Amends rule to remove requirement for insurers to offer Basic and Standard Health benefit plan due to change in statute.

 

DEPARTMENT OF FINANCIAL SERVICES

OIR – Insurance Regulation

RULE NO.:RULE TITLE:

69O-150.206Marketing Communications of Benefits Payable, Losses Covered, and Premiums Payable

PURPOSE AND EFFECT: Amends rule to remove requirement for insurers to offer Basic and Standard Health benefit plan due to change in statute.

SUMMARY: The requirements for standard, basic and limited small employer health plans were removed from the statute and therefore the rule is amended to conform to the statute.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Agency personnel familiar with the subject matter of the rule amendment have performed an economic analysis of the rule amendment that shows that the rule amendment is unlikely to have an adverse impact on the State economy in excess of the criteria established in Section 120.541(2)(a), Florida Statutes.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 624.308(1), 626.9611, 627.6699(12), FS.

LAW IMPLEMENTED: 624.307(1), 626.9541(1)(a), (b), (e), (k), (l), 626.9641(1), 627.6699(9)(d)1., 4., FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: February 26, 2018, 10:00 a.m.

PLACE: 116 Larson Building, 200 East Gaines Street, Tallahassee, Florida. To join by telephone, call [phone] and enter conference ID# 879383.

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Christopher Struk, Office of Insurance Regulation, E-mail [e-mail].. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Christopher Struk, Office of Insurance Regulation, E-mail [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

69O-150.206 Marketing Communications of Benefits Payable, Losses Covered, and Premiums Payable.

(1) Deceptive Words, Phrases, or Illustrations Prohibited.

(a) through (f) No change.

(g) A marketing communication that is an invitation to contract and is intended to be used in the marketing of a standard, basic, or limited health benefit plan in this state must contain the disclosures stated in Section 627.6699(9)(d)1., F.S.

(h)1. A marketing communication for a plan providing benefits for either a basic or standard health benefit plan shall state clearly and conspicuously in a prominent type the kind of plan marketed.

2. A marketing communication for a health benefit plan providing limited benefits, such as specified diseases or specified accidents, shall state clearly and conspicuously in prominent type the limited nature of the plan.

3. The statement shall be worded in language identical to, or substantially similar to the following: “THIS IS A LIMITED SMALL EMPLOYER HEALTH BENEFIT PLAN”, “THIS IS A BASIC SMALL EMPLOYER HEALTH BENEFIT PLAN”, “THIS IS A STANDARD SMALL EMPLOYER HEALTH BENEFIT PLAN”, whichever is applicable.

(g)(i) A marketing communication of a health benefit plan sold by direct response shall not use in a misleading manner the phrases, “no salesman will call”, “no agent will call”, “by eliminating the agent and/or commission, we can offer this low cost plan” or similar wording.

Rulemaking Authority 624.308(1), 626.9611, 627.6699(12) FS. Law Implemented 624.307(1), 626.9541(1)(a), (b), (e), (k), (l), 626.9641(1), 627.6699(9)(d)1., 4. FS. History–New 2-25-93, Formerly 4-150.206, Amended_______.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Christopher Struk, Office of Insurance Regulation, E-mail [e-mail].

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: THE FINANCIAL SERVICES COMMISSION

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 13, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: July 12, 2017.