The rules are being amended to conform rules and forms governing discount plan organizations to recent statutory changes and to remove regulations no longer supported by statutory authority.

 

DEPARTMENT OF FINANCIAL SERVICES

OIR – Insurance Regulation

RULE NOS.:RULE TITLES:

69O-203.201Definitions

69O-203.203Standards for the Form and Content of Advertisements or Marketing Materials

69O-203.210 Forms Incorporated by Reference

PURPOSE AND EFFECT: The rules are being amended to conform rules and forms governing discount plan organizations to recent statutory changes and to remove regulations no longer supported by statutory authority.

SUMMARY: The rules will be updated to conform to the statutory changes, implemented by Chapter 2017-112, Laws of Florida, renaming “discount medical plan organizations” to “discount plan organizations” and revising conditions for reimbursement, disclosure requirements, reporting requirements, fee requirements, marketing requirements, and the authority for the Financial Services Commission to adopt rules.

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: 636.232; 624.424(1)(c), FS.

LAW IMPLEMENTED: 636.202; 636.228; 624.424; 636.204; 636.218; 636.220; 636.226; 636.236, 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: Wednesday, May 9, 2018, 9:30 a.m.

PLACE: 116 Larson Building, 200 East Gaines Street, Tallahassee, Florida. To join by telephone, call [phone] and enter conference ID# 7023472.

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-203.201 Definitions.

(1) No change.

(2) Contract or Form means the document, by whatever name called; such as agreement, certificate or handbook which describes the benefits under the discount medical Plan.

(3) Discount Medical Plan (Plan) means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, provides access for Pplan members to providers of medical services and the right to receive one or more medical services from those providers at a discount.

(4) DPO DMPO is the Discount Medical Plan Organization defined in Section 636.202(2), F.S., that contracts with providers, provider networks, or other DMPOs, to provide discounted medical services to Plan members and determines the charges to the members.

(5) No change.

Rulemaking Specific Authority 636.232 FS. Law Implemented 636.202 FS. History–New 4-7-05, Amended________________.

 

69O-203.203 Standards for the Form and Content of Advertisements or Marketing Materials.

(1) No change.

(2) (a) through (c) No change.

(d) The term “insurance” may not be used as a descriptive term for DPO DMPO benefits. However, the term “insurance” may be used in a disclaimer of any relationship between DPO DMPO benefits and insurance including the disclosures required in Section 636.212, F.S.

Rulemaking Specific Authority 636.232 FS. Law Implemented 636.228 FS. History–New 4-7-05, Amended______________.

 

69O-203.210 Forms Incorporated by Reference.

(1) The following forms are incorporated herein by reference to implement the provisions of Chapter 636, Part II, F.S.:

(a) The following forms which are hereby adopted:

	FORM #	TITLE	DATE
1.	OIR-C1-1606 http://www.flrules.org/Gateway/reference.asp?No=Ref-08285	APPLICATION FOR LICENSE DISCOUNT MEDICAL PLAN ORGANIZATION (DPO) (DMPO)	01/18 12/05
2.	No change.

(b) The following forms as adopted in Chapter 69O-136, F.A.C.:

	FORM #	TITLE	DATE
1.	OIR-C1-144	SERVICE OF PROCESS CONSENT & AGREEMENT	06/04 01/97
2.	through 4. No change.

(c) OIR-A1-1671, Annual Report – Discount Medical Plan Organizations (06/08).

(2) No change.

Rulemaking Authority 624.424(1)(c), 636.232 FS. Law Implemented 624.424, 636.204, 636.218, 636.220, 636.226, 636.228, 636.234, 636.236 FS. History–New 5-22-05, Amended 10-29-08, 7-30-17, 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: March 07, 2018

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: October 24, 2017