RULE NOS.:RULE TITLES:
69O-203.042Filing, Approval of Subscriber Contract and Related Forms
69O-203.210Forms 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.
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 firstname.lastname@example.org. 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, email email@example.com.
THE FULL TEXT OF THE PROPOSED RULE IS:
69O-203.042 Filing, Approval of Subscriber Contract and Related Forms.
(1) and (2) No change.
(3) Filing Format for All Forms. PLHSOs in possession of a Certificate of Authority shall submit contract filings to the Office electronically through http://www.floir.com/iportal. mail contract filings to: Bureau of Life and Health Forms and Rates, Office of Insurance Regulation, Post Office Box 8040, Tallahassee, Florida 32301-8040; submit filings electronically to https://Iportal.fldoi.com; or submit filings to the Office by Federal Express or any other form of special delivery by delivery to: Bureau of Life and Health Forms and Rates, Office of Insurance Regulation, 1st Floor, Larson Building, 200 East Gaines Street, Tallahassee, FL 32399-0328. A filing shall consist of one copy of each of the following items:
(a) through (e) No change.
(4) Subsequent to July 1, 2003, all filings shall be submitted electronically to https://iportal.fldfs.com, or by computer diskette meeting the compatibility requirements mandated by Section 624.424(1)(c), F.S. Deadlines for filing will not be extended due to shipping delays, format incompatibility, data corruption, or any other impediment which results from an election to file by diskette.
(1) through (8) No change.
(9) Filings shall be submitted electronically to http://www.floir.com/iportal. mailed to: Office of Insurance Regulation, Division of Insurer Services, Bureau of Life and Health Forms and Rates, Post Office Box 8040, Tallahassee, FL 32301-8040; submitted electronically to https://iportal.fldfs.com; or submitted to the Office by Federal Express or any other form of special delivery by delivery to: Office of Insurance Regulation, Division of Insurer Services, Bureau of Life and Health Forms and Rates, 1st Floor, Larson Building, 200 East Gaines Street, Tallahassee, FL 32399-0328.
69O-203.100 Prescribed Forms.
The forms listed below are incorporated herein, and made a part of, these rules by reference:
(1) Application for Certificate of Authority Prepaid Limited Health Service Organization
OIR-C1-1119 (12/05) (8/94)
(2) Invoice – Request for Payment of Application Fees
OIR-C1-111920 (12/05) (7/93)
(3) Invoice – Request for Payment of Fingerprint Charges
OIR-C1-903 (12/05) (1/94)
(4) Biographical Statement and Affidavit
OIR-C1-1423422 (8/11) (11/90)
(5) Abbreviated Biographical Statement
(5)(6) Authority for Release of Information
(6)(7) Consent and Agreement; Service of Process
(7)(8) Instructions for Furnishing Background Investigative Reports
(8)(9) Fingerprint Card Instructions
(9)(10) Acquisition Application
(11) Annual Report
(12) Annual Report-Supplement
(13) Quarterly Report
(10) Annual Report Supplement - Contracts Issued and Outstanding
(11) Annual Report Supplement – Damage Claims & Medical Injury
All of the above 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. All other forms may be obtained from the Office of Insurance Regulation, Bureau of Life and Health Insurer Solvency, Larson Building, Tallahassee, FL 32399-0327.
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:
APPLICATION FOR LICENSE DISCOUNT MEDICAL PLAN ORGANIZATION (DMPO)
(b) The following forms as adopted in Chapter 69O-136, F.A.C.:
SERVICE OF PROCESS CONSENT & AGREEMENT
INVOICE REQUEST FOR PAYMENT OF FINGERPRINT CHARGES
FINGERPRINT CARD INSTRUCTIONS
MANAGEMENT INFORMATION FORM COMPLETE LIST OF OFFICERS, DIRECTORS, AND SHAREHOLDERS (10% OR MORE)
(c) OIR-A1-1671, Annual Report – Discount Medical Plan Organizations (06/08).
(2) All of the above referenced forms are available and may be printed from the Office’s of Insurance Regulation’s website: http://www.floir.com/iportal. http://fldfs.com.
NAME OF PERSON ORIGINATING PROPOSED RULE: Chris Struk, Office of Insurance Regulation, E-mail firstname.lastname@example.org.
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.
- Comments Open:
- 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.
- These rule revisions update the rules to reflect electronic filing process.
- Rulemaking Authority:
- 624.424(1)(c), 636.067, 636.232, FS.
- 624.321(1)(a),624.424, 636.005, 636.008, 636.009, 636.012, 636.016, 636.017, 636.018, 636.043, 636.204, 636.218, 636.220, 636.226, 636.228, 636.234, 636.236, FS.
- Chris Struk, Office of Insurance Regulation, E-mail email@example.com.
- Related Rules: (4)
- 69O-203.042. Filing, Approval of Subscriber Contract and Related Forms
- 69O-203.045. Rates
- 69O-203.100. Prescribed Forms
- 69O-203.210. Forms Incorporated by Reference