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 […]
641.281 – Injunction.
641.281 Injunction.—In addition to the penalties and other enforcement provisions of this part, the office and department, within the scope of their regulatory jurisdictions, are vested with the power to seek both temporary and permanent injunctive relief when: (1) A health maintenance organization is being operated by any person or entity without a subsisting certificate of authority. […]
641.282 – Payment of judgment by health maintenance organization.
641.282 Payment of judgment by health maintenance organization.—Except as otherwise ordered by the court or mutually agreed upon by the parties, every judgment or decree entered in any of the courts of this state against any health maintenance organization for the recovery of money shall be fully satisfied within 60 days from and after the entry […]
641.284 – Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy.
641.284 Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy.—A delinquency proceeding under part I of chapter 631, or supervision by the office under ss. 624.80-624.87, constitute the sole and exclusive means of liquidating, reorganizing, rehabilitating, or conserving a health maintenance organization. History.—ss. 118, 188, ch. 91-108; s. 4, ch. 91-429; s. 1573, ch. 2003-261.
641.285 – Insolvency protection.
641.285 Insolvency protection.— (1) Each health maintenance organization shall deposit with the department cash or securities of the type eligible under s. 625.52, which shall have at all times a market value in the amount set forth in this subsection. The amount of the deposit shall be reviewed annually, or more often, as the office deems necessary. […]