The Office of Insurance Regulation is updating Rules 69O-157.023 and 69O-157.111 to correct form titles and revision dates.

 

DEPARTMENT OF FINANCIAL SERVICES

OIR – Insurance Regulation

RULE NOS.:RULE TITLES:

69O-157.023Reporting

69O-157.111Reporting Requirements

PURPOSE AND EFFECT: The Office of Insurance Regulation is updating Rules 69O-157.023 and 69O-157.111 to correct form titles and revision dates.

SUMMARY: The Office of Insurance Regulation is updating Rules 69O-157.023 and 69O-157.111 to correct form titles and revision dates.

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.

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), 627.9407(1), 627.9408 FS.

LAW IMPLEMENTED: 624.307(1), 624.424, 627.9402, 627.9407(1), 627.410(7) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Kama Monroe, Assistant General Counsel, Office of Insurance Regulation, [e-mail], [phone].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

69O-157.023 Reporting.

(1) Every insurer shall maintain records for each agent of that agent’s amount of replacement sales as a percentage of the agent’s total annual sales in this state and the amount of lapses of long-term care insurance policies sold by the agent as a percentage of the agent’s total annual sales in this state.

(2) Every insurer shall report annually by June 30 the 10 percent of its agents with the greatest percentages of lapses and replacements as measured by subsection 69O-157.023(1), F.A.C., in the format prescribed by Appendix J, “Long-Term Care Insurance Replacement and Lapse Reporting Form OIR-B2-1555,” which is incorporated by reference in Rule 69O-157.111. “Replacement and Lapse Reporting Form OIR-1555” (10/02), which is incorporated herein by reference.

(3) through (5) No change.

(6) Every insurer shall report annually by June 30, for qualified long-term care insurance contracts, the number of claims denied for each class of business, expressed as a percentage of claims denied in this state, in the format as prescribed in Appendix E, “Annual Long-Term Care Claims Denial Reporting Form” OIR-B2-1553, which is incorporated by reference in Rule 69O-157.111. “Claims Denial Reporting Form OIR-1553” (10/02), which is incorporated herein by reference.

(7) No change.

(8) Every insurer or other entity selling or issuing long-term care insurance benefits shall maintain a record of all policy or certificate rescissions, both state and countrywide, except those that the insured voluntarily effectuated, and shall annually furnish this information to the Department by March 1 of each year in the format prescribed in Appendix A, “Long-Term Care Rescission Report” OIR-B2-1552, which is incorporated by reference in Rule 69O-157.111. “Rescission Reporting Form OIR-1552” (10/02), which is incorporated herein by reference.

(9) No change.

Specific Authority 624.308(1), 627.9407(1), 627.9408 FS. Law Implemented 624.307(1), 627.9402, 627.9407(1), 627.410(7) FS. History–New 1-13-03, Formerly 4-157.023. Amended ________.

 

69O-157.111 Reporting Requirements.

(1) No change.

(2) Every insurer shall report annually by June 30 the 10 percent of its agents with the greatest percentages of lapses and replacements as measured by subsection 69O-157.111(1), F.A.C., in the format as prescribed in Appendix J, “Long-Term Care Insurance Replacement and Lapse Reporting Form OIR-B2-1555,” effective 07/23 hereby incorporated by reference and available at www.flrules.org/XXXXX http://www.flrules.org/Gateway/reference.asp?No=Ref-08269, (06/2017), which is incorporated herein by reference.

(3) through (5) No change.

(6) Every insurer shall report annually by June 30, for qualified long-term care insurance contracts, the number of claims denied for each class of business, expressed as a percentage of claims denied in this state in the format as prescribed in Appendix E, “Annual Long-Term Care Claims Denial Reporting Form” “Claims Denial Reporting Form Long-Term Care Insurance for the State of Florida for the Reporting Year 20__” OIR-B2-1553, effective 07/23, hereby incorporated by reference and available at www.flrules.org/XXXXX http://www.flrules.org/Gateway/reference.asp?No=Ref-08268, (06/2017),  which is incorporated herein by reference.

(7) through (8) No change.

(9) Based on the provisions of Rule 69O-157.109, F.A.C., every insurer or other entity selling or issuing long-term care insurance benefits shall maintain a record of all policy or certificate rescissions, both state and countrywide, except those that the insured voluntarily effectuated and shall annually furnish this information, by March 1 of each year, in the format as prescribed in Appendix A, “Long-Term Care Rescission Reporting Form” For Long-Term Care Policies for the State of Florida For the Reporting Year 20__” OIR-B2-1552, effective 07/23, hereby incorporated by reference and available at www.flrules.org/XXXXX http://www.flrules.org/Gateway/reference.asp?No=Ref-08270, (06/2017), which is incorporated herein by reference.

(10) through (11) No change.

Rulemaking Authority 624.308(1), 627.9407(1), 627.9408 FS. Law Implemented 624.424, 624.307(1), 627.9407(1), 627.410(7) FS. History–New 1-13-03, Formerly 4-157.111, Amended 7-30-17, _________________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Kama Monroe, Assistant General Counsel

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Financial Services Commission

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: September 18, 2023

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: July 24, 2023