Senate Bill sb2082

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    Florida Senate - 2001                                  SB 2082

    By Senator Carlton





    24-1187-01                                              See HB

  1                      A bill to be entitled

  2         An act relating to public records and meetings;

  3         creating s. 641.264, F.S.; providing exemptions

  4         from public records requirements and public

  5         meetings requirements for health maintenance

  6         organizations for certain risk-based capital

  7         reports, orders, instructions, and plans and

  8         related documents, materials, and information;

  9         providing for future review and repeal;

10         providing a finding of public necessity;

11         providing an effective date.

12

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

14

15         Section 1.  Section 641.264, Florida Statutes, is

16  created to read:

17         641.264  Confidentiality of risk-based capital

18  proceedings and records.--

19         (1)  For the purposes of this section, the definitions

20  of terms provided in s. 641.263 apply.

21         (2)  All risk-based capital reports and related

22  documents, materials, or other information, to the extent the

23  information is not required to be set forth in a publicly

24  available annual statement schedule, and risk-based capital

25  plans and related documents, materials, and other information,

26  including the results or report of any examination or analysis

27  of a health maintenance organization performed pursuant to s.

28  641.263 and any corrective order issued by the department

29  pursuant to such examination or analysis, with respect to a

30  health maintenance organization that are in the possession or

31  control of the department shall be confidential by law and

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    Florida Senate - 2001                                  SB 2082
    24-1187-01                                              See HB




  1  privileged, shall be exempt from the provisions of s.

  2  119.07(1) and s. 24(a), Art. I of the State Constitution,

  3  shall not be subject to subpoena, and shall not be subject to

  4  discovery or admissible in evidence in any private civil

  5  action. However, the department is authorized to use a

  6  risk-based capital report, plan, or related documents,

  7  materials, or other information in the furtherance of any

  8  regulatory or legal action brought as a part of the

  9  department's official duties.  Proceedings and hearings

10  conducted pursuant to s. 641.263 relating to the department's

11  actions regarding any health maintenance organization's

12  risk-based capital plan, revised risk-based capital plan,

13  risk-based capital report or adjusted risk-based capital

14  report are exempt from the provisions of s. 286.011 and s.

15  24(b), Art. I of the State Constitution, except as otherwise

16  provided in this section.

17         (3)  Neither the department nor any person who received

18  a confidential risk-based capital report, plan, or related

19  documents, materials, or other information while acting under

20  the authority of the department shall be permitted or required

21  to testify in any private civil action concerning such report,

22  plan, or related documents, materials, or information, subject

23  to the exceptions contained in subsections (2) and (4).

24         (4)  In order to assist in the performance of its

25  duties, the department may:

26         (a)  Share a confidential or privileged risk-based

27  capital report, plan, or related documents, materials, or

28  other information with other state, federal, and international

29  regulatory agencies, with the National Association of

30  Insurance Commissioners and its affiliates and subsidiaries,

31  and with state, federal, and international law enforcement

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    Florida Senate - 2001                                  SB 2082
    24-1187-01                                              See HB




  1  authorities, provided that the recipient agrees to maintain

  2  the confidentiality of the document, material, or other

  3  information.

  4         (b)  Receive confidential risk-based capital reports,

  5  plans, and related documents, materials, or information from

  6  the National Association of Insurance Commissioners and its

  7  affiliates and subsidiaries, and from regulatory and law

  8  enforcement officials of other foreign or domestic

  9  jurisdictions, and shall maintain as confidential or

10  privileged any such report, plan, or related document,

11  material, or information received with notice or the

12  understanding that it is confidential or privileged under the

13  laws of the jurisdiction that is the source of the document,

14  material, or information.

15         (c)  Enter into agreements governing sharing and use of

16  information consistent with this subsection.

17         (5)  No waiver of any applicable privilege or claim of

18  confidentiality in the documents, materials, or information

19  shall occur as a result of disclosure to the department under

20  this section or as a result of sharing as authorized in

21  paragraph (4)(c).

22         (6)  It is the judgment of the Legislature that the

23  comparison of a health maintenance organization's total

24  adjusted capital to any of its risk-based capital levels is a

25  regulatory tool which may indicate the need for corrective

26  action with respect to the health maintenance organization and

27  is not intended as a means to rank health maintenance

28  organizations generally. Therefore, except as otherwise

29  required under the provisions of this section, the making,

30  publishing, disseminating, circulating, or placing before the

31  public, or causing, directly or indirectly, to be made,

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    Florida Senate - 2001                                  SB 2082
    24-1187-01                                              See HB




  1  published, disseminated, circulated, or placed before the

  2  public in a newspaper, magazine, or other publication, in the

  3  form of a notice, circular, pamphlet, letter, or poster, or

  4  over a radio or television station, or in any other way, an

  5  advertisement, announcement, or statement containing an

  6  assertion, representation, or statement with regard to the

  7  risk-based capital levels of any health maintenance

  8  organization, or of any component derived in the calculation,

  9  by any health maintenance organization, agent, broker, or

10  other person engaged in any manner in the health maintenance

11  organization insurance business would be misleading and is

12  therefore prohibited; provided, if any materially false

13  statement with respect to the comparison regarding a health

14  maintenance organization's total adjusted capital to any of

15  its risk-based capital levels, or an inappropriate comparison

16  of any other amount to the health maintenance organization's

17  risk-based capital levels, is published in any written

18  publication and the health maintenance organization is able to

19  demonstrate to the department with substantial proof the

20  inappropriateness or falsity of the statement, the health

21  maintenance organization may publish an announcement in a

22  written publication if the sole purpose of the announcement is

23  to rebut the materially false statement.

24         (7)  It is the further judgment of the Legislature that

25  the risk-based capital instructions, risk-based capital

26  reports, adjusted risk-based capital reports, risk-based

27  capital plans and revised risk-based capital plans, and

28  related documents, materials, or information are intended

29  solely for use by the department in monitoring the solvency of

30  health maintenance organizations and the need for possible

31  corrective action with respect to health maintenance

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    Florida Senate - 2001                                  SB 2082
    24-1187-01                                              See HB




  1  organizations and shall not be used by the department for

  2  ratemaking nor considered or introduced as evidence in any

  3  rate proceeding nor used by the department to calculate or

  4  derive any elements of an appropriate premium level or rate of

  5  return for any line of insurance that a health maintenance

  6  organization or any affiliate is authorized to write.

  7         (8)  This section is subject to the Open Government

  8  Sunset Review Act of 1995 in accordance with s. 119.15, and

  9  shall stand repealed on October 2, 2006, unless reviewed and

10  saved from repeal through reenactment by the Legislature.

11         Section 2.  The Legislature finds that the public

12  records and meetings exemptions provided for in section

13  641.264, Florida Statutes, are a public necessity because

14  unrestricted public access to information, proceedings, and

15  hearings relating to a health maintenance organization's

16  risk-based capital plan and risk-based capital adjusted

17  report, and documents and examination reports related thereto,

18  might damage the health maintenance organization if made

19  available to its competitors and could substantially affect

20  the solvency of a health maintenance organization. Damage to a

21  health maintenance organization's solvency could have a

22  substantial negative effect on the public as well as on other

23  health maintenance organizations. Furthermore, public access

24  to such information would not serve a public interest in that

25  such information can be misleading as to a health maintenance

26  organization's ranking because risk-based data does not

27  reflect all of the factors involved in the assessment of a

28  health maintenance organization's financial strength. The

29  Legislature also finds that risk-based capital reports and

30  plans reveal a health maintenance organization's investment

31  decisions and that such decisions are a trade secret that give

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    Florida Senate - 2001                                  SB 2082
    24-1187-01                                              See HB




  1  the health maintenance organization a competitive advantage in

  2  the private market. Public access to such information could

  3  affect a health maintenance organization's ability to do

  4  business in Florida and the health maintenance organization's

  5  solvency. Therefore, it is a public necessity to maintain the

  6  confidentiality of this information and these proceedings and

  7  hearings within the regulatory body responsible for the

  8  oversight of health maintenance organization solvency.

  9  Finally, the Legislature finds that the public has access

10  through other means to information regarding the financial

11  strength of a health maintenance organization and its ranking

12  with regard to other health maintenance organizations.

13         Section 3.  This act shall take effect October 1, 2001,

14  if SB ____ or similar legislation is adopted in the same

15  legislative session or an extension thereof and becomes law.

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18                       LEGISLATIVE SUMMARY

19    Provides an exemption from public records requirements
      for risk-based capital reports, orders, instructions, and
20    plans and related documents, materials, and information
      of health maintenance organizations. Provides an
21    exemption from public meetings requirements for
      proceedings and hearings relating to the Department of
22    Insurance's supervision of health maintenance
      organizations relating to risk based capital.  Provides
23    for future review and repeal.

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