Florida Administrative Code

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 7-16-86, Formerly 22K-1.216, Amended 8-22-96, Repromulgated 1-31-02, Repealed 1-20-16.

Payment of claims for reimbursement of covered expenses under an individual or family coverage is contingent upon certification by the subscriber of the following: (1) The names, sex, social security numbers, addresses and birthdays of eligible dependents; (2) The name and addres…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-22-96, Repromulgated 1-31-02, Repealed 1-20-16.

Date of receipt of applications, personal checks, money orders, or agency checks by the Department shall be the date of the Department's date stamp shown. Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-22-96, Repromulgated 1-31-02.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.43, 22K-1.043, 22K-1.301, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.44, 22K-1.044, 22K-1.302, Amended 8-26-96, Repromulgated 1-31-02, Amended 3-16-05, Repealed 1-20-16.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.45, 22K-1.045, 22K-1.303, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.46, 22K-1.046, 22K-1.304, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.47, 22K-1.047, 22K-1.305, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

(1) Payment of Employee Contributions. (a) Employee contributions are due in advance of each month's coverage. (b) Payroll deductions for insurance coverage should always be made in such a manner that a full month's employee contribution has been deducted prior to the first day o…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.49, 22K-1.049, 22K-1.307, Amended 8-26-96, Repromulgated 1-31-02, Repealed 3-2-17.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.50, 22K-1.050, 22K-1.308, Amended 8-26-96, Repromulgated 1-31-02, Repealed 3-2-17.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.51, 22K-1.051, 22K-1.309, Amended 8-26-96, Repromulgated 1-31-02, Repealed 3-2-17.

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.52, 22K-1.052, 22K-1.310, Amended 8-26-96, Repromulgated as Amended 1-31-02, Repealed 1-20-16.

(1) An employee who retires and is covered under the Life Plan must elect one of the following options: (a) Submit a request to continue coverage during retirement. The request should include the retiree's name, social security number, date of retirement, date of last payroll ded…

(1) For employees not on payroll, premiums shall be paid in monthly amounts by personal check or money order during the period the employee is not on the payroll. An employee who is not on the payroll for an entire payroll period, whether paid biweekly or monthly, should have the…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.55, 22K-1.055, 22K-1.313, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

(1) When a check for the employee contribution is returned for nonpayment, a certified letter will be mailed directly to the signer of the check requesting payment of the amount due plus a service charge of fifteen dollars ($15) or five percent (5%) of the face amount of the chec…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-12-80, Formerly 22K-1.57, 22K-1.057, 22K-1.315, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

Unless otherwise expressly stated whenever used in chapter 60P-6, F.A.C., the following terms shall have the respective meaning indicated: (1) "Claim Filing Deadline" is April 15 following the participant's period of eligibility. All initial prior plan year claims filings must be…

(1) Those employees participating in the Health Program or Life Plan through premium contributions shall be enrolled in the Pretax Premium Plan in accordance with subsection 60P-2.002(7), F.A.C. (2) Those employees participating in a supplemental insurance plan shall be enrolled …

Rulemaking Authority 110.161(5) FS. Law Implemented 110.161 FS. History-New 8-26-96, Repromulgated 4-25-02, Repealed 1-20-16.

(1) A participant's salary reduction amount shall be increased or decreased automatically to correspond to any changes in employee contributions where, during the Plan Year, there has been a change in the cost of the premium under the State Health Insurance Program. (2) An electi…

Rulemaking Authority 110.161(5) FS. Law Implemented 110.161 FS. History-New 8-3-89, Amended 4-17-91, Formerly 22FB-1.007, Amended 8-26-96, Repromulgated 4-25-02, Repealed 3-2-17.

Rulemaking Authority 110.161(5), 110.403(1), 110.605(1) FS. Law Implemented 110.161, 110.205(2), 110.403(1)(c), 110.603(2) FS. History-New 8-26-96, Repromulgated 4-25-02, Repromulgated as Amended 4-25-02, Amended 10-20-10, Repealed 1-20-16.

Rulemaking Authority 110.161(5) FS. Law Implemented 110.161 FS. History-New 8-26-96, Repromulgated 4-25-02, Repealed 3-2-17.

(1) The participant shall submit to the Department a request which shall include the following: (a) Social security number, name, address, work and home telephone numbers; (b) A description of the expenses; 1. For medical expenses, the patient's name, the dates and descriptions o…

(1) If non-payment of the required contribution to any plan occurs as a result of an authorized leave without pay, the amount of such contribution will be adjusted and payment will resume with the next payroll check. (2) Upon receipt of the required contributions, participation i…

Rulemaking Authority 110.161(5) FS. Law Implemented 110.161 FS. History-New 8-26-96, Repromulgated 4-25-02, Repealed 1-20-16.

(1) The Shared Savings Program allows the enrollee of a state group health insurance plan or state-contracted health maintenance organization (HMO) to collect a Reward for receiving a healthcare service or bundled service provided through the online transparency platform establis…

For the purpose of administering this Plan, the following words and terms shall have the meaning indicated: (1) "Active work" or "actively at work" means the actual expenditure of time and energy by the employee, performing duties pertaining to the employee's job in the place whe…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.

Rulemaking Authority 110.123(5), 20.05(5) FS. Law Implemented 110.123 FS. History-New 8-26-96, Repromulgated 1-31-02, Repealed 3-2-17.

The effective date of coverage for an employee under the Plan shall be as follows: (1) The date of an employee's appointment to an eligible position; unless the employee is disabled or under a physician's care on account of sickness or injury and not actively at work on that date…

If an employee, while insured under the Plan and as a result of sickness or injury, becomes totally disabled, the Plan will pay biweekly benefits to the employee for the period of such disability. Such benefits are payable in an amount of sixty-five (65) percent of the employee's…

(1) The employing agency will pay 100% of the premium for each employee participating in the Plan, while that employee is on the active state payroll. (2) The employing agency will pay 100% of the premium for an employee on an approved medical leave, unless the employee is receiv…

Rulemaking Authority 110.123(5) FS. Law Implemented 110.123 FS. History-New 8-26-96, Repromulgted as Amended 1-31-02, Repealed 3-2-17.

The date of termination of coverage will be as follows: (1) In the event of termination of employment, the employment termination date. (2) In the event the employee requests to cancel coverage, the last day of the month in which the Department receives a signed waiver of coverag…

(1) These rules shall apply to all voluntary binding arbitration proceedings of medical negligence claims initiated in accordance with Sections 766.201 through 766.212, F.S., to determine and to allocate the amount of damages. All references to DOAH are to the Division of Adminis…

In computing any period of time prescribed or allowed by these rules, by order of the chief arbitrator, or by an applicable statute, the day of the act from which the designated period of time begins to run shall not be included. The last day of the period shall be included unles…

(1) A party has the right to be represented by an attorney at any arbitration proceeding or hearing conducted under Sections 766.201 through 766.212, F.S. (2) Attorneys shall promptly file notices of appearance. Counsel who file any pleading with the Office of the Clerk or the ch…

(1) In construing these rules, any applicable statute, any order of an arbitration panel, or any order of the chief arbitrator, filing means receipt by the Office of the Clerk at DOAH during normal business hours or by the chief arbitrator during the course of a hearing. (2) Any …

(1) All parties agreeing to arbitration shall execute and file with the Office of the Clerk a request for arbitration substantially in the following form: "We hereby agree to submit to arbitration under Sections 766.201-.212, F.S., and Chapter 60Q-3, F.A.C., the determination of …

At any time before entry of an arbitration award, all parties may agree to terminate the arbitration proceedings due to a settlement. Rulemaking Authority 766.207(9), (10) FS. Law Implemented 766.201-.212 FS. History-New 9-6-88, Formerly 22I-7.006, Amended 6-27-00.

(1) When the Director of DOAH determines that an offer to arbitrate has been made and accepted in substantial conformity with Rule 60Q-3.005, F.A.C., the Director shall appoint an Administrative Law Judge as chief arbitrator of the assessment arbitration panel. (2) The chief arbi…

(1) No party or other person directly or indirectly interested in an arbitration proceeding nor anyone authorized to act on behalf of a party or other interested person shall communicate ex parte with an arbitrator or nominee relative to the merits of the arbitration proceeding, …

(1) Unless good cause is shown, motions for disqualification of arbitrators shall be filed within 15 days from the appointment of that arbitrator. At least one affidavit shall accompany the motion and state particular grounds. A motion to disqualify the chief arbitrator shall be …