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





                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 397

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 5                                           ORIGINAL STAMP BELOW

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10                                                                

11  Representative(s) Rayson and Cosgrove offered the following:

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13         Amendment 

14         On page 11, line 21 through page 12, line 15

15  remove from the bill:  all of said lines

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17  and insert in lieu thereof:

18         627.411  Grounds for disapproval.--

19         (1)  The department shall disapprove any form filed

20  under s. 627.410, or withdraw any previous approval thereof,

21  only if the form:

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

23  comply with, this code.

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

25  incorporation is otherwise permissible, any inconsistent,

26  ambiguous, or misleading clauses, or exceptions and conditions

27  which deceptively affect the risk purported to be assumed in

28  the general coverage of the contract.

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

30  provisions which is misleading.

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

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    File original & 9 copies    04/11/00
    hmo0006                     01:20 pm         00397-0090-404123




                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 397

    Amendment No.     (for drafter's use only)





 1  as to render any material provision of the form substantially

 2  illegible.

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

 4  which are unreasonable in relation to the premium charged as

 5  specified in s. 627.411(2); or,

 6         2.  Contains provisions which are unfair or inequitable

 7  or contrary to the public policy of this state or which

 8  encourage misrepresentation, or are unfairly discriminatory

 9  pursuant to s. 626.9541(1) or which apply rating methods,

10  assumptions or practices which result in: practices which

11  result in premium escalations that are not viable for the

12  policyholder market or result in unfair discrimination in

13  sales practices.

14         i.  Rate increases as a result of insurer conduct as

15  defined in s. 627.402 unless such increase is implemented with

16  an approved rate for new insureds and as to insureds existing

17  at the time of the increase, over a period of years as

18  follows:  for forms with benefits subject to medical

19  inflation, the premium schedule increase applicable to

20  existing insureds at the time of the filing shall be the

21  greater of 10% or 135% of medical trend.  Annual rate

22  increases in subsequent years for the new issue rate schedule

23  shall be increased in accordance with the provisions of this

24  section, s. 627.410 and rules promulgated by the department.

25  The annual increase for the existing insureds shall be the

26  greater of 10% of the new issue rate schedule or 135% of the

27  rate increase approved for the new issue premium schedule

28  until the two rate schedules converge.  For forms with

29  benefits not subject to medical inflation, the period of years

30  for the two schedules to converge shall be two years, if the

31  two rate increases are both less than 10%, otherwise three

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    File original & 9 copies    04/11/00
    hmo0006                     01:20 pm         00397-0090-404123




                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 397

    Amendment No.     (for drafter's use only)





 1  years;

 2         ii.  Rate increases as a result of multiple events of

 3  insurer conduct, unless a plan of corrective action is

 4  approved by the department;

 5         iii.  Rate increases attributed to forms(s) being

 6  closed as to new sales and not pooled with any form with

 7  similar benefits currently available for sale, unless such

 8  increase is limited to the rate increase being realized in the

 9  general insurance market of current forms available for sale

10  with similar benefits;

11         iv.  For new forms, rate schedules that are not

12  actuarially sustainable, except for medical trend increases

13  where applicable.

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15  The department shall promulgate rules to implement the

16  provisions of this section.

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    File original & 9 copies    04/11/00
    hmo0006                     01:20 pm         00397-0090-404123