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





                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    

                            CHAMBER ACTION
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10                                                                

11  Senator Meek moved the following amendment:

12

13         Senate Amendment (with title amendment) 

14         On page 10, between lines 26 and 27,

15

16  insert:

17         Section 10.  Subsections (1), (6), (7), and (8) of

18  section 627.410, Florida Statutes, 1998 Supplement, are

19  amended to read:

20         627.410  Filing, approval of forms.--

21         (1)  No basic insurance policy or annuity contract

22  form, or application form where written application is

23  required and is to be made a part of the policy or contract,

24  or group certificates issued under a master contract delivered

25  in this state, or printed rider or endorsement form or form of

26  renewal certificate, shall be delivered or issued for delivery

27  in this state, unless the form has been filed with the

28  department at its offices in Tallahassee by or in behalf of

29  the insurer which proposes to use such form and has been

30  approved by the department. This provision does not apply to:

31         (a)  Surety bonds or to specially rated inland marine

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  risks, or

 2         (b)  Policies, riders, endorsements, or forms of unique

 3  character which are designed for and used with relation to

 4  insurance upon a particular subject (other than as to

 5  individual or small group health insurance), or which relate

 6  to the manner of distribution of benefits or to the

 7  reservation of rights and benefits under life or health

 8  insurance policies and are used at the request of the

 9  individual policyholder, contract holder, or

10  certificateholder.  As to group insurance policies effectuated

11  and delivered outside this state but covering persons resident

12  in this state, the group certificates to be delivered or

13  issued for delivery in this state shall be filed with the

14  department for information purposes only.

15         (6)(a)  An insurer shall not deliver or issue for

16  delivery or renew in this state any health insurance policy

17  form until it has filed with the department a copy of every

18  applicable rating manual, rating schedule, change in rating

19  manual, and change in rating schedule; if rating manuals and

20  rating schedules are not applicable, the insurer must file

21  with the department applicable premium rates and any change in

22  applicable premium rates. This provision does not apply to

23  rating manuals, rating schedules, changes in rating manuals or

24  schedules, or if rating manuals or schedules are not

25  applicable, to premium rates or changes in such rates,

26  relating to policies, riders, endorsements, or forms of unique

27  character which are designed for and used with relation to

28  insurance upon a particular subject or to benefits under group

29  health insurance policies insuring 51 or more persons and are

30  used at the request of the individual policyholder, contract

31  holder, or certificate holder.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1         (b)  The department may establish by rule, for each

 2  type of health insurance form, procedures to be used in

 3  ascertaining the reasonableness of benefits in relation to

 4  premium rates and may, by rule, exempt from any requirement of

 5  paragraph (a) any health insurance policy form or type thereof

 6  (as specified in such rule) to which form or type such

 7  requirements may not be practically applied or to which form

 8  or type the application of such requirements is not desirable

 9  or necessary for the protection of the public. With respect to

10  any health insurance policy form or type thereof which is

11  exempted by rule from any requirement of paragraph (a),

12  premium rates filed pursuant to ss. 627.640 and 627.662 shall

13  be for informational purposes.

14         (c)  Every filing made pursuant to this subsection

15  shall be made within the same time period provided in, and

16  shall be deemed to be approved under the same conditions as

17  those provided in, subsection (2).

18         (d)  Every filing made pursuant to this subsection,

19  except disability income policies and accidental death

20  policies, shall be prohibited from applying the following

21  rating practices:

22         1.  Select and ultimate premium schedules.

23         2.  Premium class definitions which classify insured

24  based on year of issue or duration since issue.

25         3.  Attained age premium structures on policy forms

26  under which more than 50 percent of the policies are issued to

27  persons age 65 or over.

28         (e)  Except as provided in subparagraph 1., an insurer

29  shall continue to make available for purchase any individual

30  policy form issued on or after October 1, 1993.  A policy form

31  shall not be considered to be available for purchase unless

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  the insurer has actively offered it for sale in the previous

 2  12 months.

 3         1.  An insurer may discontinue the availability of a

 4  policy form if the insurer provides to the department in

 5  writing its decision at least 30 days prior to discontinuing

 6  the availability of the form of the policy or certificate.

 7  After receipt of the notice by the department, the insurer

 8  shall no longer offer for sale the policy form or certificate

 9  form in this state.

10         2.  An insurer that discontinues the availability of a

11  policy form pursuant to subparagraph 1. shall not file for

12  approval a new policy form providing similar benefits as the

13  discontinued form for a period of 5 years after the insurer

14  provides notice to the department of the discontinuance. The

15  period of discontinuance may be reduced if the department

16  determines that a shorter period is appropriate.

17         2.3.  The experience of an individual accident and

18  health insurance all policy form that is no longer being

19  marketed in this state, except for policies rated pursuant to

20  a loss ratio guarantee under subsection (8), shall be combined

21  with the experience of at least one other individual accident

22  and health insurance policy form forms providing similar

23  benefits, as determined by the insurer, which is still being

24  marketed in the state by the same insurer, unless the insurer

25  has no other policy form providing similar benefits, as

26  determined by the insurer, which is still being marketed in

27  the state shall be combined for all rating purposes.

28         3.  Each individual accident and health insurer that

29  discontinues the availability of a policy form and that has no

30  other policy form providing similar benefits which is still

31  being marketed in the state shall offer every existing insured

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  who is currently paying premiums under the discontinued policy

 2  form the option to apply for coverage under any individual

 3  accident and health insurance policy form which is still being

 4  marketed in the state by the same insurer. Individuals who

 5  fail to satisfy the insurer's underwriting guidelines or

 6  standards for issuance of a replacement policy shall be issued

 7  coverage if they apply for such replacement coverage within

 8  180 days' written notice to the insured persons from the

 9  insurer, without regard to health status or claims experience.

10  However, individuals who apply for the replacement coverage

11  described in this subparagraph who fail to satisfy the

12  insurer's underwriting guidelines or standards may be charged

13  a premium rate not to exceed 140 percent of the standard

14  premium rate charged by the insurer for the coverage. The

15  replacement coverage described in this subparagraph shall

16  waive any preexisting condition limitations or waiting periods

17  satisfied under the preceding, discontinued policy form.

18         4.  For purposes of this paragraph an individual

19  accident and health insurance policy form shall be deemed to

20  provide similar benefits to another individual accident and

21  health insurance policy form if the forms are of the same

22  type, e.g. major medical; hospital/surgical; disability; home

23  health care; long-term care, and at least 70 percent of the

24  benefits provided by one form are also provided by the other.

25         (7)(a)  Each insurer subject to the requirements of

26  subsection (6) shall make an annual filing with the department

27  no later than 12 months after its previous filing,

28  establishing demonstrating the reasonableness of benefits in

29  relation to premium rates.  The department, after receiving a

30  request to be exempted from the provisions of this section,

31  may, for good cause due to insignificant numbers of policies

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  in force or insignificant premium volume, exempt a company, by

 2  line of coverage, from filing rates or rate certification as

 3  required by this section.

 4         (b)  The filing required by this subsection shall be

 5  satisfied by one of the following methods:

 6         1.  A rate filing prepared by an actuary which contains

 7  documentation establishing demonstrating the reasonableness of

 8  benefits in relation to premiums charged in accordance with

 9  the applicable rating laws and rules promulgated by the

10  department. For premium rate changes, benefits shall be deemed

11  reasonable in relation to premium charged if both of the

12  following loss ratios meet or exceed the standards established

13  in s. 627.411(2).

14         a.  The anticipated loss ratio over the entire future

15  period for which the revised rates are computed to provide

16  coverage; and

17         b.  The lifetime anticipated loss ratio derived by

18  dividing the amount determined under sub-sub-subparagraph (I)

19  by the amount determined under sub-sub-subparagraph (II):

20         (I)  The sum of the accumulated benefits from the

21  original effective date of the form to the effective date of

22  the revision, and the present value of future benefits.

23         (II)  The sum of the accumulated premiums from the

24  original effective date of the form to the effective date of

25  the revision, and the present value of future premiums, which

26  present values shall be taken over the entire period for which

27  the revised rates are computed to provide coverage and which

28  accumulated benefits and premiums shall include an explicit

29  estimate of actual benefits and premiums from the last date an

30  accounting has been made to the effective date of the

31  revision.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1

 2  Interest shall be used in the calculation of these accumulated

 3  benefits and premiums and present values  in the calculation

 4  of the loss ratio. For purposes of sub-sub-subparagraph (I),

 5  the present value of benefits may, at the insurer's option,

 6  include recognition of the policy reserve as a benefit

 7  (addition), or the present value of premiums may, at the

 8  insurer's option, include recognition of the policy reserve as

 9  a deduction. Anticipated loss ratios lower than those

10  indicated in sub-sub-subparagraphs (I) and (II) will require

11  justification based on special circumstances that may be

12  applicable. Examples of coverages that may require special

13  consideration are accident only, short-term nonrenewable,

14  specified peril, and other special risks. Examples of other

15  factors that may require special consideration are marketing

16  methods; giving due consideration to acquistion and

17  administration costs and premium mode; extraordinary expenses;

18  high risk of claims fluctuation because of low loss frequency

19  or the catastrophic or experimental nature of the coverage;

20  product features such as long elimination periods, high

21  deductibles, and high maximum limits; and the industrial or

22  debit method of distribution.

23         2.  If no rate change is proposed, a filing which

24  consists of a certification by an actuary that benefits are

25  reasonable in relation to premiums currently charged in

26  accordance with the loss ratio standards established in this

27  section and s. 627.411(2) applicable laws and rules

28  promulgated by the department.

29         (c)  As used in this section, the term "actuary" means

30  an individual who is a member of the Society of Actuaries or

31  the American Academy of Actuaries.  If an insurer does not

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  employ or otherwise retain the services of an actuary, the

 2  insurer's certification shall be prepared by insurer personnel

 3  or consultants with a minimum of 5 years' experience in

 4  insurance ratemaking. The chief executive officer of the

 5  insurer shall review and sign the certification indicating his

 6  or her agreement with its conclusions.

 7         (d)  If at the time a filing is required under this

 8  section an insurer is in the process of completing a rate

 9  review, the insurer may apply to the department for an

10  extension of up to an additional 30 days in which to make the

11  filing.  The request for extension must be received by the

12  department in its offices in Tallahassee no later than the

13  date the filing is due.

14         (e)  If an insurer fails to meet the filing

15  requirements of this subsection and does not submit the filing

16  within 60 days following the date the filing is due, the

17  department may, in addition to any other penalty authorized by

18  law, order the insurer to discontinue the issuance of policies

19  for which the required filing was not made, until such time as

20  the department determines that the required filing is properly

21  submitted.

22         (8)(a)  For the purposes of subsections (6) and (7) and

23  s. 627.411, benefits of an individual accident and health

24  insurance policy form, including Medicare supplement policies

25  as defined in s. 627.672, when authorized by rules adopted by

26  the department, and excluding long-term care insurance

27  policies as defined in s. 627.9404, and other policy forms

28  under which more than 50 percent of the policies are issued to

29  individuals age 65 and over, are deemed to comply with the

30  provisions cited in this section to be reasonable in relation

31  to premium rates if the rates are filed pursuant to a loss

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  ratio guarantee and both the initial rates and the durational

 2  and lifetime loss ratios have been approved by the department,

 3  and such benefits shall continue to be deemed reasonable for

 4  renewal rates while the insurer complies with such guarantee,

 5  provided the currently expected lifetime loss ratio is not

 6  more than 5 percent less than the filed lifetime loss ratio as

 7  certified to by an actuary.  The department shall have the

 8  right to bring an administrative action should it deem that

 9  the lifetime loss ratio will not be met.  For Medicare

10  supplement filings, the department may withdraw a previously

11  approved filing which was made pursuant to a loss ratio

12  guarantee if it determines that the filing is not in

13  compliance with ss. 627.671-627.675 or the currently expected

14  lifetime loss ratio is less than the filed lifetime loss ratio

15  as certified by an actuary in the initial guaranteed loss

16  ratio filing.  If this section conflicts with ss.

17  627.671-627.675, ss. 627.671-627.675 shall control.

18         (b)  The renewal premium rates shall be deemed to be

19  approved upon filing with the department if the filing is

20  accompanied by the most current approved loss ratio guarantee.

21  The loss ratio guarantee shall be in writing, shall be signed

22  by an officer of the insurer, and shall contain at least:

23         1.  A recitation of the anticipated lifetime and

24  durational target loss ratios contained in the actuarial

25  memorandum filed with the policy form when it was originally

26  approved.  The durational target loss ratios shall be

27  calculated for 1-year experience periods.  If statutory

28  changes have rendered any portion of such actuarial memorandum

29  obsolete, the loss ratio guarantee shall also include an

30  amendment to the actuarial memorandum reflecting current law

31  and containing new lifetime and durational loss ratio targets.

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                                                  SENATE AMENDMENT

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    Amendment No.    





 1         2.  A guarantee that the applicable loss ratios for the

 2  experience period in which the new rates will take effect, and

 3  for each experience period thereafter until new rates are

 4  filed, will meet the loss ratios referred to in subparagraph

 5  1.

 6         3.  A guarantee that the applicable loss ratio results

 7  for the experience period will be independently audited at the

 8  insurer's expense.  The audit shall be performed in the second

 9  calendar quarter of the year following the end of the

10  experience period, and the audited results shall be reported

11  to the department no later than the end of such quarter.  The

12  department shall establish by rule the minimum information

13  reasonably necessary to be included in the report.  The audit

14  shall be done in accordance with accepted accounting and

15  actuarial principles.

16         4.  A guarantee that affected policyholders in this

17  state shall be issued a proportional refund, based on the

18  premium earned, of the amount necessary to bring the

19  applicable experience period loss ratio up to the durational

20  target loss ratio referred to in subparagraph 1.  The refund

21  shall be made to all policyholders in this state who are

22  insured under the applicable policy form as of the last day of

23  the experience period, except that no refund need be made to a

24  policyholder in an amount less than $10. Refunds less than $10

25  shall be aggregated and paid pro rata to the policyholders

26  receiving refunds.  The refund shall include interest at the

27  then-current variable loan interest rate for life insurance

28  policies established by the National Association of Insurance

29  Commissioners, from the end of the experience period until the

30  date of payment.  Payments shall be made during the third

31  calendar quarter of the year following the experience period

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  for which a refund is determined to be due. However, no

 2  refunds shall be made until 60 days after the filing of the

 3  audit report in order that the department has adequate time to

 4  review the report.

 5         5.  A guarantee that if the applicable loss ratio

 6  exceeds the durational target loss ratio for that experience

 7  period by more than 20 percent, provided there are at least

 8  2,000 policyholders on the form nationwide or, if not, then

 9  accumulated each calendar year until 2,000 policyholder years

10  is reached, the insurer, if directed by the department, shall

11  withdraw the policy form for the purposes of issuing new

12  policies.

13         (c)  As used in this subsection:

14         1.  "Loss ratio" means the ratio of incurred claims to

15  earned premium.

16         2.  "Applicable loss ratio" means the loss ratio

17  attributable solely to this state if there are 2,000 or more

18  policyholders in the state. If there are 500 or more

19  policyholders in this state but less than 2,000, it is the

20  linear interpolation of the nationwide loss ratio and the loss

21  ratio for this state.  If there are less than 500

22  policyholders in this state, it is the nationwide loss ratio;

23  however, if there are less than 2,000 policyholder years

24  nationwide, the experience must be accumulated until the end

25  of the calendar year in which 2,000 policyholder years are

26  obtained.

27         3.  "Experience period" means the period, ordinarily a

28  calendar year, for which a loss ratio guarantee is calculated.

29         (d)  The department shall not disapprove or withdraw

30  any previous approval of any individual accident and health

31  insurance form pursuant to s. 627.411(1)(e) if rates have been

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  filed as provided in this subsection.

 2         Section 11.  Section 627.411, Florida Statutes, is

 3  amended to read:

 4         627.411  Grounds for Disapproval of forms.--

 5         (1)  The department shall disapprove any insurance

 6  policy form that must be filed under s. 627.410, or withdraw

 7  any previous approval thereof, only if the form:

 8         (a)  Is in any respect in violation of, or does not

 9  comply with, this code.

10         (b)  Contains or incorporates by reference, where such

11  incorporation is otherwise permissible, any inconsistent,

12  ambiguous, or misleading clauses, or exceptions and conditions

13  which deceptively affect the risk purported to be assumed in

14  the general coverage of the contract.

15         (c)  Has any title, heading, or other indication of its

16  provisions which is misleading.

17         (d)  Is printed or otherwise reproduced in such manner

18  as to render any material provision of the form substantially

19  illegible.

20         (e)1.  Is for health insurance, and provides benefits

21  which are unreasonable in relation to the premium charged; or,

22         2.  Contains provisions that constitute unfair

23  discrimination pursuant to s. 626.9541(1)(g), which are unfair

24  or inequitable as contrary to the public policy of this state

25  or which encourages misrepresentation or which apply rating

26  practices which result in premium escalations that are not

27  viable for the policyholder market or result in unfair

28  discrimination in sales practices.

29         (f)  Excludes coverage for human immunodeficiency virus

30  infection or acquired immune deficiency syndrome or contains

31  limitations in the benefits payable, or in the terms or

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  conditions of such contract, for human immunodeficiency virus

 2  infection or acquired immune deficiency syndrome which are

 3  different than those which apply to any other sickness or

 4  medical condition.

 5         (2)  In determining whether the Benefits are deemed

 6  reasonable in relation to the premium charged if premium rates

 7  are neither excessive nor inadequate., the department, in

 8  accordance with reasonable actuarial techniques, shall

 9  consider:

10         (a)  Past loss experience and prospective loss

11  experience within and without this state.

12         (b)  Allocation of expenses.

13         (c)  Risk and contingency margins, along with

14  justification of such margins.

15         (d)  Acquisition costs.

16         (a)  Premium rates are not excessive if the insurer

17  demonstrates, in accordance with generally accepted standards

18  of actuarial practice, satisfaction of the following minimum

19  anticipated loss ratios.

20         1.  Loss Ratio Table, Individual Policies for the Line

21  of Business Indicated.--

22         a.  Medical Expenses.--

23  Renewal Clause                                    Loss Ratio

24  Noncancelable                                     55 percent

25  Nonrenewable                                      60 percent

26  Guaranteed Renewable                              65 percent

27  All others                                        70 percent

28         b.  Medical Indemnity, Loss of Income.--

29  Renewal Clause                                    Loss Ratio

30  Noncancelable                                     50 percent

31  Nonrenewable                                      55 percent

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  Guaranteed Renewable                              60 percent

 2  All others                                        65 percent

 3         2.  Loss Ratio Table, Group Policies.--

 4         a.  Group Medical Expense.--

 5  Group Size                                        Loss Ratio

 6  Fewer than 51 certificates                        65 percent

 7  51 through 500 certificates                       70 percent

 8  All others                                        75 percent

 9         b.  Group Medical Indemnity or Any Group Policy with

10  and Average Annual Premium per Certificate of Less Than

11  $1,000.--

12  Group Size                                        Loss Ratio

13  Fewer than 51 certificates                        57.5 percent

14  51 through 500 certificates                       62.5 percent

15  All others                                        67.5 percent

16         3.  Group conversion insurance, other than

17  long-term-care insurance and Medicare supplement insurance,

18  issued on either a group or an individual basis, shall have a

19  loss ratio of not less than 120 percent, subject to the limits

20  described in s. 627.6675.

21         4.  The lifetime loss ratios in subparagraphs 1. and 2.

22  may be adjusted in accordance with the following formula:

23

24  R' = (A - 25I) R/A

25

26  where:

27  R = the loss ratio from subparagraphs 1. and 2.;

28  A = the average annualized premium per individual policy or

29  per group certificate;

30  I = (CPI-U, year N-1)/103.9;

31  R' = the adjusted loss ratio.

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    Amendment No.    





 1

 2  R' cannot be more than 10 percentage points less than R nor

 3  less than 50 percent, except that R' cannot be less than 45

 4  percent as to accident only non-cancellable policies. The

 5  CPI-U is the consumer price index for all urban consumers, for

 6  all items and for all regions of the U. S. combined, as

 7  determined by the U. S. Department of Labor, Bureau of

 8  Statistics as of September of each year.  Year N-1 is the

 9  calendar year immediately preceding the calendar year (N) in

10  which the rate filing is submitted in Florida.

11         5.  Blanket insurance is exempt from the loss ratios

12  described in subparagraphs 1.-3. The minimum loss ratio for

13  blanket insurance is 65 percent.

14         6.  Medicare supplement and long-term-care insurance

15  are exempt from the loss ratios described in subparagraphs

16  1.-3. The minimum loss ratios for Medicare supplement

17  insurance must be established in accordance with s. 627.674.

18  Benefits under long-term care insurance policies shall be

19  deemed reasonable in relation to premiums provided the

20  expected loss ratio is at least 60 percent, calculated in a

21  manner which provides for adequate reserving of the long-term

22  care insurance risk. In determining the expected loss ratio,

23  the Insurance Department shall adopt rules consistent with the

24  Long-Term Care Model Regulation as approved by the National

25  Association of Insurance Commissioners in July 1998.

26         (b)  Premium rates are not inadequate if the insurer

27  demonstrates, in accordance with generally accepted standards

28  of actuarial practice, that the sum of premium income and

29  investment income, minus the sum of benefit payments,

30  expenses, taxes, and contingency margins is greater than zero.

31         Section 12.  Subsection (6) is added to section

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  626.883, Florida Statutes, to read:

 2         626.883  Administrator as intermediary; collections

 3  held in fiduciary capacity; establishment of account;

 4  disbursement; payments on behalf of insurer.--

 5         (6)  All payments to a health care provider by a fiscal

 6  intermediary for noncapitated providers must include an

 7  explanation of services being reimbursed which includes, at a

 8  minimum, the patient's name, the date of service, the

 9  procedure code, the amount of reimbursement, and the

10  identification of the plan on whose behalf the payment is

11  being made.  For capitated providers, the statement of

12  services must include the number of patients covered by the

13  contract, the rate per patient, the total amount of the

14  payment, and the identification of the plan on whose behalf

15  the payment is being made.

16         Section 13.  Paragraph (a) of subsection (2) of section

17  641.316, Florida Statutes, 1998 Supplement, is amended to

18  read:

19         641.316  Fiscal intermediary services.--

20         (2)(a)  The term "fiduciary" or "fiscal intermediary

21  services" means reimbursements received or collected on behalf

22  of health care professionals for services rendered, patient

23  and provider accounting, financial reporting and auditing,

24  receipts and collections management, compensation and

25  reimbursement disbursement services, or other related

26  fiduciary services pursuant to health care professional

27  contracts with health maintenance organizations.  All payments

28  to a health care provider by a fiscal intermediary for

29  noncapitated providers must include an explanation of services

30  being reimbursed which includes, at a minimum, the patient's

31  name, the date of service, the procedure code, the amount of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2516

    Amendment No.    





 1  reimbursement, and the identification of the plan on whose

 2  behalf the payment is being made.  For capitated providers,

 3  the statement of services must include the number of patients

 4  covered by the contract, the rate per patient, the total

 5  amount of the payment, and the identification of the plan on

 6  whose behalf the payment is being made.

 7

 8  (Redesignate subsequent sections.)

 9

10

11  ================ T I T L E   A M E N D M E N T ===============

12  And the title is amended as follows:

13         On page 1, line 2, delete that line

14

15  and insert:

16         An act relating to health insurance; amending

17         s. 627.410, F.S.; modifying rate filing

18         requirements for approval of health insurance

19         policy forms by the Department of Insurance;

20         amending s. 627.411, F.S.; providing guidelines

21         for determining when benefits are considered

22         reasonable in relation to the premium charged

23         for purposes of disapproval of health insurance

24         policy forms by the department;  amending s.

25         626.883, F.S.; relating to payments on behalf

26         of insurer; amending s. 641.316, F.S.; relating

27         to payments to a health care provider; amending

28         s.

29

30

31

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