Title XXXVII, Insurance

The commission may adopt rules pursuant to ss. 120.536(1) and 120.54 to implement the provisions of this act. A violation of any such rule subjects the violator to the provisions of s. 636.048.History.—s. 54, ch. 93-148; s. 213, ch. 98-200; s. 1553, ch. 2003-261.

As used in this part, the term:(1) “Discount plan” means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, provides access for plan members to providers of medical services and the right to receive medical services …

(1) Before doing business in this state as a discount plan organization, an entity must be a corporation, a limited liability company, or a limited partnership, incorporated, organized, formed, or registered under the laws of this state or authorized to transact business in this …

(1) Following receipt of an application filed pursuant to s. 636.204, the office shall review the application and notify the applicant of any deficiencies contained therein. The office shall issue a license to an applicant who has filed a completed application pursuant to s. 636.…

(1) The office may examine or investigate the business and affairs of any discount plan organization. The office may order any discount plan organization or applicant to produce any records, books, files, advertising and solicitation materials, or other information and may take s…

Except as otherwise provided in this part, discount plan organizations are governed by this part and are exempt from the Florida Insurance Code unless specifically referenced.History.—s. 5, ch. 2005-232; s. 18, ch. 2017-112.

(1) A discount plan organization may charge a periodic charge as well as a reasonable one-time processing fee for a discount plan.(2)(a) If the member cancels his or her membership in the discount plan organization within the first 30 days after the effective date of enrollment i…

(1) A discount plan organization may not:(a) Use in its advertisements, marketing material, brochures, and discount cards the term “insurance” except as otherwise provided in this part or as a disclaimer of any relationship between discount plan organization benefits and insuranc…

A discount plan organization or marketer must provide disclosures to a prospective member and the prospective member must acknowledge the acceptance of such disclosures before enrolling in a discount plan. A discount plan organization or marketer may make additional disclosures t…

(1) All providers offering medical services to members under a discount plan must provide such services pursuant to a written agreement. The agreement may be entered into directly by the provider or by a provider network to which the provider belongs.(2) A provider agreement betw…

There must be a written agreement between the discount plan organization and the member specifying the benefits under the discount plan and complying with the disclosure requirements of this part.History.—s. 31, ch. 2004-297; s. 10, ch. 2005-232; s. 9, ch. 2017-112.

(1) Each discount plan organization shall file with the office, within 3 months after the end of each fiscal year, an annual report.(2) Such reports must be on forms prescribed by the commission and must include:(a) Audited financial statements prepared in accordance with general…

(1) Each discount plan organization shall at all times maintain a net worth of at least $150,000.(2) The office may not issue a license unless the discount plan organization has a net worth of at least $150,000.History.—s. 31, ch. 2004-297; s. 21, ch. 2017-112.

(1) The office may suspend the authority of a discount plan organization to enroll new members, revoke any license issued to a discount plan organization, or order compliance if the office finds that any of the following conditions exist:(a) The organization is not operating in c…

In lieu of suspending or revoking a certificate of authority whenever any discount plan organization has been found to have violated any provision of this part, the office may:(1) Issue and cause to be served upon the organization charged with the violation a copy of such finding…

Each discount plan organization must provide the office at least 30 days’ advance notice of any change in the discount plan organization’s name, address, principal business address, or mailing address.History.—s. 31, ch. 2004-297; s. 24, ch. 2017-112.

Each discount plan organization must maintain on an Internet website an up-to-date list of the names and addresses of the providers with which it has contracted, the address of which must be prominently displayed on all its advertisements, marketing materials, brochures, and disc…

(1) All advertisements, marketing materials, brochures, and discount cards used by marketers must be approved in writing by the discount plan organization.(2) The discount plan organization must have an executed written agreement with a marketer before the marketer markets, promo…

A marketer or discount plan organization selling a discount plan with medical services and other services may commingle those products on a single page of forms, advertisements, marketing materials, or brochures.History.—s. 31, ch. 2004-297; s. 14, ch. 2005-232; s. 11, ch. 2017-1…

The commission may adopt rules to administer this part, including rules for the licensing of discount plan organizations, providing for the collection of data, relating to disclosures to plan members, and defining terms used in this part.History.—s. 31, ch. 2004-297; s. 12, ch. 2…

Sections 624.422 and 624.423 apply to a discount plan organization as if the discount plan organization were an insurer.History.—s. 31, ch. 2004-297; s. 26, ch. 2017-112.

(1) Each discount plan organization licensed pursuant to this part shall maintain in force a surety bond in its own name in an amount not less than $35,000 to be used at the discretion of the office to protect the financial interests of members who may be adversely affected by th…

(1) Except as provided in subsection (2), a person who willfully violates any provision of this part commits a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.(2) A person who operates as or willfully aids and abets another operating as a disc…

(1) In addition to the penalties and other enforcement provisions of this part, the office may seek both temporary and permanent injunctive relief when:(a) A discount plan is being operated by any person or entity that is not licensed pursuant to this part.(b) Any person, entity,…

Sections 626.901-626.912 apply to the activities of an unlicensed discount plan organization as if the unlicensed discount plan organization were an unauthorized insurer.History.—s. 31, ch. 2004-297; s. 30, ch. 2017-112.