Florida Senate - 2017                              CS for SB 430
       By the Committee on Banking and Insurance; and Senators Bean and
       597-02139-17                                           2017430c1
    1                        A bill to be entitled                      
    2         An act relating to discount plan organizations;
    3         revising the titles of ch. 636, F.S., and part II of
    4         ch. 636, F.S.; amending s. 636.202, F.S.; revising
    5         definitions; amending s. 636.204, F.S.; conforming
    6         provisions to changes made by the act; requiring
    7         third-party entities that contract with providers to
    8         administer or provide platforms for discount plans to
    9         be licensed as discount plan organizations; amending
   10         s. 636.206, F.S.; conforming provisions to changes
   11         made by the act; requiring discount plan organizations
   12         to maintain, for a specified timeframe, certain
   13         records in a form accessible to the Office of
   14         Insurance Regulation during an examination or
   15         investigation; amending s. 636.208, F.S.; conforming
   16         provisions to changes made by the act; specifying
   17         periodic charge reimbursement and other requirements
   18         for discount plan organizations following membership
   19         cancellation requests; amending s. 636.212, F.S.;
   20         requiring discount plan organizations and marketers to
   21         provide specified disclosures to prospective members
   22         before enrollment; authorizing discount plan
   23         organizations and marketers to make other disclosures;
   24         requiring prospective members to acknowledge
   25         acceptance of disclosures before enrollment;
   26         specifying requirements for disclosures made in
   27         writing or by electronic means; revising requirements
   28         for disclosures made by telephone; amending s.
   29         636.214, F.S.; making a technical change; conforming
   30         provisions to changes made by the act; amending s.
   31         636.216, F.S.; deleting provisions relating to charge
   32         and form filings; conforming a provision to changes
   33         made by the act; amending s. 636.228, F.S.; conforming
   34         provisions to changes made by the act; authorizing a
   35         discount plan organization to delegate functions to
   36         its marketers; providing that the discount plan
   37         organization is bound by acts of its marketers within
   38         the scope of the delegation; amending s. 636.230,
   39         F.S.; conforming provisions to changes made by the
   40         act; authorizing a marketer or discount plan
   41         organization to commingle certain products on a single
   42         page of certain documents; deleting a requirement for
   43         discount medical plan fees to be provided in writing
   44         under certain circumstances; amending s. 636.232,
   45         F.S.; conforming a provision to changes made by the
   46         act; deleting rulemaking authority of the Financial
   47         Services Commission as to the establishment of certain
   48         standards; amending ss. 408.9091, 408.910, 627.64731,
   49         636.003, 636.205, 636.207, 636.210, 636.218, 636.220,
   50         636.222, 636.223, 636.224, 636.226, 636.234, 636.236,
   51         636.238, 636.240, and 636.244, F.S.; conforming
   52         provisions to changes made by the act; providing an
   53         effective date.
   55  Be It Enacted by the Legislature of the State of Florida:
   57         Section 1. Chapter 636, Florida Statutes, entitled “Prepaid
   58  Limited Health Service Organizations and Discount Medical Plan
   59  Organizations,” is retitled “Prepaid Limited Health Service
   60  Organizations and Discount Plan Organizations.”
   61         Section 2. Part II of chapter 636, Florida Statutes,
   62  entitled “Discount Medical Plan Organizations,” is retitled
   63  “Discount Plan Organizations.”
   64         Section 3. Section 636.202, Florida Statutes, is amended to
   65  read:
   66         636.202 Definitions.—As used in this part, the term:
   67         (1) “Discount medical plan” means a business arrangement or
   68  contract in which a person, in exchange for fees, dues, charges,
   69  or other consideration, provides access for plan members to
   70  providers of medical services and the right to receive medical
   71  services from those providers at a discount. The term “discount
   72  medical plan” does not include any product regulated under
   73  chapter 627, chapter 641, or part I of this chapter;, or any
   74  medical services provided through a telecommunications medium
   75  that does not offer a discount to the plan member for those
   76  medical services; or any plan that does not charge a fee to plan
   77  members. Until June 30, 2018, a discount plan may also be
   78  referred to as a discount medical plan.
   79         (2) “Discount medical plan organization” means an entity
   80  that which, in exchange for fees, dues, charges, or other
   81  consideration, provides access for plan members to providers of
   82  medical services and the right to receive medical services from
   83  those providers at a discount. Until June 30, 2018, a discount
   84  plan organization may also be referred to as a discount medical
   85  plan organization.
   86         (3) “Marketer” means a person or entity that which markets,
   87  promotes, sells, or distributes a discount medical plan,
   88  including a private label entity that which places its name on
   89  and markets or distributes a discount medical plan but does not
   90  operate a discount medical plan.
   91         (4) “Medical services” means any care, service, or
   92  treatment of illness or dysfunction of, or injury to, the human
   93  body, including, but not limited to, physician care, inpatient
   94  care, hospital surgical services, emergency services, ambulance
   95  services, dental care services, vision care services, mental
   96  health services, substance abuse services, chiropractic
   97  services, podiatric care services, laboratory services, and
   98  medical equipment and supplies. The term does not include
   99  pharmaceutical supplies or prescriptions.
  100         (5) “Member” means any person who pays fees, dues, charges,
  101  or other consideration for the right to receive the purported
  102  benefits of a discount medical plan.
  103         (6) “Provider” means any person or institution that which
  104  is contracted, directly or indirectly, with a discount medical
  105  plan organization to provide medical services to members.
  106         (7) “Provider network” means an entity that which
  107  negotiates on behalf of more than one provider with a discount
  108  medical plan organization to provide medical services to
  109  members.
  110         Section 4. Subsections (1), (2), (4), and (6) of section
  111  636.204, Florida Statutes, are amended to read:
  112         636.204 License required.—
  113         (1) Before doing business in this state as a discount
  114  medical plan organization, an entity must be a corporation, a
  115  limited liability company, or a limited partnership,
  116  incorporated, organized, formed, or registered under the laws of
  117  this state or authorized to transact business in this state in
  118  accordance with chapter 605, part I of chapter 607, chapter 617,
  119  chapter 620, or chapter 865, and must be licensed by the office
  120  as a discount medical plan organization or be licensed by the
  121  office pursuant to chapter 624, part I of this chapter, or
  122  chapter 641.
  123         (2) An application for a license to operate as a discount
  124  medical plan organization must be filed with the office on a
  125  form prescribed by the commission. Such application must be
  126  sworn to by an officer or authorized representative of the
  127  applicant and be accompanied by the following, if applicable:
  128         (a) A copy of the applicant’s articles of incorporation or
  129  other organizing documents, including all amendments.
  130         (b) A copy of the applicant’s bylaws.
  131         (c) A list of the names, addresses, official positions, and
  132  biographical information of the individuals who are responsible
  133  for conducting the applicant’s affairs, including, but not
  134  limited to, all members of the board of directors, board of
  135  trustees, executive committee, or other governing board or
  136  committee, the officers, contracted management company
  137  personnel, and any person or entity owning or having the right
  138  to acquire 10 percent or more of the voting securities of the
  139  applicant. Such listing must fully disclose the extent and
  140  nature of any contracts or arrangements between any individual
  141  who is responsible for conducting the applicant’s affairs and
  142  the discount medical plan organization, including any possible
  143  conflicts of interest.
  144         (d) A complete biographical statement, on forms prescribed
  145  by the commission, an independent investigation report, and a
  146  set of fingerprints, as provided in chapter 624, with respect to
  147  each individual identified under paragraph (c).
  148         (e) A statement generally describing the applicant, its
  149  facilities and personnel, and the medical services to be
  150  offered.
  151         (f) A copy of the form of all contracts made or to be made
  152  between the applicant and any providers or provider networks
  153  regarding the provision of medical services to members.
  154         (g) A copy of the form of any contract made or arrangement
  155  to be made between the applicant and any person listed in
  156  paragraph (c).
  157         (h) A copy of the form of any contract made or to be made
  158  between the applicant and any person, corporation, partnership,
  159  or other entity for the performance on the applicant’s behalf of
  160  any function, including, but not limited to, marketing,
  161  administration, enrollment, investment management, and
  162  subcontracting for the provision of health services to members.
  163         (i) A copy of the applicant’s most recent financial
  164  statements audited by an independent certified public
  165  accountant. An applicant that is a subsidiary of a parent entity
  166  that is publicly traded and that prepares audited financial
  167  statements reflecting the consolidated operations of the parent
  168  entity and the subsidiary may petition the office to accept, in
  169  lieu of the audited financial statement of the applicant, the
  170  audited financial statement of the parent entity and a written
  171  guaranty by the parent entity that the minimum capital
  172  requirements of the applicant required by this part will be met
  173  by the parent entity.
  174         (j) A description of the proposed method of marketing.
  175         (k) A description of the subscriber complaint procedures to
  176  be established and maintained.
  177         (l) The fee for issuance of a license.
  178         (m) Such other information as the commission or office may
  179  reasonably require to make the determinations required by this
  180  part.
  181         (4) Before Prior to licensure by the office, each discount
  182  medical plan organization must establish an Internet website so
  183  as to conform to the requirements of s. 636.226.
  184         (6) This part does not require Nothing in this part
  185  requires a provider who provides discounts to his or her own
  186  patients to obtain and maintain a license as a discount medical
  187  plan organization. If a provider contracts with a third-party
  188  entity to administer or provide a platform for a discount plan,
  189  the third-party entity must be licensed as a discount plan
  190  organization.
  191         Section 5. Section 636.206, Florida Statutes, is amended to
  192  read:
  193         636.206 Examinations and investigations.—
  194         (1) The office may examine or investigate the business and
  195  affairs of any discount medical plan organization. The office
  196  may order any discount medical plan organization or applicant to
  197  produce any records, books, files, advertising and solicitation
  198  materials, or other information and may take statements under
  199  oath to determine whether the discount medical plan organization
  200  or applicant is in violation of the law or is acting contrary to
  201  the public interest. The expenses incurred in conducting any
  202  examination or investigation must be paid by the discount
  203  medical plan organization or applicant. Examinations and
  204  investigations must be conducted as provided in chapter 624. For
  205  the duration of the agreement and for 5 years thereafter, every
  206  discount plan organization shall maintain, in a form accessible
  207  to the office during an examination or investigation, an
  208  accurate record of each member, the membership materials
  209  provided to the member, the discount plan issued to the member,
  210  and the charges billed and paid by the member.
  211         (2) Failure by the discount medical plan organization to
  212  pay the expenses incurred under subsection (1) is grounds for
  213  denial or revocation.
  214         Section 6. Section 636.208, Florida Statutes, is amended to
  215  read:
  216         636.208 Fees; charges; reimbursement.—
  217         (1) A discount medical plan organization may charge a
  218  periodic charge as well as a reasonable one-time processing fee
  219  for a discount medical plan.
  220         (2)(a) If the member cancels his or her membership in the
  221  discount medical plan organization within the first 30 days
  222  after the effective date of enrollment in the plan, the member
  223  shall receive a reimbursement of all periodic charges upon
  224  return of the discount card to the discount medical plan
  225  organization.
  226         (b)If the member cancels his or her membership in the
  227  discount plan organization consistent with the open enrollment
  228  rules established by an employer or association for a plan
  229  having an open enrollment period, the member shall receive a pro
  230  rata reimbursement of all periodic charges upon return of the
  231  discount card to the discount plan organization.
  232         (c) Except for plans enrolled under paragraph (b), if the
  233  member requests in writing the cancellation of his or her
  234  membership in the discount plan organization after the first 30
  235  days allowed in paragraph (a), the discount plan organization:
  236         1. Must make the cancellation effective no later than 30
  237  days after receiving the member’s cancellation request;
  238         2. May not make future charges to the member after the
  239  cancellation has taken effect; and
  240         3. Must provide the member a pro rata reimbursement of
  241  periodic charges for all months after the effective date of the
  242  cancellation.
  243         (3) If the discount medical plan organization cancels a
  244  membership for any reason other than nonpayment of fees by the
  245  member, the discount medical plan organization must shall make a
  246  pro rata reimbursement of all periodic charges to the member.
  247         (4) In addition to the reimbursement of periodic charges
  248  for the reasons stated in subsections (2) and (3), a discount
  249  medical plan organization shall also reimburse the member for
  250  any portion of a one-time processing fee that exceeds $30 per
  251  year.
  252         Section 7. Section 636.212, Florida Statutes, is amended to
  253  read:
  254         636.212 Disclosures.—A discount plan organization or
  255  marketer shall provide disclosures to a prospective member
  256  before his or her enrollment. A discount plan organization or
  257  marketer may make disclosures in addition to those described in
  258  this part. Before enrollment, a prospective member must
  259  acknowledge he or she has accepted the disclosures The following
  260  disclosures must be made in writing to any prospective member
  261  and must be on the first page of any advertisements, marketing
  262  materials, or brochures relating to a discount medical plan. The
  263  disclosures must be printed in not less than 12-point type:
  264         (1) The disclosures must include:
  265         (a) That the plan is not insurance.
  266         (b)(2) That the plan provides discounts at certain health
  267  care providers for medical services.
  268         (c)(3) That the plan does not make payments directly to the
  269  providers of medical services.
  270         (d)(4) That the plan member is obligated to pay for all
  271  health care services but will receive a discount from those
  272  health care providers who have contracted with the discount plan
  273  organization.
  274         (e)(5) The name and address of the licensed discount
  275  medical plan organization.
  276         (2)Written disclosures must include the disclosures in
  277  subsection (1) on the first page of any advertisement, marketing
  278  material, or brochure relating to a discount plan. The first
  279  page is the page that first includes the information describing
  280  benefits. The disclosures must be printed in not less than 12
  281  point type.
  282         (3)Disclosures provided by electronic means must include
  283  the disclosures in subsection (1) on any advertisement,
  284  marketing material, or brochure relating to a discount plan. The
  285  disclosures must be viewable in a readable font size and color.
  286         (4)Disclosures made by telephone must include the
  287  disclosures in subsection (1), and a written disclosure in
  288  accordance with subsection (2) must also be provided with the
  289  initial materials sent to the prospective or new member.
  291  If the initial contract is made by telephone, the disclosures
  292  required by this section shall be made orally and provided in
  293  the initial written materials that describe the benefits under
  294  the discount medical plan provided to the prospective or new
  295  member.
  296         Section 8. Section 636.214, Florida Statutes, is amended to
  297  read:
  298         636.214 Provider agreements.—
  299         (1) All providers offering medical services to members
  300  under a discount medical plan must provide such services
  301  pursuant to a written agreement. The agreement may be entered
  302  into directly by the provider or by a provider network to which
  303  the provider belongs.
  304         (2) A provider agreement between a discount medical plan
  305  organization and a provider must provide the following:
  306         (a) A list of the services and products to be provided at a
  307  discount.
  308         (b) The amount or amounts of the discounts or,
  309  alternatively, a fee schedule which reflects the provider’s
  310  discounted rates.
  311         (c) A statement that the provider will not charge members
  312  more than the discounted rates.
  313         (3) A provider agreement between a discount medical plan
  314  organization and a provider network must shall require that the
  315  provider network have written agreements with its providers
  316  which:
  317         (a) Contain the terms described in subsection (2).
  318         (b) Authorize the provider network to contract with the
  319  discount medical plan organization on behalf of the provider.
  320         (c) Require the network to maintain an up-to-date list of
  321  its contracted providers and to provide that list on a monthly
  322  basis to the discount medical plan organization.
  323         (4) The discount medical plan organization shall maintain a
  324  copy of each active provider agreement into which it has
  325  entered.
  326         Section 9. Section 636.216, Florida Statutes, is amended to
  327  read:
  328         636.216 Written agreement Charge or form filings.—
  329         (1) All charges to members must be filed with the office
  330  and any charge to members greater than $30 per month or $360 per
  331  year must be approved by the office before the charges can be
  332  used. The discount medical plan organization has the burden of
  333  proof that the charges bear a reasonable relation to the
  334  benefits received by the member.
  335         (2) There must be a written agreement between the discount
  336  medical plan organization and the member specifying the benefits
  337  under the discount medical plan and complying with the
  338  disclosure requirements of this part.
  339         (3)All forms used, including the written agreement
  340  pursuant to subsection (2), must first be filed with and
  341  approved by the office. Every form filed shall be identified by
  342  a unique form number placed in the lower left corner of each
  343  form.
  344         (4) A charge or form is considered approved on the 60th day
  345  after its date of filing unless it has been previously
  346  disapproved by the office. The office shall disapprove any form
  347  that does not meet the requirements of this part or that is
  348  unreasonable, discriminatory, misleading, or unfair. If such
  349  filings are disapproved, the office shall notify the discount
  350  medical plan organization and shall specify in the notice the
  351  reasons for disapproval.
  352         Section 10. Section 636.228, Florida Statutes, is amended
  353  to read:
  354         636.228 Marketing of discount medical plans.—
  355         (1) All advertisements, marketing materials, brochures, and
  356  discount cards used by marketers must be approved in writing for
  357  such use by the discount medical plan organization.
  358         (2) The discount medical plan organization must shall have
  359  an executed written agreement with a marketer before prior to
  360  the marketer’s marketing, promoting, selling, or distributing
  361  the discount medical plan. Such agreement must shall prohibit
  362  the marketer from using marketing materials, brochures, and
  363  discount cards without the approval in writing by the discount
  364  medical plan organization. The discount medical plan
  365  organization may delegate functions to its marketers but shall
  366  be bound by any acts of its marketers, within the scope of the
  367  delegation, which marketers’ agency, that do not comply with the
  368  provisions of this part.
  369         Section 11. Section 636.230, Florida Statutes, is amended
  370  to read:
  371         636.230 Bundling discount medical plans with other
  372  products.—A marketer or discount plan organization selling a
  373  discount plan with medical services and other services may
  374  commingle those products on a single page of forms,
  375  advertisements, marketing materials, or brochures When a
  376  marketer or discount medical plan organization sells a discount
  377  medical plan together with any other product, the fees for the
  378  discount medical plan must be provided in writing to the member
  379  if the fees exceed $30.
  380         Section 12. Section 636.232, Florida Statutes, is amended
  381  to read:
  382         636.232 Rules.—The commission may adopt rules to administer
  383  this part, including rules for the licensing of discount medical
  384  plan organizations,; establishing standards for evaluating
  385  forms, advertisements, marketing materials, brochures, and
  386  discount cards; providing for the collection of data,; relating
  387  to disclosures to plan members,; and defining terms used in this
  388  part.
  389         Section 13. Paragraph (b) of subsection (5) of section
  390  408.9091, Florida Statutes, is amended to read:
  391         408.9091 Cover Florida Health Care Access Program.—
  392         (5) PLAN PROPOSALS.—The agency and the office shall
  393  announce, no later than July 1, 2008, an invitation to negotiate
  394  for Cover Florida plan entities to design a Cover Florida plan
  395  proposal in which benefits and premiums are specified.
  396         (b) The agency and the office may announce an invitation to
  397  negotiate for the design of Cover Florida Plus products to
  398  companies that offer supplemental insurance, discount medical
  399  plan organizations licensed under part II of chapter 636, or
  400  prepaid health clinics licensed under part II of chapter 641.
  401         Section 14. Paragraph (d) of subsection (2) and paragraph
  402  (d) of subsection (4) of section 408.910, Florida Statutes, are
  403  amended to read:
  404         408.910 Florida Health Choices Program.—
  405         (2) DEFINITIONS.—As used in this section, the term:
  406         (d) “Insurer” means an entity licensed under chapter 624
  407  which offers an individual health insurance policy or a group
  408  health insurance policy, a preferred provider organization as
  409  defined in s. 627.6471, an exclusive provider organization as
  410  defined in s. 627.6472, or a health maintenance organization
  411  licensed under part I of chapter 641, or a prepaid limited
  412  health service organization or discount medical plan
  413  organization licensed under chapter 636.
  414         (4) ELIGIBILITY AND PARTICIPATION.—Participation in the
  415  program is voluntary and shall be available to employers,
  416  individuals, vendors, and health insurance agents as specified
  417  in this subsection.
  418         (d) All eligible vendors who choose to participate and the
  419  products and services that the vendors are permitted to sell are
  420  as follows:
  421         1. Insurers licensed under chapter 624 may sell health
  422  insurance policies, limited benefit policies, other risk-bearing
  423  coverage, and other products or services.
  424         2. Health maintenance organizations licensed under part I
  425  of chapter 641 may sell health maintenance contracts, limited
  426  benefit policies, other risk-bearing products, and other
  427  products or services.
  428         3. Prepaid limited health service organizations may sell
  429  products and services as authorized under part I of chapter 636,
  430  and discount medical plan organizations may sell products and
  431  services as authorized under part II of chapter 636.
  432         4. Prepaid health clinic service providers licensed under
  433  part II of chapter 641 may sell prepaid service contracts and
  434  other arrangements for a specified amount and type of health
  435  services or treatments.
  436         5. Health care providers, including hospitals and other
  437  licensed health facilities, health care clinics, licensed health
  438  professionals, pharmacies, and other licensed health care
  439  providers, may sell service contracts and arrangements for a
  440  specified amount and type of health services or treatments.
  441         6. Provider organizations, including service networks,
  442  group practices, professional associations, and other
  443  incorporated organizations of providers, may sell service
  444  contracts and arrangements for a specified amount and type of
  445  health services or treatments.
  446         7. Corporate entities providing specific health services in
  447  accordance with applicable state law may sell service contracts
  448  and arrangements for a specified amount and type of health
  449  services or treatments.
  451  A vendor described in subparagraphs 3.-7. may not sell products
  452  that provide risk-bearing coverage unless that vendor is
  453  authorized under a certificate of authority issued by the Office
  454  of Insurance Regulation and is authorized to provide coverage in
  455  the relevant geographic area. Otherwise eligible vendors may be
  456  excluded from participating in the program for deceptive or
  457  predatory practices, financial insolvency, or failure to comply
  458  with the terms of the participation agreement or other standards
  459  set by the corporation.
  460         Section 15. Subsection (11) of section 627.64731, Florida
  461  Statutes, is amended to read:
  462         627.64731 Leasing, renting, or granting access to a
  463  participating provider.—
  464         (11) This section does not apply to a contract between a
  465  contracting entity and a discount medical plan organization
  466  licensed or exempt under part II of chapter 636.
  467         Section 16. Paragraph (c) of subsection (7) of section
  468  636.003, Florida Statutes, is amended to read:
  469         636.003 Definitions.—As used in this act, the term:
  470         (7) “Prepaid limited health service organization” means any
  471  person, corporation, partnership, or any other entity which, in
  472  return for a prepayment, undertakes to provide or arrange for,
  473  or provide access to, the provision of a limited health service
  474  to enrollees through an exclusive panel of providers. Prepaid
  475  limited health service organization does not include:
  476         (c) Any person who is licensed pursuant to part II as a
  477  discount medical plan organization.
  478         Section 17. Paragraphs (c) and (d) of subsection (1) of
  479  section 636.205, Florida Statutes, are amended to read:
  480         636.205 Issuance of license; denial.—
  481         (1) Following receipt of an application filed pursuant to
  482  s. 636.204, the office shall review the application and notify
  483  the applicant of any deficiencies contained therein. The office
  484  shall issue a license to an applicant who has filed a completed
  485  application pursuant to s. 636.204 upon payment of the fees
  486  specified in s. 636.204 and upon the office being satisfied that
  487  the following conditions are met:
  488         (c) The ownership, control, and management of the entity
  489  are competent and trustworthy and possess managerial experience
  490  that would make the proposed operation beneficial to the
  491  subscribers. The office may shall not grant or continue to grant
  492  authority to transact the business of a discount medical plan
  493  organization in this state at any time during which the office
  494  has good reason to believe that the ownership, control, or
  495  management of the organization includes any person whose
  496  business operations are or have been marked by business
  497  practices or conduct that is detrimental to the public,
  498  stockholders, investors, or creditors.
  499         (d) The discount medical plan organization has a complaint
  500  procedure that will facilitate the resolution of subscriber
  501  grievances and that includes both formal and informal steps
  502  available within the organization.
  503         Section 18. Section 636.207, Florida Statutes, is amended
  504  to read:
  505         636.207 Applicability of part.—Except as otherwise provided
  506  in this part, discount medical plan organizations are governed
  507  by the provisions of this part and are exempt from the Florida
  508  Insurance Code unless specifically referenced.
  509         Section 19. Section 636.210, Florida Statutes, is amended
  510  to read:
  511         636.210 Prohibited activities of a discount medical plan
  512  organization.—
  513         (1) A discount medical plan organization may not:
  514         (a) Use in its advertisements, marketing material,
  515  brochures, and discount cards the term “insurance” except as
  516  otherwise provided in this part or as a disclaimer of any
  517  relationship between discount medical plan organization benefits
  518  and insurance;
  519         (b) Use in its advertisements, marketing material,
  520  brochures, and discount cards the terms “health plan,”
  521  “coverage,” “copay,” “copayments,” “preexisting conditions,”
  522  “guaranteed issue,” “premium,” “PPO,” “preferred provider
  523  organization,” or other terms in a manner that could reasonably
  524  mislead a person into believing the discount medical plan was
  525  health insurance;
  526         (c) Have restrictions on free access to plan providers,
  527  including, but not limited to, waiting periods and notification
  528  periods; or
  529         (d) Pay providers any fees for medical services.
  530         (2) A discount medical plan organization may not collect or
  531  accept money from a member for payment to a provider for
  532  specific medical services furnished or to be furnished to the
  533  member unless the organization has an active certificate of
  534  authority from the office to act as an administrator.
  535         Section 20. Subsection (1), paragraphs (b), (c), and (d) of
  536  subsection (2), and subsection (3) of section 636.218, Florida
  537  Statutes, are amended to read:
  538         636.218 Annual reports.—
  539         (1) Each discount medical plan organization shall must file
  540  with the office, within 3 months after the end of each fiscal
  541  year, an annual report.
  542         (2) Such reports must be on forms prescribed by the
  543  commission and must include:
  544         (b) If different from the initial application or the last
  545  annual report, a list of the names and residence addresses of
  546  all persons responsible for the conduct of the organization’s
  547  affairs, together with a disclosure of the extent and nature of
  548  any contracts or arrangements between such persons and the
  549  discount medical plan organization, including any possible
  550  conflicts of interest.
  551         (c) The number of discount medical plan members in the
  552  state.
  553         (d) Such other information relating to the performance of
  554  the discount medical plan organization as is reasonably required
  555  by the commission or office.
  556         (3) Every discount medical plan organization that which
  557  fails to file an annual report in the form and within the time
  558  required by this section shall forfeit up to $500 for each day
  559  for the first 10 days during which the neglect continues and
  560  shall forfeit up to $1,000 for each day after the first 10 days
  561  during which the neglect continues; and, upon notice by the
  562  office to that effect, the organization’s authority to enroll
  563  new members or to do business in this state ceases while such
  564  default continues. The office shall deposit all sums collected
  565  by the office under this section to the credit of the Insurance
  566  Regulatory Trust Fund. The office may not collect more than
  567  $50,000 for each report.
  568         Section 21. Section 636.220, Florida Statutes, is amended
  569  to read:
  570         636.220 Minimum capital requirements.—
  571         (1) Each discount medical plan organization shall must at
  572  all times maintain a net worth of at least $150,000.
  573         (2) The office may not issue a license unless the discount
  574  medical plan organization has a net worth of at least $150,000.
  575         Section 22. Section 636.222, Florida Statutes, is amended
  576  to read:
  577         636.222 Suspension or revocation of license; suspension of
  578  enrollment of new members; terms of suspension.—
  579         (1) The office may suspend the authority of a discount
  580  medical plan organization to enroll new members, revoke any
  581  license issued to a discount medical plan organization, or order
  582  compliance if the office finds that any of the following
  583  conditions exist:
  584         (a) The organization is not operating in compliance with
  585  this part.
  586         (b) The organization does not have the minimum net worth as
  587  required by this part.
  588         (c) The organization has advertised, merchandised, or
  589  attempted to merchandise its services in such a manner as to
  590  misrepresent its services or capacity for service or has engaged
  591  in deceptive, misleading, or unfair practices with respect to
  592  advertising or merchandising.
  593         (d) The organization is not fulfilling its obligations as a
  594  medical discount medical plan organization.
  595         (e) The continued operation of the organization would be
  596  hazardous to its members.
  597         (2) If the office has cause to believe that grounds for the
  598  suspension or revocation of a license exist, the office must
  599  shall notify the discount medical plan organization in writing
  600  specifically stating the grounds for suspension or revocation
  601  and shall pursue a hearing on the matter in accordance with the
  602  provisions of chapter 120.
  603         (3) When the license of a discount medical plan
  604  organization is surrendered or revoked, such organization must
  605  proceed, immediately following the effective date of the order
  606  of revocation, to wind up its affairs transacted under the
  607  license. The organization may not engage in any further
  608  advertising, solicitation, collecting of fees, or renewal of
  609  contracts.
  610         (4) The office shall, in its order suspending the authority
  611  of a discount medical plan organization to enroll new members,
  612  specify the period during which the suspension is to be in
  613  effect and the conditions, if any, which must be met by the
  614  discount medical plan organization before prior to reinstatement
  615  of its license to enroll new members. The order of suspension is
  616  subject to rescission or modification by further order of the
  617  office before prior to the expiration of the suspension period.
  618  Reinstatement may not be made unless requested by the discount
  619  medical plan organization; however, the office may not grant
  620  reinstatement if it finds that the circumstances for which the
  621  suspension occurred still exist or are likely to recur.
  622         Section 23. Section 636.223, Florida Statutes, is amended
  623  to read:
  624         636.223 Administrative penalty.—In lieu of suspending or
  625  revoking a certificate of authority whenever any discount
  626  medical plan organization has been found to have violated any
  627  provision of this part, the office may:
  628         (1) Issue and cause to be served upon the organization
  629  charged with the violation a copy of such findings and an order
  630  requiring such organization to cease and desist from engaging in
  631  the act or practice that constitutes the violation.
  632         (2) Impose a monetary penalty of not less than $100 for
  633  each violation, but not to exceed an aggregate penalty of
  634  $75,000.
  635         Section 24. Section 636.224, Florida Statutes, is amended
  636  to read:
  637         636.224 Notice of change of name or address of discount
  638  medical plan organization.—Each discount medical plan
  639  organization must provide the office at least 30 days’ advance
  640  notice of any change in the discount medical plan organization’s
  641  name, address, principal business address, or mailing address.
  642         Section 25. Section 636.226, Florida Statutes, is amended
  643  to read:
  644         636.226 Provider name listing.—Each discount medical plan
  645  organization must maintain on an Internet website an up-to-date
  646  list of the names and addresses of the providers with which it
  647  has contracted, on an Internet website page, the address of
  648  which must shall be prominently displayed on all its
  649  advertisements, marketing materials, brochures, and discount
  650  cards. This section applies to those providers with whom the
  651  discount medical plan organization has contracted directly, as
  652  well as those who are members of a provider network with which
  653  the discount medical plan organization has contracted.
  654         Section 26. Section 636.234, Florida Statutes, is amended
  655  to read:
  656         636.234 Service of process on a discount medical plan
  657  organization.—Sections 624.422 and 624.423 apply to a discount
  658  medical plan organization as if the discount medical plan
  659  organization were an insurer.
  660         Section 27. Section 636.236, Florida Statutes, is amended
  661  to read:
  662         636.236 Surety bond or security deposit.—
  663         (1) Each discount medical plan organization licensed
  664  pursuant to the provisions of this part shall must maintain in
  665  force a surety bond in its own name in an amount not less than
  666  $35,000 to be used at the discretion of the office to protect
  667  the financial interests of members who may be adversely affected
  668  by the insolvency of a discount medical plan organization. The
  669  bond must be issued by an insurance company that is licensed to
  670  do business in this state.
  671         (2) In lieu of the bond specified in subsection (1), a
  672  licensed discount medical plan organization may deposit and
  673  maintain deposited in trust with the department securities
  674  eligible for deposit under s. 625.52 having at all times a value
  675  of not less than $35,000. If a licensed discount medical plan
  676  organization substitutes its deposited securities under this
  677  subsection with a surety bond authorized in subsection (1), such
  678  deposited securities must shall be returned to the discount
  679  medical plan organization no later than 45 days following the
  680  effective date of the surety bond.
  681         (3) A No judgment creditor or other claimant of a discount
  682  medical plan organization, other than the office or department,
  683  does not shall have the right to levy upon any of the assets or
  684  securities held in this state as a deposit under subsections (1)
  685  and (2).
  686         Section 28. Subsections (2) and (3) of section 636.238,
  687  Florida Statutes, are amended to read:
  688         636.238 Penalties for violation of this part.—
  689         (2) A person who operates as or willfully aids and abets
  690  another operating as a discount medical plan organization in
  691  violation of s. 636.204(1) commits a felony punishable as
  692  provided for in s. 624.401(4)(b), as if the unlicensed discount
  693  medical plan organization were an unauthorized insurer, and the
  694  fees, dues, charges, or other consideration collected from the
  695  members by the unlicensed discount medical plan organization or
  696  marketer were insurance premium.
  697         (3) A person who collects fees for purported membership in
  698  a discount medical plan but purposefully fails to provide the
  699  promised benefits commits a theft, punishable as provided in s.
  700  812.014.
  701         Section 29. Subsection (1) of section 636.240, Florida
  702  Statutes, is amended to read:
  703         636.240 Injunctions.—
  704         (1) In addition to the penalties and other enforcement
  705  provisions of this part, the office may seek both temporary and
  706  permanent injunctive relief when:
  707         (a) A discount medical plan is being operated by any person
  708  or entity that is not licensed pursuant to this part.
  709         (b) Any person, entity, or discount medical plan
  710  organization has engaged in any activity prohibited by this part
  711  or any rule adopted pursuant to this part.
  712         Section 30. Section 636.244, Florida Statutes, is amended
  713  to read:
  714         636.244 Unlicensed discount medical plan organizations.
  715  Sections The provisions of ss. 626.901-626.912 apply to the
  716  activities of an unlicensed discount medical plan organization
  717  as if the unlicensed discount medical plan organization were an
  718  unauthorized insurer.
  719         Section 31. This act shall take effect upon becoming a law.