69O-191.060. Form and Content of Advertisements

(1) Advertising must be truthful and not misleading in fact or implication. Words or phrases shall be clear and understandable without reliance upon technical terminology.

(2) Testimonials or Endorsements by Third Parties.

(a) If the person making a testimonial, an endorsement or an appraisal has a financial interest in the HMO or in a related entity as a stockholder, director, officer, employee, compensated party, or otherwise, such fact shall be disclosed in the advertisement.

(b) An advertisement shall not state or imply that an HMO or a contract has been approved or endorsed by an individual, group of individuals, society, association or other organization, unless the HMO or contract has been so approved or endorsed, and unless any proprietary relationship between an organization and the HMO is disclosed. Any entity which makes an endorsement or testimonial and which is formed, owned or controlled by the HMO or persons who own or control the HMO, shall disclose the ownership or controlling interest within the advertisement.

(3) Use of Statistics.

(a) An advertisement relating to the dollar amounts of claims paid, the number of subscribers, or similar statistical information relating to any HMO or contract shall not use irrelevant facts, and shall not be used unless it accurately reflects all of the relevant facts. Such an advertisement shall not imply that such statistics are derived from the contract advertised unless such is the fact. If the statistics are applicable to other contracts or plans the advertisement shall specifically so state.

(b) An advertisement shall not represent or imply that claim settlements or coverages by the HMO are more liberal or generous, or will be more favorable than the actual terms of the contract.

(c) The source of any statistics used in an advertisement shall be identified in the advertisement.

(4) Disparaging Comparisons and Statements.

(a) Advertising shall not directly or indirectly make false comparisons of contracts or benefits of other HMOs or insurers, and shall not disparage competitors, their contracts, policies, services or business methods, and shall not disparage competing methods of marketing HMO products or insurance.

(5) Geographical Licensing and Status of HMO.

(a) An advertisement which is likely to be seen or heard beyond the limits of the geographical service area in which the HMO is licensed shall not imply licensing beyond those limits.

(b) An advertisement shall not create the impression directly or indirectly that the HMO, its financial condition or status, the payment of its claims, the merits, desirability, or advisability of its contract forms, or the HMO’s coverage plans are endorsed by any division or agency of this State or of the United States Government.

(6) Identity of HMO.

(a) All advertisements must contain the full name of the HMO as filed with the Office and as shown on the HMO’s Certificate of Authority.

(b) The full name and address of the HMO shall be identified and made clear in all of its printed advertisements. An advertisement shall not use a trade name, any HMO designation, the name of the parent company of the HMO, the name of a particular division of the HMO, a service mark, slogan, symbol, or other device that misleads or deceives as to the true identity of the HMO.

(c) No advertisement shall use any combination of words, symbols, or physical materials which by their content, phraseology, shape, color, or other characteristics are so similar to materials used by agencies of the federal government or of this State, or which would tend to confuse or mislead prospective subscribers into believing that the solicitation is in some manner connected with an agency of the municipal, state, or federal government.

(7) Statements About an HMO.

(a) An advertisement shall not contain statements which are untrue, or by implication misleading, with respect to the assets, corporate structure, financial standing, age or relative position of the HMO in the Health Maintenance Organization type insurance business.

(b) An advertisement shall not refer to a holding company or subsidiary of an HMO unless it fully discloses that it is a separate entity and not responsible for the HMO’s financial condition or contractual obligations. However, if the holding company or subsidiary of the HMO is a qualified, approved guaranteeing organization for the HMO, and is a guarantor pursuant to Sections 641.225 and 641.285, F.S., and Rule 69O-191.091, F.A.C., this may be stated.

(8) Exceptions, Reductions, and Limitations. When an advertisement states a dollar amount, or a period of time for which any benefit, or the conditions for which such benefit is covered, the advertisement shall also state the existence of exceptions, reductions, and limitations affecting the basic provisions of the contract without which reference the advertisement might have the capacity or tendency to mislead or deceive.

(9) Deceptive Words, Phrases or Illustrations Prohibited.

(a) Words, phrases, or illustrations shall not be used in a manner which misleads or have the capacity or tendency to deceive or mislead.

(b) No advertising shall omit or give false information, contain untrue, deceptive or misleading words, phrases, statements, references or illustrations as to the contract benefits, health conditions covered or premium rate.

(c) An advertisement shall not contain descriptions of a contract limitation, exception, or reduction, worded in a positive manner to imply that it is a benefit. Words and phrases used in an advertisement to describe such contract limitations, exceptions and reductions shall fairly and accurately describe the negative features of such limitations, exceptions and reductions of the contract offered.

Specific Authority 641.36 FS. Law Implemented 641.3903(1), (2), (3), (4), (9) FS. History–New 2-22-88, Formerly 4-31.060, Amended 5-28-92, Formerly 4-191.060.