Senate Bill 1238

    Florida Senate - 1999                                  SB 1238

    By Senator Brown-Waite





    10-655A-99

  1                      A bill to be entitled

  2         An act relating to insurance; amending s.

  3         641.31, F.S.; providing for return of excessive

  4         premiums received for health maintenance

  5         contracts; providing an effective date.

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  7  Be It Enacted by the Legislature of the State of Florida:

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  9         Section 1.  Subsection (2) of section 641.31, Florida

10  Statutes, 1998 Supplement, is amended to read:

11         641.31  Health maintenance contracts.--

12         (2)  The rates charged by any health maintenance

13  organization to its subscribers shall not be excessive,

14  inadequate, or unfairly discriminatory.  The department, in

15  accordance with generally accepted actuarial practice as

16  applied to health maintenance organizations, may define by

17  rule what constitutes excessive, inadequate, or unfairly

18  discriminatory rates and may require whatever information it

19  deems necessary to determine that a rate or proposed rate

20  meets the requirements of this subsection. If the department

21  finds that a rate or rate change is excessive, inadequate, or

22  unfairly discriminatory, the department shall issue an order

23  of disapproval specifying that a new rate or rate schedule

24  that responds to the findings of the department be filed by

25  the health maintenance organization. The department shall

26  further order that premiums charged each contractholder

27  constituting the portion of the rate above that which was

28  actuarially justified be returned to such contractholder in

29  the form of a credit or refund. If the department finds that a

30  health maintenance organization's rate or rate change is

31  inadequate, the new rate or rate schedule filed with the

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 1999                                  SB 1238
    10-655A-99




  1  department in response to such a finding shall be applicable

  2  only to new or renewal business of the health maintenance

  3  organization written or after the effective date of the

  4  responsive filing.

  5         Section 2.  This act shall take effect July 1, 1999,

  6  and shall apply to policies and contracts issued or renewed on

  7  or after that date.

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10                          SENATE SUMMARY

11    Requires the department to issue an order of disapproval
      against a health maintenance organization that it
12    determines has charged excessive, inadequate, or unfairly
      discriminatory rates.
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