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Florida Administrative Code (Last Updated: November 11, 2024) |
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69. Department of Financial Services |
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69O. OIR – Insurance Regulation |
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69O-203. Prepaid Limited Health Service Organizations And Discount Medical Plan Organizations |
1(1) Contracts for all Plans shall include all elements contained in this section:
14(a) Name and address of the DPO;
21(b) Telephone number for member assistance and Plan information;
30(c) Contracts shall include the name of the group, if applicable, and the name of the member;
47(d) Effective date and term of contract;
54(e) Space for charges and any one-time processing fee;
63(f) Mode of payment (monthly, quarterly, etc. with provision for change of mode if applicable);
78(g) Renewal, termination and cancellation conditions;
84(h) Benefits to be provided;
89(i) All limitations, exclusions and exceptions;
95(j) Provisions for adding new family members; and
103(k) Member complaint procedure.
107(2) The contract shall contain the entire agreement with the member. If a group arrangement is involved, contract terms may be included in a member handbook if incorporated by reference.
137Rulemaking Authority 139636.232 FS. 141Law Implemented 143636.216 FS. 145History–New 4-7-05, Amended 11-1-07, 4-11-19.
