69O-149.044. Forms  


Effective on Thursday, September 15, 2005
  • 1(1) The following forms are hereby adopted and incorporated by reference:

    12(a) OIR-B2-1117, Rev. 1/05, Florida Employee Health Care Access Act Enrollment Report.

    24(b) OIR-B2-1093, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Become a Risk Assuming Carrier or a Reinsuring Carrier, as Required by Section 48627.6475(5), F.S.

    50(c) OIR-B2-1095, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Modify Previous Election to Become a Risk Assuming or a Reinsuring Carrier, as Required by Section 77627.6699(9), F.S.

    79(d) OIR-B2-1575, Rev. 10/03, Small Employer Group Underwriting Experience Report Form.

    90(2)(a) Copies of forms are available and may be printed from the Office’s website: http://www.fldfs.com/.

    105(b) Filings shall be submitted electronically through https://iportal.fldfs.com.

    113Specific Authority 115624.308(1), 116626.9641, 117627.6699(16) FS. 119Law Implemented 121626.9541, 122627.401, 123627.410, 124627.411, 125627.6699 FS. 127History–New 8-4-02, Formerly 4-149.044, Amended 5-18-04, 9-15-05.

     

Rulemaking Events: