To publish the standard risk rates as required by Section 627.6675(3)(c), F.S.  

  •  

    DEPARTMENT OF FINANCIAL SERVICES
    OIR – Insurance Regulation

    RULE NO: RULE TITLE
    69O-149.205: Indemnity Standard Risk Rates
    69O-149.206: Preferred Provider/Exclusive Provider Standard Risk Rates
    69O-149.207: Health Maintenance Organization Standard Risk Rates
    PURPOSE AND EFFECT: To publish the standard risk rates as required by Section 627.6675(3)(c), F.S.
    SUMMARY: The Office is required by Section 627.6675(3)(c), F.S., to conduct an annual survey of the individual market and determine “standard risk rates”. These standard risk rates are the average rates charged in the individual market for health insurance. The standard risk rates are used by the health insurers in setting their conversion rates, because pursuant to Section 627.6675(3)(a), F.S., the maximum a health insurer can charge for a conversion policy is 200% of the standard risk rate.
    SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
    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.
    SPECIFIC AUTHORITY: 624.308, 627.6675(3)(c) FS.
    LAW IMPLEMENTED: 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) 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 20, 2007, 9:30 a.m.
    PLACE: Room 142, 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 calendar days before the workshop/meeting by contacting: Tracie Lambright, Life and Health Product Review, Office of Insurance Regulation, E-mail: Tracie.Lambright@fldfs.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: Tracie Lambright, Life and Health Product Review, Office of Insurance Regulation, E-mail: Tracie.Lambright@fldfs.com

    THE FULL TEXT OF THE PROPOSED RULE IS:

    69O-149.205 Indemnity Standard Risk Rates.

    (1) through (3) No change.

     

    STANDARD HEALTH BENEFIT PLAN

    Age

    Male

    Female

     

    County

    Area Factor

    0-17

    $1,224.24

    $1,224.24

     

    Alachua

    0.72

    18

    $1,741.39

    $2,182.58

     

    Baker

    0.78

    19

    $1,741.39

    $2,182.58

     

    Bay

    0.77

    20

    $1,741.39

    $2,182.58

     

    Bradford 

    0.82

    21

    $1,741.39

    $2,182.58

     

    Brevard

    0.95

    22

    $1,741.39

    $2,182.58

     

    Broward

    1.40

    23

    $1,741.39

    $2,182.58

     

    Calhoun

    0.75

    24

    $1,741.39

    $2,182.58

     

    Charlotte 

    1.00

    25

    $1,741.39

    $2,182.58

     

    Citrus

    0.69

    26

    $1,809.30

    $2,274.25

     

    Clay

    0.81

    27

    $1,879.86

    $2,369.77

     

    Collier

    0.93

    28

    $1,953.18

    $2,469.30

     

    Columbia 

    0.81

    29

    $2,029.35

    $2,573.01

     

    Dade

    1.37

    30

    $2,108.50

    $2,681.07

     

    De Soto 

    0.74

    31

    $2,190.73

    $2,793.68

     

    Dixie 

    0.73

    32

    $2,276.17

    $2,911.01

     

    Duval

    0.99

    33

    $2,364.94

    $3,033.27

     

    Escambia 

    0.77

    34

    $2,425.93

    $3,160.67

     

    Flagler

    0.82

    35

    $2,486.93

    $3,277.77

     

    Franklin 

    0.75

    36

    $2,577.45

    $3,390.52

     

    Gadsden 

    0.75

    37

    $2,671.27

    $3,507.15

     

    Gilchrist

    0.75

    38

    $2,768.51

    $3,627.80

     

    Glades

    0.98

    39

    $2,869.28

    $3,752.60

     

    Gulf

    0.76

    40

    $2,973.72

    $3,881.69

     

    Hamilton 

    0.77

    41

    $3,081.97

    $4,015.22

     

    Hardee

    0.80

    42

    $3,194.15

    $4,153.34

     

    Hendry

    1.01

    43

    $3,310.42

    $4,296.22

     

    Hernando

    0.85

    44

    $3,430.92

    $4,444.01

     

    Highlands 

    0.75

    45

    $3,524.12

    $4,543.38

     

    Hillsborough

    0.86

    46

    $3,692.58

    $4,657.42

     

    Holmes

    0.75

    47

    $3,869.08

    $4,774.32

     

    Indian River 

    0.97

    48

    $4,054.02

    $4,894.16

     

    Jackson 

    0.76

    49

    $4,247.81

    $5,017.00

     

    Jefferson 

    0.75

    50

    $4,450.85

    $5,142.93

     

    Lafayette 

    0.78

    51

    $4,663.60

    $5,272.01

     

    Lake 

    0.90

    52

    $4,886.52

    $5,404.34

     

    Lee

    0.99

    53

    $5,120.10

    $5,539.99

     

    Leon 

    0.79

    54

    $5,364.84

    $5,647.53

     

    Levy

    0.80

    55

    $5,567.49

    $5,755.06

     

    Liberty 

    0.75

    56

    $5,743.43

    $5,897.79

     

    Madison 

    0.79

    57

    $5,924.92

    $6,044.05

     

    Manatee

    0.90

    58

    $6,112.14

    $6,193.95

     

    Marion 

    0.77

    59

    $6,305.29

    $6,347.56

     

    Martin

    0.95

    60

    $6,504.54

    $6,504.98

     

    Monroe 

    1.37

    61

    $6,710.08

    $6,666.30

     

    Nassau 

    0.85

    62

    $6,922.12

    $6,831.62

     

    Okaloosa

    0.72

    63

    $7,140.86

    $7,001.05

     

    Okeechobee

    0.97

    64

    $7,366.51

    $7,174.67

     

    Orange 

    0.95

    65

    $7,366.63

    $7,140.13

     

    Osceola

    0.92

    66

    $7,366.63

    $7,140.13

     

    Palm Beach 

    1.00

    67

    $7,366.63

    $7,140.13

     

    Pasco 

    0.90

    68

    $7,366.63

    $7,140.13

     

    Pinellas

    0.87

    69

    $7,366.63

    $7,140.13

     

    Polk

    0.84

    70

    $7,366.63

    $7,140.13

     

    Putnam

    0.79

    71

    $7,366.63

    $7,140.13

     

    St. Johns 

    0.77

    72

    $7,366.63

    $7,140.13

     

    St. Lucie

    0.99

    73

    $7,366.63

    $7,140.13

     

    Santa Rosa 

    0.77

    74

    $7,366.63

    $7,140.13

     

    Sarasota 

    0.76

    75

    $7,366.63

    $7,140.13

     

    Seminole

    0.92

    76

    $7,366.63

    $7,140.13

     

    Sumter 

    0.80

    77

    $7,366.63

    $7,140.13

     

    Suwannee 

    0.82

    78

    $7,366.63

    $7,140.13

     

    Taylor 

    0.79

    79

    $7,366.63

    $7,140.13

     

    Union 

    0.79

     

     

     

     

    Volusia

    0.88

     

     

     

     

    Wakulla

    0.75

     

     

     

     

    Walton

    0.76

     

     

     

     

    Washington 

    0.76

     

     

     

     

     

     

    0-17

    $1,110.70

    $1,110.70

     

    Alachua

    0.76

    18

    $1,568.94

    $1,974.82

     

    Baker

    0.78

    19

    $1,568.94

    $1,974.82

     

    Bay

    0.73

    20

    $1,568.94

    $1,974.82

     

    Bradford 

    0.82

    21

    $1,568.94

    $1,974.82

     

    Brevard

    1.00

    22

    $1,568.94

    $1,974.82

     

    Broward

    1.39

    23

    $1,568.94

    $1,974.82

     

    Calhoun

    0.75

    24

    $1,568.94

    $1,974.82

     

    Charlotte 

    1.05

    25

    $1,568.94

    $1,974.82

     

    Citrus

    0.66

    26

    $1,630.13

    $2,057.77

     

    Clay

    0.82

    27

    $1,693.70

    $2,144.19

     

    Collier

    0.91

    28

    $1,759.75

    $2,234.25

     

    Columbia 

    0.81

    29

    $1,828.38

    $2,328.09

     

    Dade

    1.44

    30

    $1,899.69

    $2,425.87

     

    De Soto 

    0.74

    31

    $1,973.78

    $2,527.75

     

    Dixie 

    0.77

    32

    $2,050.76

    $2,633.92

     

    Duval

    1.04

    33

    $2,130.74

    $2,744.54

     

    Escambia 

    0.79

    34

    $2,213.84

    $2,859.81

     

    Flagler

    0.78

    35

    $2,209.78

    $2,963.38

     

    Franklin 

    0.75

    36

    $2,290.22

    $3,065.32

     

    Gadsden 

    0.75

    37

    $2,373.58

    $3,170.77

     

    Gilchrist

    0.75

    38

    $2,459.98

    $3,279.84

     

    Glades

    0.98

    39

    $2,549.52

    $3,392.67

     

    Gulf

    0.76

    40

    $2,642.33

    $3,509.38

     

    Hamilton 

    0.77

    41

    $2,738.51

    $3,630.10

     

    Hardee

    0.80

    42

    $2,838.19

    $3,754.97

     

    Hendry

    1.01

    43

    $2,941.50

    $3,884.14

     

    Hernando

    0.83

    44

    $3,048.57

    $4,017.76

     

    Highlands 

    0.79

    45

    $3,166.41

    $4,104.11

     

    Hillsborough

    0.91

    46

    $3,317.77

    $4,207.12

     

    Holmes

    0.75

    47

    $3,476.36

    $4,312.72

     

    Indian River 

    1.02

    48

    $3,642.53

    $4,420.97

     

    Jackson 

    0.76

    49

    $3,816.64

    $4,531.93

     

    Jefferson 

    0.75

    50

    $3,999.08

    $4,645.69

     

    Lafayette 

    0.78

    51

    $4,190.23

    $4,762.29

     

    Lake 

    0.89

    52

    $4,390.53

    $4,881.83

     

    Lee

    1.04

    53

    $4,600.39

    $5,004.36

     

    Leon 

    0.77

    54

    $4,820.29

    $5,129.97

     

    Levy

    0.80

    55

    $5,007.58

    $5,148.84

     

    Liberty 

    0.75

    56

    $5,165.82

    $5,276.53

     

    Madison 

    0.79

    57

    $5,329.06

    $5,407.39

     

    Manatee

    0.89

    58

    $5,497.46

    $5,541.50

     

    Marion 

    0.76

    59

    $5,671.18

    $5,678.92

     

    Martin

    0.98

    60

    $5,850.39

    $5,819.76

     

    Monroe 

    1.44

    61

    $6,035.26

    $5,964.09

     

    Nassau 

    0.84

    62

    $6,225.97

    $6,112.00

     

    Okaloosa

    0.69

    63

    $6,422.72

    $6,263.58

     

    Okeechobee

    0.97

    64

    $6,625.67

    $6,418.92

     

    Orange 

    1.00

    65

    $6,627.91

    $6,419.53

     

    Osceola

    0.94

    66

    $6,627.91

    $6,419.53

     

    Palm Beach 

    1.00

    67

    $6,627.91

    $6,419.53

     

    Pasco 

    0.86

    68

    $6,627.91

    $6,419.53

     

    Pinellas

    0.89

    69

    $6,627.91

    $6,419.53

     

    Polk

    0.85

    70

    $6,627.91

    $6,419.53

     

    Putnam

    0.77

    71

    $6,627.91

    $6,419.53

     

    St. Johns 

    0.77

    72

    $6,627.91

    $6,419.53

     

    St. Lucie

    0.99

    73

    $6,627.91

    $6,419.53

     

    Santa Rosa 

    0.77

    74

    $6,627.91

    $6,419.53

     

    Sarasota 

    0.76

    75

    $6,627.91

    $6,419.53

     

    Seminole

    0.92

    76

    $6,627.91

    $6,419.53

     

    Sumter 

    0.79

    77

    $6,627.91

    $6,419.53

     

    Suwannee 

    0.82

    78

    $6,627.91

    $6,419.53

     

    Taylor 

    0.79

    79

    $6,627.91

    $6,419.53

     

    Union 

    0.79

     

     

     

     

    Volusia

    0.84

     

     

     

     

    Wakulla

    0.75

     

     

     

     

    Walton

    0.76

     

     

     

     

    Washington 

    0.76

     

    Specific Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS. History–New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.205, Amended 5-18-04, 5-22-05, 6-1-06, ___________.

     

    69O-149.206 Preferred Provider/Exclusive Provider Standard Risk Rates.

    (1) through (4) No change.

     

    STANDARD HEALTH BENEFIT PLAN

    Age

    Male

    Female

     

    County

    Area Factor

    0

    $2,084.83

    $2,020.10

     

    Alachua

    0.72

    1

    $2,084.83

    $2,020.10

     

    Baker

    0.78

    2

    $1,752.86

    $1,723.43

     

    Bay

    0.77

    3

    $1,543.96

    $1,514.54

     

    Bradford 

    0.82

    4

    $1,426.28

    $1,367.43

     

    Brevard

    0.95

    5

    $1,367.43

    $1,246.80

     

    Broward

    1.40

    6

    $1,305.65

    $1,129.12

     

    Calhoun

    0.75

    7

    $1,280.33

    $1,074.38

     

    Charlotte 

    1.00

    8

    $1,221.49

    $983.17

     

    Citrus

    0.69

    9

    $1,192.07

    $983.17

     

    Clay

    0.81

    10

    $1,221.49

    $1,012.59

     

    Collier

    0.93

    11

    $1,250.91

    $1,074.38

     

    Columbia 

    0.81

    12

    $1,280.33

    $1,162.64

     

    Dade

    1.37

    13

    $1,309.75

    $1,280.33

     

    De Soto 

    0.74

    14

    $1,430.38

    $1,400.96

     

    Dixie 

    0.73

    15

    $1,518.65

    $1,518.65

     

    Duval

    0.99

    16

    $1,636.33

    $1,636.33

     

    Escambia 

    0.77

    17

    $1,698.12

    $1,727.54

     

    Flagler

    0.82

    18

    $1,513.96

    $1,572.92

     

    Franklin 

    0.75

    19

    $1,563.23

    $1,670.62

     

    Gadsden 

    0.75

    20

    $1,611.67

    $1,771.19

     

    Gilchrist

    0.75

    21

    $1,685.62

    $1,890.53

     

    Glades

    0.98

    22

    $1,738.40

    $2,015.25

     

    Gulf

    0.76

    23

    $1,788.50

    $2,120.27

     

    Hamilton 

    0.77

    24

    $1,838.42

    $2,227.33

     

    Hardee

    0.80

    25

    $1,885.49

    $2,318.90

     

    Hendry

    1.01

    26

    $1,938.08

    $2,376.03

     

    Hernando

    0.85

    27

    $1,990.35

    $2,433.67

     

    Highlands 

    0.75

    28

    $2,067.67

    $2,491.99

     

    Hillsborough

    0.86

    29

    $2,121.11

    $2,551.82

     

    Holmes

    0.75

    30

    $2,171.54

    $2,591.84

     

    Indian River 

    0.97

    31

    $2,231.85

    $2,633.19

     

    Jackson 

    0.76

    32

    $2,294.05

    $2,699.25

     

    Jefferson 

    0.75

    33

    $2,357.57

    $2,766.00

     

    Lafayette 

    0.78

    34

    $2,420.26

    $2,809.21

     

    Lake 

    0.90

    35

    $2,506.99

    $2,852.42

     

    Lee

    0.99

    36

    $2,572.55

    $2,896.81

     

    Leon 

    0.79

    37

    $2,644.50

    $2,945.07

     

    Levy

    0.80

    38

    $2,713.92

    $2,972.14

     

    Liberty 

    0.75

    39

    $2,782.66

    $3,012.49

     

    Madison 

    0.79

    40

    $2,847.37

    $3,061.91

     

    Manatee

    0.90

    41

    $2,913.62

    $3,145.27

     

    Marion 

    0.77

    42

    $3,008.46

    $3,252.03

     

    Martin

    0.95

    43

    $3,090.64

    $3,374.95

     

    Monroe 

    1.37

    44

    $3,173.17

    $3,498.34

     

    Nassau 

    0.85

    45

    $3,271.10

    $3,632.92

     

    Okaloosa

    0.72

    46

    $3,374.26

    $3,771.39

     

    Okeechobee

    0.97

    47

    $3,475.57

    $3,898.07

     

    Orange 

    0.95

    48

    $3,626.99

    $4,032.97

     

    Osceola

    0.92

    49

    $3,810.31

    $4,174.28

     

    Palm Beach 

    1.00

    50

    $4,012.82

    $4,321.61

     

    Pasco 

    0.90

    51

    $4,214.32

    $4,450.89

     

    Pinellas

    0.87

    52

    $4,465.09

    $4,578.17

     

    Polk

    0.84

    53

    $4,688.76

    $4,677.00

     

    Putnam

    0.79

    54

    $4,947.13

    $4,816.24

     

    St. Johns 

    0.77

    55

    $5,184.67

    $4,955.53

     

    St. Lucie

    0.99

    56

    $5,463.95

    $5,120.27

     

    Santa Rosa 

    0.77

    57

    $5,785.99

    $5,311.64

     

    Sarasota 

    0.76

    58

    $6,098.51

    $5,514.89

     

    Seminole

    0.92

    59

    $6,427.77

    $5,736.18

     

    Sumter 

    0.80

    60

    $6,647.42

    $5,983.42

     

    Suwannee 

    0.82

    61

    $6,856.36

    $6,196.74

     

    Taylor 

    0.79

    62

    $7,020.01

    $6,407.38

     

    Union 

    0.79

    63

    $7,156.05

    $6,561.01

     

    Volusia

    0.88

    64

    $7,252.08

    $6,650.07

     

    Wakulla

    0.75

    65

    $7,658.43

    $6,942.77

     

    Walton

    0.76

    66

    $7,684.51

    $6,965.97

     

    Washington 

    0.76

    67

    $7,727.50

    $6,989.85

     

     

     

    68

    $7,785.23

    $7,019.80

     

     

     

    69

    $7,842.79

    $7,051.80

     

     

     

    70

    $7,900.53

    $7,081.44

     

     

     

    71

    $7,957.91

    $7,111.74

     

     

     

    72

    $8,018.35

    $7,145.25

     

     

     

    73

    $8,073.20

    $7,171.83

     

     

     

    74

    $8,125.51

    $7,200.10

     

     

     

    75

    $8,180.54

    $7,230.24

     

     

     

    76

    $8,235.39

    $7,254.79

     

     

     

    77

    $8,290.24

    $7,283.73

     

     

     

    78

    $8,317.67

    $7,322.17

     

     

     

    79

    $8,345.26

    $7,360.43

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    0-17

    $1,155.51

    $1,141.18

     

    Alachua

    0.76

    18

    $1,129.44

    $1,115.11

     

    Baker

    0.78

    19

    $1,380.57

    $1,780.25

     

    Bay

    0.73

    20

    $1,383.26

    $1,784.73

     

    Bradford 

    0.82

    21

    $1,383.26

    $1,790.10

     

    Brevard

    1.00

    22

    $1,386.00

    $1,806.40

     

    Broward

    1.39

    23

    $1,386.00

    $1,823.64

     

    Calhoun

    0.75

    24

    $1,388.75

    $1,836.41

     

    Charlotte 

    1.05

    25

    $1,391.49

    $1,847.33

     

    Citrus

    0.66

    26

    $1,386.71

    $1,859.14

     

    Clay

    0.82

    27

    $1,474.29

    $1,949.47

     

    Collier

    0.91

    28

    $1,547.10

    $2,034.52

     

    Columbia 

    0.81

    29

    $1,607.01

    $2,122.89

     

    Dade

    1.44

    30

    $1,660.30

    $2,209.27

     

    De Soto 

    0.74

    31

    $1,699.87

    $2,293.09

     

    Dixie 

    0.77

    32

    $1,757.75

    $2,393.24

     

    Duval

    1.04

    33

    $1,797.62

    $2,489.52

     

    Escambia 

    0.79

    34

    $1,837.10

    $2,584.95

     

    Flagler

    0.78

    35

    $1,877.27

    $2,684.60

     

    Franklin 

    0.75

    36

    $1,907.75

    $2,788.23

     

    Gadsden 

    0.75

    37

    $1,941.83

    $2,871.55

     

    Gilchrist

    0.75

    38

    $1,985.10

    $2,965.83

     

    Glades

    0.98

    39

    $2,024.58

    $3,067.98

     

    Gulf

    0.76

    40

    $2,094.46

    $3,175.24

     

    Hamilton 

    0.77

    41

    $2,175.17

    $3,293.24

     

    Hardee

    0.80

    42

    $2,269.15

    $3,406.75

     

    Hendry

    1.01

    43

    $2,382.24

    $3,526.26

     

    Hernando

    0.83

    44

    $2,526.45

    $3,642.71

     

    Highlands 

    0.79

    45

    $2,673.57

    $3,764.95

     

    Hillsborough

    0.91

    46

    $2,839.14

    $3,900.01

     

    Holmes

    0.75

    47

    $3,009.18

    $4,029.05

     

    Indian River 

    1.02

    48

    $3,159.64

    $4,159.51

     

    Jackson 

    0.76

    49

    $3,286.03

    $4,239.70

     

    Jefferson 

    0.75

    50

    $3,436.42

    $4,329.13

     

    Lafayette 

    0.78

    51

    $3,607.04

    $4,432.11

     

    Lake 

    0.89

    52

    $3,797.75

    $4,508.47

     

    Lee

    1.04

    53

    $3,987.63

    $4,594.56

     

    Leon 

    0.77

    54

    $4,187.01

    $4,640.69

     

    Levy

    0.80

    55

    $4,405.83

    $4,689.94

     

    Liberty 

    0.75

    56

    $4,674.80

    $4,761.84

     

    Madison 

    0.79

    57

    $4,952.21

    $4,825.92

     

    Manatee

    0.89

    58

    $5,271.90

    $4,925.57

     

    Marion 

    0.76

    59

    $5,580.41

    $5,030.42

     

    Martin

    0.98

    60

    $5,870.33

    $5,181.01

     

    Monroe 

    1.44

    61

    $6,119.10

    $5,318.18

     

    Nassau 

    0.84

    62

    $6,307.60

    $5,489.75

     

    Okaloosa

    0.69

    63

    $6,424.37

    $5,655.41

     

    Okeechobee

    0.97

    64

    $6,617.10

    $5,836.86

     

    Orange 

    1.00

    65

    $6,848.70

    $6,041.15

     

    Osceola

    0.94

    66

    $7,088.41

    $6,252.59

     

    Palm Beach 

    1.00

    67

    $7,207.46

    $6,483.97

     

    Pasco 

    0.86

    68

    $7,341.93

    $6,649.34

     

    Pinellas

    0.89

    69

    $7,418.18

    $6,715.18

     

    Polk

    0.85

    70

    $7,494.43

    $6,780.14

     

    Putnam

    0.77

    71

    $7,569.78

    $6,846.08

     

    St. Johns 

    0.77

    72

    $7,645.13

    $6,911.03

     

    St. Lucie

    0.99

    73

    $7,721.38

    $6,977.86

     

    Santa Rosa 

    0.77

    74

    $7,794.04

    $7,036.54

     

    Sarasota 

    0.76

    75

    $7,865.81

    $7,098.00

     

    Seminole

    0.92

    76

    $7,937.58

    $7,157.58

     

    Sumter 

    0.79

    77

    $7,989.54

    $7,207.74

     

    Suwannee 

    0.82

    78

    $8,040.60

    $7,257.91

     

    Taylor 

    0.79

    79

    $8,067.47

    $7,305.39

     

    Union 

    0.79

     

     

     

     

    Volusia

    0.84

     

     

     

     

    Wakulla

    0.75

     

     

     

     

    Walton

    0.76

     

     

     

     

    Washington 

    0.76

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Specific Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS. History–New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.205, Amended 5-18-04, 5-22-05, 6-1-06,___________.

     

    69O-149.207 Health Maintenance Organization Standard Risk Rates.

    (1) through (3) No change.

     

    STANDARD HEALTH BENEFIT PLAN

    Age

    Male

    Female

     

    County

    Area Factor

    0

    $4,549.06

    $4,540.08

     

    Alachua

    1.04

    1

    $2,844.95

    $2,835.97

     

    Baker

    1.08

    2-6

    $2,795.78

    $2,786.81

     

    Bay

    0.90

    7-12

    $2,722.34

    $2,713.36

     

    Bradford 

    1.04

    13-17

    $2,853.04

    $3,396.75

     

    Brevard

    0.94

    18

    $2,432.62

    $3,953.57

     

    Broward

    1.00

    19

    $2,467.46

    $4,161.38

     

    Calhoun

    0.90

    20

    $2,484.87

    $4,309.58

     

    Charlotte 

    0.98

    21

    $2,519.74

    $4,452.46

     

    Citrus

    0.88

    22

    $2,537.83

    $4,586.82

     

    Clay

    1.08

    23

    $2,555.92

    $4,720.44

     

    Collier

    0.90

    24

    $2,636.28

    $4,824.84

     

    Columbia 

    1.04

    25

    $2,657.34

    $4,916.66

     

    Dade

    1.00

    26

    $2,750.27

    $5,051.52

     

    DeSoto

    0.90

    27

    $2,814.76

    $5,178.03

     

    Dixie 

    1.04

    28

    $2,893.63

    $5,185.92

     

    Duval

    1.08

    29

    $2,957.60

    $5,199.76

     

    Escambia 

    1.07

    30

    $3,057.35

    $5,207.63

     

    Flagler

    0.90

    31

    $3,097.50

    $5,198.32

     

    Franklin 

    0.90

    32

    $3,154.83

    $5,195.85

     

    Gadsden 

    0.90

    33

    $3,195.81

    $5,114.57

     

    Gilchrist

    1.05

    34

    $3,253.97

    $5,056.36

     

    Glades

    0.90

    35

    $3,302.10

    $4,975.57

     

    Gulf

    0.90

    36

    $3,382.08

    $4,973.32

     

    Hamilton 

    0.90

    37

    $3,465.24

    $4,900.54

     

    Hardee

    0.84

    38

    $3,542.63

    $4,897.93

     

    Hendry

    0.94

    39

    $3,623.88

    $4,910.68

     

    Hernando

    1.04

    40

    $3,690.05

    $4,905.22

     

    Highlands 

    0.84

    41

    $3,767.50

    $4,954.19

     

    Hillsborough

    1.01

    42

    $3,861.40

    $4,991.64

     

    Holmes

    0.90

    43

    $3,968.29

    $5,109.03

     

    Indian River 

    0.90

    44

    $4,068.78

    $5,190.95

     

    Jackson 

    0.90

    45

    $4,205.16

    $5,284.01

     

    Jefferson 

    0.90

    46

    $4,370.20

    $5,396.17

     

    Lafayette 

    0.90

    47

    $4,555.28

    $5,517.31

     

    Lake 

    0.94

    48

    $4,769.26

    $5,626.02

     

    Lee

    1.01

    49

    $4,978.66

    $5,737.04

     

    Leon 

    0.90

    50

    $5,231.67

    $5,895.35

     

    Levy

    1.04

    51

    $5,520.59

    $6,063.06

     

    Liberty 

    0.90

    52

    $5,838.89

    $6,209.12

     

    Madison 

    0.90

    53

    $6,157.94

    $6,373.60

     

    Manatee

    1.04

    54

    $6,515.14

    $6,536.05

     

    Marion 

    0.94

    55

    $6,907.68

    $6,669.55

     

    Martin

    1.03

    56

    $7,237.73

    $6,783.55

     

    Monroe 

    0.90

    57

    $7,622.33

    $6,946.80

     

    Nassau 

    1.08

    58

    $8,065.46

    $7,219.43

     

    Okaloosa

    1.00

    59

    $8,563.34

    $7,528.10

     

    Okeechobee

    0.94

    60

    $9,071.45

    $7,848.00

     

    Orange 

    0.94

    61

    $9,484.04

    $8,252.49

     

    Osceola

    0.97

    62

    $9,894.47

    $8,650.37

     

    Palm Beach 

    1.05

    63

    $10,399.58

    $9,142.07

     

    Pasco 

    1.01

    64

    $10,893.65

    $9,606.52

     

    Pinellas

    1.01

    65

    $12,936.81

    $11,527.67

     

    Polk

    1.10

    66

    $12,999.71

    $11,576.46

     

    Putnam

    1.01

    67

    $13,062.20

    $11,624.93

     

    St. Johns 

    1.06

    68

    $13,124.13

    $11,672.96

     

    St. Lucie

    0.99

    69

    $13,185.41

    $11,720.48

     

    Santa Rosa 

    1.07

    70

    $13,245.82

    $11,767.35

     

    Sarasota 

    1.05

    71

    $13,305.29

    $11,813.46

     

    Seminole

    0.99

    72

    $13,363.66

    $11,858.73

     

    Sumter 

    0.99

    73

    $13,420.76

    $11,903.01

     

    Suwannee 

    0.90

    74

    $13,476.48

    $11,946.23

     

    Taylor 

    0.90

    75

    $13,530.64

    $11,988.22

     

    Union 

    0.90

    76

    $13,583.13

    $12,028.95

     

    Volusia

    1.03

    77

    $13,633.80

    $12,068.24

     

    Wakulla

    0.90

    78

    $13,682.54

    $12,106.03

     

    Walton

    1.05

    79

    $13,729.17

    $12,142.19

     

    Washington 

    0.90

     

     

     

     

     

     

    0

    $3,782.33

    $3,782.33

     

    Alachua

    1.05

    1

    $2,402.45

    $2,402.45

     

    Baker

    1.09

    2-6

    $2,362.62

    $2,362.62

     

    Bay

    0.90

    7-12

    $2,302.88

    $2,302.88

     

    Bradford 

    1.05

    13-17

    $2,409.09

    $2,856.18

     

    Brevard

    0.96

    18

    $2,059.70

    $3,311.40

     

    Broward

    1.00

    19

    $2,086.82

    $3,497.86

     

    Calhoun

    0.90

    20

    $2,100.33

    $3,631.03

     

    Charlotte 

    0.97

    21

    $2,127.39

    $3,761.58

     

    Citrus

    0.84

    22

    $2,141.01

    $3,880.78

     

    Clay

    1.09

    23

    $2,154.52

    $3,998.63

     

    Collier

    0.90

    24

    $2,231.10

    $4,087.54

     

    Columbia 

    1.05

    25

    $2,248.88

    $4,163.78

     

    Dade

    1.00

    26

    $2,325.86

    $4,270.30

     

    De Soto 

    0.90

    27

    $2,379.57

    $4,376.58

     

    Dixie 

    1.05

    28

    $2,440.88

    $4,382.38

     

    Duval

    1.09

    29

    $2,493.72

    $4,388.54

     

    Escambia 

    1.05

    30

    $2,574.53

    $4,392.23

     

    Flagler

    0.90

    31

    $2,603.97

    $4,387.88

     

    Franklin 

    0.90

    32

    $2,651.77

    $4,385.51

     

    Gadsden 

    0.90

    33

    $2,681.10

    $4,317.09

     

    Gilchrist

    1.05

    34

    $2,728.87

    $4,267.84

     

    Glades

    0.90

    35

    $2,771.57

    $4,199.10

     

    Gulf

    0.90

    36

    $2,840.11

    $4,197.87

     

    Hamilton 

    0.90

    37

    $2,912.35

    $4,133.78

     

    Hardee

    0.84

    38

    $2,983.13

    $4,130.42

     

    Hendry

    0.90

    39

    $3,053.89

    $4,143.63

     

    Hernando

    1.05

    40

    $3,108.53

    $4,140.32

     

    Highlands 

    0.84

    41

    $3,170.06

    $4,186.08

     

    Hillsborough

    1.00

    42

    $3,248.70

    $4,217.92

     

    Holmes

    0.90

    43

    $3,333.91

    $4,317.94

     

    Indian River 

    0.90

    44

    $3,418.04

    $4,383.62

     

    Jackson 

    0.90

    45

    $3,531.69

    $4,461.70

     

    Jefferson 

    0.90

    46

    $3,672.42

    $4,560.08

     

    Lafayette 

    0.90

    47

    $3,825.56

    $4,661.26

     

    Lake 

    0.95

    48

    $4,007.40

    $4,757.49

     

    Lee

    1.01

    49

    $4,183.58

    $4,854.51

     

    Leon 

    0.90

    50

    $4,401.50

    $4,996.56

     

    Levy

    1.05

    51

    $4,641.47

    $5,141.69

     

    Liberty 

    0.90

    52

    $4,910.83

    $5,266.36

     

    Madison 

    0.90

    53

    $5,190.77

    $5,408.58

     

    Manatee

    1.01

    54

    $5,502.81

    $5,543.16

     

    Marion 

    0.90

    55

    $5,846.67

    $5,654.06

     

    Martin

    1.05

    56

    $6,139.95

    $5,748.81

     

    Monroe 

    0.90

    57

    $6,481.29

    $5,885.39

     

    Nassau 

    1.09

    58

    $6,859.71

    $6,111.14

     

    Okaloosa

    0.95

    59

    $7,289.02

    $6,367.76

     

    Okeechobee

    0.95

    60

    $7,723.10

    $6,640.13

     

    Orange 

    0.94

    61

    $8,077.36

    $6,979.54

     

    Osceola

    0.98

    62

    $8,426.64

    $7,307.21

     

    Palm Beach 

    1.05

    63

    $8,886.60

    $7,728.03

     

    Pasco 

    1.02

    64

    $9,323.09

    $8,117.30

     

    Pinellas

    1.00

    65

    $11,000.08

    $9,688.83

     

    Polk

    1.05

    66

    $11,113.19

    $9,773.72

     

    Putnam

    1.01

    67

    $11,231.95

    $9,862.85

     

    St. Johns 

    1.07

    68

    $11,356.65

    $9,956.44

     

    St. Lucie

    0.95

    69

    $11,487.58

    $10,054.71

     

    Santa Rosa 

    1.05

    70

    $11,625.06

    $10,157.90

     

    Sarasota 

    1.03

    71

    $11,769.42

    $10,266.24

     

    Seminole

    1.02

    72

    $11,920.99

    $10,380.00

     

    Sumter 

    1.02

    73

    $12,080.14

    $10,499.45

     

    Suwannee 

    0.90

    74

    $12,247.25

    $10,624.87

     

    Taylor 

    0.90

    75

    $12,422.72

    $10,756.56

     

    Union 

    0.90

    76

    $12,606.95

    $10,894.83

     

    Volusia

    1.03

    77

    $12,800.40

    $11,040.02

     

    Wakulla

    0.90

    78

    $13,003.53

    $11,192.47

     

    Walton

    1.05

    79

    $13,216.80

    $11,352.54

     

    Washington 

    0.90

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Specific Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS. History–New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.205, Amended 5-18-04, 5-22-05, 6-1-06,___________.


    NAME OF PERSON ORIGINATING PROPOSED RULE: Monica Rutkowski, Director, Life and Health Product Review, Office of Insurance Regulation
    NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Rich Robleto, Deputy Commissioner, Office of Insurance Regulation
    DATE PROPOSED RULE APPROVED BY AGENCY HEAD: February 13, 2007
    DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: January 19, 2007

Document Information

Comments Open:
3/23/2007
Summary:
The Office is required by Section 627.6675(3)(c), F.S., to conduct an annual survey of the individual market and determine “standard risk rates”. These standard risk rates are the average rates charged in the individual market for health insurance. The standard risk rates are used by the health insurers in setting their conversion rates, because pursuant to Section 627.6675(3)(a), F.S., the maximum a health insurer can charge for a conversion policy is 200% of the standard risk rate.
Purpose:
To publish the standard risk rates as required by Section 627.6675(3)(c), F.S.
Rulemaking Authority:
624.308, 627.6675(3)(c) FS.
Law:
624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS.
Contact:
Tracie Lambright, Life and Health Product Review, Office of Insurance Regulation, E-mail: Tracie.Lambright@fldfs.com
Related Rules: (3)
69O-149.205. Indemnity Standard Risk Rates
69O-149.206. Preferred Provider/Exclusive Provider Standard Risk Rates
69O-149.207. Health Maintenance Organization Standard Risk Rates