Pursuant to Section 636.218, Florida Statutes, each discount medical plan organization (“DMPO”) must file with the Office, within 3 months after the end of each fiscal year, an annual report. Such reports must be on forms prescribed by the Financial ...

 

DEPARTMENT OF FINANCIAL SERVICES
OIR – Insurance Regulation

RULE NO: RULE TITLE
69O-203.210: Forms Incorporated by Reference
PURPOSE AND EFFECT: Pursuant to Section 636.218, Florida Statutes, each discount medical plan organization (“DMPO”) must file with the Office, within 3 months after the end of each fiscal year, an annual report. Such reports must be on forms prescribed by the Financial Services Commission. The purpose of the proposed amendments is to adopt the form for the Annual Report of the Discount Medical Plan Organization which includes the DMPO Annual Report Instructions.
SUMMARY 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: 624.424(1), 636.232 FS.
LAW IMPLEMENTED: 636.204, 636.220, 636.226, 636.228, 636.234, 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):
TIME AND DATE: September 22, 2006, 10:00 a.m.
PLACE: Room 116, Larson Building, 200 East Gaines Street, Tallahassee, Florida
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Annie Wang, Life and Health Financial Oversight, Office of Insurance Regulation, E-mail: [e-mail].
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this program, please advise the Office at least 5 calendar days before the program by contacting the person listed above.

THE FULL TEXT OF THE PROPOSED RULE IS:

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, Florida Statutes:

(a) The following forms which are hereby adopted:

	FORM #	TITLE	DATE
1.	OIR-C1-1606	APPLICATION FOR LICENSE DISCOUNT MEDICAL PLAN ORGANIZATION (DMPO)	08/05 10/14/04
2.	OIR-C1-1423	BIOGRAPHICAL AFFIDAVIT	1/27/05 04/12/04
3.	OIR-A1-1671	ANNUAL REPORT – DISCOUNT MEDICAL PLAN ORGANIZATIONS	07/06

 

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

	FORM #	TITLE	DATE
1.	DI4-144	SERVICE OF PROCESS CONSENT & AGREEMENT	01/97
2.	OIR-C1-903	INVOICE-REQUEST FOR PAYMENT OF FINGERPRINT CHARGES	10/05 04/97
3.	OIR-C1-938	FINGERPRINT CARD INSTRUCTIONS	10/05 05/02
4.	OIR-C1-1298	MANAGEMENT INFORMATION FORM – COMPLETE LIST OF OFFICERS, DIRECTORS, AND SHAREHOLDERS (10% OR MORE)	10/05 04/97
5.	OIR-C1-905	INSTRUCTIONS FOR FURNISHING BACKGROUND INVESTIGATIVE REPORTS	10/05

(2) All of the above referenced forms are available and may be printed from the Office’s website: www.floir.com.

Specific Authority 624.424(1)(c), 636.232 FS. Law Implemented 636.204, 636.220, 636.226, 636.228, 636.234, 636.236 FS. History– New 5-22-05, Amended________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Annie Wang, Life and Health Financial Oversight, 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: July 25, 2006
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: February 3, 2006