DEPARTMENT OF FINANCIAL SERVICES
RULE NO.:RULE TITLE:
69O-192.058Forms Incorporated by Reference
PURPOSE AND EFFECT: These rule revisions update the rules to reflect electronic filing process.
SUMMARY: The various rules indicate how forms and filings are to be made to the Office. These rule revisions update the rules to reflect the electronic fling process and in some cases the forms have been updated to reflect current practice.
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: 624.4431, FS.
LAW IMPLEMENTED: 624.424, 624.439, 624.442, 628.4615, 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: April 13, 2017 at 9:30 a.m.
PLACE: 116 Larson Building, 200 East Gaines Street, Tallahassee, Florida
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: Chris Struk, Office of Insurance Regulation, Email christopher.struk@floir.com. 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: Chris Struk, Office of Insurance Regulation, E-mail christopher.struk@floir.com.
THE FULL TEXT OF THE PROPOSED RULE IS:
69O-192.058 Forms Incorporated by Reference.
The following forms are incorporated into this rule chapter by reference to implement the provisions of Sections 624.436 through 624.45, F.S.:
Title
Form Number
(1) Application for Certificate of Authority as a Multiple Employer Welfare Arrangement
OIR-C1-983 (4/95)486 (10/93)
(2) Application Cover letter
OIR-C1-983 (4/95)486 (10/93)
(3) Application Instructions
OIR-C1-984 (11/04) (10/93)
(4) Application Checklist
OIR-C1-985 (11/04) (10/93)
(5) Invoice
OIR-C1-980 (10/93)
(6) Management Information
OIR-C1-844 (4/97) (10/91)
(7) Instructions for Furnishing Background Investigative Reports
OIR-C1-905 939 (08/93) (2/15)
(8) Annual Statement
OIR-487 (4/89)
(9) Statement of Net Assets
OIR-488 (5/89)
(10) Statement of Change in Net Assets
OIR-489 (5/89)
(11) Authority to Release Information
OIR-C1-450 (5/00) (8/91)
(12) Biographical Statement and Affidavit
OIR-C1-422 (10/26/98)(11/90)
(13) Statement of Acquisition Merger or Consolidation of a Specialty Insurer
OIR-C1-448 (12/91) (12/05)
(14) Fingerprint Card Instructions
OIR-C1-938 (5/2013)
These forms shall become effective on the date this rule becomes effective. Copies of forms may be obtained from the Office of Insurance Regulation’s website: http://www.floir.com/iportal.Application forms may be obtained from the Application Coordinator, Insurer Services Support, Tallahassee, FL 32399-0327. Copies of all other forms may be obtained from the Office of Insusrance Regulation, Bureau of Life and Health Insurer Solvency and Market Conduct, Larson Building, Tallahassee, FL 32399-0300.
Rulemaking Specific Authority 624.4431 FS. Law Implemented 624.424, 624.439, 624.442, 628.4615 FS. History–New 7-15-90, Formerly 4-116.015, Amended 7-28-94, Formerly 4-192.058, Amended .
NAME OF PERSON ORIGINATING PROPOSED RULE: Chris Struk, Office of Insurance Regulation, E-mail christopher.struk@floir.com.
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: THE FINANCIAL SERVICES COMMISSION
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: March 14, 2017
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: February 22, 2017
Document Information
- Comments Open:
- 3/20/2017
- Summary:
- The various rules indicate how forms and filings are to be made to the Office. These rule revisions update the rules to reflect the electronic fling process and in some cases the forms have been updated to reflect current practice.
- Purpose:
- These rule revisions update the rules to reflect electronic filing process.
- Rulemaking Authority:
- 624.4431, FS.
- Law:
- 624.424, 624.439, 624.442, 628.4615, FS.
- Contact:
- Chris Struk, Office of Insurance Regulation, E-mail christopher.struk@floir.com.
- Related Rules: (1)
- 69O-192.058. Forms Incorporated by Reference