641.3107 – Delivery of contract; definitions.
641.3107 Delivery of contract; definitions.— (1) A health maintenance contract, certificate of coverage, endorsements and riders, or member handbook shall be mailed, delivered, or otherwise provided to the subscriber or, in the case of a group health maintenance contract, to the employer or other person who will hold the contract on behalf of the subscriber group, as […]
641.31071 – Preexisting conditions.
641.31071 Preexisting conditions.— (1) As used in this section, the term: (a) “Enrollment date” means, with respect to an individual covered under a group health maintenance organization contract, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period of such enrollment. (b) “Late enrollee” means, with respect […]
641.31072 – Special enrollment periods.
641.31072 Special enrollment periods.— (1) A health maintenance organization that issues a group health insurance policy shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the contract, or a dependent of such an employee if the dependent is eligible but not enrolled for coverage under such terms, to enroll for […]
641.31073 – Prohibiting discrimination against individual participants and beneficiaries based on health status.
641.31073 Prohibiting discrimination against individual participants and beneficiaries based on health status.— (1) Subject to subsection (2), a health maintenance organization that offers group health insurance coverage may not establish rules for eligibility, including continued eligibility, of an individual to enroll under the terms of the contract based on any of the following health-status-related factors in relation […]
641.31074 – Guaranteed renewability of coverage.
641.31074 Guaranteed renewability of coverage.— (1) Except as otherwise provided in this section, a health maintenance organization that issues a health insurance contract must renew or continue in force such coverage at the option of the contract holder. (2) A health maintenance organization may nonrenew or discontinue a contract based only on one or more of the following […]
641.31075 – Advanced practice registered nurse services.
641.31075 Advanced practice registered nurse services.—A health maintenance contract that is delivered, issued, or renewed in this state on or after January 1, 2021, may not require a subscriber to receive services from an advanced practice registered nurse registered under s. 464.0123 in place of a physician. History.—s. 32, ch. 2020-9.
641.31076 – Shared savings incentive program.
641.31076 Shared savings incentive program.— (1) This section and ss. 627.6387 and 627.6648 may be cited as the “Patient Savings Act.” (2) As used in this section, the term: (a) “Health care provider” means a hospital or facility licensed under chapter 395; an entity licensed under chapter 400; a health care practitioner as defined in s. 456.001; a blood […]
641.309 – Standards for marketing to persons eligible for Medicare.
641.309 Standards for marketing to persons eligible for Medicare.— (1) Every health maintenance organization marketing coverage to Medicare participants or persons eligible for Medicare in this state, directly or through its agents, shall: (a) Establish marketing procedures to assure that any comparison of benefits between Medicare or any other health maintenance organization offering such coverage by its agents […]
641.31077 – Coverage for organ transplants.
641.31077 Coverage for organ transplants.—A health maintenance contract issued or renewed on or after July 1, 2020, in this state by a health maintenance organization which provides coverage for organ transplants may not deny coverage for an organ transplant solely on the basis of a subscriber’s disability. This section may not be construed to require such […]
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 […]