641.31 – Health maintenance contracts.
641.31 Health maintenance contracts.— (1) Any entity issued a certificate and otherwise in compliance with this part may enter into contracts in this state to provide an agreed-upon set of comprehensive health care services to subscribers in exchange for a prepaid per capita sum or a prepaid aggregate fixed sum. Each subscriber shall be given a copy […]
641.3108 – Notice of cancellation of contract.
641.3108 Notice of cancellation of contract.— (1) Except for nonpayment of premium or termination of eligibility, no health maintenance organization may cancel or otherwise terminate or fail to renew a health maintenance contract without giving the subscriber at least 45 days’ notice in writing of the cancellation, termination, or nonrenewal of the contract. The written notice shall […]
641.3101 – Additional contract contents.
641.3101 Additional contract contents.—A health maintenance contract may contain additional provisions not inconsistent with this part which are: (1) Necessary, on account of the manner in which the organization is constituted or operated, in order to state the rights and obligations of the parties to the contract; or (2) Desired by the organization and neither prohibited by law […]
641.31085 – Disclosures to subscribers; coverage of behavioral health care services.
641.31085 Disclosures to subscribers; coverage of behavioral health care services.— (1) A health maintenance organization shall make all of the following information available on its website: (a) The federal and state requirements for coverage of behavioral health care services. (b) Contact information for the Division of Consumer Services of the department, including a hyperlink, for consumers to submit inquiries […]
641.31015 – Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.
1641.31015 Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.—Each health maintenance organization or exclusive provider organization shall provide prospective enrollees with written information about the terms and conditions of the plan in accordance with s. 641.31(4) so that the prospective enrollees can make informed decisions about accepting a managed-care system […]
641.31094 – Nondiscrimination of coverage for certain surgical procedures involving bones or joints.
641.31094 Nondiscrimination of coverage for certain surgical procedures involving bones or joints.—No health maintenance contract or policy which provides coverage for any diagnostic or surgical procedure involving bones or joints of the skeleton shall discriminate against coverage for any similar diagnostic or surgical procedure involving bones or joints of the jaw and facial region, if, under […]
641.3102 – Restrictions upon expulsion or refusal to issue or renew contract.
641.3102 Restrictions upon expulsion or refusal to issue or renew contract.— (1) A health maintenance organization that offers individual health maintenance contracts in this state may not decline to offer coverage to an eligible individual as required in s. 627.6487. (2) A health maintenance organization shall not expel or refuse to renew the coverage of, or refuse to […]
641.3103 – Charter, bylaw provisions.
641.3103 Charter, bylaw provisions.—No health maintenance contract shall contain any provision purporting to make any portion of the articles of incorporation, charter, bylaws, or other organizational document of the health maintenance organization a part of the contract unless the provision is set forth in full in the contract. Any contract provision in violation of this section […]
641.3104 – Execution of contracts.
641.3104 Execution of contracts.— (1) Every health maintenance contract shall be executed in the name of and on behalf of the health maintenance organization by its officer, attorney in fact, employee, or representative duly authorized by the organization. (2) A facsimile signature of any executing individual may be used in lieu of an original signature. (3) No health maintenance […]
641.3105 – Validity of noncomplying contracts.
641.3105 Validity of noncomplying contracts.— (1) Any health maintenance contract, rider, endorsement, attachment, or addendum otherwise valid which contains any condition or provision not in compliance with the requirements of this part shall not be thereby rendered invalid, but shall be construed and applied in accordance with such conditions and provisions as would have applied had such […]