Florida Administrative Code

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 History-New 8-12-80, Formerly 22K-1.55, 22K-1.055, 22K-1.313, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.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 History-New 8-12-80, Formerly 22K-1.57, 22K-1.057, 22K-1.315, Amended 8-26-96, Repromulgated 1-31-02, Repealed 1-20-16.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 History-New 8-26-96, Repromulgated 4-25-02, Repealed 1-20-16.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 History-New 8-3-89, Amended 4-17-91, Formerly 22FB-1.007, Amended 8-26-96, Repromulgated 4-25-02, Repealed 3-2-17.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 History-New 8-26-96, Repromulgated 4-25-02, Repromulgated as Amended 4-25-02, Amended 10-20-10, Repealed 1-20-16.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 History-New 8-26-96, Repromulgated 4-25-02, Repealed 3-2-17.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 …

(1) Parties may obtain discovery as provided in Rules 1.280 through 1.400, Florida Rules of Civil Procedure, provided that no party may serve any written interrogatories, requests for production or inspection, requests for admissions or requests for physical or mental examination…

(1) All requests for relief shall be by motion. Written motions will normally be disposed of on the basis of the motion, together with any memoranda in support or in opposition, following the expiration of a seven-day response period. If the subject matter of the motion requires …

(1) The chief arbitrator shall issue subpoenas on forms supplied by DOAH through the eALJ portal. Subpoenas shall issue in blank except for the style of the case, the case number, the name, address and telephone number of the attorney or party requesting the subpoena, and the chi…

Except as to matters Sections 766.201-.212, F.S., specifically require arbitration panels or the Director to decide, the chief arbitrator may issue any orders necessary to effectuate discovery, to prevent delay, and to promote the just, speedy and inexpensive determination of all…

The defendant shall arrange for and bear the expense of a court reporter's appearance at the assessment arbitration and any allocation arbitration hearings and recordation of the proceeding. Rulemaking Authority 766.207(9), (10) FS. Law Implemented 766.201-.212 FS. History-New 9-…

Unless all parties otherwise agree, when an arbitration is conducted live, the arbitration shall take place in the county in which the medical incident occurred or in which a defendant who lives in Florida resides. Rulemaking Authority 766.207(9), (10) FS. Law Implemented 766.201…

(1) After the panel has been confirmed, the chief arbitrator shall set a time and place for assessment arbitration and give the parties at least 90 days' notice, unless prior proceedings resulted in misarbitration. The notice shall state the time, place and nature of the hearing …

(1) The chief arbitrator may grant a continuance for good cause shown. Except in cases of emergency, all requests for postponement of an arbitration hearing shall be made by motion for continuance filed at least 10 days prior to the scheduled commencement of the arbitration heari…

(1) Mediation is encouraged but not required for arbitration. Should the parties choose to mediate, mediation shall be conducted at least ten days prior to the date that the arbitration hearing is scheduled to commence. (2) The parties shall notify the chief arbitrator of the res…

(1) Unless a majority the assessment arbitration panel decides to defer entry of the arbitration award, the arbitration award shall be announced on the record after the conclusion of the evidence. (2) The chief arbitrator shall sign the arbitration award within 10 days from the c…

(1) If no two members of the assessment arbitration panel can agree on an arbitration award, the chief arbitrator shall enter an order of misarbitration. (2) Within 20 days of an order of misarbitration, the parties shall nominate at least three but no more than five arbitrators …

(1) Where more than one defendant has participated in an assessment arbitration proceeding, any defendant against whom an arbitration award has been made may initiate allocation arbitration proceedings by filing a demand for allocation with the Office of the Clerk within 20 days …

At any time before an order allocating financial responsibility is entered, all arbitrating defendants may agree to entry of a stipulated statement allocating financial responsibility, which, when signed by all arbitrating defendants and filed, shall have the same effect as an or…

(1) If all arbitrating defendants agree in writing, they may, within 20 days of the arbitration award, select two arbitrators, and up to four alternates, by filing their names, addresses and telephone numbers, along with certificates in accordance with Rule 60Q-3.007, F.A.C., exe…

(1) The chief arbitrator shall set the time and place for allocation arbitration and give the parties at least 30 days' notice. (2) In the event a motion for continuance is granted, the chief arbitrator shall issue a new notice of hearing, but need not give 30 days' notice of the…

(1) No later than 10 days before the allocation arbitration hearing, or by such other time as the chief arbitrator orders, the arbitrating defendants shall file a pre-hearing stipulation, which shall contain: (a) A brief general statement of each party's position; (b) A list of a…

(1) Unless a majority of the allocation arbitration panel decides to defer entry of the order allocating financial responsibility, the order shall be announced on the record after the conclusion of the evidence. (2) The order allocating financial responsibility shall list all def…

The chief arbitrator may impose reasonable sanctions for violations of these rules, or of any order entered by the Director or the chief arbitrator. Rulemaking Authority 766.207(9), (10) FS. Law Implemented 766.201-.212 FS. History-New 9-6-88, Formerly 22I-7.035, Amended 6-27-00.

These rules of procedure apply in all workers' compensation proceedings before the judges of compensation claims. Rulemaking Authority 440.45(1)(a), (4) FS. Law Implemented 440.45(1)(a), (4) FS. History-New 2-23-03, Amended 11-1-06.