-22-92, Formerly 4E-3.006, Repealed 10-25-16.

Rulemaking Authority 120.53 FS. Law Implemented 386.205, 386.208 FS. History-New 4-22-92, Formerly 4E-3.007, Repealed 10-25-16.

Rulemaking Authority 624.308(1) FS. Law Implemented 624.155, 624.307(1) FS. History-New 4-25-90, Formerly 4-103.001, 4-123.001, Repealed 1-18-15.

Rulemaking Authority 624.308(1) FS. Law Implemented 624.155 FS. History-New 4-25-90, Formerly 4-103.002, Amended 8-28-00, Formerly 4-123.002, Repealed 1-18-15.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 12-24-74, Formerly 4-3.01, 4-3.001, 4-124.001, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 12-24-74, Formerly 4-3.02, 4-3.002, 4-124.002, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 5-20-64, Repromulgated 12-24-74, Formerly 4-3.10, 4-3.010, 4-124.010, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 12-24-74, Formerly 4-3.11, 4-3.011, Formerly 4-124.011, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 12-24-74, Formerly 4-3.13, 4-3.013, 4-124.013, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 5-20-64, Repromulgated 12-24-74, Formerly 4-3.14, 4-3.014, 4-124.014, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1), 626.9951(1)(d) FS. History-New 5-20-64, Repromulgated 12-24-74, Formerly 4-3.15, 4-3.015, 4-124.015, Repealed 2-19-20.

Rulemaking Authority 624.308, 626.9611 FS. Law Implemented 624.307(1), 626.9551(1) FS. History-New 5-20-64, Repromulgated 12-24-74, Formerly 4-3.16, 4-3.016, 4-124.016, Repealed 2-19-20.

Rulemaking Authority 624.308(1) FS. Law Implemented 626.9541(1)(a), 624.307(1), 626.9551(1)(a) FS. History-New 11-24-85, Formerly 4-64.01, 4-64.001, 4-124.021, Repealed 2-19-20.

Rulemaking Authority 624.308(1) FS. Law Implemented 624.307(1), 626.9541(1)(a), 626.9551(1)(a) FS. History-New 11-24-85, Formerly 4-64.02, 4-64.002, 4-124.022, Repealed 2-19-20.

Concurrent with the solicitation of an application for an insurance product that is marketed in conjunction with obtaining a student loan from the same insurance company, the insurance company shall provide the applicant with a written disclosure form as provided in Rule 69O-124.…

The following disclosure form shall be utilized: IMPORTANT NOTICE TO APPLICANTS REGARDING STUDENT LOANS OBTAINED THROUGH: ___________ Name of Insurance Company PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY: 1. IF YOU APPLY FOR A STUDENT LOAN FROM AN INSURANCE COMPANY, THE INSURA…