69O-154.305. Election and Premium Notice Form  


Effective on Sunday, July 30, 2017
  • 1(1) Within 14 days of the date that the carrier receives the notice of occurrence of a qualifying event from the qualified beneficiary the carrier must send to the employee, covered spouse and covered dependents, by certified mail, the Election and Premium Notice Form OIR-B2-1261 (REV 8/03), which is hereby adopted and incorporated by reference. Copies of the forms are available and may be printed from the Office’s website: http://www.floir.com/iportal.

    71(2) Carriers may develop a similar form which must include the information in Form OIR-B2-1261. Any similar form must be filed and approved before use pursuant to the requirements of Section 102627.410, F.S. 104Any filing shall be submitted to the Office electronically through http://www.floir.com/iportal.

    115Rulemaking Authority 117624.308(1), 118627.6692(9) FS. 120Law Implemented 122624.307(1), 123624.424, 124627.6692(5) FS. 126History–New 4-24-97, Formerly 4-154.305, Amended 5-4-06, 7-30-17.

     

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