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A bill to be entitled |
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An act relating to governmental reorganization; revising |
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and conforming provisions of the Florida Statutes to the |
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amendment of Article IV, Section 4 of the State |
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Constitution, in which the functions of the former |
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positions of Comptroller and Treasurer were combined into |
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the office of Chief Financial Officer, and chapter 2002- |
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404, Laws of Florida, which reorganized certain executive- |
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branch duties and functions to implement such |
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constitutional amendment; revising and conforming |
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provisions of the Florida Statues to the creation of the |
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Department of Financial Services and the Financial |
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Services Commission and the abolition of the Department of |
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Insurance and the Department of Banking and Finance; |
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amending ss. 20.121, 103.091, 110.1127, 112.215, 215.555, |
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215.559, 391.221, 401.245, 408.05, 408.7056, 440.13, |
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440.20, 440.24, 440.38, 440.381, 440.385, 440.386, 440.44, |
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440.52, 440.525, 553.74,.624.05, 624.155, 624.303, |
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624.305, 624.316, 624.317, 624.404, 624.4072, 624.413, |
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624.424, 624.476, 624.477, 625.01115, 625.121, 625.151, |
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625.317, 625.325, and 626.015, F.S., to revise and |
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conform; creating s. 626.016, F.S.; prescribing powers and |
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duties of the Department of Financial Services, Financial |
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Services Commission, and Office of Insurance Regulation; |
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amending ss. 626.025, 626.112, 626.161, 626.171, 626.181, |
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626.191, 626.201, 626.202, 626.211, 626.221, 626.231, |
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626.241, 626.251, 626.261, 626.266, 626.271, 626.281, |
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626.2815, 626.2817, 626.291, 626.292, 626.301, 626.322, |
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626.361, 626.371, 626.381, 626.431, 626.451, 626.461, |
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626.471, 626.511, 626.521, 626.541, 626.551, 626.561, |
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626.591, 626.592, 626.601, 626.611, 626.621, 626.631, |
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626.641, 626.661, 626.681, 626.691, 626.692, 626.7315, |
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626.732, 626.742, 626.7451, 626.7454, 626.7491, 626.7492, |
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626.752, 626.7845, 626.7851, 626.8305, 626.8311, 626.8427, |
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626.8463, 626.8467, 626.847, 626.8473, 626.8582, 626.8584, |
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626.859, 626.861, 626.863, 626.865, 626.866, 626.867, |
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626.869, 626.8695, 626.8696, 626.8697, 626.8698, 626.870, |
38
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626.871, 626.872, 626.873, 626.8732, 626.8734, 626.8736, |
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626.8738, 626.874, 626.878, 626.88, 626.8805, 626.8809, |
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626.8814, 626.884, 626.89, 626.891, 626.892, 626.894, |
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626.895, 626.896, 626.897, 626.898, 626.899, 626.901, |
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626.906, 626.907, 626.909, 626.910, 626.912, 626.914, |
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626.916, 626.917, 626.918, 626.919, 626.921, 626.931, |
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626.932, 626.936, 626.9361, 626.937, 626.938, 626.9511, |
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626.9541, 626.9543, 626.9545, 626.9551, 626.9561, |
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626.9571, 626.9581, 626.9591, 626.9601, 626.9611, |
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626.9621, 626.9631, 626.9641, 626.9651, 626.989, 626.9892, |
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626.99, 626.9911, 626.9912, 626.9913, 626.9914, 626.9915, |
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626.9916, 626.9919, 626.9921, 626.9922, 626.99235, |
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626.99245, 626.9925, 626.9926, 626.9927, 626.99272, |
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626.99285, 626.99295, 627.0628, 627.0629, 627.311, |
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627.3111, 627.351, 627.3511, 627.3513, 627.3515, 627.357, |
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627.4236, 627.6488, 627.6699, 627.7015, 627.745, 628.4615, |
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628.917, 631.021, 631.025, 631.031, 631.041, 631.042, |
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631.051, 631.0515, 631.061, 631.071, 631.081, 631.091, |
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631.111, 631.152, 631.154, 631.221, 631.231, 631.361, |
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631.371, 631.391, 631.392, 631.398, 631.54, 631.55, |
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631.56, 631.57, 631.59, 631.60, 631.62, 631.66, 631.714, |
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631.72, 631.722, 631.723, 631.727, 631.813, 631.814, |
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631.821, 631.825, 631.904, 631.911, 631.912, 631. 917, |
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631.918, 631.931, 634.3284, 634.430, 634.433, 636.067, |
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641.183, 641.185, 641.19, 641.2017, 641.2018, 641.21, |
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641.215, 641.22, 641.225, 641.227, 641.228, 641.23, |
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641.234, 641.2342, 641.25, 641.255, 641.26, 641.27, |
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641.28, 641.281, 641.284, 641.285, 641.29, 641.3007, |
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641.305, 641.31, 641.3105, 641.31071, 641.31074, 641.315, |
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641.3154, 641.3155, 641.316, 641.35, 641.35, 641.36, |
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641.365, 641.385, 641.39001, 641.3903, 641.3905, 641.3907, |
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641.3909, 641.3911, 641.3913, 641.3917, 641.3922, 641.402, |
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641.403, 641.,405, 641.406, 641.4065, 641.407, 641.409, |
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641.41, 641.412, 641.418, 641.42, 641.421, 641.424, |
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641.437, 641.443, 641.444, 641.445, 641.446, 641.447, |
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641.448, 641.45, 641.452, 641.453, 641.454, 641.455, |
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641.457, 641.48, 641.49, 641.495, 641.511, 641.511, |
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641.512, 641.52, 641.54, 641.55, 641.58, 642.0475, |
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651.119, 252.62, 288.778, 288.99, 289.051, 289.081, |
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289.121, 420.101, 494.00125, 494.00421 517.021, 517.03, |
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517.051, 517.061, 517.07, 517.075, 517.081, 517.082, |
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517.101, 517.111, 517.12, 517.1201, 517.1203, 517.1204, |
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517.121, 517.131, 517.141, 517.151, 517.161, 517.181, |
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517.191, 517.201, 517.2015, 517.221, 517.241, 517.301, |
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517.302 517.313, 517.315, 517.32, 520.996, 520.9965, |
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537.008, 537.009, 537.011, 537.013, 537.016, 537.017, |
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559.725, 560.128, 560.129, 560.404, 609.05, and 655.012, |
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F.S., to revise and conform; protecting the validity of |
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certain administrative and judicial actions; providing for |
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substitution of parties; providing for continuation and |
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effect of certain certificates of authority, forms, |
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licenses, rates, filings, and actions; providing for |
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controlling effect; providing an effective date. |
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Be It Enacted by the Legislature of the State of Florida: |
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Section 1. Section 20.121, Florida Statutes, is amended to |
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read: |
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20.121 Department of Financial Services.--There is created |
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a Department of Financial Services. |
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(1) DEPARTMENT HEAD.--The head of the Department of |
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Financial Services is the Chief Financial Officer. |
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(2) DIVISIONS.--The Department of Financial Services shall |
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consist of the following divisions: |
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(a) The Division of Accounting and Auditing, which shall |
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include the following bureau and office: |
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1. The Bureau of Unclaimed Property. |
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2. The Office of Fiscal Integrity which shall function as |
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a criminal justice agency for purposes of ss. 943.045-943.08 and |
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shall have a separate budget. The office may conduct |
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investigations within or outside this state as the bureau deems |
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necessary to aid in the enforcement of this section. If during |
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an investigation the office has reason to believe that any |
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criminal law of this state has or may have been violated, the |
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office shall refer any records tending to show such violation to |
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state or federal law enforcement or prosecutorial agencies and |
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shall provide investigative assistance to those agencies as |
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required. |
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(b) The Division of State Fire Marshal. |
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(c) The Division of Risk Management. |
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(d) The Division of Treasury, which shall include a Bureau |
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of Deferred Compensation responsible for administering the |
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Government Employees Deferred Compensation Plan established |
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under s. 112.215 for state employees. |
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(e) The Division of Insurance Fraud. |
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(f) The Division of Rehabilitation and Liquidation. |
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(g) The Division of Insurance Agents and Agency Services. |
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(h) The Division of Consumer Services, which shall include |
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a Bureau of Funeral and Cemetery Services. |
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1. The Division of Consumer Services shall perform the |
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following functions concerning products or services regulated by |
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the Department of Financial Services or by either office of the |
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Financial Services Commission: |
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a. Receive inquiries and complaints from consumers; |
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b. Prepare and disseminate such information as the |
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department deems appropriate to inform or assist consumers; |
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c. Provide direct assistance and advocacy for consumers |
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who request such assistance or advocacy; |
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d. With respect to apparent or potential violations of law |
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or applicable rules by a person or entity licensed by the |
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department or by either office of the commission, report such |
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apparent or potential violation to the appropriate division of |
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the department or office of the commission, which may take such |
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further action as it deems appropriate. |
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2. Any person licensed or issued a certificate of |
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authority by the department or by either office of the |
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commission shall respond, in writing, to the Division of |
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Consumer Services within 15 days after receipt of a written |
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request from the division to do so concerning a consumer |
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complaint. Failure to timely respond is subject to an |
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administrative fine by the department or office that issued the |
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license or certificate of authority, as may be imposed for a |
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violation of law. |
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(i) The Division of Workers' Compensation. |
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(j) The Division of Administration. |
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(k) The Division of Legal Services. |
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(l) The Division of Information Systems. |
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(m) The Office of Insurance Consumer Advocate. |
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(3) FINANCIAL SERVICES COMMISSION.--Effective January 7, |
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2003, there is created within the Department of Financial |
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Services the Financial Services Commission, composed of the |
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Governor, the Attorney General, the Chief Financial Officer, and |
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the Commissioner of Agriculture, which shall for purposes of |
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this section be referred to as the commission. Commission |
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members shall serve as agency head of the Financial Services |
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Commission. The commission shall be a separate budget entity |
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and shall be exempt from the provisions of s. 20.052. Commission |
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action shall be by majority vote consisting of at least three |
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affirmative votes. The commission shall not be subject to |
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control, supervision, or direction by the Department of |
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Financial Services in any manner, including purchasing, |
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transactions involving real or personal property, personnel, or |
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budgetary matters. |
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(a) Structure.--The major structural unit of the |
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commission is the office. Each office shall be headed by a |
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director. The following offices are established: |
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1. The Office of Insurance Regulation, which shall be |
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responsible for all activities concerning insurers and other |
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risk bearing entities, including licensing, rates, policy forms, |
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market conduct, claims, adjusters, issuance of certificates of |
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authority, solvency, viatical settlements, premium financing, |
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and administrative supervision, as provided under the insurance |
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code or chapter 636. The head of the Office of Insurance |
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Regulation is the Director of the Office of Insurance |
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Regulation. |
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2. The Office of Financial Institutions and Securities |
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Regulation, which shall be responsible for all activities of the |
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Financial Services Commission relating to the regulation of |
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banks, credit unions, other financial institutions, finance |
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companies, and the securities industry. The head of the office |
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is the Director of the Office of Financial Institutions and |
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Securities Regulation. The Office of Financial Institutions and |
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Securities Regulation shall include a Bureau of Financial |
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Investigations, which shall function as a criminal justice |
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agency for purposes of ss. 943.045-943.08 and shall have a |
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separate budget. The bureau may conduct investigations within |
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or outside this state as the bureau deems necessary to aid in |
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the enforcement of this section. If, during an investigation, |
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the office has reason to believe that any criminal law of this |
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state has or may have been violated, the office shall refer any |
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records tending to show such violation to state or federal law |
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enforcement or prosecutorial agencies and shall provide |
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investigative assistance to those agencies as required. |
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(b) Organization.--The commission shall establish by rule |
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any additional organizational structure of the offices. It is |
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the intent of the Legislature to provide the commission with the |
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flexibility to organize the offices in any manner they determine |
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appropriate to promote both efficiency and accountability. |
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(c) Powers.--Commission members shall serve as the agency |
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head for purposes of rulemaking under ss. 120.536-120.565 by the |
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commission and all subunits of the commission. Each director is |
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agency head for purposes of final agency action under chapter |
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120 for all areas within the regulatory authority delegated to |
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the director's office. |
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(d) Appointment and qualifications of directors.--The |
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commission shall appoint or remove each director by a majority |
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vote consisting of at least three affirmative votes, with both |
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the Governor and the Chief Financial Officer on the prevailing |
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side. The minimum qualifications of the directors are as |
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follows: |
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1. Prior to appointment as director, the Director of the |
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Office of Insurance Regulation must have had, within the |
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previous 10 years, at least 5 years of responsible private |
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sector experience working full time in areas within the scope of |
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the subject matter jurisdiction of the Office of Insurance |
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Regulation or at least 5 years of experience as a senior |
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examiner or other senior employee of a state or federal agency |
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having regulatory responsibility over insurers or insurance |
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agencies. |
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2. Prior to appointment as director, the Director of the |
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Office of Financial Institutions and Securities Regulation must |
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have had, within the previous 10 years, at least 5 years of |
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responsible private sector experience working full time in areas |
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within the subject matter jurisdiction of the Office of |
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Financial Institutions and Securities Regulation or at least 5 |
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years of experience as a senior examiner or other senior |
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employee of a state or federal agency having regulatory |
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responsibility over financial institutions, finance companies, |
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or securities companies. |
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(e) Administrative support.--The offices shall have a |
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sufficient number of attorneys, examiners, investigators, other |
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professional personnel to carry out their responsibilities and |
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administrative personnel as determined annually in the |
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appropriations process. The Department of Financial Services |
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shall provide administrative and information systems support to |
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the offices. |
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Section 2. Subsection (6) of section 103.091, Florida |
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Statutes, is amended to read: |
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103.091 Political parties.-- |
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(6)(a)1.In addition to the members provided for in |
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subsection (1), each county executive committee shall include |
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all members of the Legislature who are residents of the county |
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and members of their respective political party and who shall be |
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known as at-large committeemen and committeewomen. |
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(b)2.Each state executive committee shall include, as at- |
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large committeemen and committeewomen, all members of the United |
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States Congress representing the State of Florida who are |
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members of the political party, all statewide elected officials |
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who are members of the party, and the President of the Senate or |
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the Minority Leader in the Senate, and the Speaker of the House |
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of Representatives or the Minority Leader in the House of |
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Representatives, whichever is a member of the political party, |
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and 20 members of the Legislature who are members of the |
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political party. Ten of the legislators shall be appointed with |
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the concurrence of the state chair of the respective party, as |
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follows: five to be appointed by the President of the Senate; |
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five by the Minority Leader in the Senate; five by the Speaker |
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of the House of Representatives; and five by the Minority Leader |
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in the House. |
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(c)3.When a political party allows any member of the |
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state executive committee to have more than one vote per person, |
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other than by proxy, in a matter coming before the state |
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executive committee, the 20 members of the Legislature appointed |
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under subparagraph 2. shall not be appointed to the state |
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executive committee and the following elected officials who are |
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members of that political party shall be appointed and shall |
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have the following votes: |
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1.a.Governor: a number equal to 15 percent of votes cast |
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by state executive committeemen and committeewomen; |
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2.b.Lieutenant Governor: a number equal to 5 percent of |
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the votes cast by state executive committeemen and |
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committeewomen; |
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3.c.Each member of the United States Senate representing |
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the state: a number equal to 10 percent of the votes cast by |
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state executive committeemen and committeewomen; |
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d. Secretary of State: a number equal to 5 percent of the |
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votes cast by state executive committeemen and committeewomen; |
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4.e.Attorney General: a number equal to 5 percent of the |
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votes cast by state executive committeemen and committeewomen; |
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5.f.Chief Financial OfficerComptroller: a number equal |
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to 5 percent of the votes cast by state executive committeemen |
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and committeewomen; |
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g. Treasurer: a number equal to 5 percent of the votes |
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cast by state executive committeemen and committeewomen;
|
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6.h.Commissioner of Agriculture: a number equal to 5 |
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percent of the votes cast by state executive committeemen and |
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committeewomen; |
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i. Commissioner of Education: a number equal to 5 percent |
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of the votes cast by state executive committeemen and |
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committeewomen; |
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7.j.President of the Senate: a number equal to 10 percent |
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of the votes cast by state executive committeemen and |
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committeewomen; |
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8.k.Minority leader of the Senate: a number equal to 10 |
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percent of the votes cast by state executive committeemen and |
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committeewomen; |
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9.l.Speaker of the House of Representatives: a number |
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equal to 10 percent of the votes cast by state executive |
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committeemen and committeewomen; |
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10.m.Minority leader of the House of Representatives: a |
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number equal to 10 percent of the votes cast by state executive |
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committeemen and committeewomen; and |
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11.n.Each member of the United States House of |
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Representatives representing the state: a number equal to 1 |
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percent of the votes cast by state executive committeemen and |
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committeewomen. |
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(d)1.4.a.The governing body of each state executive |
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committee as defined by party rule shall include as at-large |
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committeemen and committeewomen all statewide elected officials |
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who are members of such political party; up to four members of |
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the United States Congress representing the state who are |
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members of such political party and who shall be appointed by |
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the state chair on the basis of geographic representation; the |
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permanent presiding officer selected by the members of each |
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house of the Legislature who are members of such political |
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party; and the minority leader selected by the members of each |
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house of the Legislature who are members of such political |
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party. |
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2.b.All members of the governing body shall have one vote |
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per person. |
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Section 3. Paragraph (a) of subsection (2) of section |
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110.1127, Florida Statutes, is amended to read: |
330
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110.1127 Employee security checks.-- |
331
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(2)(a) All positions within the Division of Treasury of |
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the Department of Financial ServicesInsuranceare deemed to be |
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positions of special trust or responsibility, and a person may |
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be disqualified for employment in any such position by reason |
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of: |
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1. The conviction or prior conviction of a crime which is |
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reasonably related to the nature of the position sought or held |
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by the individual; or |
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2. The entering of a plea of nolo contendere or, when a |
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jury verdict of guilty is rendered but adjudication of guilt is |
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withheld, with respect to a crime which is reasonably related to |
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the nature of the position sought or held by the individual. |
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Section 4. Subsection (4), paragraph (a) of subsection |
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(6), paragraphs (a), (d), (f), and(h) of subsection (8), |
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paragraph (b) of subsection (10), and subsections (11) and (12) |
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of section 112.215, Florida Statutes, are amended to read: |
347
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112.215 Government employees; deferred compensation |
348
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program.-- |
349
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(4)(a) The Chief Financial OfficerTreasurer, with the |
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approval of the State Board of Administration, shall establish |
351
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such plan or plans of deferred compensation for state employees, |
352
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including all such investment vehicles or products incident |
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|
thereto, as may be available through, or offered by, qualified |
354
|
companies or persons, and may approve one or more such plans for |
355
|
implementation by and on behalf of the state and its agencies |
356
|
and employees. |
357
|
(b) If the Chief Financial OfficerTreasurerdeems it |
358
|
advisable, he or she shall have the power, with the approval of |
359
|
the State Board of Administration, to create a trust or other |
360
|
special funds for the segregation of funds or assets resulting |
361
|
from compensation deferred at the request of employees of the |
362
|
state or its agencies and for the administration of such |
363
|
program. |
364
|
(c) The Chief Financial OfficerTreasurer, with the |
365
|
approval of the State Board of Administration, may delegate |
366
|
responsibility for administration of the plan to a person the |
367
|
Chief Financial OfficerTreasurerdetermines to be qualified, |
368
|
compensate such person, and, directly or through such person or |
369
|
pursuant to a collective bargaining agreement, contract with a |
370
|
private corporation or institution to provide such services as |
371
|
may be part of any such plan or as may be deemed necessary or |
372
|
proper by the Chief Financial OfficerTreasureror such person, |
373
|
including, but not limited to, providing consolidated billing, |
374
|
individual and collective recordkeeping and accountings, asset |
375
|
purchase, control, and safekeeping, and direct disbursement of |
376
|
funds to employees or other beneficiaries. The Chief Financial |
377
|
OfficerTreasurermay authorize a person, private corporation, |
378
|
or institution to make direct disbursement of funds under the |
379
|
plan to an employee or other beneficiary only upon the order of |
380
|
the Comptroller to the Treasurer. |
381
|
(d) In accordance with such approved plan, and upon |
382
|
contract or agreement with an eligible employee, deferrals of |
383
|
compensation may be accomplished by payroll deductions made by |
384
|
the appropriate officer or officers of the state, with such |
385
|
funds being thereafter held and administered in accordance with |
386
|
the plan. |
387
|
(6)(a) No deferred compensation plan of the state shall |
388
|
become effective until approved by the State Board of |
389
|
Administration and the Chief Financial OfficerTreasureris |
390
|
satisfied by opinion from such federal agency or agencies as may |
391
|
be deemed necessary that the compensation deferred thereunder |
392
|
and/or the investment products purchased pursuant to the plan |
393
|
will not be included in the employee's taxable income under |
394
|
federal or state law until it is actually received by such |
395
|
employee under the terms of the plan, and that such compensation |
396
|
will nonetheless be deemed compensation at the time of deferral |
397
|
for the purposes of social security coverage, for the purposes |
398
|
of the state retirement system, and for any other retirement, |
399
|
pension, or benefit program established by law. |
400
|
(8)(a) There is herebycreated a Deferred Compensation |
401
|
Advisory Council composed of seven members. |
402
|
1. One member shall be appointed by the Speaker of the |
403
|
House of Representatives and the President of the Senate jointly |
404
|
and shall be an employee of the legislative branch. |
405
|
2. One member shall be appointed by the Chief Justice of |
406
|
the Supreme Court and shall be an employee of the judicial |
407
|
branch. |
408
|
3. One member shall be appointed by the chair of the |
409
|
Public Employees Relations Commission and shall be a nonexempt |
410
|
public employee. |
411
|
4. The remaining four members shall be employed by the |
412
|
executive branch and shall be appointed as follows: |
413
|
a. One member shall be appointed by the Chancellor of the |
414
|
State University System and shall be an employee of the |
415
|
university system. |
416
|
b. One member shall be appointed by the Chief Financial |
417
|
OfficerTreasurer and shall be an employee of the Chief |
418
|
Financial OfficerTreasurer. |
419
|
c. One member shall be appointed by the Governor and shall |
420
|
be an employee of the executive branch. |
421
|
d. One member shall be appointed by the Comptroller and |
422
|
shall be an employee of the Comptroller.
|
423
|
(d) The council shall meet at the call of its chair, at |
424
|
the request of a majority of its membership, or at the request |
425
|
of the Chief Financial OfficerTreasurer, but not less than |
426
|
twice a year. The business of the council shall be presented to |
427
|
the council in the form of an agenda. The agenda shall be set |
428
|
by the Chief Financial OfficerTreasurerand shall include items |
429
|
of business requested by the council members. |
430
|
(f) The council shall make a report of each meeting to the |
431
|
Chief Financial OfficerTreasurer, which shall show the names of |
432
|
the members present and shall include a record of its |
433
|
discussions, recommendations, and actions taken. The Chief |
434
|
Financial OfficerTreasurershall keep the records of the |
435
|
proceedings of each meeting on file and shall make the records |
436
|
available to any interested person or group. |
437
|
(h) The advisory council shall provide assistance and |
438
|
recommendations to the Chief Financial OfficerTreasurer |
439
|
relating to the provisions of the plan, the insurance or |
440
|
investment options to be offered under the plan, and any other |
441
|
contracts or appointments deemed necessary by the council and |
442
|
the Chief Financial OfficerTreasurerto carry out the |
443
|
provisions of this act. The Chief Financial OfficerTreasurer |
444
|
shall inform the council of the manner in which each council |
445
|
recommendation is being addressed. The Chief Financial Officer |
446
|
Treasurershall provide the council, at least annually, a report |
447
|
on the status of the deferred compensation program, including, |
448
|
but not limited to, information on participant enrollment, |
449
|
amount of compensation deferred, total plan assets, product |
450
|
provider performance, and participant satisfaction with the |
451
|
program. |
452
|
(10) |
453
|
(b)1. There is created in the State Treasury the Deferred |
454
|
Compensation Trust Fund, through which the Chief Financial |
455
|
OfficerTreasureras trustee shall hold moneys, pensions, |
456
|
annuities, or other benefits accrued or accruing under and |
457
|
pursuant to 26 U.S.C. s. 457 and the deferred compensation plan |
458
|
provided for therein and adopted by this state; and |
459
|
a. All amounts of compensation deferred thereunder; |
460
|
b. All property and rights purchased with such amounts; |
461
|
and |
462
|
c. All income attributable to such amounts, property, or |
463
|
rights. |
464
|
2. Notwithstanding the mandates of 26 U.S.C. s. 457(b)(6), |
465
|
all of the assets specified in subparagraph 1. shall be held in |
466
|
trust for the exclusive benefit of participants and their |
467
|
beneficiaries as mandated by 26 U.S.C. s. 457(g)(1). |
468
|
(11) With respect to any funds held pursuant to a deferred |
469
|
compensation plan, any plan provider which is a bank or savings |
470
|
association and which provides time deposit accounts and |
471
|
certificates of deposit as an investment product to the plan |
472
|
participants may, with the approval of the State Board of |
473
|
Administration for providers in the state plan, or with the |
474
|
approval of the appropriate official or body designated under |
475
|
subsection (5) for a plan of a county, municipality, other |
476
|
political subdivision, or constitutional county officer, be |
477
|
exempt from the provisions of chapter 280 requiring it to be a |
478
|
qualified public depository, provided: |
479
|
(a) The bank or savings association shall, to the extent |
480
|
that the time deposit accounts or certificates of deposit are |
481
|
not insured by the Federal Deposit Insurance Corporation or the |
482
|
Federal Savings and Loan Insurance Corporation, pledge |
483
|
collateral with the Chief Financial OfficerTreasurerfor all |
484
|
state funds held by it under a deferred compensation plan, or |
485
|
with such other appropriate official for all public funds held |
486
|
by it under a deferred compensation plan of a county, |
487
|
municipality, other political subdivision, or constitutional |
488
|
county officer, in an amount which equals at least 150 percent |
489
|
of all uninsured deferred compensation funds then held. |
490
|
(b) Said collateral shall be of the kind permitted by s. |
491
|
280.13 and shall be pledged in the manner provided for by the |
492
|
applicable provisions of chapter 280. |
493
|
|
494
|
The Chief Financial OfficerTreasurershall have all the |
495
|
applicable powers provided in ss. 280.04, 280.05, and 280.08 |
496
|
relating to the sale or other disposition of the pledged |
497
|
collateral. |
498
|
(12) The Chief Financial OfficerTreasurermay adopt any |
499
|
rule necessary to administer and implement this act with respect |
500
|
to deferred compensation plans for state employees. |
501
|
Section 5. Paragraph (c) of subsection (2), paragraph (d) |
502
|
of subsection (4), and paragraphs (a), (b), and (c) of |
503
|
subsection (6) of section 215.555, Florida Statutes, are amended |
504
|
to read: |
505
|
215.555 Florida Hurricane Catastrophe Fund.-- |
506
|
(2) DEFINITIONS.--As used in this section: |
507
|
(c) "Covered policy" means any insurance policy covering |
508
|
residential property in this state, including, but not limited |
509
|
to, any homeowner's, mobile home owner's, farm owner's, |
510
|
condominium association, condominium unit owner's, tenant's, or |
511
|
apartment building policy, or any other policy covering a |
512
|
residential structure or its contents issued by any authorized |
513
|
insurer, including any joint underwriting association or similar |
514
|
entity created pursuant to law. The term "covered policy" |
515
|
includes any collateral protection insurance policy covering |
516
|
personal residences which protects both the borrower's and the |
517
|
lender's financial interests, in an amount at least equal to the |
518
|
coverage for the dwelling in place under the lapsed homeowner's |
519
|
policy, if such policy can be accurately reported as required in |
520
|
subsection(5). Additionally, covered policies include policies |
521
|
covering the peril of wind removed from the Florida Residential |
522
|
Property and Casualty Joint Underwriting Association or from the |
523
|
Citizens Property Insurance Corporation, created pursuant to s. |
524
|
627.351(6), or from the Florida Windstorm Underwriting |
525
|
Association, created pursuant to s. 627.351(2), by an authorized |
526
|
insurer under the terms and conditions of an executed assumption |
527
|
agreement between the authorized insurer and eithersuch |
528
|
association. Each assumption agreement between theeither |
529
|
association and such authorized insurer must be approved by the |
530
|
Florida Department of Insurance or the Office of Insurance |
531
|
Regulationprior to the effective date of the assumption, and |
532
|
the Department of Insurance or the Office of Insurance |
533
|
Regulationmust provide written notification to the board within |
534
|
15 working days after such approval. "Covered policy" does not |
535
|
include any policy that excludes wind coverage or hurricane |
536
|
coverage or any reinsurance agreement and does not include any |
537
|
policy otherwise meeting this definition which is issued by a |
538
|
surplus lines insurer or a reinsurer. |
539
|
(4) REIMBURSEMENT CONTRACTS.-- |
540
|
(d)1. For purposes of determining potential liability and |
541
|
to aid in the sound administration of the fund, the contract |
542
|
shall require each insurer to report such insurer's losses from |
543
|
each covered event on an interim basis, as directed by the |
544
|
board. The contract shall require the insurer to report to the |
545
|
board no later than December 31 of each year, and quarterly |
546
|
thereafter, its reimbursable losses from covered events for the |
547
|
year. The contract shall require the board to determine and pay, |
548
|
as soon as practicable after receiving these reports of |
549
|
reimbursable losses, the initial amount of reimbursement due and |
550
|
adjustments to this amount based on later loss information. The |
551
|
adjustments to reimbursement amounts shall require the board to |
552
|
pay, or the insurer to return, amounts reflecting the most |
553
|
recent calculation of losses. |
554
|
2. In determining reimbursements pursuant to this |
555
|
subsection, the contract shall provide that the board shall: |
556
|
a. First reimburse insurers writing covered policies, |
557
|
which insurers are in full compliance with this section and have |
558
|
petitioned the Office of Insurance RegulationDepartment of |
559
|
Insuranceand qualified as limited apportionment companies under |
560
|
s. 627.351(2)(b)3. The amount of such reimbursement shall be |
561
|
the lesser of $10 million or an amount equal to 10 times the |
562
|
insurer's reimbursement premium for the current year. The |
563
|
amount of reimbursement paid under this sub-subparagraph may not |
564
|
exceed the full amount of reimbursement promised in the |
565
|
reimbursement contract. This sub-subparagraph does not apply |
566
|
with respect to any contract year in which the year-end |
567
|
projected cash balance of the fund, exclusive of any bonding |
568
|
capacity of the fund, exceeds $2 billion. Only one member of any |
569
|
insurer group may receive reimbursement under this sub- |
570
|
subparagraph. |
571
|
b. Next pay to each insurer such insurer's projected |
572
|
payout, which is the amount of reimbursement it is owed, up to |
573
|
an amount equal to the insurer's share of the actual premium |
574
|
paid for that contract year, multiplied by the actual claims- |
575
|
paying capacity available for that contract year; provided, |
576
|
entities created pursuant to s. 627.351 shall be further |
577
|
reimbursed in accordance with sub-subparagraph c. |
578
|
c. Thereafter, establish, based on reimbursable losses, |
579
|
the prorated reimbursement level at the highest level for which |
580
|
any remaining fund balance or bond proceeds are sufficient to |
581
|
reimburse entities created pursuant to s. 627.351 for losses |
582
|
exceeding the amounts payable pursuant to sub-subparagraph b. |
583
|
for the current contract year. |
584
|
(6) REVENUE BONDS.-- |
585
|
(a) General provisions.-- |
586
|
1. Upon the occurrence of a hurricane and a determination |
587
|
that the moneys in the fund are or will be insufficient to pay |
588
|
reimbursement at the levels promised in the reimbursement |
589
|
contracts, the board may take the necessary steps under |
590
|
paragraph (b) or paragraph (c) for the issuance of revenue bonds |
591
|
for the benefit of the fund. The proceeds of such revenue bonds |
592
|
may be used to make reimbursement payments under reimbursement |
593
|
contracts; to refinance or replace previously existing |
594
|
borrowings or financial arrangements; to pay interest on bonds; |
595
|
to fund reserves for the bonds; to pay expenses incident to the |
596
|
issuance or sale of any bond issued under this section, |
597
|
including costs of validating, printing, and delivering the |
598
|
bonds, costs of printing the official statement, costs of |
599
|
publishing notices of sale of the bonds, and related |
600
|
administrative expenses; or for such other purposes related to |
601
|
the financial obligations of the fund as the board may |
602
|
determine. The term of the bonds may not exceed 30 years. The |
603
|
board may pledge or authorize the corporation to pledge all or a |
604
|
portion of all revenues under subsection (5) and under |
605
|
subparagraph 3. to secure such revenue bonds and the board may |
606
|
execute such agreements between the board and the issuer of any |
607
|
revenue bonds and providers of other financing arrangements |
608
|
under paragraph (7)(b) as the board deems necessary to evidence, |
609
|
secure, preserve, and protect such pledge. If reimbursement |
610
|
premiums received under subsection (5) or earnings on such |
611
|
premiums are used to pay debt service on revenue bonds, such |
612
|
premiums and earnings shall be used only after the use of the |
613
|
moneys derived from assessments under subparagraph 3. The |
614
|
funds, credit, property, or taxing power of the state or |
615
|
political subdivisions of the state shall not be pledged for the |
616
|
payment of such bonds. The board may also enter into agreements |
617
|
under paragraph (b) or paragraph (c) for the purpose of issuing |
618
|
revenue bonds in the absence of a hurricane upon a determination |
619
|
that such action would maximize the ability of the fund to meet |
620
|
future obligations. |
621
|
2. The Legislature finds and declares that the issuance of |
622
|
bonds under this subsection is for the public purpose of paying |
623
|
the proceeds of the bonds to insurers, thereby enabling insurers |
624
|
to pay the claims of policyholders to assure that policyholders |
625
|
are able to pay the cost of construction, reconstruction, |
626
|
repair, restoration, and other costs associated with damage to |
627
|
property of policyholders of covered policies after the |
628
|
occurrence of a hurricane. Revenue bonds may not be issued under |
629
|
this subsection until validated under chapter 75. The validation |
630
|
of at least the first obligations incurred pursuant to this |
631
|
subsection shall be appealed to the Supreme Court, to be handled |
632
|
on an expedited basis. |
633
|
3. If the board determines that the amount of revenue |
634
|
produced under subsection (5) is insufficient to fund the |
635
|
obligations, costs, and expenses of the fund and the |
636
|
corporation, including repayment of revenue bonds, the board |
637
|
shall direct the Office of Insurance RegulationDepartment of |
638
|
Insuranceto levy an emergency assessment on each insurer |
639
|
writing property and casualty business in this state. Pursuant |
640
|
to the emergency assessment, each such insurer shall pay to the |
641
|
corporation by July 1 of each year an amount set by the board |
642
|
not exceeding 2 percent of its gross direct written premium for |
643
|
the prior year from all property and casualty business in this |
644
|
state except for workers' compensation, except that, if the |
645
|
Governor has declared a state of emergency under s. 252.36 due |
646
|
to the occurrence of a covered event, the amount of the |
647
|
assessment for the contract year may be increased to an amount |
648
|
not exceeding 4 percent of such premium. Any assessment |
649
|
authority not used for the contract year may be used for a |
650
|
subsequent contract year. If, for a subsequent contract year, |
651
|
the board determines that the amount of revenue produced under |
652
|
subsection (5) is insufficient to fund the obligations, costs, |
653
|
and expenses of the fund and the corporation, including |
654
|
repayment of revenue bonds for that contract year, the board |
655
|
shall direct the Office of Insurance RegulationDepartment of |
656
|
Insuranceto levy an emergency assessment up to an amount not |
657
|
exceeding the amount of unused assessment authority from a |
658
|
previous contract year or years, plus an additional 2 percent if |
659
|
the Governor has declared a state of emergency under s. 252.36 |
660
|
due to the occurrence of a covered event. Any assessment |
661
|
authority not used for the contract year may be used for a |
662
|
subsequent contract year. As used in this subsection, the term |
663
|
"property and casualty business" includes all lines of business |
664
|
identified on Form 2, Exhibit of Premiums and Losses, in the |
665
|
annual statement required by s. 624.424 and any rules adopted |
666
|
under such section, except for those lines identified as |
667
|
accident and health insurance. The annual assessments under this |
668
|
subparagraph shall continue as long as the revenue bonds issued |
669
|
with respect to which the assessment was imposed are |
670
|
outstanding, unless adequate provision has been made for the |
671
|
payment of such bonds pursuant to the documents authorizing |
672
|
issuance of the bonds. An insurer shall not at any time be |
673
|
subject to aggregate annual assessments under this subparagraph |
674
|
of more than 2 percent of premium, except that in the case of a |
675
|
declared emergency, an insurer shall not at any time be subject |
676
|
to aggregate annual assessments under this subparagraph of more |
677
|
than 6 percent of premium; provided, no more than 4 percent may |
678
|
be assessed for any one contract year. Any rate filing or |
679
|
portion of a rate filing reflecting a rate change attributable |
680
|
entirely to the assessment levied under this subparagraph shall |
681
|
be deemed approved when made, subject to the authority of the |
682
|
Office of Insurance RegulationDepartment of Insuranceto |
683
|
require actuarial justification as to the adequacy of any rate |
684
|
at any time. If the rate filing reflects only a rate change |
685
|
attributable to the assessment under this paragraph, the filing |
686
|
may consist of a certification so stating. The assessments |
687
|
otherwise payable to the corporation pursuant to this |
688
|
subparagraph shall be paid instead to the fund unless and until |
689
|
the Office of Insurance RegulationDepartment of Insurancehas |
690
|
received from the corporation and the fund a notice, which shall |
691
|
be conclusive and upon which the Office of Insurance Regulation |
692
|
Department of Insurancemay rely without further inquiry, that |
693
|
the corporation has issued bonds and the fund has no agreements |
694
|
in effect with local governments pursuant to paragraph (b). On |
695
|
or after the date of such notice and until such date as the |
696
|
corporation has no bonds outstanding, the fund shall have no |
697
|
right, title, or interest in or to the assessments, except as |
698
|
provided in the fund's agreements with the corporation. |
699
|
(b) Revenue bond issuance through counties or |
700
|
municipalities.-- |
701
|
1. If the board elects to enter into agreements with local |
702
|
governments for the issuance of revenue bonds for the benefit of |
703
|
the fund, the board shall enter into such contracts with one or |
704
|
more local governments, including agreements providing for the |
705
|
pledge of revenues, as are necessary to effect such issuance. |
706
|
The governing body of a county or municipality is authorized to |
707
|
issue bonds as defined in s. 125.013 or s. 166.101 from time to |
708
|
time to fund an assistance program, in conjunction with the |
709
|
Florida Hurricane Catastrophe Fund, for the purposes set forth |
710
|
in this section or for the purpose of paying the costs of |
711
|
construction, reconstruction, repair, restoration, and other |
712
|
costs associated with damage to properties of policyholders of |
713
|
covered policies due to the occurrence of a hurricane by |
714
|
assuring that policyholders located in this state are able to |
715
|
recover claims under property insurance policies after a covered |
716
|
event. |
717
|
2. In order to avoid needless and indiscriminate |
718
|
proliferation, duplication, and fragmentation of such assistance |
719
|
programs, any local government may provide for the payment of |
720
|
fund reimbursements, regardless of whether or not the losses for |
721
|
which reimbursement is made occurred within or outside of the |
722
|
territorial jurisdiction of the local government. |
723
|
3. The state hereby covenants with holders of bonds issued |
724
|
under this paragraph that the state will not repeal or abrogate |
725
|
the power of the board to direct the Office of Insurance |
726
|
RegulationDepartment of Insuranceto levy the assessments and |
727
|
to collect the proceeds of the revenues pledged to the payment |
728
|
of such bonds as long as any such bonds remain outstanding |
729
|
unless adequate provision has been made for the payment of such |
730
|
bonds pursuant to the documents authorizing the issuance of such |
731
|
bonds. |
732
|
4. There shall be no liability on the part of, and no |
733
|
cause of action shall arise against any members or employees of |
734
|
the governing body of a local government for any actions taken |
735
|
by them in the performance of their duties under this paragraph. |
736
|
(c) Florida Hurricane Catastrophe Fund Finance |
737
|
Corporation.-- |
738
|
1. In addition to the findings and declarations in |
739
|
subsection (1), the Legislature also finds and declares that: |
740
|
a. The public benefits corporation created under this |
741
|
paragraph will provide a mechanism necessary for the cost- |
742
|
effective and efficient issuance of bonds. This mechanism will |
743
|
eliminate unnecessary costs in the bond issuance process, |
744
|
thereby increasing the amounts available to pay reimbursement |
745
|
for losses to property sustained as a result of hurricane |
746
|
damage. |
747
|
b. The purpose of such bonds is to fund reimbursements |
748
|
through the Florida Hurricane Catastrophe Fund to pay for the |
749
|
costs of construction, reconstruction, repair, restoration, and |
750
|
other costs associated with damage to properties of |
751
|
policyholders of covered policies due to the occurrence of a |
752
|
hurricane. |
753
|
c. The efficacy of the financing mechanism will be |
754
|
enhanced by the corporation's ownership of the assessments, by |
755
|
the insulation of the assessments from possible bankruptcy |
756
|
proceedings, and by covenants of the state with the |
757
|
corporation's bondholders. |
758
|
2.a. There is created a public benefits corporation, which |
759
|
is an instrumentality of the state, to be known as the Florida |
760
|
Hurricane Catastrophe Fund Finance Corporation. |
761
|
b. The corporation shall operate under a five-member board |
762
|
of directors consisting of the Governor or a designee, the Chief |
763
|
Financial OfficerComptroller or a designee, the Attorney |
764
|
GeneralTreasureror a designee, the director of the Division of |
765
|
Bond Finance of the State Board of Administration, and the |
766
|
senior employee of the State Board of Administration responsible |
767
|
for operationschief operating officerof the Florida Hurricane |
768
|
Catastrophe Fund. |
769
|
c. The corporation has all of the powers of corporations |
770
|
under chapter 607 and under chapter 617, subject only to the |
771
|
provisions of this subsection. |
772
|
d. The corporation may issue bonds and engage in such |
773
|
other financial transactions as are necessary to provide |
774
|
sufficient funds to achieve the purposes of this section. |
775
|
e. The corporation may invest in any of the investments |
776
|
authorized under s. 215.47. |
777
|
f. There shall be no liability on the part of, and no |
778
|
cause of action shall arise against, any board members or |
779
|
employees of the corporation for any actions taken by them in |
780
|
the performance of their duties under this paragraph. |
781
|
3.a. In actions under chapter 75 to validate any bonds |
782
|
issued by the corporation, the notice required by s. 75.06 shall |
783
|
be published only in Leon County and in two newspapers of |
784
|
general circulation in the state, and the complaint and order of |
785
|
the court shall be served only on the State Attorney of the |
786
|
Second Judicial Circuit. |
787
|
b. The state hereby covenants with holders of bonds of the |
788
|
corporation that the state will not repeal or abrogate the power |
789
|
of the board to direct the Office of Insurance Regulation |
790
|
Department of Insuranceto levy the assessments and to collect |
791
|
the proceeds of the revenues pledged to the payment of such |
792
|
bonds as long as any such bonds remain outstanding unless |
793
|
adequate provision has been made for the payment of such bonds |
794
|
pursuant to the documents authorizing the issuance of such |
795
|
bonds. |
796
|
4. The bonds of the corporation are not a debt of the |
797
|
state or of any political subdivision, and neither the state nor |
798
|
any political subdivision is liable on such bonds. The |
799
|
corporation does not have the power to pledge the credit, the |
800
|
revenues, or the taxing power of the state or of any political |
801
|
subdivision. The credit, revenues, or taxing power of the state |
802
|
or of any political subdivision shall not be deemed to be |
803
|
pledged to the payment of any bonds of the corporation. |
804
|
5.a. The property, revenues, and other assets of the |
805
|
corporation; the transactions and operations of the corporation |
806
|
and the income from such transactions and operations; and all |
807
|
bonds issued under this paragraph and interest on such bonds are |
808
|
exempt from taxation by the state and any political subdivision, |
809
|
including the intangibles tax under chapter 199 and the income |
810
|
tax under chapter 220. This exemption does not apply to any tax |
811
|
imposed by chapter 220 on interest, income, or profits on debt |
812
|
obligations owned by corporations other than the Florida |
813
|
Hurricane Catastrophe Fund Finance Corporation. |
814
|
b. All bonds of the corporation shall be and constitute |
815
|
legal investments without limitation for all public bodies of |
816
|
this state; for all banks, trust companies, savings banks, |
817
|
savings associations, savings and loan associations, and |
818
|
investment companies; for all administrators, executors, |
819
|
trustees, and other fiduciaries; for all insurance companies and |
820
|
associations and other persons carrying on an insurance |
821
|
business; and for all other persons who are now or may hereafter |
822
|
be authorized to invest in bonds or other obligations of the |
823
|
state and shall be and constitute eligible securities to be |
824
|
deposited as collateral for the security of any state, county, |
825
|
municipal, or other public funds. This sub-subparagraph shall be |
826
|
considered as additional and supplemental authority and shall |
827
|
not be limited without specific reference to this sub- |
828
|
subparagraph. |
829
|
6. The corporation and its corporate existence shall |
830
|
continue until terminated by law; however, no such law shall |
831
|
take effect as long as the corporation has bonds outstanding |
832
|
unless adequate provision has been made for the payment of such |
833
|
bonds pursuant to the documents authorizing the issuance of such |
834
|
bonds. Upon termination of the existence of the corporation, all |
835
|
of its rights and properties in excess of its obligations shall |
836
|
pass to and be vested in the state. |
837
|
Section 6. Subsection (5) of section 215.559, Florida |
838
|
Statutes, is amended to read: |
839
|
215.559 Hurricane Loss Mitigation Program.-- |
840
|
(5) Except for the program set forth in subsection (3), |
841
|
the Department of Community Affairs shall develop the programs |
842
|
set forth in this section in consultation with an advisory |
843
|
council consisting of a representative designated by the Chief |
844
|
Financial OfficerDepartment of Insurance, a representative |
845
|
designated by the Florida Home Builders Association, a |
846
|
representative designated by the Florida Insurance Council, a |
847
|
representative designated by the Federation of Manufactured Home |
848
|
Owners, a representative designated by the Florida Association |
849
|
of Counties, and a representative designated by the Florida |
850
|
Manufactured Housing Association. |
851
|
Section 7. Subsection (2) of section 391.221, Florida |
852
|
Statutes, is amended to read: |
853
|
391.221 Statewide Children's Medical Services Network |
854
|
Advisory Council.-- |
855
|
(2) The council shall be composed of 12 members |
856
|
representing the private health care provider sector, families |
857
|
with children who have special health care needs, the Agency for |
858
|
Health Care Administration, the Office of Insurance Regulation |
859
|
of the Financial Services CommissionDepartment of Insurance, |
860
|
the Florida Chapter of the American Academy of Pediatrics, an |
861
|
academic health center pediatric program, and the health |
862
|
insurance industry. Members shall be appointed for 4-year, |
863
|
staggered terms. In no case shall an employee of the Department |
864
|
of Health serve as a member or as an ex officio member of the |
865
|
advisory council. A vacancy shall be filled for the remainder |
866
|
of the unexpired term in the same manner as the original |
867
|
appointment. A member may not be appointed to more than two |
868
|
consecutive terms. However, a member may be reappointed after |
869
|
being off the council for at least 2 years. |
870
|
Section 8. Paragraph (b) of subsection (2) of section |
871
|
401.245, Florida Statutes, is amended to read: |
872
|
401.245 Emergency Medical Services Advisory Council.-- |
873
|
(2) |
874
|
(b) Representation on the Emergency Medical Services |
875
|
Advisory Council shall include: two licensed physicians who are |
876
|
"medical directors" as defined in s. 401.23(15) or whose medical |
877
|
practice is closely related to emergency medical services; two |
878
|
emergency medical service administrators, one of whom is |
879
|
employed by a fire service; two certified paramedics, one of |
880
|
whom is employed by a fire service; two certified emergency |
881
|
medical technicians, one of whom is employed by a fire service; |
882
|
one emergency medical services educator; one emergency nurse; |
883
|
one hospital administrator; one representative of air ambulance |
884
|
services; one representative of a commercial ambulance operator; |
885
|
and two laypersons who are in no way connected with emergency |
886
|
medical services, one of whom is a representative of the |
887
|
elderly. Ex officio members of the advisory council from state |
888
|
agencies shall include, but shall not be limited to, |
889
|
representatives from the Department of Education, the Department |
890
|
of Management Services, the Office of Insurance Regulation of |
891
|
the Financial Services CommissionDepartment of Insurance, the |
892
|
Department of Highway Safety and Motor Vehicles, the Department |
893
|
of Transportation, and the Department of Community Affairs. |
894
|
Section 9. Paragraph (a) of subsection (8) of section |
895
|
408.05, Florida Statutes, is amended to read: |
896
|
408.05 State Center for Health Statistics.-- |
897
|
(8) STATE COMPREHENSIVE HEALTH INFORMATION SYSTEM ADVISORY |
898
|
COUNCIL.-- |
899
|
(a) There is established in the agency the State |
900
|
Comprehensive Health Information System Advisory Council to |
901
|
assist the center in reviewing the comprehensive health |
902
|
information system and to recommend improvements for such |
903
|
system. The council shall consist of the following members: |
904
|
1. An employee of the Executive Office of the Governor, to |
905
|
be appointed by the Governor. |
906
|
2. An employee of the Department of Financial Services |
907
|
Department of Insurance, to be appointed by the Chief Financial |
908
|
OfficerInsurance Commissioner. |
909
|
3. An employee of the Department of Education, to be |
910
|
appointed by the Commissioner of Education. |
911
|
4. Ten persons, to be appointed by the Secretary of Health |
912
|
Care Administration, representing other state and local |
913
|
agencies, state universities, the Florida Association of |
914
|
Business/Health Coalitions, local health councils, professional |
915
|
health-care-related associations, consumers, and purchasers. |
916
|
Section 10. Section 408.7056, Florida Statutes, is amended |
917
|
to read: |
918
|
408.7056 Statewide Provider and Subscriber Assistance |
919
|
Program.-- |
920
|
(1) As used in this section, the term: |
921
|
(a) "Agency" means the Agency for Health Care |
922
|
Administration. |
923
|
(b) "Department" means the Department of Insurance. |
924
|
(b)(c)"Grievance procedure" means an established set of |
925
|
rules that specify a process for appeal of an organizational |
926
|
decision. |
927
|
(c)(d)"Health care provider" or "provider" means a state- |
928
|
licensed or state-authorized facility, a facility principally |
929
|
supported by a local government or by funds from a charitable |
930
|
organization that holds a current exemption from federal income |
931
|
tax under s. 501(c)(3) of the Internal Revenue Code, a licensed |
932
|
practitioner, a county health department established under part |
933
|
I of chapter 154, a prescribed pediatric extended care center |
934
|
defined in s. 400.902, a federally supported primary care |
935
|
program such as a migrant health center or a community health |
936
|
center authorized under s. 329 or s. 330 of the United States |
937
|
Public Health Services Act that delivers health care services to |
938
|
individuals, or a community facility that receives funds from |
939
|
the state under the Community Alcohol, Drug Abuse, and Mental |
940
|
Health Services Act and provides mental health services to |
941
|
individuals. |
942
|
(d)(e)"Managed care entity" means a health maintenance |
943
|
organization or a prepaid health clinic certified under chapter |
944
|
641, a prepaid health plan authorized under s. 409.912, or an |
945
|
exclusive provider organization certified under s. 627.6472. |
946
|
(e) "Office" means the Office of Insurance Regulation of |
947
|
the Financial Services Commission. |
948
|
(f) "Panel" means a statewide provider and subscriber |
949
|
assistance panel selected as provided in subsection (11). |
950
|
(2) The agency shall adopt and implement a program to |
951
|
provide assistance to subscribers and providers, including those |
952
|
whose grievances are not resolved by the managed care entity to |
953
|
the satisfaction of the subscriber or provider. The program |
954
|
shall consist of one or more panels that meet as often as |
955
|
necessary to timely review, consider, and hear grievances and |
956
|
recommend to the agency or the officedepartmentany actions |
957
|
that should be taken concerning individual cases heard by the |
958
|
panel. The panel shall hear every grievance filed by subscribers |
959
|
and providers on behalf of subscribers, unless the grievance: |
960
|
(a) Relates to a managed care entity's refusal to accept a |
961
|
provider into its network of providers; |
962
|
(b) Is part of an internal grievance in a Medicare managed |
963
|
care entity or a reconsideration appeal through the Medicare |
964
|
appeals process which does not involve a quality of care issue; |
965
|
(c) Is related to a health plan not regulated by the state |
966
|
such as an administrative services organization, third-party |
967
|
administrator, or federal employee health benefit program; |
968
|
(d) Is related to appeals by in-plan suppliers and |
969
|
providers, unless related to quality of care provided by the |
970
|
plan; |
971
|
(e) Is part of a Medicaid fair hearing pursued under 42 |
972
|
C.F.R. ss. 431.220 et seq.; |
973
|
(f) Is the basis for an action pending in state or federal |
974
|
court; |
975
|
(g) Is related to an appeal by nonparticipating providers, |
976
|
unless related to the quality of care provided to a subscriber |
977
|
by the managed care entity and the provider is involved in the |
978
|
care provided to the subscriber; |
979
|
(h) Was filed before the subscriber or provider completed |
980
|
the entire internal grievance procedure of the managed care |
981
|
entity, the managed care entity has complied with its timeframes |
982
|
for completing the internal grievance procedure, and the |
983
|
circumstances described in subsection (6) do not apply; |
984
|
(i) Has been resolved to the satisfaction of the |
985
|
subscriber or provider who filed the grievance, unless the |
986
|
managed care entity's initial action is egregious or may be |
987
|
indicative of a pattern of inappropriate behavior; |
988
|
(j) Is limited to seeking damages for pain and suffering, |
989
|
lost wages, or other incidental expenses, including accrued |
990
|
interest on unpaid balances, court costs, and transportation |
991
|
costs associated with a grievance procedure; |
992
|
(k) Is limited to issues involving conduct of a health |
993
|
care provider or facility, staff member, or employee of a |
994
|
managed care entity which constitute grounds for disciplinary |
995
|
action by the appropriate professional licensing board and is |
996
|
not indicative of a pattern of inappropriate behavior, and the |
997
|
agency or officedepartmenthas reported these grievances to the |
998
|
appropriate professional licensing board or to the health |
999
|
facility regulation section of the agency for possible |
1000
|
investigation; or |
1001
|
(l) Is withdrawn by the subscriber or provider. Failure |
1002
|
of the subscriber or the provider to attend the hearing shall be |
1003
|
considered a withdrawal of the grievance. |
1004
|
(3) The agency shall review all grievances within 60 days |
1005
|
after receipt and make a determination whether the grievance |
1006
|
shall be heard. Once the agency notifies the panel, the |
1007
|
subscriber or provider, and the managed care entity that a |
1008
|
grievance will be heard by the panel, the panel shall hear the |
1009
|
grievance either in the network area or by teleconference no |
1010
|
later than 120 days after the date the grievance was filed. The |
1011
|
agency shall notify the parties, in writing, by facsimile |
1012
|
transmission, or by phone, of the time and place of the hearing. |
1013
|
The panel may take testimony under oath, request certified |
1014
|
copies of documents, and take similar actions to collect |
1015
|
information and documentation that will assist the panel in |
1016
|
making findings of fact and a recommendation. The panel shall |
1017
|
issue a written recommendation, supported by findings of fact, |
1018
|
to the provider or subscriber, to the managed care entity, and |
1019
|
to the agency or the officedepartmentno later than 15 working |
1020
|
days after hearing the grievance. If at the hearing the panel |
1021
|
requests additional documentation or additional records, the |
1022
|
time for issuing a recommendation is tolled until the |
1023
|
information or documentation requested has been provided to the |
1024
|
panel. The proceedings of the panel are not subject to chapter |
1025
|
120. |
1026
|
(4) If, upon receiving a proper patient authorization |
1027
|
along with a properly filed grievance, the agency requests |
1028
|
medical records from a health care provider or managed care |
1029
|
entity, the health care provider or managed care entity that has |
1030
|
custody of the records has 10 days to provide the records to the |
1031
|
agency. Failure to provide requested medical records may result |
1032
|
in the imposition of a fine of up to $500. Each day that |
1033
|
records are not produced is considered a separate violation. |
1034
|
(5) Grievances that the agency determines pose an |
1035
|
immediate and serious threat to a subscriber's health must be |
1036
|
given priority over other grievances. The panel may meet at the |
1037
|
call of the chair to hear the grievances as quickly as possible |
1038
|
but no later than 45 days after the date the grievance is filed, |
1039
|
unless the panel receives a waiver of the time requirement from |
1040
|
the subscriber. The panel shall issue a written recommendation, |
1041
|
supported by findings of fact, to the officedepartmentor the |
1042
|
agency within 10 days after hearing the expedited grievance. |
1043
|
(6) When the agency determines that the life of a |
1044
|
subscriber is in imminent and emergent jeopardy, the chair of |
1045
|
the panel may convene an emergency hearing, within 24 hours |
1046
|
after notification to the managed care entity and to the |
1047
|
subscriber, to hear the grievance. The grievance must be heard |
1048
|
notwithstanding that the subscriber has not completed the |
1049
|
internal grievance procedure of the managed care entity. The |
1050
|
panel shall, upon hearing the grievance, issue a written |
1051
|
emergency recommendation, supported by findings of fact, to the |
1052
|
managed care entity, to the subscriber, and to the agency or the |
1053
|
officedepartmentfor the purpose of deferring the imminent and |
1054
|
emergent jeopardy to the subscriber's life. Within 24 hours |
1055
|
after receipt of the panel's emergency recommendation, the |
1056
|
agency or officedepartmentmay issue an emergency order to the |
1057
|
managed care entity. An emergency order remains in force until: |
1058
|
(a) The grievance has been resolved by the managed care |
1059
|
entity; |
1060
|
(b) Medical intervention is no longer necessary; or |
1061
|
(c) The panel has conducted a full hearing under |
1062
|
subsection (3) and issued a recommendation to the agency or the |
1063
|
officedepartment, and the agency or officedepartmenthas |
1064
|
issued a final order. |
1065
|
(7) After hearing a grievance, the panel shall make a |
1066
|
recommendation to the agency or the officedepartmentwhich may |
1067
|
include specific actions the managed care entity must take to |
1068
|
comply with state laws or rules regulating managed care |
1069
|
entities. |
1070
|
(8) A managed care entity, subscriber, or provider that is |
1071
|
affected by a panel recommendation may within 10 days after |
1072
|
receipt of the panel's recommendation, or 72 hours after receipt |
1073
|
of a recommendation in an expedited grievance, furnish to the |
1074
|
agency or officedepartmentwritten evidence in opposition to |
1075
|
the recommendation or findings of fact of the panel. |
1076
|
(9) No later than 30 days after the issuance of the |
1077
|
panel's recommendation and, for an expedited grievance, no later |
1078
|
than 10 days after the issuance of the panel's recommendation, |
1079
|
the agency or the officedepartmentmay adopt the panel's |
1080
|
recommendation or findings of fact in a proposed order or an |
1081
|
emergency order, as provided in chapter 120, which it shall |
1082
|
issue to the managed care entity. The agency or office |
1083
|
departmentmay issue a proposed order or an emergency order, as |
1084
|
provided in chapter 120, imposing fines or sanctions, including |
1085
|
those contained in ss. 641.25 and 641.52. The agency or the |
1086
|
officedepartmentmay reject all or part of the panel's |
1087
|
recommendation. All fines collected under this subsection must |
1088
|
be deposited into the Health Care Trust Fund. |
1089
|
(10) In determining any fine or sanction to be imposed, |
1090
|
the agency and the officedepartmentmay consider the following |
1091
|
factors: |
1092
|
(a) The severity of the noncompliance, including the |
1093
|
probability that death or serious harm to the health or safety |
1094
|
of the subscriber will result or has resulted, the severity of |
1095
|
the actual or potential harm, and the extent to which provisions |
1096
|
of chapter 641 were violated. |
1097
|
(b) Actions taken by the managed care entity to resolve or |
1098
|
remedy any quality-of-care grievance. |
1099
|
(c) Any previous incidents of noncompliance by the managed |
1100
|
care entity. |
1101
|
(d) Any other relevant factors the agency or office |
1102
|
departmentconsiders appropriate in a particular grievance. |
1103
|
(11) The panel shall consist of members employed by the |
1104
|
agency,and members employed by the officedepartment, and |
1105
|
members employed by the Department of Financial Services,chosen |
1106
|
by their respective agencies; a consumer appointed by the |
1107
|
Governor; a physician appointed by the Governor, as a standing |
1108
|
member; and physicians who have expertise relevant to the case |
1109
|
to be heard, on a rotating basis. The agency may contract with a |
1110
|
medical director and a primary care physician who shall provide |
1111
|
additional technical expertise to the panel. The medical |
1112
|
director shall be selected from a health maintenance |
1113
|
organization with a current certificate of authority to operate |
1114
|
in Florida. |
1115
|
(12) Every managed care entity shall submit a quarterly |
1116
|
report to the agency and the officedepartmentlisting the |
1117
|
number and the nature of all subscribers' and providers' |
1118
|
grievances which have not been resolved to the satisfaction of |
1119
|
the subscriber or provider after the subscriber or provider |
1120
|
follows the entire internal grievance procedure of the managed |
1121
|
care entity. The agency shall notify all subscribers and |
1122
|
providers included in the quarterly reports of their right to |
1123
|
file an unresolved grievance with the panel. |
1124
|
(13) Any information which would identify a subscriber or |
1125
|
the spouse, relative, or guardian of a subscriber and which is |
1126
|
contained in a report obtained by the officeDepartment of |
1127
|
Insurancepursuant to this section is confidential and exempt |
1128
|
from the provisions of s. 119.07(1) and s. 24(a), Art. I of the |
1129
|
State Constitution. |
1130
|
(14) A proposed order issued by the agency or office |
1131
|
departmentwhich only requires the managed care entity to take a |
1132
|
specific action under subsection (7) is subject to a summary |
1133
|
hearing in accordance with s. 120.574, unless all of the parties |
1134
|
agree otherwise. If the managed care entity does not prevail at |
1135
|
the hearing, the managed care entity must pay reasonable costs |
1136
|
and attorney's fees of the agency or the officedepartment |
1137
|
incurred in that proceeding. |
1138
|
(15)(a) Any information which would identify a subscriber |
1139
|
or the spouse, relative, or guardian of a subscriber which is |
1140
|
contained in a document, report, or record prepared or reviewed |
1141
|
by the panel or obtained by the agency pursuant to this section |
1142
|
is confidential and exempt from the provisions of s. 119.07(1) |
1143
|
and s. 24(a), Art. I of the State Constitution. |
1144
|
(b) Meetings of the panel shall be open to the public |
1145
|
unless the provider or subscriber whose grievance will be heard |
1146
|
requests a closed meeting or the agency or the officeDepartment |
1147
|
of Insurancedetermines that information of a sensitive personal |
1148
|
nature which discloses the subscriber's medical treatment or |
1149
|
history; or information which constitutes a trade secret as |
1150
|
defined by s. 812.081; or information relating to internal risk |
1151
|
management programs as defined in s. 641.55(5)(c), (6), and (8) |
1152
|
may be revealed at the panel meeting, in which case that portion |
1153
|
of the meeting during which such sensitive personal information, |
1154
|
trade secret information, or internal risk management program |
1155
|
information is discussed shall be exempt from the provisions of |
1156
|
s. 286.011 and s. 24(b), Art. I of the State Constitution. All |
1157
|
closed meetings shall be recorded by a certified court reporter. |
1158
|
|
1159
|
This subsection is subject to the Open Government Sunset Review |
1160
|
Act of 1995 in accordance with s. 119.15, and shall stand |
1161
|
repealed on October 2, 2003, unless reviewed and saved from |
1162
|
repeal through reenactment by the Legislature. |
1163
|
Section 11. Subsections (11) and (12) of section 440.13, |
1164
|
Florida Statutes, are amended to read: |
1165
|
440.13 Medical services and supplies; penalty for |
1166
|
violations; limitations.-- |
1167
|
(11) AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION AND |
1168
|
THE DEPARTMENT OF INSURANCE; JURISDICTION.-- |
1169
|
(a) The Agency for Health Care Administration may |
1170
|
investigate health care providers to determine whether providers |
1171
|
are complying with this chapter and with rules adopted by the |
1172
|
agency, whether the providers are engaging in overutilization, |
1173
|
and whether providers are engaging in improper billing |
1174
|
practices. If the agency finds that a health care provider has |
1175
|
improperly billed, overutilized, or failed to comply with agency |
1176
|
rules or the requirements of this chapter it must notify the |
1177
|
provider of its findings and may determine that the health care |
1178
|
provider may not receive payment from the carrier or may impose |
1179
|
penalties as set forth in subsection (8) or other sections of |
1180
|
this chapter. If the health care provider has received payment |
1181
|
from a carrier for services that were improperly billed or for |
1182
|
overutilization, it must return those payments to the carrier. |
1183
|
The agency may assess a penalty not to exceed $500 for each |
1184
|
overpayment that is not refunded within 30 days after |
1185
|
notification of overpayment by the agency or carrier. |
1186
|
(b) The department shall monitor carriers as provided in |
1187
|
this chapter and the Office of Insurance Regulation shalland |
1188
|
audit insurers and group self-insurance fundscarriersas |
1189
|
provided in s. 624.3161, to determine if medical bills are paid |
1190
|
in accordance with this section and department rules of the |
1191
|
department and Financial Services Commission, respectively. Any |
1192
|
employer, if self-insured, or carrier found by the department or |
1193
|
Office of Insurance Regulationdivisionnot to be within 90 |
1194
|
percent compliance as to the payment of medical bills after July |
1195
|
1, 1994, must be assessed a fine not to exceed 1 percent of the |
1196
|
prior year's assessment levied against such entity under s. |
1197
|
440.51 for every quarter in which the entity fails to attain 90- |
1198
|
percent compliance. The department shall fine or otherwise |
1199
|
discipline an employer or carrier, pursuant to this chapter, the |
1200
|
insurance code, or rules adopted by the department, and the |
1201
|
Office of Insurance Regulation shall fine or otherwise |
1202
|
discipline an insurer or group self-insurance fund pursuant to |
1203
|
the insurance code or rules adopted by the Financial Services |
1204
|
Commission,for each late payment of compensation that is below |
1205
|
the minimum 90-percent performance standard. Any carrier that is |
1206
|
found to be not in compliance in subsequent consecutive quarters |
1207
|
must implement a medical-bill review program approved by the |
1208
|
department or officedivision, and an insurer or group self- |
1209
|
insurance fundthe carrieris subject to disciplinary action by |
1210
|
the Office of Insurance RegulationDepartment of Insurance. |
1211
|
(c) The agency has exclusive jurisdiction to decide any |
1212
|
matters concerning reimbursement, to resolve any overutilization |
1213
|
dispute under subsection (7), and to decide any question |
1214
|
concerning overutilization under subsection (8), which question |
1215
|
or dispute arises after January 1, 1994. |
1216
|
(d) The following agency actions do not constitute agency |
1217
|
action subject to review under ss. 120.569 and 120.57 and do not |
1218
|
constitute actions subject to s. 120.56: referral by the entity |
1219
|
responsible for utilization review; a decision by the agency to |
1220
|
refer a matter to a peer review committee; establishment by a |
1221
|
health care provider or entity of procedures by which a peer |
1222
|
review committee reviews the rendering of health care services; |
1223
|
and the review proceedings, report, and recommendation of the |
1224
|
peer review committee. |
1225
|
(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM |
1226
|
REIMBURSEMENT ALLOWANCES.-- |
1227
|
(a) A three-member panel is created, consisting of the |
1228
|
Chief Financial OfficerInsurance Commissioner, or the Chief |
1229
|
Financial Officer'sInsurance Commissioner'sdesignee, and two |
1230
|
members to be appointed by the Governor, subject to confirmation |
1231
|
by the Senate, one member who, on account of present or previous |
1232
|
vocation, employment, or affiliation, shall be classified as a |
1233
|
representative of employers, the other member who, on account of |
1234
|
previous vocation, employment, or affiliation, shall be |
1235
|
classified as a representative of employees. The panel shall |
1236
|
determine statewide schedules of maximum reimbursement |
1237
|
allowances for medically necessary treatment, care, and |
1238
|
attendance provided by physicians, hospitals, ambulatory |
1239
|
surgical centers, work-hardening programs, pain programs, and |
1240
|
durable medical equipment. The maximum reimbursement allowances |
1241
|
for inpatient hospital care shall be based on a schedule of per |
1242
|
diem rates, to be approved by the three-member panel no later |
1243
|
than March 1, 1994, to be used in conjunction with a |
1244
|
precertification manual as determined by the agency. All |
1245
|
compensable charges for hospital outpatient care shall be |
1246
|
reimbursed at 75 percent of usual and customary charges. Until |
1247
|
the three-member panel approves a schedule of per diem rates for |
1248
|
inpatient hospital care and it becomes effective, all |
1249
|
compensable charges for hospital inpatient care must be |
1250
|
reimbursed at 75 percent of their usual and customary charges. |
1251
|
Annually, the three-member panel shall adopt schedules of |
1252
|
maximum reimbursement allowances for physicians, hospital |
1253
|
inpatient care, hospital outpatient care, ambulatory surgical |
1254
|
centers, work-hardening programs, and pain programs. However, |
1255
|
the maximum percentage of increase in the individual |
1256
|
reimbursement allowance may not exceed the percentage of |
1257
|
increase in the Consumer Price Index for the previous year. An |
1258
|
individual physician, hospital, ambulatory surgical center, pain |
1259
|
program, or work-hardening program shall be reimbursed either |
1260
|
the usual and customary charge for treatment, care, and |
1261
|
attendance, the agreed-upon contract price, or the maximum |
1262
|
reimbursement allowance in the appropriate schedule, whichever |
1263
|
is less. |
1264
|
(b) As to reimbursement for a prescription medication, the |
1265
|
reimbursement amount for a prescription shall be the average |
1266
|
wholesale price times 1.2 plus $4.18 for the dispensing fee, |
1267
|
except where the carrier has contracted for a lower amount. Fees |
1268
|
for pharmaceuticals and pharmaceutical services shall be |
1269
|
reimbursable at the applicable fee schedule amount. Where the |
1270
|
employer or carrier has contracted for such services and the |
1271
|
employee elects to obtain them through a provider not a party to |
1272
|
the contract, the carrier shall reimburse at the schedule, |
1273
|
negotiated, or contract price, whichever is lower. |
1274
|
(c) Reimbursement for all fees and other charges for such |
1275
|
treatment, care, and attendance, including treatment, care, and |
1276
|
attendance provided by any hospital or other health care |
1277
|
provider, ambulatory surgical center, work-hardening program, or |
1278
|
pain program, must not exceed the amounts provided by the |
1279
|
uniform schedule of maximum reimbursement allowances as |
1280
|
determined by the panel or as otherwise provided in this |
1281
|
section. This subsection also applies to independent medical |
1282
|
examinations performed by health care providers under this |
1283
|
chapter. Until the three-member panel approves a uniform |
1284
|
schedule of maximum reimbursement allowances and it becomes |
1285
|
effective, all compensable charges for treatment, care, and |
1286
|
attendance provided by physicians, ambulatory surgical centers, |
1287
|
work-hardening programs, or pain programs shall be reimbursed at |
1288
|
the lowest maximum reimbursement allowance across all 1992 |
1289
|
schedules of maximum reimbursement allowances for the services |
1290
|
provided regardless of the place of service. In determining the |
1291
|
uniform schedule, the panel shall first approve the data which |
1292
|
it finds representative of prevailing charges in the state for |
1293
|
similar treatment, care, and attendance of injured persons. Each |
1294
|
health care provider, health care facility, ambulatory surgical |
1295
|
center, work-hardening program, or pain program receiving |
1296
|
workers' compensation payments shall maintain records verifying |
1297
|
their usual charges. In establishing the uniform schedule of |
1298
|
maximum reimbursement allowances, the panel must consider: |
1299
|
1. The levels of reimbursement for similar treatment, |
1300
|
care, and attendance made by other health care programs or |
1301
|
third-party providers; |
1302
|
2. The impact upon cost to employers for providing a level |
1303
|
of reimbursement for treatment, care, and attendance which will |
1304
|
ensure the availability of treatment, care, and attendance |
1305
|
required by injured workers; |
1306
|
3. The financial impact of the reimbursement allowances |
1307
|
upon health care providers and health care facilities, including |
1308
|
trauma centers as defined in s. 395.4001, and its effect upon |
1309
|
their ability to make available to injured workers such |
1310
|
medically necessary remedial treatment, care, and attendance. |
1311
|
The uniform schedule of maximum reimbursement allowances must be |
1312
|
reasonable, must promote health care cost containment and |
1313
|
efficiency with respect to the workers' compensation health care |
1314
|
delivery system, and must be sufficient to ensure availability |
1315
|
of such medically necessary remedial treatment, care, and |
1316
|
attendance to injured workers; and |
1317
|
4. The most recent average maximum allowable rate of |
1318
|
increase for hospitals determined by the Health Care Board under |
1319
|
chapter 408. |
1320
|
(d) In addition to establishing the uniform schedule of |
1321
|
maximum reimbursement allowances, the panel shall: |
1322
|
1. Take testimony, receive records, and collect data to |
1323
|
evaluate the adequacy of the workers' compensation fee schedule, |
1324
|
nationally recognized fee schedules and alternative methods of |
1325
|
reimbursement to certified health care providers and health care |
1326
|
facilities for inpatient and outpatient treatment and care. |
1327
|
2. Survey certified health care providers and health care |
1328
|
facilities to determine the availability and accessibility of |
1329
|
workers' compensation health care delivery systems for injured |
1330
|
workers. |
1331
|
3. Survey carriers to determine the estimated impact on |
1332
|
carrier costs and workers' compensation premium rates by |
1333
|
implementing changes to the carrier reimbursement schedule or |
1334
|
implementing alternative reimbursement methods. |
1335
|
4. Submit recommendations on or before January 1, 2003, |
1336
|
and biennially thereafter, to the President of the Senate and |
1337
|
the Speaker of the House of Representatives on methods to |
1338
|
improve the workers' compensation health care delivery system. |
1339
|
|
1340
|
The agency and the department, as requested,divisionshall |
1341
|
provide data to the panel, including but not limited to, |
1342
|
utilization trends in the workers' compensation health care |
1343
|
delivery system. The agencydivisionshall provide the panel |
1344
|
with an annual report regarding the resolution of medical |
1345
|
reimbursement disputes and any actions pursuant to s. 440.13(8). |
1346
|
The departmentdivisionshall provide administrative support and |
1347
|
service to the panel to the extent requested by the panel. |
1348
|
Section 12. Paragraph (c) of subsection (8) and |
1349
|
subsections (10), (15), (16), and (17) of section 440.20, |
1350
|
Florida Statutes, are amended to read: |
1351
|
440.20 Time for payment of compensation; penalties for |
1352
|
late payment.-- |
1353
|
(8) In addition to any other penalties provided by this |
1354
|
chapter for late payment, if any installment of compensation is |
1355
|
not paid when it becomes due, the employer, carrier, or |
1356
|
servicing agent shall pay interest thereon at the rate of 12 |
1357
|
percent per year from the date the installment becomes due until |
1358
|
it is paid, whether such installment is payable without an order |
1359
|
or under the terms of an order. The interest payment shall be |
1360
|
the greater of the amount of interest due or $5. |
1361
|
(c) In order to ensure carrier compliance under this |
1362
|
chapter and provisions of the Florida Insurance Code, the office |
1363
|
departmentshall monitor the performance of carriers by |
1364
|
conducting market conduct examinations, as provided in s. |
1365
|
624.3161, and conducting investigations, as provided in s. |
1366
|
624.317. The department shall establish by rule minimum |
1367
|
performance standards for carriers to ensure that a minimum of |
1368
|
90 percent of all compensation benefits are timely paid. The |
1369
|
department shall fine a carrier as provided in s. 440.13(11)(b) |
1370
|
up to $50 for each late payment of compensation that is below |
1371
|
the minimum 90 percent performance standard. This paragraph does |
1372
|
not affect the imposition of any penalties or interest due to |
1373
|
the claimant. If a carrier contracts with a servicing agent to |
1374
|
fulfill its administrative responsibilities under this chapter, |
1375
|
the payment practices of the servicing agent are deemed the |
1376
|
payment practices of the carrier for the purpose of assessing |
1377
|
penalties against the carrier. |
1378
|
(10) Whenever the department deems it advisable, it may |
1379
|
require any employer to make a deposit with the Chief Financial |
1380
|
OfficerTreasurerto secure the prompt and convenient payments |
1381
|
of such compensation; and payments therefrom upon any awards |
1382
|
shall be made upon order of the department or judge of |
1383
|
compensation claims. |
1384
|
(15)(a) The officedepartmentshall examine on an ongoing |
1385
|
basis claims files in accordance with s. 624.3161 and may impose |
1386
|
fines pursuant to s. 624.310(5) and this chapter in order to |
1387
|
identify questionable claims-handling techniques, questionable |
1388
|
patterns or practices of claims, or a pattern of repeated |
1389
|
unreasonably controverted claims by carriers, as defined in s. |
1390
|
440.02, providing services to employees pursuant to this |
1391
|
chapter. If the officedepartmentfinds such questionable |
1392
|
techniques, patterns, or repeated unreasonably controverted |
1393
|
claims as constitute a general business practice of a carrier, |
1394
|
as defined in s. 440.02, the officedepartmentshall take |
1395
|
appropriate action so as to bring such general business |
1396
|
practices to a halt pursuant to s. 440.38(3) or may impose |
1397
|
penalties pursuant to s. 624.4211. The department and officemay |
1398
|
initiate investigations of questionable techniques, patterns, |
1399
|
practices, or repeated unreasonably controverted claims. The |
1400
|
Financial Services Commissiondepartmentmay by rule establish |
1401
|
forms and procedures for corrective action plans and for |
1402
|
auditing carriers. |
1403
|
(b) As to any examination, investigation, or hearing being |
1404
|
conducted under this chapter, the department and office |
1405
|
Insurance Commissioner or his or her designee: |
1406
|
1. May administer oaths, examine and cross-examine |
1407
|
witnesses, receive oral and documentary evidence; and |
1408
|
2. Shall have the power to subpoena witnesses, compel |
1409
|
their attendance and testimony, and require by subpoena the |
1410
|
production of books, papers, records, files, correspondence, |
1411
|
documents, or other evidence which is relevant to the inquiry. |
1412
|
(c) If any person refuses to comply with any such subpoena |
1413
|
or to testify as to any matter concerning which she or he may be |
1414
|
lawfully interrogated, the Circuit Court of Leon County or of |
1415
|
the county wherein such examination, investigation, or hearing |
1416
|
is being conducted, or of the county wherein such person |
1417
|
resides, may, on the application of the department or the |
1418
|
office, issue an order requiring such person to comply with the |
1419
|
subpoena and to testify. |
1420
|
(d) Subpoenas shall be served, and proof of such service |
1421
|
made, in the same manner as if issued by a circuit court. |
1422
|
Witness fees, costs, and reasonable travel expenses, if claimed, |
1423
|
shall be allowed the same as for testimony in a circuit court. |
1424
|
(e) The department shall publish annually a report which |
1425
|
indicates the promptness of first payment of compensation |
1426
|
records of each carrier or self-insurer so as to focus attention |
1427
|
on those carriers or self-insurers with poor payment records for |
1428
|
the preceding year. The department and the officeshall take |
1429
|
appropriate steps so as to cause such poor carrier payment |
1430
|
practices to halt pursuant to s. 440.38(3). In addition, the |
1431
|
department shall take appropriate action so as to halt such poor |
1432
|
payment practices of self-insurers. "Poor payment practice" |
1433
|
means a practice of late payment sufficient to constitute a |
1434
|
general business practice. |
1435
|
(f) The Financial Services Commission, in consultation |
1436
|
with the department, shall adoptpromulgaterules providing |
1437
|
guidelines to carriers, as defined in s. 440.02, self-insurers, |
1438
|
and employers to indicate behavior that may be construed as |
1439
|
questionable claims-handling techniques, questionable patterns |
1440
|
of claims, repeated unreasonably controverted claims, or poor |
1441
|
payment practices. |
1442
|
(16) No penalty assessed under this section may be |
1443
|
recouped by any carrier or self-insurer in the rate base, the |
1444
|
premium, or any rate filing. The officeDepartment of Insurance |
1445
|
shall enforce this subsection. |
1446
|
(17) The Financial Services Commissiondepartmentmay by |
1447
|
rule establish audit procedures and set standards for the |
1448
|
Automated Carrier Performance System. |
1449
|
Section 13. Subsections (2) and (3) of section 440.24, |
1450
|
Florida Statutes, is amended to read: |
1451
|
440.24 Enforcement of compensation orders; penalties.-- |
1452
|
(2) In any case where the employer is insured and the |
1453
|
carrier fails to comply with any compensation order of a judge |
1454
|
of compensation claims or court within 10 days after such order |
1455
|
becomes final, the department shall notify the office of such |
1456
|
failure and the office shallthereuponsuspend the license of |
1457
|
such carrier to do an insurance business in this state, until |
1458
|
such carrier has complied with such order. |
1459
|
(3) In any case where the employer is a self-insurer and |
1460
|
fails to comply with any compensation order of a judge of |
1461
|
compensation claims or court within 10 days after such order |
1462
|
becomes final, the department of Insurancemay suspend or revoke |
1463
|
any authorization previously given to the employer to be a self- |
1464
|
insurer, and the Florida Self-Insurers Guaranty Association, |
1465
|
Incorporated, may call or sue upon the surety bond or exercise |
1466
|
its rights under the letter of credit deposited by the self- |
1467
|
insurer with the association as a qualifying security deposit as |
1468
|
may be necessary to satisfy the order. |
1469
|
Section 14. Subsections (1), (2), (3), and (4) of section |
1470
|
440.38, Florida Statutes, are amended to read: |
1471
|
440.38 Security for compensation; insurance carriers and |
1472
|
self-insurers.-- |
1473
|
(1) Every employer shall secure the payment of |
1474
|
compensation under this chapter: |
1475
|
(a) By insuring and keeping insured the payment of such |
1476
|
compensation with any stock company or mutual company or |
1477
|
association or exchange, authorized to do business in the state; |
1478
|
(b) By furnishing satisfactory proof to the Florida Self- |
1479
|
Insurers Guaranty Association, Incorporated, created in s. |
1480
|
440.385, that it has the financial strength necessary to ensure |
1481
|
timely payment of all current and future claims individually and |
1482
|
on behalf of its subsidiary and affiliated companies with |
1483
|
employees in this state and receiving an authorization from the |
1484
|
department of Insuranceto pay such compensation directly. The |
1485
|
association shall review the financial strength of applicants |
1486
|
for membership, current members, and former members and make |
1487
|
recommendations to the department of Insuranceregarding their |
1488
|
qualifications to self-insure in accordance with this section |
1489
|
and ss. 440.385 and 440.386. The department shall act in |
1490
|
accordance with the recommendations unless it finds by clear and |
1491
|
convincing evidence that the recommendations are erroneous. |
1492
|
1. As a condition of authorization under paragraph (a), |
1493
|
the association may recommend that the department of Insurance |
1494
|
require an employer to deposit with the association a qualifying |
1495
|
security deposit. The association shall recommend the type and |
1496
|
amount of the qualifying security deposit and shall prescribe |
1497
|
conditions for the qualifying security deposit, which shall |
1498
|
include authorization for the association to call the qualifying |
1499
|
security deposit in the case of default to pay compensation |
1500
|
awards and related expenses of the association. As a condition |
1501
|
to authorization to self-insure, the employer shall provide |
1502
|
proof that the employer has provided for competent personnel |
1503
|
with whom to deliver benefits and to provide a safe working |
1504
|
environment. The employer shall also provide evidence that it |
1505
|
carries reinsurance at levels that will ensure the financial |
1506
|
strength and actuarial soundness of such employer in accordance |
1507
|
with rules adopted by the department of Insurance. The |
1508
|
department of Insurancemay by rule require that, in the event |
1509
|
of an individual self-insurer's insolvency, such qualifying |
1510
|
security deposits and reinsurance policies are payable to the |
1511
|
association. Any employer securing compensation in accordance |
1512
|
with the provisions of this paragraph shall be known as a self- |
1513
|
insurer and shall be classed as a carrier of her or his own |
1514
|
insurance. The employer shall, if requested, provide the |
1515
|
association an actuarial report signed by a member of the |
1516
|
American Academy of Actuaries providing an opinion of the |
1517
|
appropriate present value of the reserves, using a 4-percent |
1518
|
discount rate, for current and future compensation claims. If |
1519
|
any member or former member of the association refuses to timely |
1520
|
provide such a report, the association may obtain an order from |
1521
|
a circuit court requiring the member to produce such a report |
1522
|
and ordering any other relief that the court determines is |
1523
|
appropriate. The association may recover all reasonable costs |
1524
|
and attorney's fees in such proceedings. |
1525
|
2. If the employer fails to maintain the foregoing |
1526
|
requirements, the association shall recommend to the department |
1527
|
of Insurancethat the department revoke the employer's authority |
1528
|
to self-insure, unless the employer provides to the association |
1529
|
the certified opinion of an independent actuary who is a member |
1530
|
of the American Academy of Actuaries as to the actuarial present |
1531
|
value of the employer's determined and estimated future |
1532
|
compensation payments based on cash reserves, using a 4-percent |
1533
|
discount rate, and a qualifying security deposit equal to 1.5 |
1534
|
times the value so certified. The employer shall thereafter |
1535
|
annually provide such a certified opinion until such time as the |
1536
|
employer meets the requirements of subparagraph 1. The |
1537
|
qualifying security deposit shall be adjusted at the time of |
1538
|
each such annual report. Upon the failure of the employer to |
1539
|
timely provide such opinion or to timely provide a security |
1540
|
deposit in an amount equal to 1.5 times the value certified in |
1541
|
the latest opinion, the association shall provide that |
1542
|
information to the department of Insurancealong with a |
1543
|
recommendation, and the department of Insuranceshall then |
1544
|
revoke such employer's authorization to self-insure. Failure to |
1545
|
comply with this subparagraph constitutes an immediate serious |
1546
|
danger to the public health, safety, or welfare sufficient to |
1547
|
justify the summary suspension of the employer's authorization |
1548
|
to self-insure pursuant to s. 120.68. |
1549
|
3. Upon the suspension or revocation of the employer's |
1550
|
authorization to self-insure, the employer shall provide to the |
1551
|
association the certified opinion of an independent actuary who |
1552
|
is a member of the American Academy of Actuaries of the |
1553
|
actuarial present value of the determined and estimated future |
1554
|
compensation payments of the employer for claims incurred while |
1555
|
the member exercised the privilege of self-insurance, using a |
1556
|
discount rate of 4 percent. The employer shall provide such an |
1557
|
opinion at 6-month intervals thereafter until such time as the |
1558
|
latest opinion shows no remaining value of claims. With each |
1559
|
such opinion, the employer shall deposit with the association a |
1560
|
qualifying security deposit in an amount equal to the value |
1561
|
certified by the actuary. The association has a cause of action |
1562
|
against an employer, and against any successor of the employer, |
1563
|
who fails to timely provide such opinion or who fails to timely |
1564
|
maintain the required security deposit with the association. The |
1565
|
association shall recover a judgment in the amount of the |
1566
|
actuarial present value of the determined and estimated future |
1567
|
compensation payments of the employer for claims incurred while |
1568
|
the employer exercised the privilege of self-insurance, together |
1569
|
with attorney's fees. For purposes of this section, the |
1570
|
successor of an employer means any person, business entity, or |
1571
|
group of persons or business entities, which holds or acquires |
1572
|
legal or beneficial title to the majority of the assets or the |
1573
|
majority of the shares of the employer. |
1574
|
4. A qualifying security deposit shall consist, at the |
1575
|
option of the employer, of: |
1576
|
a. Surety bonds, in a form and containing such terms as |
1577
|
prescribed by the association, issued by a corporation surety |
1578
|
authorized to transact surety business by the department of |
1579
|
Insurance, and whose policyholders' and financial ratings, as |
1580
|
reported in A.M. Best's Insurance Reports, Property-Liability, |
1581
|
are not less than "A" and "V", respectively. |
1582
|
b. Irrevocable letters of credit in favor of the |
1583
|
association issued by financial institutions located within this |
1584
|
state, the deposits of which are insured through the Federal |
1585
|
Deposit Insurance Corporation. |
1586
|
5. The qualifying security deposit shall be held by the |
1587
|
association exclusively for the benefit of workers' compensation |
1588
|
claimants. The security shall not be subject to assignment, |
1589
|
execution, attachment, or any legal process whatsoever, except |
1590
|
as necessary to guarantee the payment of compensation under this |
1591
|
chapter. No surety bond may be terminated, and no letter of |
1592
|
credit may be allowed to expire, without 90 days' prior written |
1593
|
notice to the association and deposit by the self-insuring |
1594
|
employer of some other qualifying security deposit of equal |
1595
|
value within 10 business days after such notice. Failure to |
1596
|
provide such written notice or failure to timely provide |
1597
|
qualifying replacement security after such notice shall |
1598
|
constitute grounds for the association to call or sue upon the |
1599
|
surety bond or to exercise its rights under a letter of credit. |
1600
|
Current self-insured employers must comply with this section on |
1601
|
or before December 31, 2001, or upon the maturity of existing |
1602
|
security deposits, whichever occurs later. The department of |
1603
|
Insurancemay specify by rule the amount of the qualifying |
1604
|
security deposit required prior to authorizing an employer to |
1605
|
self-insure and the amount of net worth required for an employer |
1606
|
to qualify for authorization to self-insure; |
1607
|
(c) By entering into a contract with a public utility |
1608
|
under an approved utility-provided self-insurance program as set |
1609
|
forth in s. 624.46225 in effect as of July 1, 1983. The |
1610
|
departmentdivisionshall adopt rules to implement this |
1611
|
paragraph; |
1612
|
(d) By entering into an interlocal agreement with other |
1613
|
local governmental entities to create a local government pool |
1614
|
pursuant to s. 624.4622; |
1615
|
(e) In accordance with s. 440.135, an employer, other than |
1616
|
a local government unit, may elect coverage under the Workers' |
1617
|
Compensation Law and retain the benefit of the exclusiveness of |
1618
|
liability provided in s. 440.11 by obtaining a 24-hour health |
1619
|
insurance policy from an authorized property and casualty |
1620
|
insurance carrier or an authorized life and health insurance |
1621
|
carrier, or by participating in a fully or partially self- |
1622
|
insured 24-hour health plan that is established or maintained by |
1623
|
or for two or more employers, so long as the law of this state |
1624
|
is not preempted by the Employee Retirement Income Security Act |
1625
|
of 1974, Pub. L. No. 93-406, or any amendment to that law, which |
1626
|
policy or plan must provide, for at least occupational injuries |
1627
|
and illnesses, medical benefits that are comparable to those |
1628
|
required by this chapter. A local government unit, as a single |
1629
|
employer, in accordance with s. 440.135, may participate in the |
1630
|
24-hour health insurance coverage plan referenced in this |
1631
|
paragraph. Disputes and remedies arising under policies issued |
1632
|
under this section are governed by the terms and conditions of |
1633
|
the policies and under the applicable provisions of the Florida |
1634
|
Insurance Code and rules adopted under the insurance code and |
1635
|
other applicable laws of this state. The 24-hour health |
1636
|
insurance policy may provide for health care by a health |
1637
|
maintenance organization or a preferred provider organization. |
1638
|
The premium for such 24-hour health insurance policy shall be |
1639
|
paid entirely by the employer. The 24-hour health insurance |
1640
|
policy may use deductibles and coinsurance provisions that |
1641
|
require the employee to pay a portion of the actual medical care |
1642
|
received by the employee. If an employer obtains a 24-hour |
1643
|
health insurance policy or self-insured plan to secure payment |
1644
|
of compensation as to medical benefits, the employer must also |
1645
|
obtain an insurance policy or policies that provide indemnity |
1646
|
benefits as follows:
|
1647
|
1. If indemnity benefits are provided only for |
1648
|
occupational-related disability, such benefits must be |
1649
|
comparable to those required by this chapter.
|
1650
|
2. If indemnity benefits are provided for both |
1651
|
occupational-related and nonoccupational-related disability, |
1652
|
such benefits must be comparable to those required by this |
1653
|
chapter, except that they must be based on 60 percent of the |
1654
|
average weekly wages.
|
1655
|
3. The employer shall provide for each of its employees |
1656
|
life insurance with a death benefit of $100,000.
|
1657
|
4. Policies providing coverage under this subsection must |
1658
|
use prescribed and acceptable underwriting standards, forms, and |
1659
|
policies approved by the Department of Insurance. If any |
1660
|
insurance policy that provides coverage under this section is |
1661
|
canceled, terminated, or nonrenewed for any reason, the |
1662
|
cancellation, termination, or nonrenewal is ineffective until |
1663
|
the self-insured employer or insurance carrier or carriers |
1664
|
notify the division and the Department of Insurance of the |
1665
|
cancellation, termination, or nonrenewal, and until the division |
1666
|
has actually received the notification. The division must be |
1667
|
notified of replacement coverage under a workers' compensation |
1668
|
and employer's liability insurance policy or plan by the |
1669
|
employer prior to the effective date of the cancellation, |
1670
|
termination, or nonrenewal; or
|
1671
|
(e)(f)By entering into a contract with an individual |
1672
|
self-insurer under an approved individual self-insurer-provided |
1673
|
self-insurance program as set forth in s. 624.46225. The |
1674
|
departmentdivisionmay adopt rules to administer this |
1675
|
subsection. |
1676
|
(2)(a) The department of Insuranceshall adopt rules by |
1677
|
which businesses may become qualified to provide underwriting |
1678
|
claims-adjusting, loss control, and safety engineering services |
1679
|
to self-insurers. |
1680
|
(b) The department of Insuranceshall adopt rules |
1681
|
requiring self-insurers to file any reports necessary to fulfill |
1682
|
the requirements of this chapter. Any self-insurer who fails to |
1683
|
file any report as prescribed by the rules adopted by the |
1684
|
department of Insuranceshall be subject to a civil penalty. |
1685
|
(3)(a) The license of any stock company or mutual company |
1686
|
or association or exchange authorized to do insurance business |
1687
|
in the state shall for good cause, upon recommendation of the |
1688
|
departmentdivision, be suspended or revoked by the office |
1689
|
Department of Insurance. No suspension or revocation shall |
1690
|
affect the liability of any carrier already incurred. |
1691
|
(b) The department of Insuranceshall suspend or revoke |
1692
|
any authorization to a self-insurer for failure to comply with |
1693
|
this section or for good cause, as defined by rule of the |
1694
|
department of Insurance. No suspension or revocation shall |
1695
|
affect the liability of any self-insurer already incurred. |
1696
|
(c) Violation of s. 440.381 by a self-insurance fund shall |
1697
|
result in the imposition of a fine not to exceed $1,000 per |
1698
|
audit if the self-insurance fund fails to act on said audits by |
1699
|
correcting errors in employee classification or accepted |
1700
|
applications for coverage where it knew employee classifications |
1701
|
were incorrect. Such fines shall be levied by the department |
1702
|
divisionand deposited into the Workers' Compensation |
1703
|
Administration Trust Fund. |
1704
|
(4)(a) A carrier of insurance, including the parties to |
1705
|
any mutual, reciprocal, or other association, may not write any |
1706
|
compensation insurance under this chapter without a certificate |
1707
|
of authoritypermit from the officeDepartment of Insurance. |
1708
|
Such certificate of authoritypermitshall be given, upon |
1709
|
application therefor, to any insurance or mutual or reciprocal |
1710
|
insurance association upon the office'sdepartment'sbeing |
1711
|
satisfied of the solvency of such corporation or association and |
1712
|
its ability to perform all its undertakings. The office |
1713
|
Department of Insurance may revoke any certificate of authority |
1714
|
permitso issued for violation of any provision of this chapter. |
1715
|
(b) A carrier of insurance, including the parties to any |
1716
|
mutual, reciprocal, or other association, may not write any |
1717
|
compensation insurance under this chapter unless such carrier |
1718
|
has a claims adjuster, either in-house or under contract, |
1719
|
situated within this state. Self-insurers whose compensation |
1720
|
payments are administered through a third party and carriers of |
1721
|
insurance shall maintain a claims adjuster within this state |
1722
|
during any period for which there are any open claims against |
1723
|
such self-insurer or carrier arising under the compensation |
1724
|
insurance written by the self-insurer or carrier. Individual |
1725
|
self-insurers whose compensation payments are administered by |
1726
|
employees of the self-insurer shall not be required to have |
1727
|
their claims adjuster situated within this state. Individual |
1728
|
self-insurers shall not be required to have their claims |
1729
|
adjusters situated within this state. |
1730
|
Section 15. Subsections (1) and (3) of section 440.381, |
1731
|
Florida Statutes, are amended to read: |
1732
|
440.381 Application for coverage; reporting payroll; |
1733
|
payroll audit procedures; penalties.-- |
1734
|
(1) Applications by an employer to a carrier for coverage |
1735
|
required by s. 440.38 must be made on a form prescribed by the |
1736
|
Financial Services CommissionDepartment of Insurance. The |
1737
|
Financial Services CommissionDepartment of Insuranceshall |
1738
|
adopt rules for applications for coverage required by s. 440.38. |
1739
|
The rules must provide that an application include information |
1740
|
on the employer, the type of business, past and prospective |
1741
|
payroll, estimated revenue, previous workers' compensation |
1742
|
experience, employee classification, employee names, and any |
1743
|
other information necessary to enable a carrier to accurately |
1744
|
underwrite the applicant. The rules must include a provision |
1745
|
that a carrier or self-insurance fund may require that an |
1746
|
employer update an application monthly to reflect any change in |
1747
|
the required application information. |
1748
|
(3) The Financial Services Commission, in consultation |
1749
|
with the department,shall establish by rule minimum |
1750
|
requirements for audits of payroll and classifications in order |
1751
|
to ensure that the appropriate premium is charged for workers' |
1752
|
compensation coverage. The rules shall ensure that audits |
1753
|
performed by both carriers and employers are adequate to provide |
1754
|
that all sources of payments to employees, subcontractors, and |
1755
|
independent contractors have been reviewed and that the accuracy |
1756
|
of classification of employees has been verified. The rules |
1757
|
shall provide that employers in all classes other than the |
1758
|
construction class be audited not less frequently than |
1759
|
biennially and may provide for more frequent audits of employers |
1760
|
in specified classifications based on factors such as amount of |
1761
|
premium, type of business, loss ratios, or other relevant |
1762
|
factors. In no event shall employers in the construction class, |
1763
|
generating more than the amount of premium required to be |
1764
|
experience rated, be audited less than annually. The annual |
1765
|
audits required for construction classes shall consist of |
1766
|
physical onsite audits. Payroll verification audit rules must |
1767
|
include, but need not be limited to, the use of state and |
1768
|
federal reports of employee income, payroll and other accounting |
1769
|
records, certificates of insurance maintained by subcontractors, |
1770
|
and duties of employees. At the completion of an audit, the |
1771
|
employer or officer of the corporation and the auditor must |
1772
|
print and sign their names on the audit document and attach |
1773
|
proof of identification to the audit document. |
1774
|
Section 16. Section 440.385, Florida Statutes, is amended |
1775
|
to read: |
1776
|
440.385 Florida Self-Insurers Guaranty Association, |
1777
|
Incorporated.-- |
1778
|
(1) CREATION OF ASSOCIATION.-- |
1779
|
(a) There is created a nonprofit corporation to be known |
1780
|
as the "Florida Self-Insurers Guaranty Association, |
1781
|
Incorporated," hereinafter referred to as "the association." |
1782
|
Upon incorporation of the association, all individual self- |
1783
|
insurers as defined in ss. 440.02(23)(a) and 440.38(1)(b), other |
1784
|
than individual self-insurers which are public utilities or |
1785
|
governmental entities, shall be members of the association as a |
1786
|
condition of their authority to individually self-insure in this |
1787
|
state. The association shall perform its functions under a plan |
1788
|
of operation as established and approved under subsection (5) |
1789
|
and shall exercise its powers and duties through a board of |
1790
|
directors as established under subsection (2). The association |
1791
|
shall have those powers granted or permitted corporations not |
1792
|
for profit, as provided in chapter 617. The activities of the |
1793
|
association shall be subject to review by the department of |
1794
|
Insurance. The department of Insuranceshall have oversight |
1795
|
responsibility as set forth in this section. The association is |
1796
|
specifically authorized to enter into agreements with this state |
1797
|
to perform specified services. |
1798
|
(b) A member may voluntarily withdraw from the association |
1799
|
when the member voluntarily terminates the self-insurance |
1800
|
privilege and pays all assessments due to the date of such |
1801
|
termination. However, the withdrawing member shall continue to |
1802
|
be bound by the provisions of this section relating to the |
1803
|
period of his or her membership and any claims charged pursuant |
1804
|
thereto. The withdrawing member who is a member on or after |
1805
|
January 1, 1991, shall also be required to provide to the |
1806
|
association upon withdrawal, and at 12-month intervals |
1807
|
thereafter, satisfactory proof, including, if requested by the |
1808
|
association, a report of known and potential claims certified by |
1809
|
a member of the American Academy of Actuaries, that it continues |
1810
|
to meet the standards of s. 440.38(1)(b)1. in relation to claims |
1811
|
incurred while the withdrawing member exercised the privilege of |
1812
|
self-insurance. Such reporting shall continue until the |
1813
|
withdrawing member demonstrates to the association that there is |
1814
|
no remaining value to claims incurred while the withdrawing |
1815
|
member was self-insured. If a withdrawing member fails or |
1816
|
refuses to timely provide an actuarial report to the |
1817
|
association, the association may obtain an order from a circuit |
1818
|
court requiring the member to produce such a report and ordering |
1819
|
any other relief that the court determines appropriate. The |
1820
|
association is entitled to recover all reasonable costs and |
1821
|
attorney's fees expended in such proceedings. If during this |
1822
|
reporting period the withdrawing member fails to meet the |
1823
|
standards of s. 440.38(1)(b)1., the withdrawing member who is a |
1824
|
member on or after January 1, 1991, shall thereupon, and at 6- |
1825
|
month intervals thereafter, provide to the association the |
1826
|
certified opinion of an independent actuary who is a member of |
1827
|
the American Academy of Actuaries of the actuarial present value |
1828
|
of the determined and estimated future compensation payments of |
1829
|
the member for claims incurred while the member was a self- |
1830
|
insurer, using a discount rate of 4 percent. With each such |
1831
|
opinion, the withdrawing member shall deposit with the |
1832
|
association security in an amount equal to the value certified |
1833
|
by the actuary and of a type that is acceptable for qualifying |
1834
|
security deposits under s. 440.38(1)(b). The withdrawing member |
1835
|
shall continue to provide such opinions and to provide such |
1836
|
security until such time as the latest opinion shows no |
1837
|
remaining value of claims. The association has a cause of |
1838
|
action against a withdrawing member, and against any successor |
1839
|
of a withdrawing member, who fails to timely provide the |
1840
|
required opinion or who fails to maintain the required deposit |
1841
|
with the association. The association shall be entitled to |
1842
|
recover a judgment in the amount of the actuarial present value |
1843
|
of the determined and estimated future compensation payments of |
1844
|
the withdrawing member for claims incurred during the time that |
1845
|
the withdrawing member exercised the privilege of self- |
1846
|
insurance, together with reasonable attorney's fees. The |
1847
|
association is also entitled to recover reasonable attorney's |
1848
|
fees in any action to compel production of any actuarial report |
1849
|
required by this section. For purposes of this section, the |
1850
|
successor of a withdrawing member means any person, business |
1851
|
entity, or group of persons or business entities, which holds or |
1852
|
acquires legal or beneficial title to the majority of the assets |
1853
|
or the majority of the shares of the withdrawing member. |
1854
|
(2) BOARD OF DIRECTORS.--The board of directors of the |
1855
|
association shall consist of nine persons and shall be organized |
1856
|
as established in the plan of operation. All board members shall |
1857
|
be experienced in self-insurance in this state. Each director |
1858
|
shall serve for a 4-year term and may be reappointed. |
1859
|
Appointments after January 1, 2002, shall be made by the |
1860
|
department of Insuranceupon recommendation of members of the |
1861
|
association. Any vacancy on the board shall be filled for the |
1862
|
remaining period of the term in the same manner as appointments |
1863
|
other than initial appointments are made. Each director shall be |
1864
|
reimbursed for expenses incurred in carrying out the duties of |
1865
|
the board on behalf of the association. |
1866
|
(3) POWERS AND DUTIES.-- |
1867
|
(a) Upon creation of the Insolvency Fund pursuant to the |
1868
|
provisions of subsection (4), the association is obligated for |
1869
|
payment of compensation under this chapter to insolvent members' |
1870
|
employees resulting from incidents and injuries existing prior |
1871
|
to the member becoming an insolvent member and from incidents |
1872
|
and injuries occurring within 30 days after the member has |
1873
|
become an insolvent member, provided the incidents giving rise |
1874
|
to claims for compensation under this chapter occur during the |
1875
|
year in which such insolvent member is a member of the guaranty |
1876
|
fund and was assessable pursuant to the plan of operation, and |
1877
|
provided the employee makes timely claim for such payments |
1878
|
according to procedures set forth by a court of competent |
1879
|
jurisdiction over the delinquency or bankruptcy proceedings of |
1880
|
the insolvent member. Such obligation includes only that amount |
1881
|
due the injured worker or workers of the insolvent member under |
1882
|
this chapter. In no event is the association obligated to a |
1883
|
claimant in an amount in excess of the obligation of the |
1884
|
insolvent member. The association shall be deemed the insolvent |
1885
|
employer for purposes of this chapter to the extent of its |
1886
|
obligation on the covered claims and, to such extent, shall have |
1887
|
all rights, duties, and obligations of the insolvent employer as |
1888
|
if the employer had not become insolvent. However, in no event |
1889
|
shall the association be liable for any penalties or interest. |
1890
|
(b) The association may: |
1891
|
1. Employ or retain such persons as are necessary to |
1892
|
handle claims and perform other duties of the association. |
1893
|
2. Borrow funds necessary to effect the purposes of this |
1894
|
section in accord with the plan of operation. |
1895
|
3. Sue or be sued. |
1896
|
4. Negotiate and become a party to such contracts as are |
1897
|
necessary to carry out the purposes of this section. |
1898
|
5. Purchase such reinsurance as is determined necessary |
1899
|
pursuant to the plan of operation. |
1900
|
6. Review all applicants for membership in the association |
1901
|
to determine whether the applicant is qualified for membership |
1902
|
under the law. The association shall recommend to the department |
1903
|
of Insurancethat the application be accepted or rejected based |
1904
|
on the criteria set forth in s. 440.38(1)(b). The department of |
1905
|
Insuranceshall approve or disapprove the application as |
1906
|
provided in paragraph (6)(a). |
1907
|
7. Collect and review financial information from employers |
1908
|
and make recommendations to the department of Insurance |
1909
|
regarding the appropriate security deposit and reinsurance |
1910
|
amounts necessary for an employer to demonstrate that it has the |
1911
|
financial strength necessary to ensure the timely payment of all |
1912
|
current and future claims. The association may audit and examine |
1913
|
an employer to verify the financial strength of its current and |
1914
|
former members. If the association determines that a current or |
1915
|
former self-insured employer does not have the financial |
1916
|
strength necessary to ensure the timely payment of all current |
1917
|
and estimated future claims, the association may recommend to |
1918
|
the department of Insurancethat the department: |
1919
|
a. Revoke the employer's self-insurance privilege. |
1920
|
b. Require the employer to provide a certified opinion of |
1921
|
an independent actuary who is a member of the American Academy |
1922
|
of Actuaries as to the actuarial present value of the employer's |
1923
|
estimated current and future compensation payments, using a 4- |
1924
|
percent discount rate. |
1925
|
c. Require an increase in the employer's security deposit |
1926
|
in an amount determined by the association to be necessary to |
1927
|
ensure payment of compensation claims. The department of |
1928
|
Insuranceshall act on such recommendations as provided in |
1929
|
paragraph (6)(a). The association has a cause of action against |
1930
|
an employer, and against any successor of an employer, who fails |
1931
|
to provide an additional security deposit required by the |
1932
|
department of Insurance. The association shall file an action |
1933
|
in circuit court to recover a judgment in the amount of the |
1934
|
requested additional security deposit together with reasonable |
1935
|
attorney's fees. For the purposes of this section, the |
1936
|
successor of an employer is any person, business entity, or |
1937
|
group of persons or business entities which holds or acquires |
1938
|
legal or beneficial title to the majority of the assets or the |
1939
|
majority of the shares of the employer. |
1940
|
8. Charge fees to any member of the association to cover |
1941
|
the actual costs of examining the financial and safety |
1942
|
conditions of that member. |
1943
|
9. Charge an applicant for membership in the association a |
1944
|
fee sufficient to cover the actual costs of examining the |
1945
|
financial condition of the applicant. |
1946
|
10. Implement any procedures necessary to ensure |
1947
|
compliance with regulatory actions taken by the department of |
1948
|
Insurance. |
1949
|
(c)1. To the extent necessary to secure funds for the |
1950
|
payment of covered claims and also to pay the reasonable costs |
1951
|
to administer them, the association, subject to approval by the |
1952
|
department of Insurance, shall levy assessments based on the |
1953
|
annual written premium each employer would have paid had the |
1954
|
employer not been self-insured. Every assessment shall be made |
1955
|
as a uniform percentage of the figure applicable to all |
1956
|
individual self-insurers, provided that the assessment levied |
1957
|
against any self-insurer in any one year shall not exceed 1 |
1958
|
percent of the annual written premium during the calendar year |
1959
|
preceding the date of the assessment. Assessments shall be |
1960
|
remitted to and administered by the board of directors in the |
1961
|
manner specified by the approved plan. Each employer so |
1962
|
assessed shall have at least 30 days' written notice as to the |
1963
|
date the assessment is due and payable. The association shall |
1964
|
levy assessments against any newly admitted member of the |
1965
|
association so that the basis of contribution of any newly |
1966
|
admitted member is the same as previously admitted members, |
1967
|
provision for which shall be contained in the plan of operation. |
1968
|
2. If, in any one year, funds available from such |
1969
|
assessments, together with funds previously raised, are not |
1970
|
sufficient to make all the payments or reimbursements then |
1971
|
owing, the funds available shall be prorated, and the unpaid |
1972
|
portion shall be paid as soon thereafter as sufficient |
1973
|
additional funds become available. |
1974
|
3. Funds may be allocated or paid from the Workers' |
1975
|
Compensation Administration Trust Fund to contract with the |
1976
|
association to perform services required by law. However, no |
1977
|
state funds of any kind shall be allocated or paid to the |
1978
|
association or any of its accounts for payment of covered claims |
1979
|
or related expenses except those state funds accruing to the |
1980
|
association by and through the assignment of rights of an |
1981
|
insolvent employer. The department of Insurancemay not levy any |
1982
|
assessment on the association. |
1983
|
(4) INSOLVENCY FUND.--Upon the adoption of a plan of |
1984
|
operation, there shall be created an Insolvency Fund to be |
1985
|
managed by the association. |
1986
|
(a) The Insolvency Fund is created for purposes of meeting |
1987
|
the obligations of insolvent members incurred while members of |
1988
|
the association and after the exhaustion of any security |
1989
|
deposit, as required under this chapter. However, if such |
1990
|
security deposit or reinsurance policy is payable to the |
1991
|
association, the association shall commence to provide benefits |
1992
|
out of the Insolvency Fund and be reimbursed from the security |
1993
|
deposit or reinsurance policy. The method of operation of the |
1994
|
Insolvency Fund shall be defined in the plan of operation as |
1995
|
provided in subsection (5). |
1996
|
(b) The department of Insuranceshall have the authority |
1997
|
to audit the financial soundness of the Insolvency Fund |
1998
|
annually. |
1999
|
(c) The department of Insurancemay offer certain |
2000
|
amendments to the plan of operation to the board of directors of |
2001
|
the association for purposes of assuring the ongoing financial |
2002
|
soundness of the Insolvency Fund and its ability to meet the |
2003
|
obligations of this section. |
2004
|
(5) PLAN OF OPERATION.--The association shall operate |
2005
|
pursuant to a plan of operation approved by the board of |
2006
|
directors. The plan of operation in effect on January 1, 2002, |
2007
|
and approved by the Department of Labor and Employment Security |
2008
|
shall remain in effect. However, any amendments to the plan |
2009
|
shall not become effective until approved by the Department of |
2010
|
Financial ServicesInsurance. |
2011
|
(a) The purpose of the plan of operation shall be to |
2012
|
provide the association and the board of directors with the |
2013
|
authority and responsibility to establish the necessary programs |
2014
|
and to take the necessary actions to protect against the |
2015
|
insolvency of a member of the association. In addition, the |
2016
|
plan shall provide that the members of the association shall be |
2017
|
responsible for maintaining an adequate Insolvency Fund to meet |
2018
|
the obligations of insolvent members provided for under this act |
2019
|
and shall authorize the board of directors to contract and |
2020
|
employ those persons with the necessary expertise to carry out |
2021
|
this stated purpose. By January 1, 2003, the board of directors |
2022
|
shall submit to the department of Insurancea proposed plan of |
2023
|
operation for the administration of the association. The |
2024
|
department of Insuranceshall approve the plan by order, |
2025
|
consistent with this section. The department of Insuranceshall |
2026
|
approve any amendments to the plan, consistent with this |
2027
|
section, which are determined appropriate to carry out the |
2028
|
duties and responsibilities of the association. |
2029
|
(b) All member employers shall comply with the plan of |
2030
|
operation. |
2031
|
(c) The plan of operation shall: |
2032
|
1. Establish the procedures whereby all the powers and |
2033
|
duties of the association under subsection (3) will be |
2034
|
performed. |
2035
|
2. Establish procedures for handling assets of the |
2036
|
association. |
2037
|
3. Establish the amount and method of reimbursing members |
2038
|
of the board of directors under subsection (2). |
2039
|
4. Establish procedures by which claims may be filed with |
2040
|
the association and establish acceptable forms of proof of |
2041
|
covered claims. Notice of claims to the receiver or liquidator |
2042
|
of the insolvent employer shall be deemed notice to the |
2043
|
association or its agent, and a list of such claims shall be |
2044
|
submitted periodically to the association or similar |
2045
|
organization in another state by the receiver or liquidator. |
2046
|
5. Establish regular places and times for meetings of the |
2047
|
board of directors. |
2048
|
6. Establish procedures for records to be kept of all |
2049
|
financial transactions of the association and its agents and the |
2050
|
board of directors. |
2051
|
7. Provide that any member employer aggrieved by any final |
2052
|
action or decision of the association may appeal to the |
2053
|
department of Insurancewithin 30 days after the action or |
2054
|
decision. |
2055
|
8. Establish the procedures whereby recommendations of |
2056
|
candidates for the board of directors shall be submitted to the |
2057
|
department of Insurance. |
2058
|
9. Contain additional provisions necessary or proper for |
2059
|
the execution of the powers and duties of the association. |
2060
|
(d) The plan of operation may provide that any or all of |
2061
|
the powers and duties of the association, except those specified |
2062
|
under subparagraphs (c)1. and 2., be delegated to a corporation, |
2063
|
association, or other organization which performs or will |
2064
|
perform functions similar to those of this association or its |
2065
|
equivalent in two or more states. Such a corporation, |
2066
|
association, or organization shall be reimbursed as a servicing |
2067
|
facility would be reimbursed and shall be paid for its |
2068
|
performance of any other functions of the association. A |
2069
|
delegation of powers or duties under this subsection shall take |
2070
|
effect only with the approval of both the board of directors and |
2071
|
the department of Insuranceand may be made only to a |
2072
|
corporation, association, or organization which extends |
2073
|
protection which is not substantially less favorable and |
2074
|
effective than the protection provided by this section. |
2075
|
(6) POWERS AND DUTIES OF DEPARTMENT OF INSURANCE.--The |
2076
|
department of Insuranceshall: |
2077
|
(a) Review recommendations of the association concerning |
2078
|
whether current or former self-insured employers or members of |
2079
|
the association have the financial strength necessary to ensure |
2080
|
the timely payment of all current and estimated future claims. |
2081
|
If the association determines an employer does not have the |
2082
|
financial strength necessary to ensure the timely payment of all |
2083
|
current and future claims and recommends action pursuant to |
2084
|
paragraph (3)(b), the department shall take such action as |
2085
|
necessary to order the employer to comply with the |
2086
|
recommendation, unless the department finds by clear and |
2087
|
convincing evidence that the recommendation is erroneous. |
2088
|
(b) Contract with the association for services, which may |
2089
|
include, but are not limited to: |
2090
|
1. Processing applications for self-insurance. |
2091
|
2. Collecting and reviewing financial statements and loss |
2092
|
reserve information from individual self-insurers. |
2093
|
3. Collecting and maintaining files for original security |
2094
|
deposit documents and reinsurance policies from individual self- |
2095
|
insurers and, if necessary, perfecting security interests in |
2096
|
security deposits. |
2097
|
4. Processing compliance documentation for individual |
2098
|
self-insurers and providing copies of such documentation to the |
2099
|
department. |
2100
|
5. Collecting all data necessary to calculate annual |
2101
|
premium for all individual self-insurers, including individual |
2102
|
self-insurers that are public utilities or governmental |
2103
|
entities, and providing such calculated annual premium to the |
2104
|
departmentdivisionfor assessment purposes. |
2105
|
6. Inspecting and auditing annually, if necessary, the |
2106
|
payroll and other records of each individual self-insurer, |
2107
|
including individual self-insurers that are public utilities or |
2108
|
governmental entities, in order to determine the wages paid by |
2109
|
each individual self-insurer, the premium such individual self- |
2110
|
insurer would have to pay if insured, and all payments of |
2111
|
compensation made by such individual self-insurer during each |
2112
|
prior period with the results of such audit provided to the |
2113
|
departmentdivision. For purposes of this section, the payroll |
2114
|
records of each individual self-insurer shall be open to |
2115
|
inspection and audit by the association and the department, or |
2116
|
their authorized representatives, during regular business hours. |
2117
|
7. Processing applications and making recommendations with |
2118
|
respect to the qualification of a business to be approved to |
2119
|
provide or continue to provide services to individual self- |
2120
|
insurers in the areas of underwriting, claims adjusting, loss |
2121
|
control, and safety engineering. |
2122
|
8. Providing legal representation to implement the |
2123
|
administration and audit of individual self-insurers and making |
2124
|
recommendations regarding prosecution of any administrative or |
2125
|
legal proceedings necessitated by the regulation of the |
2126
|
individual self-insurers by the department. |
2127
|
(c) Contract with an attorney or attorneys recommended by |
2128
|
the association for representation of the department in any |
2129
|
administrative or legal proceedings necessitated by the |
2130
|
recommended regulation of the individual self-insurers. |
2131
|
(d) Direct the association to require from each individual |
2132
|
self-insurer, at such time and in accordance with such |
2133
|
regulations as the department prescribes, reports relating to |
2134
|
wages paid, the amount of premiums such individual self-insurer |
2135
|
would have to pay if insured, and all payments of compensation |
2136
|
made by such individual self-insurer during each prior period |
2137
|
and to determine the amounts paid by each individual self- |
2138
|
insurer and the amounts paid by all individual self-insurers |
2139
|
during such period. For purposes of this section, the payroll |
2140
|
records of each individual self-insurer shall be open to annual |
2141
|
inspection and audit by the association and the department, or |
2142
|
their authorized representative, during regular business hours, |
2143
|
and if any audit of such records of an individual self-insurer |
2144
|
discloses a deficiency in the amount reported to the association |
2145
|
or in the amounts paid to the departmentdivisionby an |
2146
|
individual self-insurer for its assessment for the Workers' |
2147
|
Compensation Administration Trust Fund, the department or the |
2148
|
association may assess the cost of such audit against the |
2149
|
individual self-insurer. |
2150
|
(e) Require that the association notify the member |
2151
|
employers and any other interested parties of the determination |
2152
|
of insolvency and of their rights under this section. Such |
2153
|
notification shall be by mail at the last known address thereof |
2154
|
when available; but, if sufficient information for notification |
2155
|
by mail is not available, notice by publication in a newspaper |
2156
|
of general circulation shall be sufficient. |
2157
|
(f) Suspend or revoke the authority of any member employer |
2158
|
failing to pay an assessment when due or failing to comply with |
2159
|
the plan of operation to self-insure in this state. As an |
2160
|
alternative, the department may levy a fine on any member |
2161
|
employer failing to pay an assessment when due. Such fine shall |
2162
|
not exceed 5 percent of the unpaid assessment per month, except |
2163
|
that no fine shall be less than $100 per month. |
2164
|
(g) Revoke the designation of any servicing facility if |
2165
|
the department finds that claims are being handled |
2166
|
unsatisfactorily. |
2167
|
(7) EFFECT OF PAID CLAIMS.-- |
2168
|
(a) Any person who recovers from the association under |
2169
|
this section shall be deemed to have assigned his or her rights |
2170
|
to the association to the extent of such recovery. Every |
2171
|
claimant seeking the protection of this section shall cooperate |
2172
|
with the association to the same extent as such person would |
2173
|
have been required to cooperate with the insolvent member. The |
2174
|
association shall have no cause of action against the employee |
2175
|
of the insolvent member for any sums the association has paid |
2176
|
out, except such causes of action as the insolvent member would |
2177
|
have had if such sums had been paid by the insolvent member. In |
2178
|
the case of an insolvent member operating on a plan with |
2179
|
assessment liability, payments of claims by the association |
2180
|
shall not operate to reduce the liability of the insolvent |
2181
|
member to the receiver, liquidator, or statutory successor for |
2182
|
unpaid assessments. |
2183
|
(b) The receiver, liquidator, or statutory successor of an |
2184
|
insolvent member shall be bound by settlements of covered claims |
2185
|
by the association or a similar organization in another state. |
2186
|
The court having jurisdiction shall grant such claims priority |
2187
|
against the assets of the insolvent member equal to that to |
2188
|
which the claimant would have been entitled in the absence of |
2189
|
this section. The expense of the association or similar |
2190
|
organization in handling claims shall be accorded the same |
2191
|
priority as the expenses of the liquidator. |
2192
|
(c) The association shall file periodically with the |
2193
|
receiver or liquidator of the insolvent member statements of the |
2194
|
covered claims paid by the association and estimates of |
2195
|
anticipated claims on the association, which shall preserve the |
2196
|
rights of the association against the assets of the insolvent |
2197
|
member. |
2198
|
(8) NOTIFICATION OF INSOLVENCIES.--To aid in the detection |
2199
|
and prevention of employer insolvencies: Upon determination by |
2200
|
majority vote that any member employer may be insolvent or in a |
2201
|
financial condition hazardous to the employees thereof or to the |
2202
|
public, it shall be the duty of the board of directors to notify |
2203
|
the department of Insuranceof any information indicating such |
2204
|
condition. |
2205
|
(9) EXAMINATION OF THE ASSOCIATION.--The association shall |
2206
|
be subject to examination and regulation by the department of |
2207
|
Insurance. No later than March 30 of each year, the board of |
2208
|
directors shall submit an audited financial statement for the |
2209
|
preceding calendar year in a form approved by the department. |
2210
|
(10) IMMUNITY.--There shall be no liability on the part |
2211
|
of, and no cause of action of any nature shall arise against, |
2212
|
any member employer, the association or its agents or employees, |
2213
|
the board of directors, or the department of Insuranceor its |
2214
|
representatives for any action taken by them in the performance |
2215
|
of their powers and duties under this section. |
2216
|
(11) STAY OF PROCEEDINGS; REOPENING OF DEFAULT |
2217
|
JUDGMENTS.--All proceedings in which an insolvent employer is a |
2218
|
party, or is obligated to defend a party, in any court or before |
2219
|
any quasi-judicial body or administrative board in this state |
2220
|
shall be stayed for up to 6 months, or for such additional |
2221
|
period from the date the employer becomes an insolvent member, |
2222
|
as is deemed necessary by a court of competent jurisdiction to |
2223
|
permit proper defense by the association of all pending causes |
2224
|
of action as to any covered claims arising from a judgment under |
2225
|
any decision, verdict, or finding based on the default of the |
2226
|
insolvent member. The association, either on its own behalf or |
2227
|
on behalf of the insolvent member, may apply to have such |
2228
|
judgment, order, decision, verdict, or finding set aside by the |
2229
|
same court or administrator that made such judgment, order, |
2230
|
decision, verdict, or finding and shall be permitted to defend |
2231
|
against such claim on the merits. If requested by the |
2232
|
association, the stay of proceedings may be shortened or waived. |
2233
|
(12) LIMITATION ON CERTAIN ACTIONS.--Notwithstanding any |
2234
|
other provision of this chapter, a covered claim, as defined |
2235
|
herein, with respect to which settlement is not effected and |
2236
|
pursuant to which suit is not instituted against the insured of |
2237
|
an insolvent member or the association within 1 year after the |
2238
|
deadline for filing claims with the receiver of the insolvent |
2239
|
member, or any extension of the deadline, shall thenceforth be |
2240
|
barred as a claim against the association. |
2241
|
(13) CORPORATE INCOME TAX CREDIT.--Any sums acquired by a |
2242
|
member by refund, dividend, or otherwise from the association |
2243
|
shall be payable within 30 days of receipt to the Department of |
2244
|
Revenue for deposit with the Chief Financial OfficerTreasurer |
2245
|
to the credit of the General Revenue Fund. All provisions of |
2246
|
chapter 220 relating to penalties and interest on delinquent |
2247
|
corporate income tax payments apply to payments due under this |
2248
|
subsection. |
2249
|
Section 17. Subsections (2), (3), and (4) of section |
2250
|
440.386, Florida Statutes, are amended to read: |
2251
|
440.386 Individual self-insurers' insolvency; |
2252
|
conservation; liquidation.-- |
2253
|
(2) COMMENCEMENT OF DELINQUENCY PROCEEDING.--The |
2254
|
department of Insuranceor the Florida Self-Insurers Guaranty |
2255
|
Association, Incorporated, may commence a delinquency proceeding |
2256
|
by application to the court for an order directing the |
2257
|
individual self-insurer to show cause why the department or |
2258
|
association should not have the relief sought. On the return of |
2259
|
such order to show cause, and after a full hearing, the court |
2260
|
shall either deny the application or grant the application, |
2261
|
together with such other relief as the nature of the case and |
2262
|
the interests of the claimants, creditors, stockholders, |
2263
|
members, subscribers, or public may require. The department and |
2264
|
the association shall give reasonable written notice to each |
2265
|
other of all hearings which pertain to an adjudication of |
2266
|
insolvency of a member individual self-insurer. |
2267
|
(3) GROUNDS FOR LIQUIDATION.--The department of Insurance |
2268
|
or the association may apply to the court for an order |
2269
|
appointing a receiver and directing the receiver to liquidate |
2270
|
the business of a domestic individual self-insurer if such |
2271
|
individual self-insurer is insolvent. |
2272
|
(4) GROUNDS FOR CONSERVATION; FOREIGN INDIVIDUAL SELF- |
2273
|
INSURERS.-- |
2274
|
(a) The department of Insuranceor the association may |
2275
|
apply to the court for an order appointing a receiver or |
2276
|
ancillary receiver, and directing the receiver to conserve the |
2277
|
assets within this state, of a foreign individual self-insurer |
2278
|
if such individual self-insurer is insolvent. |
2279
|
(b) An order to conserve the assets of an individual self- |
2280
|
insurer shall require the receiver forthwith to take possession |
2281
|
of the property of the receiver within the state and to conserve |
2282
|
it, subject to the further direction of the court. |
2283
|
Section 18. Subsections (3), (4), and (6) of section |
2284
|
440.44, Florida Statutes, are amended to read: |
2285
|
440.44 Workers' compensation; staff organization.-- |
2286
|
(3) EXPENDITURES.--The department, the agency, the office, |
2287
|
the Department of Education, and the director of the Division of |
2288
|
Administrative Hearings shall make such expenditures, including |
2289
|
expenditures for personal services and rent at the seat of |
2290
|
government and elsewhere, for law books; for telephone services |
2291
|
and WATS lines; for books of reference, periodicals, equipment, |
2292
|
and supplies; and for printing and binding as may be necessary |
2293
|
in the administration of this chapter. All expenditures in the |
2294
|
administration of this chapter shall be allowed and paid as |
2295
|
provided in s. 440.50 upon the presentation of itemized vouchers |
2296
|
therefor approved by the department, the agency, the office,the |
2297
|
Department of Education, or the director of the Division of |
2298
|
Administrative Hearings. |
2299
|
(4) PERSONNEL ADMINISTRATION.--Subject to the other |
2300
|
provisions of this chapter, the department, the agency, the |
2301
|
office,the Department of Education, and the Division of |
2302
|
Administrative Hearings may appoint, and prescribe the duties |
2303
|
and powers of, bureau chiefs, attorneys, accountants, medical |
2304
|
advisers, technical assistants, inspectors, claims examiners, |
2305
|
and such other employees as may be necessary in the performance |
2306
|
of their duties under this chapter. |
2307
|
(6) SEAL.--The department and the judges of compensation |
2308
|
claims shall have a seal upon which shall be inscribed the words |
2309
|
"State of Florida Department of Financial ServicesInsurance-- |
2310
|
Seal" and "Division of Administrative Hearings--Seal," |
2311
|
respectively. |
2312
|
Section 19. Subsections (3) and (4) of section 440.52, |
2313
|
Florida Statutes, are amended to read: |
2314
|
440.52 Registration of insurance carriers; notice of |
2315
|
cancellation or expiration of policy; suspension or revocation |
2316
|
of authority.-- |
2317
|
(3) If the department finds, after due notice and a |
2318
|
hearing at which the insurance carrier is entitled to be heard |
2319
|
in person or by counsel and present evidence, that the insurance |
2320
|
carrier has repeatedly failed to comply with its obligations |
2321
|
under this chapter, the department may request the office to |
2322
|
suspend or revoke the authorization of such insurance carrier to |
2323
|
write workers' compensation insurance under this chapter. Such |
2324
|
suspension or revocation shall not affect the liability of any |
2325
|
such insurance carrier under policies in force prior to the |
2326
|
suspension or revocation. |
2327
|
(4) In addition to the penalties prescribed in subsection |
2328
|
(3), violation of s. 440.381 by an insurance carrier shall |
2329
|
result in the imposition of a fine not to exceed $1,000 per |
2330
|
audit, if the insurance carrier fails to act on said audits by |
2331
|
correcting errors in employee classification or accepted |
2332
|
applications for coverage where it knew employee classifications |
2333
|
were incorrect. Such fines shall be levied by the office |
2334
|
Department of Insurance and deposited into the Insurance |
2335
|
Commissioner'sRegulatory Trust Fund. |
2336
|
Section 20. Section 440.525, Florida Statutes, is amended |
2337
|
to read: |
2338
|
440.525 Examination of carriers.--The department and |
2339
|
officemay examine each carrier as often as is warranted to |
2340
|
ensure that carriers are fulfilling their obligations under this |
2341
|
chapterthe law. The examination may cover any period of the |
2342
|
carrier's operations since the last previous examination. |
2343
|
Section 21. Paragraph (k) of subsection (1) of section |
2344
|
553.74, Florida Statutes, is amended to read: |
2345
|
553.74 Florida Building Commission.-- |
2346
|
(1) The Florida Building Commission is created and shall |
2347
|
be located within the Department of Community Affairs for |
2348
|
administrative purposes. Members shall be appointed by the |
2349
|
Governor subject to confirmation by the Senate. The commission |
2350
|
shall be composed of 23 members, consisting of the following: |
2351
|
(k) One member who represents the Department of Financial |
2352
|
ServicesInsurance. |
2353
|
Section 22. Effective October 1, 2003, paragraph (k) of |
2354
|
subsection (1) of section 553.74, Florida Statutes, as amended |
2355
|
by chapter 2002-293, Laws of Florida, is amended to read: |
2356
|
553.74 Florida Building Commission.-- |
2357
|
(1) The Florida Building Commission is created and shall |
2358
|
be located within the Department of Community Affairs for |
2359
|
administrative purposes. Members shall be appointed by the |
2360
|
Governor subject to confirmation by the Senate. The commission |
2361
|
shall be composed of 23 members, consisting of the following: |
2362
|
(k) One member who represents the Department of Financial |
2363
|
ServicesInsurance. |
2364
|
|
2365
|
Any person serving on the commission under paragraph (c) or |
2366
|
paragraph (h) on October 1, 2003, and who has served less than |
2367
|
two full terms is eligible for reappointment to the commission |
2368
|
regardless of whether he or she meets the new qualification. |
2369
|
Section 23. Section 624.05, Florida Statutes, is amended |
2370
|
to read: |
2371
|
624.05 "Department," "commission," and "office" |
2372
|
defined.--As used in the Insurance Code: |
2373
|
(1) "Department" means the Department of Financial |
2374
|
Services. The term does not mean the Financial Services |
2375
|
Commission or any office of the Financial Services Commission |
2376
|
Insurance of this state, unless the context otherwise requires. |
2377
|
(2) "Commission" means the Financial Services Commission. |
2378
|
(3) "Office" means the Office of Insurance Regulation of |
2379
|
the Financial Services Commission. |
2380
|
Section 24. Subsections (2) and (5) of section 624.155, |
2381
|
Florida Statutes, are amended to read: |
2382
|
624.155 Civil remedy.-- |
2383
|
(2)(a) As a condition precedent to bringing an action |
2384
|
under this section, the officedepartmentand the insurer must |
2385
|
have been given 60 days' written notice of the violation. If |
2386
|
the officedepartmentreturns a notice for lack of specificity, |
2387
|
the 60-day time period shall not begin until a proper notice is |
2388
|
filed. |
2389
|
(b) The notice shall be on a form adopted by the |
2390
|
commission and provided by the officedepartmentand shall state |
2391
|
with specificity the following information,and such other |
2392
|
information as the commission requiresdepartment may require: |
2393
|
1. The statutory provision, including the specific |
2394
|
language of the statute, which the insurer allegedly violated. |
2395
|
2. The facts and circumstances giving rise to the |
2396
|
violation. |
2397
|
3. The name of any individual involved in the violation. |
2398
|
4. Reference to specific policy language that is relevant |
2399
|
to the violation, if any. If the person bringing the civil |
2400
|
action is a third party claimant, she or he shall not be |
2401
|
required to reference the specific policy language if the |
2402
|
insurer has not provided a copy of the policy to the third party |
2403
|
claimant pursuant to written request. |
2404
|
5. A statement that the notice is given in order to |
2405
|
perfect the right to pursue the civil remedy authorized by this |
2406
|
section. |
2407
|
(c) Within 20 days of receipt of the notice, the office |
2408
|
departmentmay return any notice that does not provide the |
2409
|
specific information required by this section, and the office |
2410
|
departmentshall indicate the specific deficiencies contained in |
2411
|
the notice. A determination by the officedepartmentto return a |
2412
|
notice for lack of specificity shall be exempt from the |
2413
|
requirements of chapter 120. |
2414
|
(d) No action shall lie if, within 60 days after filing |
2415
|
notice, the damages are paid or the circumstances giving rise to |
2416
|
the violation are corrected. |
2417
|
(e) The insurer that is the recipient of a notice filed |
2418
|
pursuant to this section shall report to the officedepartment |
2419
|
on the disposition of the alleged violation. |
2420
|
(f) The applicable statute of limitations for an action |
2421
|
under this section shall be tolled for a period of 65 days by |
2422
|
the mailing of the notice required by this subsection or the |
2423
|
mailing of a subsequent notice required by this subsection. |
2424
|
(5) This section shall not be construed to authorize a |
2425
|
class action suit against an insurer or a civil action against |
2426
|
the commission, the office, or the department or any of their, |
2427
|
its employees, or the Insurance Commissioner,or to create a |
2428
|
cause of action when a health insurer refuses to pay a claim for |
2429
|
reimbursement on the ground that the charge for a service was |
2430
|
unreasonably high or that the service provided was not medically |
2431
|
necessary. |
2432
|
Section 25. Section 624.303, Florida Statutes, is amended |
2433
|
to read: |
2434
|
624.303 Seal; certified copies as evidence.-- |
2435
|
(1) The department, commission, and office shall eachhave |
2436
|
an official seal by which its respectiveproceedings are |
2437
|
authenticated. |
2438
|
(2) All certificates executed by the department or office, |
2439
|
other than licenses of agents, solicitors, or adjusters or |
2440
|
similar licenses or permits, shall bear its respectiveseal. |
2441
|
(3) Any written instrument purporting to be a copy of any |
2442
|
action, proceeding, or finding of fact by the department, |
2443
|
commission, or office or any record of the department, |
2444
|
commission, or officeor copy of any document on file in its |
2445
|
office when authenticated under hand of the respective agency |
2446
|
head or his or her designeecommissionerby the seal shall be |
2447
|
accepted by all the courts of this state as prima facie evidence |
2448
|
of its contents. |
2449
|
Section 26. Section 624.305, Florida Statutes, is amended |
2450
|
to read: |
2451
|
624.305 Prohibited interests, rewards.-- |
2452
|
(1) No employee of the department, commission, or office, |
2453
|
including the members of the commission, but not including |
2454
|
employees of the Office of Financial Institutions and Securities |
2455
|
Regulation,Insurance Commissioner and Treasurershall: |
2456
|
(a) Be financially interested, directly or indirectly, in |
2457
|
any insurer or insurance agency authorized to transact insurance |
2458
|
in this state, or in any insurance transaction except as a |
2459
|
policyholder or claimant under a policy; or |
2460
|
(b) Be given or receive any fee, compensation, loan, gift, |
2461
|
or other thing of value in addition to the compensation and |
2462
|
expense allowance provided by law, for any service rendered or |
2463
|
to be rendered in her or his capacity as a department, |
2464
|
commission, or officeemployee. |
2465
|
(2) This section shall not be deemed to prohibit an |
2466
|
insurer from making, in the regular course of business, a loan |
2467
|
to any employee of the department, commission, or office,if |
2468
|
such loan is adequately secured by a mortgage upon real estate |
2469
|
or other collateral and qualifies as an eligible investment of |
2470
|
the insurer under part II of chapter 625. |
2471
|
(3) When there is no conflict of interest, the department, |
2472
|
commission, and office may eachemploy or retain from time to |
2473
|
time an insurance actuary, accountant, or other professional |
2474
|
person who is independently practicing her or his profession |
2475
|
even though such person is similarly employed or retained by |
2476
|
insurers or others. |
2477
|
(4) Any person employed by the department, commission, or |
2478
|
office on January 7, 2003, including a member of the commission, |
2479
|
who was not subject to this section prior to that date, has |
2480
|
until January 1, 2004, to comply with this section. |
2481
|
Section 27. Section 624.316, Florida Statutes, is amended |
2482
|
to read: |
2483
|
624.316 Examination of insurers.-- |
2484
|
(1)(a) The officedepartmentshall examine the affairs, |
2485
|
transactions, accounts, records, and assets of each authorized |
2486
|
insurer and of the attorney in fact of a reciprocal insurer as |
2487
|
to its transactions affecting the insurer as often as it deems |
2488
|
advisable, except as provided in this section. The examination |
2489
|
may include examination of the affairs, transactions, accounts, |
2490
|
and records relating directly or indirectly to the insurer and |
2491
|
of the assets of the insurer's managing general agents and |
2492
|
controlling or controlled person, as defined in s. 625.012. The |
2493
|
examination shall be pursuant to a written order of the office |
2494
|
department. Such order shall expire upon receipt by the office |
2495
|
departmentof the written report of the examination. |
2496
|
(b) As a part of its examination procedure, the office |
2497
|
departmentshall examine each insurer regarding all of the |
2498
|
information required by s. 627.915. |
2499
|
(c) The officedepartmentshall examine each insurer |
2500
|
according to accounting procedures designed to fulfill the |
2501
|
requirements of generally accepted insurance accounting |
2502
|
principles and practices and good internal control and in |
2503
|
keeping with generally accepted accounting forms, accounts, |
2504
|
records, methods, and practices relating to insurers. To |
2505
|
facilitate uniformity in examinations, the commissiondepartment |
2506
|
may adopt, by rule, the Market and Financial Conduct Examiners |
2507
|
Examination Handbook and the Financial Condition Examiners |
2508
|
Handbook of the National Association of Insurance Commissioners, |
2509
|
20021990, and may adopt subsequent amendments thereto, if the |
2510
|
examination methodology remains substantially consistent. |
2511
|
(2)(a) Except as provided in paragraph (f), the office |
2512
|
departmentmay examine each insurer as often as may be warranted |
2513
|
for the protection of the policyholders and in the public |
2514
|
interest, and shall examine each domestic insurer not less |
2515
|
frequently than once every 3 years. The examination shall cover |
2516
|
the preceding 3 fiscal years of the insurer and shall be |
2517
|
commenced within 12 months after the end of the most recent |
2518
|
fiscal year being covered by the examination. The examination |
2519
|
may cover any period of the insurer's operations since the last |
2520
|
previous examination. The examination may include examination of |
2521
|
events subsequent to the end of the most recent fiscal year and |
2522
|
the events of any prior period that affect the present financial |
2523
|
condition of the insurer. In lieu of making its own examination, |
2524
|
the officedepartmentmay accept an independent certified public |
2525
|
accountant's audit report prepared on a statutory basis |
2526
|
consistent with the Florida Insurance Code on that specific |
2527
|
company. The officedepartmentmay not accept the report in lieu |
2528
|
of the requirement imposed by paragraph (1)(b). When an |
2529
|
examination is conducted by the officedepartmentfor the sole |
2530
|
purpose of examining the 3 preceding fiscal years of the insurer |
2531
|
within 12 months after the opinion date of an independent |
2532
|
certified public accountant's audit report prepared on a |
2533
|
statutory basis on that specific company consistent with the |
2534
|
Florida Insurance Code, the cost of the examination as charged |
2535
|
to the insurer pursuant to s. 624.320 shall be reduced by the |
2536
|
cost to the insurer of the independent certified public |
2537
|
accountant's audit reports. Requests for the reduction in cost |
2538
|
of examination must be submitted to the officedepartmentin |
2539
|
writing no later than 90 days after the conclusion of the |
2540
|
examination and shall include sufficient documentation to |
2541
|
support the charges incurred for the statutory audit performed |
2542
|
by the independent certified public accountant. |
2543
|
(b) The officedepartmentshall examine each insurer |
2544
|
applying for an initial certificate of authority to transact |
2545
|
insurance in this state before granting the initial certificate. |
2546
|
(c) In lieu of making its own examination, the office |
2547
|
departmentmay accept a full report of the last recent |
2548
|
examination of a foreign insurer, certified to by the insurance |
2549
|
supervisory official of another state. |
2550
|
(d) The examination by the officedepartmentof an alien |
2551
|
insurer shall be limited to the alien insurer's insurance |
2552
|
transactions and affairs in the United States, except as |
2553
|
otherwise required by the officedepartment. |
2554
|
(e) The commissiondepartmentshall adopt rules providing |
2555
|
that, upon agreement between the officedepartmentand the |
2556
|
insurer, an examination under this section may be conducted by |
2557
|
independent certified public accountants, actuaries meeting |
2558
|
criteria specified by rule, and reinsurance specialists meeting |
2559
|
criteria specified by rule. The rules shall provide: |
2560
|
1. That the agreement of the insurer is not required if |
2561
|
the officedepartmentreasonably suspects criminal misconduct on |
2562
|
the part of the insurer. |
2563
|
2. That the officedepartmentshall provide the insurer |
2564
|
with a list of three firms acceptable to the officedepartment, |
2565
|
and that the insurer shall select the firm to conduct the |
2566
|
examination from the list provided by the officedepartment. |
2567
|
3. That the insurer being examined must make payment for |
2568
|
the examination directly to the firm performing the examination |
2569
|
in accordance with the rates and terms agreed to by the office |
2570
|
department, the insurer, and the firm performing the |
2571
|
examination. |
2572
|
4. That if the examination is conducted without the |
2573
|
consent of the insurer, the insurer must pay all reasonable |
2574
|
charges of the examining firm if the examination finds |
2575
|
impairment, insolvency, or criminal misconduct on the part of |
2576
|
the insurer. |
2577
|
(f)1. |
2578
|
a. An examination under this section must be conducted at |
2579
|
least once every year with respect to a domestic insurer that |
2580
|
has continuously held a certificate of authority for less than 3 |
2581
|
years. The examination must cover the preceding fiscal year or |
2582
|
the period since the last examination of the insurer. The office |
2583
|
departmentmay limit the scope of the examination. |
2584
|
b. The officedepartmentmay not accept an independent |
2585
|
certified public accountant's audit report in lieu of an |
2586
|
examination required by this subparagraph. |
2587
|
c. An insurer may not be required to pay more than $25,000 |
2588
|
to cover the costs of any one examination under this |
2589
|
subparagraph. |
2590
|
2. An examination under this section must be conducted not |
2591
|
less frequently than once every 5 years with respect to an |
2592
|
insurer that has continuously held a certificate of authority, |
2593
|
without a change in ownership subject to s. 624.4245 or s. |
2594
|
628.461, for more than 15 years. The examination must cover the |
2595
|
preceding 5 fiscal years of the insurer or the period since the |
2596
|
last examination of the insurer. This subparagraph does not |
2597
|
limit the ability of the officedepartmentto conduct more |
2598
|
frequent examinations. |
2599
|
Section 28. Section 624.317, Florida Statutes, is amended |
2600
|
to read: |
2601
|
624.317 Investigation of agents, adjusters, |
2602
|
administrators, service companies, and others.--If it has reason |
2603
|
to believe that any person has violated or is violating any |
2604
|
provision of this code, or upon the written complaint signed by |
2605
|
any interested person indicating that any such violation may |
2606
|
exist:, |
2607
|
(1)The department shall conduct such investigation as it |
2608
|
deems necessary of the accounts, records, documents, and |
2609
|
transactions pertaining to or affecting the insurance affairs of |
2610
|
any: |
2611
|
(1) general agent, surplus line agent, managing general |
2612
|
agent,adjuster, administrator, service company, or other |
2613
|
person. |
2614
|
(2) insurance agent, customer representative, service |
2615
|
representative, or other person subject to its jurisdictionor |
2616
|
solicitor, subject to the requirements of s. 626.601. |
2617
|
(2) The office shall conduct such investigation as it |
2618
|
deems necessary of the accounts, records, documents, and |
2619
|
transactions pertaining to or affecting the insurance affairs of |
2620
|
any: |
2621
|
(a) Adjuster, administrator, service company, or other |
2622
|
person subject to its jurisdiction. |
2623
|
(b)(3)Person having a contract or power of attorney under |
2624
|
which she or he enjoys in fact the exclusive or dominant right |
2625
|
to manage or control an insurer. |
2626
|
(c)(4)Person engaged in or proposing to be engaged in the |
2627
|
promotion or formation of: |
2628
|
1.(a)A domestic insurer; |
2629
|
2.(b)An insurance holding corporation; or |
2630
|
3.(c)A corporation to finance a domestic insurer or in |
2631
|
the production of the domestic insurer's business. |
2632
|
Section 29. Subsections (2), (3), (4), (5), and (7) of |
2633
|
section 624.404, Florida Statutes, are amended to read: |
2634
|
624.404 General eligibility of insurers for certificate of |
2635
|
authority.--To qualify for and hold authority to transact |
2636
|
insurance in this state, an insurer must be otherwise in |
2637
|
compliance with this code and with its charter powers and must |
2638
|
be an incorporated stock insurer, an incorporated mutual |
2639
|
insurer, or a reciprocal insurer, of the same general type as |
2640
|
may be formed as a domestic insurer under this code; except |
2641
|
that: |
2642
|
(2) No foreign or alien insurer or exchange shall be |
2643
|
authorized to transact insurance in this state unless it is |
2644
|
otherwise qualified therefor under this code and has operated |
2645
|
satisfactorily for at least 3 years in its state or country of |
2646
|
domicile; however, the officedepartmentmay waive the 3-year |
2647
|
requirement if the foreign or alien insurer or exchange: |
2648
|
(a) Has operated successfully and has capital and surplus |
2649
|
of $5 million; |
2650
|
(b) Is the wholly owned subsidiary of an insurer which is |
2651
|
an authorized insurer in this state; |
2652
|
(c) Is the successor in interest through merger or |
2653
|
consolidation of an authorized insurer; or |
2654
|
(d) Provides a product or service not readily available to |
2655
|
the consumers of this state. |
2656
|
(3)(a) The officedepartmentshall not grant or continue |
2657
|
authority to transact insurance in this state as to any insurer |
2658
|
the management, officers, or directors of which are found by it |
2659
|
to be incompetent or untrustworthy; or so lacking in insurance |
2660
|
company managerial experience as to make the proposed operation |
2661
|
hazardous to the insurance-buying public; or so lacking in |
2662
|
insurance experience, ability, and standing as to jeopardize the |
2663
|
reasonable promise of successful operation; or which it has good |
2664
|
reason to believe are affiliated directly or indirectly through |
2665
|
ownership, control, reinsurance transactions, or other insurance |
2666
|
or business relations, with any person or persons whose business |
2667
|
operations are or have been marked, to the detriment of |
2668
|
policyholders or stockholders or investors or creditors or of |
2669
|
the public, by manipulation of assets, accounts, or reinsurance |
2670
|
or by bad faith. |
2671
|
(b) The officedepartmentshall not grant or continue |
2672
|
authority to transact insurance in this state as to any insurer |
2673
|
if any person, including any subscriber, stockholder, or |
2674
|
incorporator, who exercises or has the ability to exercise |
2675
|
effective control of the insurer, or who influences or has the |
2676
|
ability to influence the transaction of the business of the |
2677
|
insurer, does not possess the financial standing and business |
2678
|
experience for the successful operation of the insurer. |
2679
|
(c) The officedepartmentmay deny, suspend, or revoke the |
2680
|
authority to transact insurance in this state of any insurer if |
2681
|
any person, including any subscriber, stockholder, or |
2682
|
incorporator, who exercises or has the ability to exercise |
2683
|
effective control of the insurer, or who influences or has the |
2684
|
ability to influence the transaction of the business of the |
2685
|
insurer, has been found guilty of, or has pleaded guilty or nolo |
2686
|
contendere to, any felony or crime punishable by imprisonment of |
2687
|
1 year or more under the law of the United States or any state |
2688
|
thereof or under the law of any other country which involves |
2689
|
moral turpitude, without regard to whether a judgment of |
2690
|
conviction has been entered by the court having jurisdiction in |
2691
|
such case. However, in the case of an insurer operating under a |
2692
|
subsisting certificate of authority, the insurer shall remove |
2693
|
any such person immediately upon discovery of the conditions set |
2694
|
forth in this paragraph when applicable to such person or upon |
2695
|
the order of the officedepartment, and the failure to so act by |
2696
|
said insurer shall be grounds for revocation or suspension of |
2697
|
the insurer's certificate of authority. |
2698
|
(d) The officedepartmentmay deny, suspend, or revoke the |
2699
|
authority of an insurer to transact insurance in this state if |
2700
|
any person, including any subscriber, stockholder, or |
2701
|
incorporator, who exercises or has the ability to exercise |
2702
|
effective control of the insurer, or who influences or has the |
2703
|
ability to influence the transaction of the business of the |
2704
|
insurer, which person the officedepartmenthas good reason to |
2705
|
believe is now or was in the past affiliated directly or |
2706
|
indirectly, through ownership interest of 10 percent or more, |
2707
|
control, or reinsurance transactions, with any business, |
2708
|
corporation, or other entity that has been found guilty of or |
2709
|
has pleaded guilty or nolo contendere to any felony or crime |
2710
|
punishable by imprisonment for 1 year or more under the laws of |
2711
|
the United States, any state, or any other country, regardless |
2712
|
of adjudication. However, in the case of an insurer operating |
2713
|
under a subsisting certificate of authority, the insurer shall |
2714
|
immediately remove such person or immediately notify the office |
2715
|
departmentof such person upon discovery of the conditions set |
2716
|
forth in this paragraph, either when applicable to such person |
2717
|
or upon order of the officedepartment; the failure to remove |
2718
|
such person, provide such notice, or comply with such order |
2719
|
constitutes grounds for suspension or revocation of the |
2720
|
insurer's certificate of authority. |
2721
|
(4)(a) No authorized insurer shall act as a fronting |
2722
|
company for any unauthorized insurer which is not an approved |
2723
|
reinsurer. |
2724
|
(b) A "fronting company" is an authorized insurer which by |
2725
|
reinsurance or otherwise generally transfers more than 50 |
2726
|
percent to one unauthorized insurer which does not meet the |
2727
|
requirements of s. 624.610(3)(a), (b), or (c), or more than 75 |
2728
|
percent to two or more unauthorized insurers which do not meet |
2729
|
the requirements of s. 624.610(3)(a), (b), or (c), of the entire |
2730
|
risk of loss on all of the insurance written by it in this |
2731
|
state, or on one or more lines of insurance, on all of the |
2732
|
business produced through one or more agents or agencies, or on |
2733
|
all of the business from a designated geographical territory, |
2734
|
without obtaining the prior approval of the officedepartment. |
2735
|
(c) The officedepartmentmay, in its discretion, approve |
2736
|
a transfer of risk in excess of the limits in paragraph (b) upon |
2737
|
presentation of evidence, satisfactory to the officedepartment, |
2738
|
that the transfer would be in the best interests of the |
2739
|
financial condition of the insurer and in the best interests of |
2740
|
the policyholders. |
2741
|
(5) No insurer shall be authorized to transact insurance |
2742
|
in this state which, during the 3 years immediately preceding |
2743
|
its application for a certificate of authority, has violated any |
2744
|
of the insurance laws of this state and after being informed of |
2745
|
such violation has failed to correct the same; except that, if |
2746
|
all other requirements are met, the officedepartmentmay |
2747
|
nevertheless issue a certificate of authority to such an insurer |
2748
|
upon the filing by the insurer of a sworn statement of all such |
2749
|
insurance so written in violation of law, and upon payment to |
2750
|
the officedepartmentof a sum of money as additional filing fee |
2751
|
equivalent to all premium taxes and other state taxes and fees |
2752
|
as would have been payable by the insurer if such insurance had |
2753
|
been lawfully written by an authorized insurer under the laws of |
2754
|
this state. This fee, when collected, shall be deposited to the |
2755
|
credit of the Insurance Commissioner'sRegulatory Trust Fund. |
2756
|
(7) For the purpose of satisfying the requirements of ss. |
2757
|
624.407 and 624.408, the investment portfolio of an insurer |
2758
|
applying for an initial certificate of authority to do business |
2759
|
in this state shall value its bonds and stocks in accordance |
2760
|
with the provisions of the latest edition of the publication |
2761
|
"Purposes and Procedures Manual of the NAIC Securities Valuation |
2762
|
Office""Valuations of Securities"by the National Association |
2763
|
of Insurance Commissioners, July 1, 20021990, and subsequent |
2764
|
amendments thereto, if the valuation methodology remains |
2765
|
substantially unchanged. |
2766
|
Section 30. Subsection (1) of section 624.4072, Florida |
2767
|
Statutes, is amended to read: |
2768
|
624.4072 Minority-owned property and casualty insurers; |
2769
|
limited exemption for taxation and assessments.-- |
2770
|
(1) A minority business that is at least 51 percent owned |
2771
|
by minority persons, as defined in s. 288.703(3), initially |
2772
|
issued a certificate of authority in this state as an authorized |
2773
|
insurer after May 1, 1998, and before January 1, 2002, to write |
2774
|
property and casualty insurance shall be exempt, for a period |
2775
|
not to exceed 10 years from the date of receiving its |
2776
|
certificate of authority, from the following taxes and |
2777
|
assessments: |
2778
|
(a) Taxes imposed under ss. 175.101, 185.08, and 624.509; |
2779
|
(b) Assessments by the Citizens Property Insurance |
2780
|
CorporationFlorida Residential Property and Casualty Joint |
2781
|
Underwriting Association or by the Florida Windstorm |
2782
|
Underwriting Association, as provided under s. 627.351, except |
2783
|
for emergency assessments collected from policyholders pursuant |
2784
|
to s. 627.351(6)(b)3.d.s. 627.351(2)(b)2.d.(III) and(6)(b)3.d. |
2785
|
Any such insurer shall be a member insurer of the Citizens |
2786
|
Property Insurance CorporationFlorida Windstorm Underwriting |
2787
|
Association and the Florida Residential Property and Casualty |
2788
|
Joint Underwriting Association. The premiums of such insurer |
2789
|
shall be included in determining, for the Citizens Property |
2790
|
Insurance CorporationFlorida Windstorm Underwriting |
2791
|
Association, the aggregate statewide direct written premium for |
2792
|
property insurance and in determining, for the Florida |
2793
|
Residential Property and Casualty Joint Underwriting |
2794
|
Association, the aggregate statewide direct written premium for |
2795
|
the subject lines of business for all member insurers. |
2796
|
Section 31. Subsection (1) of section 624.413, Florida |
2797
|
Statutes, is amended to read: |
2798
|
624.413 Application for certificate of authority.-- |
2799
|
(1) To apply for a certificate of authority, an insurer |
2800
|
shall file its application therefor with the officedepartment, |
2801
|
upon a form adopted by the commission and furnished by the |
2802
|
officeit, showing its name; location of its home office and, if |
2803
|
an alien insurer, its principal office in the United States; |
2804
|
kinds of insurance to be transacted; state or country of |
2805
|
domicile; and such additional information as the commission |
2806
|
department may reasonably requiresrequire, together with the |
2807
|
following documents: |
2808
|
(a) One copy of its corporate charter, articles of |
2809
|
incorporation, existing and proposed nonfacultative reinsurance |
2810
|
contracts, declaration of trust, or other charter documents, |
2811
|
with all amendments thereto, certified by the public official |
2812
|
with whom the originals are on file in the state or country of |
2813
|
domicile. |
2814
|
(b) If a mutual insurer, a copy of its bylaws, as amended, |
2815
|
certified by its secretary or other officer having custody |
2816
|
thereof. |
2817
|
(c) If a foreign or alien reciprocal insurer, a copy of |
2818
|
the power of attorney of its attorney in fact and of its |
2819
|
subscribers' agreement, if any, certified by the attorney in |
2820
|
fact; and, if a domestic reciprocal insurer, the declaration |
2821
|
provided for in s. 629.081. |
2822
|
(d) A copy of its financial statement as of December 31 |
2823
|
next preceding, containing information generally included in |
2824
|
insurer financial statements prepared in accordance with |
2825
|
generally accepted insurance accounting principles and practices |
2826
|
and in a form generally utilized by insurers for financial |
2827
|
statements, sworn to by at least two executive officers of the |
2828
|
insurer, or certified by the public official having supervision |
2829
|
of insurance in the insurer's state of domicile or of entry into |
2830
|
the United States. To facilitate uniformity in financial |
2831
|
statements, the commissiondepartmentmay by rule adopt the form |
2832
|
for financial statements approved by the National Association of |
2833
|
Insurance Commissioners in 20021990, and may adopt subsequent |
2834
|
amendments thereto if the form remains substantially consistent. |
2835
|
(e) Supplemental quarterly financial statements for each |
2836
|
calendar quarter since the beginning of the year of its |
2837
|
application for the certificate of authority, sworn to by at |
2838
|
least two of its executive officers. To facilitate uniformity in |
2839
|
financial statements, the commissiondepartmentmay by rule |
2840
|
adopt the form for quarterly financial statements approved by |
2841
|
the National Association of Insurance Commissioners in 2002 |
2842
|
1990, and may adopt subsequent amendments thereto if the form |
2843
|
remains substantially consistent. |
2844
|
(f) If a foreign or alien insurer, a copy of the report of |
2845
|
the most recent examination of the insurer certified by the |
2846
|
public official having supervision of insurance in its state of |
2847
|
domicile or of entry into the United States. The end of the |
2848
|
most recent year covered by the examination must be within the |
2849
|
3-year period preceding the date of application. In lieu of the |
2850
|
certified examination report, the officedepartmentmay accept |
2851
|
an audited certified public accountant's report prepared on a |
2852
|
basis consistent with the insurance laws of the insurer's state |
2853
|
of domicile, certified by the public official having supervision |
2854
|
of insurance in its state of domicile or of entry into the |
2855
|
United States. |
2856
|
(g) If a foreign or alien insurer, a certificate of |
2857
|
compliance from the public official having supervision of |
2858
|
insurance in its state or country of domicile showing that it is |
2859
|
duly organized and authorized to transact insurance therein and |
2860
|
the kinds of insurance it is so authorized to transact. |
2861
|
(h) If a foreign or alien insurer, a certificate of the |
2862
|
public official having custody of any deposit maintained by the |
2863
|
insurer in another state in lieu of a deposit or part thereof |
2864
|
required in this state under s. 624.411 or s. 624.412, showing |
2865
|
the amount of such deposit and the assets or securities of which |
2866
|
comprised. |
2867
|
(i) If a life insurer, a certificate of valuation. |
2868
|
(j) If an alien insurer, a copy of the appointment and |
2869
|
authority of its United States manager, certified by its officer |
2870
|
having custody of its records. |
2871
|
Section 32. Section 624.424, Florida Statutes, is amended |
2872
|
to read: |
2873
|
624.424 Annual statement and other information.-- |
2874
|
(1)(a) Each authorized insurer shall file with the office |
2875
|
departmentfull and true statements of its financial condition, |
2876
|
transactions, and affairs. An annual statement covering the |
2877
|
preceding calendar year shall be filed on or before March 1, and |
2878
|
quarterly statements covering the periods ending on March 31, |
2879
|
June 30, and September 30 shall be filed within 45 days after |
2880
|
each such date. The officedepartmentmay, for good cause, grant |
2881
|
an extension of time for filing of an annual or quarterly |
2882
|
statement. The statements shall contain information generally |
2883
|
included in insurers' financial statements prepared in |
2884
|
accordance with generally accepted insurance accounting |
2885
|
principles and practices and in a form generally utilized by |
2886
|
insurers for financial statements, sworn to by at least two |
2887
|
executive officers of the insurer or, if a reciprocal insurer, |
2888
|
by the oath of the attorney in fact or its like officer if a |
2889
|
corporation. To facilitate uniformity in financial statements |
2890
|
and to facilitate officedepartment analysis, the commission |
2891
|
departmentmay by rule adopt the form for financial statements |
2892
|
approved by the National Association of Insurance Commissioners |
2893
|
in 20021990, and may adopt subsequent amendments thereto if the |
2894
|
methodology remains substantially consistent, and may by rule |
2895
|
require each insurer to submit to the officedepartmentor such |
2896
|
organization as the officedepartmentmay designate all or part |
2897
|
of the information contained in the financial statement in a |
2898
|
computer-readable form compatible with the electronic data |
2899
|
processing system specified by the officedepartment. |
2900
|
(b) Each insurer's annual statement must contain a |
2901
|
statement of opinion on loss and loss adjustment expense |
2902
|
reserves made by a member of the American Academy of Actuaries |
2903
|
or by a qualified loss reserve specialist, under criteria |
2904
|
established by rule of the commissiondepartment. In adopting |
2905
|
the rule, the commissiondepartmentmust consider any criteria |
2906
|
established by the National Association of Insurance |
2907
|
Commissioners. The officedepartmentmay require semiannual |
2908
|
updates of the annual statement of opinion as to a particular |
2909
|
insurer if the officedepartmenthas reasonable cause to believe |
2910
|
that such reserves are understated to the extent of materially |
2911
|
misstating the financial position of the insurer. Workpapers in |
2912
|
support of the statement of opinion must be provided to the |
2913
|
officedepartmentupon request. This paragraph does not apply to |
2914
|
life insurance or title insurance. |
2915
|
(c) The commissiondepartmentmay by rule require reports |
2916
|
or filings required under the insurance code to be submitted on |
2917
|
a computer-diskette compatible with the electronic data |
2918
|
processing equipment specified by the commissiondepartment. |
2919
|
(2) The statement of an alien insurer shall be verified by |
2920
|
the insurer's United States manager or other officer duly |
2921
|
authorized. It shall be a separate statement, to be known as |
2922
|
its general statement, of its transactions, assets, and affairs |
2923
|
within the United States unless the officedepartmentrequires |
2924
|
otherwise. If the officedepartmentrequires a statement as to |
2925
|
the insurer's affairs elsewhere, the insurer shall file such |
2926
|
statement with the officedepartmentas soon as reasonably |
2927
|
possible. |
2928
|
(3) Each insurer having a deposit as required under s. |
2929
|
624.411 shall file with the officedepartmentannually with its |
2930
|
annual statement a certificate to the effect that the assets so |
2931
|
deposited have a market value equal to or in excess of the |
2932
|
amount of deposit so required. |
2933
|
(4) At the time of filing, the insurer shall pay the fee |
2934
|
for filing its annual statement in the amount specified in s. |
2935
|
624.501. |
2936
|
(5) The officedepartmentmay refuse to continue, or may |
2937
|
suspend or revoke, the certificate of authority of an insurer |
2938
|
failing to file its annual or quarterly statements and |
2939
|
accompanying certificates when due. |
2940
|
(6) In addition to information called for and furnished in |
2941
|
connection with its annual or quarterly statements, an insurer |
2942
|
shall furnish to the officedepartmentas soon as reasonably |
2943
|
possible such information as to its transactions or affairs as |
2944
|
the officedepartmentmay from time to time request in writing. |
2945
|
All such information furnished pursuant to the office's |
2946
|
department'srequest shall be verified by the oath of two |
2947
|
executive officers of the insurer or, if a reciprocal insurer, |
2948
|
by the oath of the attorney in fact or its like officers if a |
2949
|
corporation. |
2950
|
(7) The signatures of all such persons when written on |
2951
|
annual or quarterly statements or other reports required by this |
2952
|
section shall be presumed to have been so written by authority |
2953
|
of the person whose signature is affixed thereon. The affixing |
2954
|
of any signature by anyone other than the purported signer |
2955
|
constitutes a felony of the second degree, punishable as |
2956
|
provided in s. 775.082, s. 775.083, or s. 775.084. |
2957
|
(8)(a) All authorized insurers must have conducted an |
2958
|
annual audit by an independent certified public accountant and |
2959
|
must file an audited financial report with the officedepartment |
2960
|
on or before June 1 for the preceding year ending December 31. |
2961
|
The officedepartmentmay require an insurer to file an audited |
2962
|
financial report earlier than June 1 upon 90 days' advance |
2963
|
notice to the insurer. The officedepartmentmay immediately |
2964
|
suspend an insurer's certificate of authority by order if an |
2965
|
insurer's failure to file required reports, financial |
2966
|
statements, or information required by this subsection or rule |
2967
|
adopted pursuant thereto creates a significant uncertainty as to |
2968
|
the insurer's continuing eligibility for a certificate of |
2969
|
authority. |
2970
|
(b) Any authorized insurer otherwise subject to this |
2971
|
section having direct premiums written in this state of less |
2972
|
than $1 million in any calendar year and fewerlessthan 1,000 |
2973
|
policyholders or certificateholders of directly written policies |
2974
|
nationwide at the end of such calendar year is exempt from this |
2975
|
section for such year unless the officedepartmentmakes a |
2976
|
specific finding that compliance is necessary in order for the |
2977
|
officedepartmentto carry out its statutory responsibilities. |
2978
|
However, any insurer having assumed premiums pursuant to |
2979
|
contracts or treaties or reinsurance of $1 million or more is |
2980
|
not exempt. Any insurer subject to an exemption must submit by |
2981
|
March 1 following the year to which the exemption applies an |
2982
|
affidavit sworn to by a responsible officer of the insurer |
2983
|
specifying the amount of direct premiums written in this state |
2984
|
and number of policyholders or certificateholders. |
2985
|
(c) The board of directors of an insurer shall hire the |
2986
|
certified public accountant that prepares the audit required by |
2987
|
this subsection and the board shall establish an audit committee |
2988
|
of three or more directors of the insurer or an affiliated |
2989
|
company. The audit committee shall be responsible for discussing |
2990
|
audit findings and interacting with the certified public |
2991
|
accountant with regard to her or his findings. The audit |
2992
|
committee shall be comprised solely of members who are free from |
2993
|
any relationship that, in the opinion of its board of directors, |
2994
|
would interfere with the exercise of independent judgment as a |
2995
|
committee member. The audit committee shall report to the board |
2996
|
any findings of adverse financial conditions or significant |
2997
|
deficiencies in internal controls that have been noted by the |
2998
|
accountant. The insurer may request the officedepartmentto |
2999
|
waive this requirement of the audit committee membership based |
3000
|
upon unusual hardship to the insurer. |
3001
|
(d) An insurer may not use the same accountant or partner |
3002
|
of an accounting firm responsible for preparing the report |
3003
|
required by this subsection for more than 7 consecutive years. |
3004
|
Following this period, the insurer may not use such accountant |
3005
|
or partner for a period of 2 years, but may use another |
3006
|
accountant or partner of the same firm. An insurer may request |
3007
|
the officedepartmentto waive this prohibition based upon an |
3008
|
unusual hardship to the insurer and a determination that the |
3009
|
accountant is exercising independent judgment that is not unduly |
3010
|
influenced by the insurer considering such factors as the number |
3011
|
of partners, expertise of the partners or the number of |
3012
|
insurance clients of the accounting firm; the premium volume of |
3013
|
the insurer; and the number of jurisdictions in which the |
3014
|
insurer transacts business. |
3015
|
(e) The commissiondepartmentshall adopt rules to |
3016
|
implement this subsection, which rules must be in substantial |
3017
|
conformity with the 19981990Model Rule Requiring Annual |
3018
|
Audited Financial Reports adopted by the National Association of |
3019
|
Insurance Commissioners, except where inconsistent with the |
3020
|
requirements of this subsection. Any exception to, waiver of, or |
3021
|
interpretation of accounting requirements of the commission |
3022
|
departmentmust be in writing and signed by an authorized |
3023
|
representative of the officedepartment. No insurer may raise as |
3024
|
a defense in any action, any exception to, waiver of, or |
3025
|
interpretation of accounting requirements, unless previously |
3026
|
issued in writing by an authorized representative of the office |
3027
|
department. |
3028
|
(9)(a) Each authorized insurer shall, pursuant to s. |
3029
|
409.910(20), provide records and information to the Agency for |
3030
|
Health Care Administration to identify potential insurance |
3031
|
coverage for claims filed with that agency and its fiscal agents |
3032
|
for payment of medical services under the Medicaid program. |
3033
|
(b) Each authorized insurer shall, pursuant to s. |
3034
|
409.2561(5)(c), notify the Medicaid agency of a cancellation or |
3035
|
discontinuance of a policy within 30 days if the insurer |
3036
|
received notification from the Medicaid agency to do so. |
3037
|
(c) Any information provided by an insurer under this |
3038
|
subsection does not violate any right of confidentiality or |
3039
|
contract that the insurer may have with covered persons. The |
3040
|
insurer is immune from any liability that it may otherwise incur |
3041
|
through its release of such information to the Agency for Health |
3042
|
Care Administration. |
3043
|
(10) Each insurer or insurer group doing business in this |
3044
|
state shall file on a quarterly basis in conjunction with |
3045
|
financial reports required by paragraph (1)(a) a supplemental |
3046
|
report on an individual and group basis on a form prescribed by |
3047
|
the commissiondepartmentwith information on personal lines and |
3048
|
commercial lines residential property insurance policies in this |
3049
|
state. The supplemental report shall include separate |
3050
|
information for personal lines property policies and for |
3051
|
commercial lines property policies and totals for each item |
3052
|
specified, including premiums written for each of the property |
3053
|
lines of business as described in ss. 215.555(2)(c) and |
3054
|
627.351(6)(a). The report shall include the following |
3055
|
information for each county on a monthly basis: |
3056
|
(a) Total number of policies in force at the end of each |
3057
|
month. |
3058
|
(b) Total number of policies canceled. |
3059
|
(c) Total number of policies nonrenewed. |
3060
|
(d) Number of policies canceled due to hurricane risk. |
3061
|
(e) Number of policies nonrenewed due to hurricane risk. |
3062
|
(f) Number of new policies written. |
3063
|
(g) Total dollar value of structure exposure under |
3064
|
policies that include wind coverage. |
3065
|
(h) Number of policies that exclude wind coverage. |
3066
|
Section 33. Subsections (2), (3), and (4) of section |
3067
|
624.476, Florida Statutes, are amended to read: |
3068
|
624.476 Impaired self-insurance funds.-- |
3069
|
(2) If any fund levies an assessment pursuant to |
3070
|
subsection (1), the officedepartmentshall require the fund to |
3071
|
consent to administrative supervision under part VI of this |
3072
|
chapter. The officedepartmentmay waive the requirement to |
3073
|
consent to administrative supervision for good cause. |
3074
|
(3) If the trustees fail to make an assessment as required |
3075
|
by subsection(1), the officedepartmentshall order the trustees |
3076
|
to do so. If the deficiency is not sufficiently made up within |
3077
|
60 days after the date of the order, the fund shall be deemed |
3078
|
insolvent and grounds shall exist to proceed against the fund as |
3079
|
provided for in part I of chapter 631. |
3080
|
(4) Notwithstanding the requirement of the fund to make an |
3081
|
assessment pursuant to subsection (1) or subsection (3), the |
3082
|
officedepartment may at any time request that the departmentto |
3083
|
be appointed receiver for purposes of rehabilitation or |
3084
|
liquidation if it is able to demonstrate that any grounds for |
3085
|
rehabilitation or liquidation exist pursuant to s. 631.051 or s. |
3086
|
631.061. |
3087
|
Section 34. Section 624.477, Florida Statutes, is amended |
3088
|
to read: |
3089
|
624.477 Liquidation, rehabilitation, reorganization, and |
3090
|
conservation.--Any rehabilitation, liquidation, conservation, or |
3091
|
dissolution of a self-insurance fund shall be conducted under |
3092
|
the supervision of the office and department, which shall each |
3093
|
have all power with respect thereto granted to the fund under |
3094
|
part I of chapter 631 governing the rehabilitation, liquidation, |
3095
|
conservation, or dissolution of insurers and including all |
3096
|
grounds for the appointment of a receiver contained in ss. |
3097
|
631.051 and 631.061. |
3098
|
Section 35. Section 625.01115, Florida Statutes, is |
3099
|
amended to read: |
3100
|
625.01115 Definitions.--As used in this chapter, the term |
3101
|
"statutory accounting principles" means accounting principles as |
3102
|
defined in the National Association of Insurance Commissioners |
3103
|
Accounting Practices and Procedures Manual as of March 2002 and |
3104
|
subsequent amendments thereto if the methodology remains |
3105
|
substantially consistenteffective January 1, 2001. |
3106
|
Section 36. Subsections (2), (3), and (4), paragraphs (c), |
3107
|
(d), (g), (h), (i), and (j) of subsection (5), paragraph (e) of |
3108
|
subsection (6), subsection (10), paragraph(b) of subsection |
3109
|
(12), and subsection (14) of section 625.121, Florida Statutes, |
3110
|
are amended to read: |
3111
|
625.121 Standard Valuation Law; life insurance.-- |
3112
|
(2) ANNUAL VALUATION.--The officedepartmentshall |
3113
|
annually value, or cause to be valued, the reserve liabilities, |
3114
|
hereinafter called "reserves," for all outstanding life |
3115
|
insurance policies and annuity and pure endowment contracts of |
3116
|
every life insurer doing business in this state, and may certify |
3117
|
the amount of any such reserves, specifying the mortality table |
3118
|
or tables, rate or rates of interest, and methods, net-level |
3119
|
premium method or others, used in the calculation of such |
3120
|
reserves. In the case of an alien insurer, such valuation shall |
3121
|
be limited to its insurance transactions in the United States. |
3122
|
In calculating such reserves, the officedepartmentmay use |
3123
|
group methods and approximate averages for fractions of a year |
3124
|
or otherwise. It may accept in its discretion the insurer's |
3125
|
calculation of such reserves. In lieu of the valuation of the |
3126
|
reserves herein required of any foreign or alien insurer, it may |
3127
|
accept any valuation made or caused to be made by the insurance |
3128
|
supervisory official of any state or other jurisdiction when |
3129
|
such valuation complies with the minimum standard herein |
3130
|
provided and if the official of such state or jurisdiction |
3131
|
accepts as sufficient and valid for all legal purposes the |
3132
|
certificate of valuation of the officedepartmentwhen such |
3133
|
certificate states the valuation to have been made in a |
3134
|
specified manner according to which the aggregate reserves would |
3135
|
be at least as large as if they had been computed in the manner |
3136
|
prescribed by the law of that state or jurisdiction. When any |
3137
|
such valuation is made by the officedepartment, it may use the |
3138
|
actuary of the officedepartmentor employ an actuary for the |
3139
|
purpose; and the reasonable compensation of the actuary, at a |
3140
|
rate approved by the officedepartment, and reimbursement of |
3141
|
travel expenses pursuant to s. 624.320 upon demand by the office |
3142
|
department, supported by an itemized statement of such |
3143
|
compensation and expenses, shall be paid by the insurer. When a |
3144
|
domestic insurer furnishes the officedepartmentwith a |
3145
|
valuation of its outstanding policies as computed by its own |
3146
|
actuary or by an actuary deemed satisfactory for the purpose by |
3147
|
the officedepartment, the valuation shall be verified by the |
3148
|
actuary of the officedepartmentwithout cost to the insurer. |
3149
|
(3) ACTUARIAL OPINION OF RESERVES.-- |
3150
|
(a)1. Each life insurance company doing business in this |
3151
|
state shall annually submit the opinion of a qualified actuary |
3152
|
as to whether the reserves and related actuarial items held in |
3153
|
support of the policies and contracts specified by the |
3154
|
commissiondepartmentby rule are computed appropriately, are |
3155
|
based on assumptions which satisfy contractual provisions, are |
3156
|
consistent with prior reported amounts, and comply with |
3157
|
applicable laws of this state. The commissiondepartmentby rule |
3158
|
shall define the specifics of this opinion and add any other |
3159
|
items determined to be necessary to its scope. |
3160
|
2. The opinion shall be submitted with the annual |
3161
|
statement reflecting the valuation of such reserve liabilities |
3162
|
for each year ending on or after December 31, 1992. |
3163
|
3. The opinion shall apply to all business in force, |
3164
|
including individual and group health insurance plans, in the |
3165
|
form and substance acceptable to the officedepartmentas |
3166
|
specified by rule of the commission. |
3167
|
4. The commissiondepartmentmay adopt rules providing the |
3168
|
standards of the actuarial opinion consistent with standards |
3169
|
adopted by the Actuarial Standards Board on December 31, 2002 |
3170
|
October 1, 1991, and subsequent revisions thereto, provided that |
3171
|
the standards remain substantially consistent. |
3172
|
5. In the case of an opinion required to be submitted by a |
3173
|
foreign or alien company, the officedepartmentmay accept the |
3174
|
opinion filed by that company with the insurance supervisory |
3175
|
official of another state if the officedepartmentdetermines |
3176
|
that the opinion reasonably meets the requirements applicable to |
3177
|
a company domiciled in this state. |
3178
|
6. For the purposes of this subsection, "qualified |
3179
|
actuary" means a member in good standing of the American Academy |
3180
|
of Actuaries who also meets the requirements specified by rule |
3181
|
of the commissiondepartment. |
3182
|
7. Disciplinary action by the officedepartmentagainst |
3183
|
the company or the qualified actuary shall be in accordance with |
3184
|
the insurance code and related rules adopted by the commission |
3185
|
department. |
3186
|
8. A memorandum in the form and substance specified by |
3187
|
rule shall be prepared to support each actuarial opinion. |
3188
|
9. If the insurance company fails to provide a supporting |
3189
|
memorandum at the request of the officedepartmentwithin a |
3190
|
period specified by rule of the commission, or if the office |
3191
|
departmentdetermines that the supporting memorandum provided by |
3192
|
the insurance company fails to meet the standards prescribed by |
3193
|
rule of the commission, the officedepartmentmay engage a |
3194
|
qualified actuary at the expense of the company to review the |
3195
|
opinion and the basis for the opinion and prepare such |
3196
|
supporting memorandum as is required by the officedepartment. |
3197
|
10. Except as otherwise provided in this paragraph, any |
3198
|
memorandum or other material in support of the opinion is |
3199
|
confidential and exempt from the provisions of s. 119.07(1); |
3200
|
however, the memorandum or other material may be released by the |
3201
|
officedepartmentwith the written consent of the company, or to |
3202
|
the American Academy of Actuaries upon request stating that the |
3203
|
memorandum or other material is required for the purpose of |
3204
|
professional disciplinary proceedings and setting forth |
3205
|
procedures satisfactory to the officedepartmentfor preserving |
3206
|
the confidentiality of the memorandum or other material. If any |
3207
|
portion of the confidential memorandum is cited by the company |
3208
|
in its marketing or is cited before any governmental agency |
3209
|
other than a state insurance department or is released by the |
3210
|
company to the news media, no portion of the memorandum is |
3211
|
confidential. |
3212
|
(b) In addition to the opinion required by subparagraph |
3213
|
(a)1., the officedepartment may, pursuant to commissionby |
3214
|
rule,require an opinion of the same qualified actuary as to |
3215
|
whether the reserves and related actuarial items held in support |
3216
|
of the policies and contracts specified by the commission |
3217
|
departmentby rule, when considered in light of the assets held |
3218
|
by the company with respect to the reserves and related |
3219
|
actuarial items, including but not limited to the investment |
3220
|
earnings on the assets and considerations anticipated to be |
3221
|
received and retained under the policies and contracts, make |
3222
|
adequate provision for the company's obligations under the |
3223
|
policies and contracts, including, but not limited to, the |
3224
|
benefits under, and expenses associated with, the policies and |
3225
|
contracts. |
3226
|
(c) The commissiondepartmentmay provide by rule for a |
3227
|
transition period for establishing any higher reserves which the |
3228
|
qualified actuary may deem necessary in order to render the |
3229
|
opinion required by this subsection. |
3230
|
(4) MINIMUM STANDARD FOR VALUATION OF POLICIES AND |
3231
|
CONTRACTS ISSUED BEFORE OPERATIVE DATE OF STANDARD NONFORFEITURE |
3232
|
LAW.--The minimum standard for the valuation of all such |
3233
|
policies and contracts issued prior to the operative date of s. |
3234
|
627.476 (Standard Nonforfeiture Law) shall be any basis |
3235
|
satisfactory to the officedepartment. Any basis satisfactory to |
3236
|
the former Department of Insuranceon the effective date of this |
3237
|
code shall be deemed to meet such minimum standards. |
3238
|
(5) MINIMUM STANDARD FOR VALUATION OF POLICIES AND |
3239
|
CONTRACTS ISSUED ON OR AFTER OPERATIVE DATE OF STANDARD |
3240
|
NONFORFEITURE LAW.--Except as otherwise provided in paragraph |
3241
|
(h) and subsections (6), (11), and (14), the minimum standard |
3242
|
for the valuation of all such policies and contracts issued on |
3243
|
or after the operative date of s. 627.476 (Standard |
3244
|
Nonforfeiture Law for Life Insurance) shall be the |
3245
|
commissioners' reserve valuation method defined in subsections |
3246
|
(7), (11), and (14); 5 percent interest for group annuity and |
3247
|
pure endowment contracts and 3.5 percent interest for all other |
3248
|
such policies and contracts, or in the case of life insurance |
3249
|
policies and contracts, other than annuity and pure endowment |
3250
|
contracts, issued on or after July 1, 1973, 4 percent interest |
3251
|
for such policies issued prior to October 1, 1979, and 4.5 |
3252
|
percent interest for such policies issued on or after October 1, |
3253
|
1979; and the following tables: |
3254
|
(c) For individual annuity and pure endowment contracts, |
3255
|
excluding any disability and accidental death benefits in such |
3256
|
policies, the 1937 Standard Annuity Mortality Table or, at the |
3257
|
option of the insurer, the Annuity Mortality Table for 1949, |
3258
|
Ultimate, or any modification of either of these tables approved |
3259
|
by the officedepartment. |
3260
|
(d) For group annuity and pure endowment contracts, |
3261
|
excluding any disability and accidental death benefits in such |
3262
|
policies, the Group Annuity Mortality Table for 1951; any |
3263
|
modification of such table approved by the officedepartment; |
3264
|
or, at the option of the insurer, any of the tables or |
3265
|
modifications of tables specified for individual annuity and |
3266
|
pure endowment contracts. |
3267
|
(g) For group life insurance, life insurance issued on the |
3268
|
substandard basis, and other special benefits, such tables as |
3269
|
may be approved by the officedepartmentas being sufficient |
3270
|
with relation to the benefits provided by such policies. |
3271
|
(h) Except as provided in subsection (6), the minimum |
3272
|
standard for the valuation of all individual annuity and pure |
3273
|
endowment contracts issued on or after the operative date of |
3274
|
this paragraph and for all annuities and pure endowments |
3275
|
purchased on or after such operative date under group annuity |
3276
|
and pure endowment contracts shall be the commissioners' reserve |
3277
|
valuation method defined in subsection (7) and the following |
3278
|
tables and interest rates: |
3279
|
1. For individual annuity and pure endowment contracts |
3280
|
issued prior to October 1, 1979, excluding any disability and |
3281
|
accidental death benefits in such contracts, the 1971 Individual |
3282
|
Annuity Mortality Table, or any modification of this table |
3283
|
approved by the officedepartment, and 6 percent interest for |
3284
|
single-premium immediate annuity contracts and 4 percent |
3285
|
interest for all other individual annuity and pure endowment |
3286
|
contracts. |
3287
|
2. For individual single-premium immediate annuity |
3288
|
contracts issued on or after October 1, 1979, and prior to |
3289
|
October 1, 1986, excluding any disability and accidental death |
3290
|
benefits in such contracts, the 1971 Individual Annuity |
3291
|
Mortality Table, or any modification of this table approved by |
3292
|
the officedepartment, and 7.5 percent interest. For such |
3293
|
contracts issued on or after October 1, 1986, the 1983 |
3294
|
Individual Annual Mortality Table, or any modification of such |
3295
|
table approved by the officedepartment, and the applicable |
3296
|
calendar year statutory valuation interest rate as described in |
3297
|
subsection (6). |
3298
|
3. For individual annuity and pure endowment contracts |
3299
|
issued on or after October 1, 1979, and prior to October 1, |
3300
|
1986, other than single-premium immediate annuity contracts, |
3301
|
excluding any disability and accidental death benefits in such |
3302
|
contracts, the 1971 Individual Annuity Mortality Table, or any |
3303
|
modification of this table approved by the officedepartment, |
3304
|
and 5.5 percent interest for single-premium deferred annuity and |
3305
|
pure endowment contracts and 4.5 percent interest for all other |
3306
|
such individual annuity and pure endowment contracts. For such |
3307
|
contracts issued on or after October 1, 1986, the 1983 |
3308
|
Individual Annual Mortality Table, or any modification of such |
3309
|
table approved by the officedepartment, and the applicable |
3310
|
calendar year statutory valuation interest rate as described in |
3311
|
subsection (6). |
3312
|
4. For all annuities and pure endowments purchased prior |
3313
|
to October 1, 1979, under group annuity and pure endowment |
3314
|
contracts, excluding any disability and accidental death |
3315
|
benefits purchased under such contracts, the 1971 Group Annuity |
3316
|
Mortality Table, or any modification of this table approved by |
3317
|
the officedepartment, and 6 percent interest. |
3318
|
5. For all annuities and pure endowments purchased on or |
3319
|
after October 1, 1979, and prior to October 1, 1986, under group |
3320
|
annuity and pure endowment contracts, excluding any disability |
3321
|
and accidental death benefits purchased under such contracts, |
3322
|
the 1971 Group Annuity Mortality Table, or any modification of |
3323
|
this table approved by the officedepartment, and 7.5 percent |
3324
|
interest. For such contracts purchased on or after October 1, |
3325
|
1986, the 1983 Group Annuity Mortality Table, or any |
3326
|
modification of such table approved by the officedepartment, |
3327
|
and the applicable calendar year statutory valuation interest |
3328
|
rate as described in subsection (6). |
3329
|
|
3330
|
|
3331
|
After July 1, 1973, any insurer may have filedfile with the |
3332
|
former Department of Insurancea written notice of its election |
3333
|
to comply with the provisions of this paragraph after a |
3334
|
specified date before January 1, 1979, which shall be the |
3335
|
operative date of this paragraph for such insurer. However, an |
3336
|
insurer may elect a different operative date for individual |
3337
|
annuity and pure endowment contracts from that elected for group |
3338
|
annuity and pure endowment contracts. If an insurer makes no |
3339
|
such election, the operative date of this paragraph for such |
3340
|
insurer shall be January 1, 1979. |
3341
|
(i) In lieu of the mortality tables specified in this |
3342
|
subsection, and subject to rules previously adopted by the |
3343
|
former Department of Insurance, the insurance company may, at |
3344
|
its option: |
3345
|
1. Substitute the applicable 1958 CSO or CET Smoker and |
3346
|
Nonsmoker Mortality Tables, in lieu of the 1980 CSO or CET |
3347
|
mortality table standard, for policies issued on or after the |
3348
|
operative date of s. 627.476(9) and before January 1, 1989. |
3349
|
2. Substitute the applicable 1980 CSO or CET Smoker and |
3350
|
Nonsmoker Mortality Tables in lieu of the 1980 CSO or CET |
3351
|
mortality table standard; |
3352
|
3. Use the Annuity 2000 Mortality Table for determining |
3353
|
the minimum standard of valuation for individual annuity and |
3354
|
pure endowment contracts issued on or after January 1, 1998, and |
3355
|
before July 1, 1998the operative date of this section until the |
3356
|
department, on a date certain that is on or after January 1, |
3357
|
1998, adopts by rule that table for determining the minimum |
3358
|
standard for valuation purposes. |
3359
|
4. Use the 1994 GAR Table for determining the minimum |
3360
|
standard of valuation for annuities and pure endowments |
3361
|
purchased on or after January 1, 1998, and before July 1, 1998, |
3362
|
the operative date of this sectionunder group annuity and pure |
3363
|
endowment contracts until the department, on a date certain that |
3364
|
is on or after January 1, 1998, adopts by rule that table for |
3365
|
determining the minimum standard for valuation purposes. |
3366
|
(j) The commissiondepartmentmay adopt by rule the model |
3367
|
regulation for valuation of life insurance policies as approved |
3368
|
by the National Association of Insurance Commissioners in March |
3369
|
1999, including tables of select mortality factors, and may make |
3370
|
the regulation effective for policies issued on or afterJanuary |
3371
|
1, 2000. |
3372
|
(6) MINIMUM STANDARD OF VALUATION.-- |
3373
|
(e) The interest rate index shall be the Moody's Corporate |
3374
|
Bond Yield Average-Monthly Average Corporates as published by |
3375
|
Moody's Investors Service, Inc., as long as this index is |
3376
|
calculated by using substantially the same methodology as used |
3377
|
by it on January 1, 1981. If Moody's corporate bond yield |
3378
|
average ceases to be calculated in this manner, the interest |
3379
|
rate index shall be the index approved by rule promulgated by |
3380
|
the commissiondepartment. The methodology used in determining |
3381
|
the index approved by rule shall be substantially the same as |
3382
|
the methodology employed on January 1, 1981, for determining |
3383
|
Moody's Corporate Bond Yield Average-Monthly Average Corporates |
3384
|
as published by Moody's Investors Services, Inc. |
3385
|
(10) LOWER VALUATIONS.--An insurer which at any time had |
3386
|
adopted any standard of valuation producing greater aggregate |
3387
|
reserves than those calculated according to the minimum standard |
3388
|
herein provided may, with the approval of the officedepartment, |
3389
|
adopt any lower standard of valuation, but not lower than the |
3390
|
minimum herein provided; however, for the purposes of this |
3391
|
subsection, the holding of additional reserves previously |
3392
|
determined by a qualified actuary to be necessary to render the |
3393
|
opinion required by subsection (3) shall not be deemed to be the |
3394
|
adoption of a higher standard of valuation. |
3395
|
(12) ALTERNATE METHOD FOR DETERMINING RESERVES IN CERTAIN |
3396
|
CASES.--In the case of any plan of life insurance which provides |
3397
|
for future premium determination, the amounts of which are to be |
3398
|
determined by the insurer based on then estimates of future |
3399
|
experience, or in the case of any plan of life insurance or |
3400
|
annuity which is of such a nature that the minimum reserves |
3401
|
cannot be determined by the methods described in subsection (7), |
3402
|
the reserves which are held under any such plan shall: |
3403
|
(b) Be computed by a method which is consistent with the |
3404
|
principles of this section, as determined by rules promulgated |
3405
|
by the commissiondepartment. |
3406
|
(14) MINIMUM STANDARDS FOR HEALTH PLANS.--The commission |
3407
|
departmentshall adopt a rule containing the minimum standards |
3408
|
applicable to the valuation of health plans in accordance with |
3409
|
sound actuarial principles. |
3410
|
Section 37. Subsections (1), (2), and (4) of section |
3411
|
625.151, Florida Statutes, are amended to read: |
3412
|
625.151 Valuation of other securities.-- |
3413
|
(1) Securities, other than those referred to in s. |
3414
|
625.141, held by an insurer shall be valued, in the discretion |
3415
|
of the officedepartment, at their market value, or at their |
3416
|
appraised value, or at prices determined by it as representing |
3417
|
their fair market value. |
3418
|
(2) Preferred or guaranteed stocks or shares while paying |
3419
|
full dividends may be carried at a fixed value in lieu of market |
3420
|
value, at the discretion of the officedepartmentand in |
3421
|
accordance with such method of valuation as it may approve. |
3422
|
(4) No valuations under this section shall be inconsistent |
3423
|
with any applicable valuation or method contained in the latest |
3424
|
edition of the publication "Valuation of Securities" published |
3425
|
by the National Association of Insurance Commissioners or its |
3426
|
successor organization; provided that such valuation methodology |
3427
|
is substantially similar to the methodology used by the National |
3428
|
Association of Insurance Commissioners in its July 1, 2002,1988 |
3429
|
edition of such publication. |
3430
|
Section 38. Section 625.317, Florida Statutes, is amended |
3431
|
to read: |
3432
|
625.317 Corporate bonds and debentures.--An insurer may |
3433
|
invest in bonds, notes, or other interest-bearing or interest- |
3434
|
accruing obligations of any solvent corporation organized under |
3435
|
the laws of the United States or Canada or under the laws of any |
3436
|
state, the District of Columbia, any territory or possession of |
3437
|
the United States, or any Province of Canada or in bonds or |
3438
|
notes issued by the Citizens Property Insurance Corporation as |
3439
|
authorized by s. 627.351(6)Florida Windstorm Underwriting |
3440
|
Association or a private nonprofit corporation, a private |
3441
|
nonprofit unincorporated association, or a nonprofit mutual |
3442
|
company organized by that association, all as authorized in s. |
3443
|
627.351(2)(c), or any subsidiary or affiliate thereof authorized |
3444
|
by the Department of Insurance to issue such bonds or notes. |
3445
|
Section 39. Subsection (4) of section 625.325, Florida |
3446
|
Statutes, is amended to read: |
3447
|
625.325 Investments in subsidiaries and related |
3448
|
corporations.-- |
3449
|
(4) DEBT OBLIGATIONS.--Debt obligations, other than |
3450
|
mortgage loans, made under the authority of this section must |
3451
|
meet amortization requirements in accordance with the latest |
3452
|
edition of the publication "Valuation of Securities" by the |
3453
|
National Association of Insurance Commissioners or its successor |
3454
|
organization; provided that such amortization methodology is |
3455
|
substantially similar to the methodology used by the National |
3456
|
Association of Insurance Commissioners in its July 1, 2002,1988 |
3457
|
edition of such publication. |
3458
|
Section 40. Subsections (6) and (11) of section 626.015, |
3459
|
Florida Statutes, are amended, and present subsections (7)-(19) |
3460
|
of said section are renumbered as subsections (6)-(18), |
3461
|
respectively, to read: |
3462
|
626.015 Definitions.--As used in this part: |
3463
|
(6) "Department" means the Department of Insurance.
|
3464
|
(10)(11)"License" means a document issued by the |
3465
|
department or officeauthorizing a person to be appointed to |
3466
|
transact insurance or adjust claims for the kind, line, or class |
3467
|
of insurance identified in the document. |
3468
|
Section 41. Section 626.016, Florida Statutes, is created |
3469
|
to read: |
3470
|
626.016 Powers and duties of department, commission, and |
3471
|
office.-- |
3472
|
(1) The powers and duties of the Chief Financial Officer |
3473
|
and the department specified in this chapter apply only with |
3474
|
respect to insurance agents, managing general agents, |
3475
|
reinsurance intermediaries, viatical settlement brokers, |
3476
|
customer representatives, service representatives, agencies, and |
3477
|
unlicensed persons subject to the regulatory jurisdiction of the |
3478
|
department. |
3479
|
(2) The powers and duties of the commission and office |
3480
|
specified in this chapter apply only with respect to insurance |
3481
|
adjusters, service companies, administrators, viatical |
3482
|
settlement providers and contracts, and unlicensed persons |
3483
|
subject to the regulatory jurisdiction of the commission and |
3484
|
office. |
3485
|
(3) The department has jurisdiction to enforce provisions |
3486
|
of this chapter with respect to persons who engage in actions |
3487
|
for which a license issued by the department is legally |
3488
|
required. The office has jurisdiction to enforce provisions of |
3489
|
this chapter with respect to persons who engage in actions for |
3490
|
which a license or certificate of authority issued by the office |
3491
|
is legally required. For persons who violate a provision of this |
3492
|
chapter for whom a license or certificate of authority issued by |
3493
|
either the department or office is not required, either the |
3494
|
department or office may take administrative action against such |
3495
|
person as authorized by this chapter, pursuant to agreement |
3496
|
between the office and department. |
3497
|
(4) Nothing in this section is intended to limit the |
3498
|
authority of the department and the Division of Insurance Fraud, |
3499
|
as specified in s. 626.989. |
3500
|
Section 42. Subsection (16) of section 626.025, Florida |
3501
|
Statutes, is amended to read: |
3502
|
626.025 Consumer protections.--To transact insurance, |
3503
|
agents shall comply with consumer protection laws, including the |
3504
|
following, as applicable: |
3505
|
(16) Any other licensing requirement, restriction, or |
3506
|
prohibition designated a consumer protection by the Chief |
3507
|
Financial OfficerInsurance Commissioner, but not inconsistent |
3508
|
with the requirements of Subtitle C of the Gramm-Leach-Bliley |
3509
|
Act, 15 U.S.C.A. ss. 6751 et seq. |
3510
|
Section 43. Paragraph (a) of subsection (1) of section |
3511
|
626.112, Florida Statutes, is amended to read: |
3512
|
626.112 License and appointment required; agents, customer |
3513
|
representatives, adjusters, insurance agencies, service |
3514
|
representatives, managing general agents.-- |
3515
|
(1)(a) No person may be, act as, or advertise or hold |
3516
|
himself or herself out to be an insurance agent, orcustomer |
3517
|
representative, or adjusterunless he or she is currently |
3518
|
licensed by the department and appointed by one or more |
3519
|
insurers. No person may be, act as, or advertise or hold himself |
3520
|
or herself out to be an insurance adjuster unless he or she is |
3521
|
currently licensed by the office and appointed by one or more |
3522
|
insurers. |
3523
|
|
3524
|
However, an employee leasing company licensed pursuant to |
3525
|
chapter 468 which is seeking to enter into a contract with an |
3526
|
employer that identifies products and services offered to |
3527
|
employees may deliver proposals for the purchase of employee |
3528
|
leasing services to prospective clients of the employee leasing |
3529
|
company setting forth the terms and conditions of doing |
3530
|
business; classify employees as permitted by s. 468.529; collect |
3531
|
information from prospective clients and other sources as |
3532
|
necessary to perform due diligence on the prospective client and |
3533
|
to prepare a proposal for services; provide and receive |
3534
|
enrollment forms, plans, and other documents; and discuss or |
3535
|
explain in general terms the conditions, limitations, options, |
3536
|
or exclusions of insurance benefit plans available to the client |
3537
|
or employees of the employee leasing company were the client to |
3538
|
contract with the employee leasing company. Any advertising |
3539
|
materials or other documents describing specific insurance |
3540
|
coverages must identify and be from a licensed insurer or its |
3541
|
licensed agent or a licensed and appointed agent employed by the |
3542
|
employee leasing company. The employee leasing company may not |
3543
|
advise or inform the prospective business client or individual |
3544
|
employees of specific coverage provisions, exclusions, or |
3545
|
limitations of particular plans. As to clients for which the |
3546
|
employee leasing company is providing services pursuant to s. |
3547
|
468.525(4), the employee leasing company may engage in |
3548
|
activities permitted by ss. 626.7315, 626.7845, and 626.8305, |
3549
|
subject to the restrictions specified in those sections. If a |
3550
|
prospective client requests more specific information concerning |
3551
|
the insurance provided by the employee leasing company, the |
3552
|
employee leasing company must refer the prospective business |
3553
|
client to the insurer or its licensed agent or to a licensed and |
3554
|
appointed agent employed by the employee leasing company. |
3555
|
Section 44. Section 626.161, Florida Statutes, is amended |
3556
|
to read: |
3557
|
626.161 Licensing forms.--The department shall prescribe |
3558
|
and furnish all printed forms required in connection with the |
3559
|
application for issuance of and termination of all licenses and |
3560
|
appointments, except that, with respect to adjusters, the |
3561
|
commission shall prescribe and the office shall furnish such |
3562
|
forms. |
3563
|
Section 45. Subsections (1), (2), and (5) of section |
3564
|
626.171, Florida Statutes, are amended to read: |
3565
|
626.171 Application for license.-- |
3566
|
(1) The department or officeshall not issue a license as |
3567
|
agent, customer representative, adjuster, insurance agency, |
3568
|
service representative, managing general agent, or reinsurance |
3569
|
intermediary to any person except upon written application |
3570
|
therefor filed with it, qualification therefor, and payment in |
3571
|
advance of all applicable fees. Any such application shall be |
3572
|
made under the oath of the applicant and be signed by the |
3573
|
applicant. Beginning November 1, 2002, the department shall |
3574
|
accept the uniform application for nonresident agent licensing. |
3575
|
The department may adopt revised versions of the uniform |
3576
|
application by rule. |
3577
|
(2) In the application, the applicant shall set forth: |
3578
|
(a) His or her full name, age, social security number, |
3579
|
residence, and place of business. |
3580
|
(b) Proof that he or she has completed or is in the |
3581
|
process of completing any required prelicensing course. |
3582
|
(c) Whether he or she has been refused or has voluntarily |
3583
|
surrendered or has had suspended or revoked a license to solicit |
3584
|
insurance by the department or by the supervising officials of |
3585
|
any state. |
3586
|
(d) Whether any insurer or any managing general agent |
3587
|
claims the applicant is indebted under any agency contract or |
3588
|
otherwise and, if so, the name of the claimant, the nature of |
3589
|
the claim, and the applicant's defense thereto, if any. |
3590
|
(e) Proof that the applicant meets the requirements for |
3591
|
the type of license for which he or she is applying. |
3592
|
(f) Such other or additional information as the department |
3593
|
or officemay deem proper to enable it to determine the |
3594
|
character, experience, ability, and other qualifications of the |
3595
|
applicant to hold himself or herself out to the public as an |
3596
|
insurance representative. |
3597
|
(5) An application for a license as an agent, customer |
3598
|
representative, adjuster, insurance agency, service |
3599
|
representative, managing general agent, or reinsurance |
3600
|
intermediary must be accompanied by a set of the individual |
3601
|
applicant's fingerprints, or, if the applicant is not an |
3602
|
individual, by a set of the fingerprints of the sole proprietor, |
3603
|
majority owner, partners, officers, and directors, on a form |
3604
|
adopted by rule of the department or commissionand accompanied |
3605
|
by the fingerprint processing fee set forth in s. 624.501. The |
3606
|
fingerprints shall be certified by a law enforcement officer. |
3607
|
Section 46. Section 626.181, Florida Statutes, is amended |
3608
|
to read: |
3609
|
626.181 Number of applications for licensure |
3610
|
required.--After a license as agent, customer representative, or |
3611
|
adjuster has been issued to an individual, the same individual |
3612
|
shall not be required to take another examination for a similar |
3613
|
license, regardless, in the case of an agent, of the number of |
3614
|
insurers to be represented by him or her as agent, unless: |
3615
|
(1) Specifically ordered by the department or officeto |
3616
|
complete a new application for license; or |
3617
|
(2) During any period of 48 months since the filing of the |
3618
|
original license application, such individual was not appointed |
3619
|
as an agent, customer representative, or adjuster, unless the |
3620
|
failure to be so appointed was due to military service, in which |
3621
|
event the period within which a new application is not required |
3622
|
may, in the discretion of the department or office, be extended |
3623
|
to 12 months following the date of discharge from military |
3624
|
service if the military service does not exceed 3 years, but in |
3625
|
no event to extend under this clause for a period of more than 6 |
3626
|
years from the date of filing of the original application for |
3627
|
license. |
3628
|
Section 47. Section 626.191, Florida Statutes, is amended |
3629
|
to read: |
3630
|
626.191 Repeated applications.--The failure of an |
3631
|
applicant to secure a license upon an application shall not |
3632
|
preclude him or her from applying again as many times as |
3633
|
desired, but the department or officeshall not give |
3634
|
consideration to or accept any further application by the same |
3635
|
individual for a similar license dated or filed within 30 days |
3636
|
subsequent to the date the department or officedenied the last |
3637
|
application, except as provided in s. 626.281. |
3638
|
Section 48. Section 626.201, Florida Statutes, is amended |
3639
|
to read: |
3640
|
626.201 Investigation.--The department or officemay |
3641
|
propound any reasonable interrogatories in addition to those |
3642
|
contained in the application, to any applicant for license or |
3643
|
appointment, or on any renewal, reinstatement, or continuation |
3644
|
thereof, relating to his or her qualifications, residence, |
3645
|
prospective place of business, and any other matter which, in |
3646
|
the opinion of the department or office, is deemed necessary or |
3647
|
advisable for the protection of the public and to ascertain the |
3648
|
applicant's qualifications. The department or officemay, upon |
3649
|
completion of the application, make such further investigation |
3650
|
as it may deem advisable of the applicant's character, |
3651
|
experience, background, and fitness for the license or |
3652
|
appointment. Such an inquiry or investigation shall be in |
3653
|
addition to any examination required to be taken by the |
3654
|
applicant as hereinafter in this chapter provided. |
3655
|
Section 49. Section 626.202, Florida Statutes, is amended |
3656
|
to read: |
3657
|
626.202 Fingerprinting requirements.--If there is a change |
3658
|
in ownership or control of any entity licensed under this |
3659
|
chapter, or if a new partner, officer, or director is employed |
3660
|
or appointed, a set of fingerprints of the new owner, partner, |
3661
|
officer, or director must be filed with the department or office |
3662
|
within 30 days after the change. The acquisition of 10 percent |
3663
|
or more of the voting securities of a licensed entity is |
3664
|
considered a change of ownership or control. The fingerprints |
3665
|
must be certified by a law enforcement officer and be |
3666
|
accompanied by the fingerprint processing fee in s. 624.501. |
3667
|
Section 50. Section 626.211, Florida Statutes, is amended |
3668
|
to read: |
3669
|
626.211 Approval, disapproval of application.-- |
3670
|
(1) If upon the basis of a completed application for |
3671
|
license and such further inquiry or investigation as the |
3672
|
department or officemay make concerning an applicant the |
3673
|
department or officeis satisfied that, subject to any |
3674
|
examination required to be taken and passed by the applicant for |
3675
|
a license, the applicant is qualified for the license applied |
3676
|
for and that all pertinent fees have been paid, it shall approve |
3677
|
the application. The department or officeshall not deny, |
3678
|
delay, or withhold approval of an application due to the fact |
3679
|
that it has not received a criminal history report based on the |
3680
|
applicant's fingerprints. |
3681
|
(2) Upon approval of an applicant for license as agent, |
3682
|
customer representative, or adjuster who is subject to written |
3683
|
examination, the department or officeshall notify the applicant |
3684
|
when and where he or she may take the required examination. |
3685
|
(3) Upon approval of an applicant for license who is not |
3686
|
subject to examination, the department or officeshall promptly |
3687
|
issue the license. |
3688
|
(4) If upon the basis of the completed application and |
3689
|
such further inquiry or investigation the department or office |
3690
|
deems the applicant to be lacking in any one or more of the |
3691
|
required qualifications for the license applied for, the |
3692
|
department or officeshall disapprove the application and notify |
3693
|
the applicant, stating the grounds of disapproval. |
3694
|
Section 51. Section 626.221, Florida Statutes, is amended |
3695
|
to read: |
3696
|
626.221 Examination requirement; exemptions.-- |
3697
|
(1) The department or officeshall not issue any license |
3698
|
as agent, customer representative, or adjuster to any individual |
3699
|
who has not qualified for, taken, and passed to the satisfaction |
3700
|
of the department or officea written examination of the scope |
3701
|
prescribed in s. 626.241. |
3702
|
(2) However, no such examination shall be necessary in any |
3703
|
of the following cases: |
3704
|
(a) An applicant for renewal of appointment as an agent, |
3705
|
customer representative, or adjuster, unless the department or |
3706
|
officedetermines that an examination is necessary to establish |
3707
|
the competence or trustworthiness of such applicant. |
3708
|
(b) An applicant for limited license as agent for personal |
3709
|
accident insurance, baggage and motor vehicle excess liability |
3710
|
insurance, credit life or disability insurance, credit |
3711
|
insurance, credit property insurance, in-transit and storage |
3712
|
personal property insurance, or communications equipment |
3713
|
property insurance or communication equipment inland marine |
3714
|
insurance. |
3715
|
(c) In the discretion of the department or office, an |
3716
|
applicant for reinstatement of license or appointment as an |
3717
|
agent, customer representative, or adjuster whose license has |
3718
|
been suspended within 2 years prior to the date of application |
3719
|
or written request for reinstatement. |
3720
|
(d) An applicant who, within 2 years prior to application |
3721
|
for license and appointment as an agent, customer |
3722
|
representative, or adjuster, was a full-time salaried employee |
3723
|
of the department or officeand had continuously been such an |
3724
|
employee with responsible insurance duties for not less than 2 |
3725
|
years and who had been a licensee within 2 years prior to |
3726
|
employment by the department or officewith the same class of |
3727
|
license as that being applied for. |
3728
|
(e) An individual who qualified as a managing general |
3729
|
agent, service representative, customer representative, or all- |
3730
|
lines adjuster by passing a general lines agent's examination |
3731
|
and subsequently was licensed and appointed and has been |
3732
|
actively engaged in all lines of property and casualty insurance |
3733
|
may, upon filing an application for appointment, be licensed and |
3734
|
appointed as a general lines agent for the same kinds of |
3735
|
business without taking another examination if he or she holds |
3736
|
any such currently effective license referred to in this |
3737
|
paragraph or held the license within 24 months prior to the date |
3738
|
of filing the application with the department. |
3739
|
(f) A person who has been licensed and appointed by the |
3740
|
departmentas a public adjuster or independent adjuster, or |
3741
|
licensed and appointed either as an agent or company adjuster as |
3742
|
to all property, casualty, and surety insurances, may be |
3743
|
licensed and appointed as a company adjuster as to any of such |
3744
|
insurances, or as an independent adjuster or public adjuster, |
3745
|
without additional written examination if an application for |
3746
|
appointment is filed with the officedepartmentwithin 24 months |
3747
|
following the date of cancellation or expiration of the prior |
3748
|
appointment. |
3749
|
(g) A person who has been licensed by the departmentas an |
3750
|
adjuster for motor vehicle, property and casualty, workers' |
3751
|
compensation, and health insurance may be licensed as such an |
3752
|
adjuster without additional written examination if his or her |
3753
|
application for appointment is filed with the officedepartment |
3754
|
within 24 months after cancellation or expiration of the prior |
3755
|
license. |
3756
|
(h) An applicant for temporary license, except as provided |
3757
|
in this code. |
3758
|
(i) An applicant for a life or health license who has |
3759
|
received the designation of chartered life underwriter (CLU) |
3760
|
from the American College of Life Underwriters and who has been |
3761
|
engaged in the insurance business within the past 4 years, |
3762
|
except that such an individual may be examined on pertinent |
3763
|
provisions of this code. |
3764
|
(j) An applicant for license as a general lines agent, |
3765
|
customer representative, or adjuster who has received the |
3766
|
designation of chartered property and casualty underwriter |
3767
|
(CPCU) from the American Institute for Property and Liability |
3768
|
Underwriters and who has been engaged in the insurance business |
3769
|
within the past 4 years, except that such an individual may be |
3770
|
examined on pertinent provisions of this code. |
3771
|
(k) An applicant for license as a customer representative |
3772
|
who has the designation of Accredited Advisor in Insurance (AAI) |
3773
|
from the Insurance Institute of America, the designation of |
3774
|
Certified Insurance Counselor (CIC) from the Society of |
3775
|
Certified Insurance Service Counselors, the designation of |
3776
|
Accredited Customer Service Representative (ACSR) from the |
3777
|
Independent Insurance Agents of America, the designation of |
3778
|
Certified Professional Service Representative (CPSR) from the |
3779
|
National Association of Professional Insurance Agents, the |
3780
|
designation of Certified Insurance Service Representative (CISR) |
3781
|
from the Society of Certified Insurance Service Representatives. |
3782
|
Also, an applicant for license as a customer representative who |
3783
|
has the designation of Certified Customer Service Representative |
3784
|
(CCSR) from the Florida Association of Insurance Agents, or the |
3785
|
designation of Registered Customer Service Representative (RCSR) |
3786
|
from a regionally accredited postsecondary institution in this |
3787
|
state, or the designation of Professional Customer Service |
3788
|
Representative (PCSR) from the Professional Career Institute, |
3789
|
whose curriculum has been approved by the department and whose |
3790
|
curriculum includes comprehensive analysis of basic property and |
3791
|
casualty lines of insurance and testing at least equal to that |
3792
|
of standard department testing for the customer representative |
3793
|
license. The department shall adopt rules establishing standards |
3794
|
for the approval of curriculum. |
3795
|
(l) An applicant for license as an adjuster who has the |
3796
|
designation of Accredited Claims Adjuster (ACA) from a |
3797
|
regionally accredited postsecondary institution in this state, |
3798
|
or the designation of Professional Claims Adjuster(PCA) from the |
3799
|
Professional Career Institute, whose curriculum has been |
3800
|
approved by the officedepartmentand whose curriculum includes |
3801
|
comprehensive analysis of basic property and casualty lines of |
3802
|
insurance and testing at least equal to that of standard office |
3803
|
department testing for the all-lines adjuster license. The |
3804
|
commissiondepartmentshall adopt rules establishing standards |
3805
|
for the approval of curriculum. |
3806
|
(m) An applicant qualifying for a license transfer under |
3807
|
s. 626.292, if the applicant: |
3808
|
1. Has successfully completed the prelicensing examination |
3809
|
requirements in the applicant's previous state which are |
3810
|
substantially equivalent to the examination requirements in this |
3811
|
state, as determined by the departmentInsurance Commissioner of |
3812
|
this state; |
3813
|
2. Has received the designation of chartered property and |
3814
|
casualty underwriter (CPCU) from the American Institute for |
3815
|
Property and Liability Underwriters and has been engaged in the |
3816
|
insurance business within the past 4 years if applying to |
3817
|
transfer a general lines agent license; or |
3818
|
3. Has received the designation of chartered life |
3819
|
underwriter (CLU) from the American College of Life Underwriters |
3820
|
and has been engaged in the insurance business within the past 4 |
3821
|
years, if applying to transfer a life or health agent license. |
3822
|
(n) An applicant for a nonresident agent license, if the |
3823
|
applicant: |
3824
|
1. Has successfully completed prelicensing examination |
3825
|
requirements in the applicant's home state which are |
3826
|
substantially equivalent to the examination requirements in this |
3827
|
state, as determined by the departmentInsurance Commissioner of |
3828
|
this state, as a requirement for obtaining a resident license in |
3829
|
his or her home state; |
3830
|
2. Held a general lines agent license, life agent license, |
3831
|
or health agent license prior to the time a written examination |
3832
|
was required; |
3833
|
3. Has received the designation of chartered property and |
3834
|
casualty underwriter (CPCU) from the American Institute for |
3835
|
Property and Liability Underwriters and has been engaged in the |
3836
|
insurance business within the past 4 years, if an applicant for |
3837
|
a nonresident license as a general lines agent; or |
3838
|
4. Has received the designation of chartered life |
3839
|
underwriter (CLU) from the American College of Life Underwriters |
3840
|
and has been in the insurance business within the past 4 years, |
3841
|
if an applicant for a nonresident license as a life agent or |
3842
|
health agent. |
3843
|
(3) An individual who is already licensed as a customer |
3844
|
representative shall not be licensed as a general lines agent |
3845
|
without application and examination for such license. |
3846
|
Section 52. Section 626.231, Florida Statutes, is amended |
3847
|
to read: |
3848
|
626.231 Eligibility for examination.--No person shall be |
3849
|
permitted to take an examination for license until his or her |
3850
|
application for the license has been approved and the required |
3851
|
fees have been received by the department or officeor a person |
3852
|
designated by the department or officeto administer the |
3853
|
examination. |
3854
|
Section 53. Subsection (1) of section 626.241, Florida |
3855
|
Statutes, is amended to read: |
3856
|
626.241 Scope of examination.-- |
3857
|
(1) Each examination for a license as agent, customer |
3858
|
representative, or adjuster shall be of such scope as is deemed |
3859
|
by the department or officeto be reasonably necessary to test |
3860
|
the applicant's ability and competence and knowledge of the |
3861
|
kinds of insurance and transactions to be handled under the |
3862
|
license applied for, of the duties and responsibilities of such |
3863
|
a licensee, and of the pertinent provisions of the laws of this |
3864
|
state. |
3865
|
Section 54. Section 626.251, Florida Statutes, is amended |
3866
|
to read: |
3867
|
626.251 Time and place of examination; notice.-- |
3868
|
(1) The department or officeor a person designated by the |
3869
|
department or officeshall mail written notice of the time and |
3870
|
place of the examination to each applicant for license required |
3871
|
to take an examination who will be eligible to take the |
3872
|
examination as of the examination date. The notice shall be so |
3873
|
mailed, postage prepaid, and addressed to the applicant at his |
3874
|
or her address shown on the application for license or at such |
3875
|
other address as requested by the applicant in writing filed |
3876
|
with the department or officeprior to the mailing of the |
3877
|
notice. Notice shall be deemed given when so mailed. |
3878
|
(2) The examination shall be held in an adequate and |
3879
|
designated examination center in this state. |
3880
|
(3) The department or officeshall make an examination |
3881
|
available to the applicant, to be taken as soon as reasonably |
3882
|
possible after the applicant is eligible therefor. Any |
3883
|
examination required under this part shall be available in this |
3884
|
state at a designated examination center. |
3885
|
Section 55. Section 626.261, Florida Statutes, is amended |
3886
|
to read: |
3887
|
626.261 Conduct of examination.-- |
3888
|
(1) The applicant for license shall appear in person and |
3889
|
personally take the examination for license at the time and |
3890
|
place specified by the department or officeor by a person |
3891
|
designated by the department or office. |
3892
|
(2) The examination shall be conducted by an employee of |
3893
|
the department or officeor a person designated by the |
3894
|
department or officefor that purpose. |
3895
|
(3) The questions propounded shall be as prepared by the |
3896
|
department or office, or by a person designated by the |
3897
|
department or officefor that purpose, consistent with the |
3898
|
applicable provisions of this code. |
3899
|
(4) All examinations shall be given and graded in a fair |
3900
|
and impartial manner and without unfair discrimination in favor |
3901
|
of or against any particular applicant. |
3902
|
Section 56. Section 626.266, Florida Statutes, is amended |
3903
|
to read: |
3904
|
626.266 Printing of examinations or related materials to |
3905
|
preserve examination security.--A contract let for the |
3906
|
development, administration, or grading of examinations or |
3907
|
related materials by the department or officeof Insurance |
3908
|
pursuant to the various agent, customer representative, |
3909
|
solicitor, or adjuster licensing and examination provisions of |
3910
|
this code may include the printing or furnishing of these |
3911
|
examinations or related materials in order to preserve security. |
3912
|
Any such contract shall be let as a contract for a contractual |
3913
|
service pursuant to s. 287.057. |
3914
|
Section 57. Subsection (1) of section 626.271, Florida |
3915
|
Statutes, is amended to read: |
3916
|
626.271 Examination fee; determination, refund.-- |
3917
|
(1) Prior to being permitted to take an examination, each |
3918
|
applicant who is subject to examination shall pay to the |
3919
|
department or office or a person designated by the department or |
3920
|
officean examination fee. A separate and additional |
3921
|
examination fee shall be payable for each separate class of |
3922
|
license applied for, notwithstanding that all such examinations |
3923
|
are taken on the same date and at the same place. |
3924
|
Section 58. Section 626.281, Florida Statutes, is amended |
3925
|
to read: |
3926
|
626.281 Reexamination.-- |
3927
|
(1) Any applicant for license who has either: |
3928
|
(a) Taken an examination and failed to make a passing |
3929
|
grade, or |
3930
|
(b) Failed to appear for the examination or to take or |
3931
|
complete the examination at the time and place specified in the |
3932
|
notice of the department or office, |
3933
|
|
3934
|
|
3935
|
may take additional examinations, after filing with the |
3936
|
department or officean application for reexamination together |
3937
|
with applicable fees. The failure of an applicant to pass an |
3938
|
examination or the failure to appear for the examination or to |
3939
|
take or complete the examination does not preclude the applicant |
3940
|
from taking subsequent examinations. |
3941
|
(2) The department or officemay require any individual |
3942
|
whose license as an agent, customer representative, or adjuster |
3943
|
has expired or has been suspended to pass an examination prior |
3944
|
to reinstating or relicensing the individual as to any class of |
3945
|
license. The examination fee shall be paid as to each |
3946
|
examination. |
3947
|
Section 59. Subsections (5) and (6) of section 626.2815, |
3948
|
Florida Statutes, are amended to read: |
3949
|
626.2815 Continuing education required; application; |
3950
|
exceptions; requirements; penalties.-- |
3951
|
(5) The department of Insuranceshall refuse to renew the |
3952
|
appointment of any agent who has not had his or her continuing |
3953
|
education requirements certified unless the agent has been |
3954
|
granted an extension by the department. The department may not |
3955
|
issue a new appointment of the same or similar type, with any |
3956
|
insurer, to an agent who was denied a renewal appointment for |
3957
|
failure to complete continuing education as required until the |
3958
|
agent completes his or her continuing education requirement. |
3959
|
(6)(a) There is created an 11-member continuing education |
3960
|
advisory board to be appointed by the Chief Financial Officer |
3961
|
Insurance Commissioner and Treasurer. Appointments shall be for |
3962
|
terms of 4 years. The purpose of the board is to advise the |
3963
|
department in determining standards by which courses may be |
3964
|
evaluated and categorized as basic, intermediate, or advanced. |
3965
|
The board shall establish such criteria and the department shall |
3966
|
implement such criteria by January 1, 1997.The board shall |
3967
|
submit recommendations to the department of changes needed in |
3968
|
such criteria not less frequently than every 2 years thereafter. |
3969
|
The department shall require all approved course providers to |
3970
|
submit courses for approval to the department using the |
3971
|
criteria. All materials, brochures, and advertisements related |
3972
|
to the approved courses must specify the level assigned to the |
3973
|
course. |
3974
|
(b) The board members shall be appointed as follows: |
3975
|
1. Seven members representing agents of which at least one |
3976
|
must be a representative from each of the following |
3977
|
organizations: the Florida Association of Insurance Agents; the |
3978
|
Florida Association of Life Underwriters; the Professional |
3979
|
Insurance Agents of Florida, Inc.; the Florida Association of |
3980
|
Health Underwriters; the Specialty Agents' Association; the |
3981
|
Latin American Agents' Association; and the National Association |
3982
|
of Insurance Women. Such board members must possess at least a |
3983
|
bachelor's degree or higher from an accredited college or |
3984
|
university with major coursework in insurance, risk management, |
3985
|
or education or possess the designation of CLU, CPCU, CHFC, CFP, |
3986
|
AAI, or CIC. In addition, each member must possess 5 years of |
3987
|
classroom instruction experience or 5 years of experience in the |
3988
|
development or design of educational programs or 10 years of |
3989
|
experience as a licensed resident agent. Each organization may |
3990
|
submit to the department a list of recommendations for |
3991
|
appointment. If one organization does not submit a list of |
3992
|
recommendations, the Chief Financial OfficerInsurance |
3993
|
Commissionermay select more than one recommended person from a |
3994
|
list submitted by other eligible organizations. |
3995
|
2. Two members representing insurance companies at least |
3996
|
one of whom must represent a Florida Domestic Company and one of |
3997
|
whom must represent the Florida Insurance Council. Such board |
3998
|
members must be employed within the training department of the |
3999
|
insurance company. At least one such member must be a member of |
4000
|
the Society of Insurance Trainers and Educators. |
4001
|
3. One member representing the general public who is not |
4002
|
directly employed in the insurance industry. Such board member |
4003
|
must possess a minimum of a bachelor's degree or higher from an |
4004
|
accredited college or university with major coursework in |
4005
|
insurance, risk management, training, or education. |
4006
|
4. One member, appointed by the Chief Financial Officer |
4007
|
Insurance Commissioner, who represents the department. |
4008
|
(c) The members of the board shall serve at the pleasure |
4009
|
of the Chief Financial OfficerInsurance Commissioner and |
4010
|
Treasurer. Each board member shall be entitled to reimbursement |
4011
|
for expenses pursuant to s. 112.061. The board shall designate |
4012
|
one member as chair. The board shall meet at the call of the |
4013
|
chair or the Chief Financial OfficerInsurance Commissioner and |
4014
|
Treasurer. |
4015
|
Section 60. Section 626.2817, Florida Statutes, is amended |
4016
|
to read: |
4017
|
626.2817 Regulation of course providers, instructors, |
4018
|
school officials, and monitor groups involved in prelicensure |
4019
|
education for insurance agents and other licensees.-- |
4020
|
(1) Any course provider, instructor, school official, or |
4021
|
monitor group must be approved by and registered with the |
4022
|
department or officebefore offering prelicensure education |
4023
|
courses for insurance agents and other licensees. |
4024
|
(2) The department or commissionshall adopt rules |
4025
|
establishing standards for the approval, registration, |
4026
|
discipline, or removal from registration of course providers, |
4027
|
instructors, school officials, and monitor groups. The standards |
4028
|
must be designed to ensure that such persons have the knowledge, |
4029
|
competence, and integrity to fulfill the educational objectives |
4030
|
of the prelicensure requirements of this chapter and chapter 648 |
4031
|
and to assure that insurance agents and licensees are competent |
4032
|
to engage in the activities authorized under the license. |
4033
|
(3) The department or commissionshall adopt rules to |
4034
|
establish a process for determining compliance with the |
4035
|
prelicensure requirements of this chapter and chapter 648 and |
4036
|
shall establish a prelicensure cycle for insurance agents and |
4037
|
other licensees. The department or commissionshall adopt rules |
4038
|
prescribing the forms necessary to administer the prelicensure |
4039
|
requirements. |
4040
|
Section 61. Section 626.291, Florida Statutes, is amended |
4041
|
to read: |
4042
|
626.291 Denial, issuance of license.-- |
4043
|
(1) Within 30 days after the applicant has completed any |
4044
|
examination required under s. 626.221, the department or office |
4045
|
or its designee shall provide a score report; and, if it finds |
4046
|
that the applicant has received a passing grade, the department |
4047
|
or officeshall within such period notify the applicant and |
4048
|
issue and transmit the license to which such examination |
4049
|
related. If it finds that the applicant did not make a passing |
4050
|
grade on the examination for a particular license, the |
4051
|
department or officeor its designee shall within this period |
4052
|
provide notice to the applicant to that effect and of its denial |
4053
|
of the license. |
4054
|
(2) As to an applicant for a license for which no |
4055
|
examination is required, the department or officeshall promptly |
4056
|
issue the license applied for as soon as it has approved the |
4057
|
application. |
4058
|
(3) The department or officeshall not deny, delay, or |
4059
|
withhold issuance of a license due to the fact that it has not |
4060
|
received a criminal history report based on the applicant's |
4061
|
fingerprints. |
4062
|
Section 62. Paragraph (d) of subsection (2) of section |
4063
|
626.292, Florida Statutes, is amended to read: |
4064
|
626.292 Transfer of license from another state.-- |
4065
|
(2) To qualify for a license transfer, an individual |
4066
|
applicant must meet the following requirements: |
4067
|
(d) The individual shall satisfy prelicensing education |
4068
|
requirements in this state, unless the completion of |
4069
|
prelicensing education requirements was a prerequisite for |
4070
|
licensure in the other state and the prelicensing education |
4071
|
requirements in the other state are substantially equivalent to |
4072
|
the prelicensing requirements of this state as determined by the |
4073
|
departmentInsurance Commissioner of this state. |
4074
|
Section 63. Section 626.301, Florida Statutes, is amended |
4075
|
to read: |
4076
|
626.301 Form and contents of licenses, in general.--Each |
4077
|
license issued by the department or officeshall be in such form |
4078
|
as the department or commissionmay designate and contain the |
4079
|
licensee's name, lines of authority the licensee is authorized |
4080
|
to transact, the licensee's personal identification number, the |
4081
|
date of issuance, and any other information the department or |
4082
|
commissiondeems necessary to fully identify the licensee and |
4083
|
the authority being granted. The department or commissionmay by |
4084
|
rule require photographs of applicants as a part of the |
4085
|
licensing process. |
4086
|
Section 64. Section 626.322, Florida Statutes, is amended |
4087
|
to read: |
4088
|
626.322 License, appointment; certain military |
4089
|
installations.--A natural person, not a resident of this state, |
4090
|
may be licensed and appointed to represent an authorized life |
4091
|
insurer domiciled in this state or an authorized foreign life |
4092
|
insurer which maintains a regional home office in this state, |
4093
|
provided such person represents such insurer exclusively at a |
4094
|
United States military installation located in a foreign |
4095
|
country. The department may, upon request of the applicant and |
4096
|
the insurer on application forms furnished by the department and |
4097
|
upon payment of fees as prescribed in s. 624.501, issue a |
4098
|
license and appointment to such person. The insurer shall |
4099
|
certify to the department that the applicant has the necessary |
4100
|
training to hold himself or herself out as a life insurance |
4101
|
representative, and the insurer shall further certify that it is |
4102
|
willing to be bound by the acts of such applicant within the |
4103
|
scope of his or her employment. Appointments shall be continued |
4104
|
as prescribed in s. 626.381 and upon payment of a fee as |
4105
|
prescribed in s. 624.501, unless sooner terminated. Such fees |
4106
|
received shall be credited to the Insurance Commissioner's |
4107
|
Regulatory Trust Fund as provided for in s. 624.523. |
4108
|
Section 65. Section 626.361, Florida Statutes, is amended |
4109
|
to read: |
4110
|
626.361 Effective date of appointments.--All appointments |
4111
|
shall be submitted to the department or officeon a monthly |
4112
|
basis no later than 45 days after the date of appointment. All |
4113
|
appointments shall be effective as of the date requested on the |
4114
|
appointment form. |
4115
|
Section 66. Section 626.371, Florida Statutes, is amended |
4116
|
to read: |
4117
|
626.371 Payment of fees, taxes for appointment period |
4118
|
without appointment.--If, upon application and qualification for |
4119
|
an appointment and such investigation as the department or |
4120
|
office may make, it appears to the department or officethat an |
4121
|
individual who was formerly appointed has been actively engaged |
4122
|
or is currently actively engaged as such an appointee, but |
4123
|
without being appointed as required, the department or office |
4124
|
may, if it finds that such failure to be appointed was an |
4125
|
inadvertent error on the part of the insurer or employer so |
4126
|
represented, nevertheless issue the appointment as applied for |
4127
|
but subject to the condition that, before the appointment is |
4128
|
issued, all fees and taxes which would have been due had the |
4129
|
applicant been so appointed during such current and prior |
4130
|
periods, together with a continuation fee for such current and |
4131
|
prior terms of appointment, shall be paid to the department or |
4132
|
office. |
4133
|
Section 67. Subsections (2), (3), and (4), of section |
4134
|
626.381, Florida Statutes, are amended to read: |
4135
|
626.381 Renewal, continuation, reinstatement, or |
4136
|
termination of appointment.-- |
4137
|
(2) Each appointing entity shall file with the department |
4138
|
or officethe lists, statements, and information as to |
4139
|
appointees whose appointments are being renewed or terminated, |
4140
|
accompanied by payment of the applicable renewal fees and taxes |
4141
|
as prescribed in s. 624.501, by a date set forth by the |
4142
|
department or officefollowing the month during which the |
4143
|
appointments will expire. |
4144
|
(3) Renewal of an appointment which is received on a date |
4145
|
set forth by the department or officein the succeeding month |
4146
|
may be renewed by the department or officewithout penalty and |
4147
|
shall be effective as of the day the appointment would have |
4148
|
expired. |
4149
|
(4) Renewal of an appointment which is received by the |
4150
|
department or office after the date set by the department or |
4151
|
office may be accepted and effectuated by the department or |
4152
|
officein its discretion if an additional appointment, |
4153
|
continuation, and reinstatement fee accompanies the renewal |
4154
|
pursuant to s. 624.501. |
4155
|
Section 68. Subsection (2) of section 626.431, Florida |
4156
|
Statutes, is amended to read: |
4157
|
626.431 Effect of expiration of license and appointment.-- |
4158
|
(2) When a licensee's last appointment for a particular |
4159
|
class of insurance has been terminated or not renewed, the |
4160
|
department or officemust notify the licensee that his or her |
4161
|
eligibility for appointment as such an appointee will expire |
4162
|
unless he or she is appointed prior to expiration of the 48- |
4163
|
month period referred to in subsection (3). |
4164
|
Section 69. Section 626.451, Florida Statutes, is amended |
4165
|
to read: |
4166
|
626.451 Appointment of agent or other representative.-- |
4167
|
(1) Each appointing entity appointing an agent, adjuster, |
4168
|
service representative, customer representative, or managing |
4169
|
general agent in this state shall file the appointment with the |
4170
|
department or officeand, at the same time, pay the applicable |
4171
|
appointment fee and taxes. Every appointment shall be subject |
4172
|
to the prior issuance of the appropriate agent's, adjuster's, |
4173
|
service representative's, customer representative's, or managing |
4174
|
general agent's license. |
4175
|
(2) As a part of each appointment there shall be a |
4176
|
certified statement or affidavit of an appropriate officer or |
4177
|
official of the appointing entity stating what investigation the |
4178
|
appointing entity has made concerning the proposed appointee and |
4179
|
his or her background and the appointing entity's opinion to the |
4180
|
best of its knowledge and belief as to the moral character, |
4181
|
fitness, and reputation of the proposed appointee and any other |
4182
|
information the department or officemay reasonably require |
4183
|
relative to the proposed appointee. |
4184
|
(3) In the appointment of an agent, adjuster, service |
4185
|
representative, customer representative, or managing general |
4186
|
agent the appointing entity shall also certify therein that it |
4187
|
is willing to be bound by the acts of the agent, adjuster, |
4188
|
service representative, customer representative, or managing |
4189
|
general agent, within the scope of his or her employment. |
4190
|
(4) Each appointing entity shall advise the department or |
4191
|
officein writing within 15 days after it or its general agent, |
4192
|
officer, or other official becomes aware that an appointee has |
4193
|
pleaded guilty or nolo contendere to or has been found guilty of |
4194
|
a felony after being appointed. |
4195
|
(5) Any law enforcement agency or state attorney's office |
4196
|
that is aware that an agent, adjuster, service representative, |
4197
|
customer representative, or managing general agent has pleaded |
4198
|
guilty or nolo contendere to or has been found guilty of a |
4199
|
felony shall notify the department or officeof such fact. |
4200
|
(6) Upon the filing of an information or indictment |
4201
|
against an agent, adjuster, service representative, customer |
4202
|
representative, or managing general agent, the state attorney |
4203
|
shall immediately furnish the department or officea certified |
4204
|
copy of the information or indictment. |
4205
|
Section 70. Section 626.461, Florida Statutes, is amended |
4206
|
to read: |
4207
|
626.461 Continuation of appointment of agent or other |
4208
|
representative.--Subject to renewal or continuation by the |
4209
|
appointing entity, the appointment of the agent, adjuster, |
4210
|
solicitor, service representative, customer representative, or |
4211
|
managing general agent shall continue in effect until the |
4212
|
person's license is revoked or otherwise terminated, unless |
4213
|
written notice of earlier termination of the appointment is |
4214
|
filed with the department or officeby either the appointing |
4215
|
entity or the appointee. |
4216
|
Section 71. Subsections (2), (3), (4), and (5) of section |
4217
|
626.471, Florida Statutes, are amended to read: |
4218
|
626.471 Termination of appointment.-- |
4219
|
(2) As soon as possible and at all events within 30 days |
4220
|
after terminating the appointment of an appointee, other than as |
4221
|
to an appointment terminated by the appointing entity's failure |
4222
|
to continue or renew it, the appointing entity shall file |
4223
|
written notice thereof with the department or office, together |
4224
|
with a statement that it has given the appointee notice thereof |
4225
|
as provided in subsection (1) and shall file with the department |
4226
|
or officethe reasons and facts involved in such termination as |
4227
|
required under s. 626.511. |
4228
|
(3) Upon termination of the appointment of an appointee, |
4229
|
whether by failure to renew or continue the appointment, the |
4230
|
appointing entity shall: |
4231
|
(a) File with the department or officethe information |
4232
|
required under s. 626.511. |
4233
|
(b) Subject to the exceptions provided under subsection |
4234
|
(1), continue the outstanding contracts transacted by an agent |
4235
|
until the expiration date or anniversary date when the policy is |
4236
|
a continuous policy with no expiration date. This paragraph |
4237
|
shall not be construed to prohibit the cancellation of such |
4238
|
contracts when not otherwise prohibited by law. |
4239
|
(4) An appointee may terminate the appointment at any time |
4240
|
by giving written notice thereof to the appointing entity and |
4241
|
filing a copy of the notice with the department or office. Such |
4242
|
termination shall be subject to the appointee's contract rights, |
4243
|
if any. |
4244
|
(5) Upon receiving notice of termination, the department |
4245
|
or officeshall terminate the appointment. |
4246
|
Section 72. Section 626.511, Florida Statutes, is amended |
4247
|
to read: |
4248
|
626.511 Reasons for termination; confidential |
4249
|
information.-- |
4250
|
(1) Any insurer terminating the appointment of an agent; |
4251
|
any general lines agent terminating the appointment of a |
4252
|
customer representative or a crop hail or multiple-peril crop |
4253
|
insurance agent; and any employer terminating the appointment of |
4254
|
an adjuster, service representative, or managing general agent, |
4255
|
whether such termination is by direct action of the appointing |
4256
|
insurer, agent, or employer or by failure to renew or continue |
4257
|
the appointment as provided, shall file with the department or |
4258
|
officea statement of the reasons, if any, for and the facts |
4259
|
relative to such termination. In the case of termination of the |
4260
|
appointment of an agent, such information may be filed by the |
4261
|
insurer or by the general agent of the insurer. |
4262
|
(2) In the case of terminations by failure to renew or |
4263
|
continue the appointment, the information required under |
4264
|
subsection (1) shall be filed with the department or officeas |
4265
|
soon as possible, and at all events within 30 days, after the |
4266
|
date notice of intention not to so renew or continue was filed |
4267
|
with the department or officeas required in this chapter. In |
4268
|
all other cases, the information required under subsection (1) |
4269
|
shall be filed with the department or officeat the time, or at |
4270
|
all events within 10 days after, notice of the termination was |
4271
|
filed with the department or office. |
4272
|
(3) Any information, document, record, or statement |
4273
|
furnished to the department or officeunder subsection (1) is |
4274
|
confidential and exempt from the provisions of s. 119.07(1). |
4275
|
Section 73. Subsections (2), (3), and (5) of section |
4276
|
626.521, Florida Statutes, are amended to read: |
4277
|
626.521 Character, credit reports.-- |
4278
|
(2) If requested by the department or office, the insurer, |
4279
|
manager, general agent, general lines agent, or employer, as the |
4280
|
case may be, shall furnish to the department or office on a form |
4281
|
adopted by the department or commission andfurnished by the |
4282
|
department or office, such information as it may reasonably |
4283
|
require relative to such individual and investigation. |
4284
|
(3) As to an applicant for an adjuster's or reinsurance |
4285
|
intermediary's license who is to be self-employed, the |
4286
|
department or officemay secure, at the cost of the applicant, a |
4287
|
full detailed credit and character report made by an established |
4288
|
and reputable independent reporting service relative to the |
4289
|
applicant. |
4290
|
(5) Information contained in credit or character reports |
4291
|
furnished to or secured by the department or officeunder this |
4292
|
section is confidential and exempt from the provisions of s. |
4293
|
119.07(1). |
4294
|
Section 74. Subsections (1) and (2) of section 626.541, |
4295
|
Florida Statutes, are amended to read: |
4296
|
626.541 Firm, corporate, and business names; officers; |
4297
|
associates; notice of changes.-- |
4298
|
(1) Any licensed agent or adjuster doing business under a |
4299
|
firm or corporate name or under any business name other than his |
4300
|
or her own individual name shall, within 30 days after the |
4301
|
initial transaction of insurance under such business name, file |
4302
|
with the department or office, on forms adopted by the |
4303
|
department or commission and furnished by the department or |
4304
|
officeit, a written statement of the firm, corporate, or |
4305
|
business name being so used, the address of any office or |
4306
|
offices or places of business making use of such name, and the |
4307
|
name and social security number of each officer and director of |
4308
|
the corporation and of each individual associated in such firm |
4309
|
or corporation as to the insurance transactions thereof or in |
4310
|
the use of such business name. |
4311
|
(2) In the event of any change of such name, or of any of |
4312
|
the officers and directors, or of any of such addresses, or in |
4313
|
the personnel so associated, written notice of such change must |
4314
|
be filed with the department or officewithin 30 days by or on |
4315
|
behalf of those licensees terminating any such firm, corporate, |
4316
|
or business name or continuing to operate thereunder. |
4317
|
Section 75. Section 626.551, Florida Statutes, is amended |
4318
|
to read: |
4319
|
626.551 Notice of change of address, name.--Every licensee |
4320
|
shall notify the department or officein writing within 60 days |
4321
|
after a change of name, residence address, principal business |
4322
|
street address, or mailing address. Any licensed agent who has |
4323
|
moved his or her residence from this state shall have his or her |
4324
|
license and all appointments immediately terminated by the |
4325
|
department or office. Failure to notify the department or office |
4326
|
within the required time period shall result in a fine not to |
4327
|
exceed $250 for the first offense and, for subsequent offenses, |
4328
|
a fine of not less than $500 or suspension or revocation of the |
4329
|
license pursuant to s. 626.611 or s. 626.621. |
4330
|
Section 76. Subsections (1) and (2) of section 626.561, |
4331
|
Florida Statutes, are amended to read: |
4332
|
626.561 Reporting and accounting for funds.-- |
4333
|
(1) All premiums, return premiums, or other funds |
4334
|
belonging to insurers or others received by an agent, customer |
4335
|
representative, or adjuster in transactions under his or her |
4336
|
license are trust funds received by the licensee in a fiduciary |
4337
|
capacity. An agent shall keep the funds belonging to each |
4338
|
insurer for which he or she is not appointed, other than a |
4339
|
surplus lines insurer, in a separate account so as to allow the |
4340
|
department or officeto properly audit such funds. The licensee |
4341
|
in the applicable regular course of business shall account for |
4342
|
and pay the same to the insurer, insured, or other person |
4343
|
entitled thereto. |
4344
|
(2) The licensee shall keep and make available to the |
4345
|
department or officebooks, accounts, and records as will enable |
4346
|
the department or officeto determine whether such licensee is |
4347
|
complying with the provisions of this code. Every licensee shall |
4348
|
preserve books, accounts, and records pertaining to a premium |
4349
|
payment for at least 3 years after payment; provided, however, |
4350
|
the preservation of records by computer or photographic |
4351
|
reproductions or records in photographic form shall constitute |
4352
|
compliance with this requirement. All other records shall be |
4353
|
maintained in accordance with s. 626.748. The 3-year |
4354
|
requirement shall not apply to insurance binders when no policy |
4355
|
is ultimately issued and no premium is collected. |
4356
|
Section 77. Section 626.591, Florida Statutes, is amended |
4357
|
to read: |
4358
|
626.591 Penalty for violation of s. 626.581.-- |
4359
|
(1) If any insurer oragent is found by the department to |
4360
|
be in violation of s. 626.581, the department may, in its |
4361
|
discretion, suspend or revoke the insurer's certificate of |
4362
|
authority and the agent's license. If any insurer is found by |
4363
|
the office to be in violation of s. 626.581, the office may, in |
4364
|
its discretion, suspend or revoke the insurer's certificate of |
4365
|
authority. |
4366
|
(2)Any such suspension or revocation shall be for a |
4367
|
period of not less than 6 months, and the insurer or agent shall |
4368
|
not subsequently be authorized or licensed to transact insurance |
4369
|
unless the office ordepartment is satisfied that the insurer or |
4370
|
agent will not again violate any of the provisions of s. |
4371
|
626.581. |
4372
|
Section 78. Subsection (1) of section 626.592, Florida |
4373
|
Statutes, is amended to read: |
4374
|
626.592 Primary agents.-- |
4375
|
(1) Each person operating an insurance agency and each |
4376
|
location of a multiple location agency shall designate a primary |
4377
|
agent for each insurance agency location and shall file the name |
4378
|
of the person so designated, and the address of the insurance |
4379
|
agency location where he or she is primary agent, with the |
4380
|
department of Insurance, on a form approved by the department. |
4381
|
The designation of the primary agent may be changed at the |
4382
|
option of the agency, and any change shall be effective upon |
4383
|
notification to the department. Notice of change must be sent to |
4384
|
the department within 30 days after such change. |
4385
|
Section 79. Section 626.601, Florida Statutes, is amended |
4386
|
to read: |
4387
|
626.601 Improper conduct; inquiry; fingerprinting.-- |
4388
|
(1) The department or officemay, upon its own motion or |
4389
|
upon a written complaint signed by any interested person and |
4390
|
filed with the department or office, inquire into any alleged |
4391
|
improper conduct of any licensed agent, adjuster, service |
4392
|
representative, managing general agent, customer representative, |
4393
|
title insurance agent, title insurance agency, continuing |
4394
|
education course provider, instructor, school official, or |
4395
|
monitor group under this code. The department or officemay |
4396
|
thereafter initiate an investigation of any such licensee if it |
4397
|
has reasonable cause to believe that the licensee has violated |
4398
|
any provision of the insurance code. During the course of its |
4399
|
investigation, the department or officeshall contact the |
4400
|
licensee being investigated unless it determines that contacting |
4401
|
such person could jeopardize the successful completion of the |
4402
|
investigation or cause injury to the public. |
4403
|
(2) In the investigation by the department or officeof |
4404
|
the alleged misconduct, the licensee shall, whenever so required |
4405
|
by the department or office, cause his or her books and records |
4406
|
to be open for inspection for the purpose of such inquiries. |
4407
|
(3) The complaints against any licensee may be informally |
4408
|
alleged and need not be in any such language as is necessary to |
4409
|
charge a crime on an indictment or information. |
4410
|
(4) The expense for any hearings or investigations under |
4411
|
this law, as well as the fees and mileage of witnesses, may be |
4412
|
paid out of the appropriate fund. |
4413
|
(5) If the department or office, after investigation, has |
4414
|
reason to believe that a licensee may have been found guilty of |
4415
|
or pleaded guilty or nolo contendere to a felony or a crime |
4416
|
related to the business of insurance in this or any other state |
4417
|
or jurisdiction, the department or officemay require the |
4418
|
licensee to file with the department or officea complete set of |
4419
|
his or her fingerprints, which shall be accompanied by the |
4420
|
fingerprint processing fee set forth in s. 624.501. The |
4421
|
fingerprints shall be certified by an authorized law enforcement |
4422
|
officer. |
4423
|
(6) The complaint and any information obtained pursuant to |
4424
|
the investigation by the department or officeare confidential |
4425
|
and are exempt from the provisions of s. 119.07, unless the |
4426
|
department or officefiles a formal administrative complaint, |
4427
|
emergency order, or consent order against the licensee. Nothing |
4428
|
in this subsection shall be construed to prevent the department |
4429
|
or officefrom disclosing the complaint or such information as |
4430
|
it deems necessary to conduct the investigation, to update the |
4431
|
complainant as to the status and outcome of the complaint, or to |
4432
|
share such information with any law enforcement agency. |
4433
|
Section 80. Section 626.611, Florida Statutes, is amended |
4434
|
to read: |
4435
|
626.611 Grounds for compulsory refusal, suspension, or |
4436
|
revocation of agent's, title agency's, adjuster's, customer |
4437
|
representative's, service representative's, or managing general |
4438
|
agent's license or appointment.--The department or officeshall |
4439
|
deny an application for, suspend, revoke, or refuse to renew or |
4440
|
continue the license or appointment of any applicant, agent, |
4441
|
title agency, adjuster, customer representative, service |
4442
|
representative, or managing general agent, and it shall suspend |
4443
|
or revoke the eligibility to hold a license or appointment of |
4444
|
any such person, if it finds that as to the applicant, licensee, |
4445
|
or appointee any one or more of the following applicable grounds |
4446
|
exist: |
4447
|
(1) Lack of one or more of the qualifications for the |
4448
|
license or appointment as specified in this code. |
4449
|
(2) Material misstatement, misrepresentation, or fraud in |
4450
|
obtaining the license or appointment or in attempting to obtain |
4451
|
the license or appointment. |
4452
|
(3) Failure to pass to the satisfaction of the department |
4453
|
or officeany examination required under this code. |
4454
|
(4) If the license or appointment is willfully used, or to |
4455
|
be used, to circumvent any of the requirements or prohibitions |
4456
|
of this code. |
4457
|
(5) Willful misrepresentation of any insurance policy or |
4458
|
annuity contract or willful deception with regard to any such |
4459
|
policy or contract, done either in person or by any form of |
4460
|
dissemination of information or advertising. |
4461
|
(6) If, as an adjuster, or agent licensed and appointed to |
4462
|
adjust claims under this code, he or she has materially |
4463
|
misrepresented to an insured or other interested party the terms |
4464
|
and coverage of an insurance contract with intent and for the |
4465
|
purpose of effecting settlement of claim for loss or damage or |
4466
|
benefit under such contract on less favorable terms than those |
4467
|
provided in and contemplated by the contract. |
4468
|
(7) Demonstrated lack of fitness or trustworthiness to |
4469
|
engage in the business of insurance. |
4470
|
(8) Demonstrated lack of reasonably adequate knowledge and |
4471
|
technical competence to engage in the transactions authorized by |
4472
|
the license or appointment. |
4473
|
(9) Fraudulent or dishonest practices in the conduct of |
4474
|
business under the license or appointment. |
4475
|
(10) Misappropriation, conversion, or unlawful withholding |
4476
|
of moneys belonging to insurers or insureds or beneficiaries or |
4477
|
to others and received in conduct of business under the license |
4478
|
or appointment. |
4479
|
(11) Unlawfully rebating, attempting to unlawfully rebate, |
4480
|
or unlawfully dividing or offering to divide his or her |
4481
|
commission with another. |
4482
|
(12) Having obtained or attempted to obtain, or having |
4483
|
used or using, a license or appointment as agent or customer |
4484
|
representative for the purpose of soliciting or handling |
4485
|
"controlled business" as defined in s. 626.730 with respect to |
4486
|
general lines agents, s. 626.784 with respect to life agents, |
4487
|
and s. 626.830 with respect to health agents. |
4488
|
(13) Willful failure to comply with, or willful violation |
4489
|
of, any proper order or rule of the department, commission, or |
4490
|
officeor willful violation of any provision of this code. |
4491
|
(14) Having been found guilty of or having pleaded guilty |
4492
|
or nolo contendere to a felony or a crime punishable by |
4493
|
imprisonment of 1 year or more under the law of the United |
4494
|
States of America or of any state thereof or under the law of |
4495
|
any other country which involves moral turpitude, without regard |
4496
|
to whether a judgment of conviction has been entered by the |
4497
|
court having jurisdiction of such cases. |
4498
|
(15) Fraudulent or dishonest practice in submitting or |
4499
|
aiding or abetting any person in the submission of an |
4500
|
application for workers' compensation coverage under chapter 440 |
4501
|
containing false or misleading information as to employee |
4502
|
payroll or classification for the purpose of avoiding or |
4503
|
reducing the amount of premium due for such coverage. |
4504
|
(16) Sale of an unregistered security that was required to |
4505
|
be registered, pursuant to chapter 517. |
4506
|
Section 81. Section 626.621, Florida Statutes, is amended |
4507
|
to read: |
4508
|
626.621 Grounds for discretionary refusal, suspension, or |
4509
|
revocation of agent's, adjuster's, customer representative's, |
4510
|
service representative's, or managing general agent's license or |
4511
|
appointment.--The department or officemay, in its discretion, |
4512
|
deny an application for, suspend, revoke, or refuse to renew or |
4513
|
continue the license or appointment of any applicant, agent, |
4514
|
adjuster, customer representative, service representative, or |
4515
|
managing general agent, and it may suspend or revoke the |
4516
|
eligibility to hold a license or appointment of any such person, |
4517
|
if it finds that as to the applicant, licensee, or appointee any |
4518
|
one or more of the following applicable grounds exist under |
4519
|
circumstances for which such denial, suspension, revocation, or |
4520
|
refusal is not mandatory under s. 626.611: |
4521
|
(1) Any cause for which issuance of the license or |
4522
|
appointment could have been refused had it then existed and been |
4523
|
known to the department or office. |
4524
|
(2) Violation of any provision of this code or of any |
4525
|
other law applicable to the business of insurance in the course |
4526
|
of dealing under the license or appointment. |
4527
|
(3) Violation of any lawful order or rule of the |
4528
|
department, commission, or office. |
4529
|
(4) Failure or refusal, upon demand, to pay over to any |
4530
|
insurer he or she represents or has represented any money coming |
4531
|
into his or her hands belonging to the insurer. |
4532
|
(5) Violation of the provision against twisting, as |
4533
|
defined in s. 626.9541(1)(l). |
4534
|
(6) In the conduct of business under the license or |
4535
|
appointment, engaging in unfair methods of competition or in |
4536
|
unfair or deceptive acts or practices, as prohibited under part |
4537
|
IX of this chapter, or having otherwise shown himself or herself |
4538
|
to be a source of injury or loss to the public or detrimental to |
4539
|
the public interest. |
4540
|
(7) Willful overinsurance of any property or health |
4541
|
insurance risk. |
4542
|
(8) Having been found guilty of or having pleaded guilty |
4543
|
or nolo contendere to a felony or a crime punishable by |
4544
|
imprisonment of 1 year or more under the law of the United |
4545
|
States of America or of any state thereof or under the law of |
4546
|
any other country, without regard to whether a judgment of |
4547
|
conviction has been entered by the court having jurisdiction of |
4548
|
such cases. |
4549
|
(9) If a life agent, violation of the code of ethics. |
4550
|
(10) Cheating on an examination required for licensure or |
4551
|
violating test center or examination procedures published |
4552
|
orally, in writing, or electronically at the test site by |
4553
|
authorized representatives of the examination program |
4554
|
administrator. Communication of test center and examination |
4555
|
procedures must be clearly established and documented. |
4556
|
(11) Failure to inform the department or officein writing |
4557
|
within 30 days after pleading guilty or nolo contendere to, or |
4558
|
being convicted or found guilty of, any felony or a crime |
4559
|
punishable by imprisonment of 1 year or more under the law of |
4560
|
the United States or of any state thereof, or under the law of |
4561
|
any other country without regard to whether a judgment of |
4562
|
conviction has been entered by the court having jurisdiction of |
4563
|
the case. |
4564
|
(12) Knowingly aiding, assisting, procuring, advising, or |
4565
|
abetting any person in the violation of or to violate a |
4566
|
provision of the insurance code or any order or rule of the |
4567
|
department, commission, or office. |
4568
|
Section 82. Section 626.631, Florida Statutes, is amended |
4569
|
to read: |
4570
|
626.631 Procedure for refusal, suspension, or revocation |
4571
|
of license.-- |
4572
|
(1) If any licensee is convicted by a court of a violation |
4573
|
of this code or a felony, the licenses and appointments of such |
4574
|
person shall be immediately revoked by the department or office. |
4575
|
The licensee may subsequently request a hearing pursuant to ss. |
4576
|
120.569 and 120.57, and the department or officeshall expedite |
4577
|
any such requested hearing. The sole issue at such hearing |
4578
|
shall be whether the revocation should be rescinded because such |
4579
|
person was not in fact convicted of a violation of this code or |
4580
|
a felony. |
4581
|
(2) The papers, documents, reports, or evidence of the |
4582
|
department or officerelative to a hearing for revocation or |
4583
|
suspension of a license or appointment pursuant to the |
4584
|
provisions of this chapter and chapter 120 are confidential and |
4585
|
exempt from the provisions of s. 119.07(1) until after the same |
4586
|
have been published at the hearing. However, such papers, |
4587
|
documents, reports, or items of evidence are subject to |
4588
|
discovery in a hearing for revocation or suspension of a license |
4589
|
or appointment. |
4590
|
Section 83. Subsections (1) and (2) of section 626.641, |
4591
|
Florida Statutes, are amended to read: |
4592
|
626.641 Duration of suspension or revocation.-- |
4593
|
(1) The department or officeshall, in its order |
4594
|
suspending a license or appointment or in its order suspending |
4595
|
the eligibility of a person to hold or apply for such license or |
4596
|
appointment, specify the period during which the suspension is |
4597
|
to be in effect; but such period shall not exceed 2 years. The |
4598
|
license, appointment, or eligibility shall remain suspended |
4599
|
during the period so specified, subject, however, to any |
4600
|
rescission or modification of the order by the department or |
4601
|
office, or modification or reversal thereof by the court, prior |
4602
|
to expiration of the suspension period. A license, appointment, |
4603
|
or eligibility which has been suspended shall not be reinstated |
4604
|
except upon request for such reinstatement; but the department |
4605
|
or officeshall not grant such reinstatement if it finds that |
4606
|
the circumstance or circumstances for which the license, |
4607
|
appointment, or eligibility was suspended still exist or are |
4608
|
likely to recur. |
4609
|
(2) No person or appointee under any license or |
4610
|
appointment revoked by the department or office, nor any person |
4611
|
whose eligibility to hold same has been revoked by the |
4612
|
department or office, shall have the right to apply for another |
4613
|
license or appointment under this code within 2 years from the |
4614
|
effective date of such revocation or, if judicial review of such |
4615
|
revocation is sought, within 2 years from the date of final |
4616
|
court order or decree affirming the revocation. The department |
4617
|
or officeshall not, however, grant a new license or appointment |
4618
|
or reinstate eligibility to hold such license or appointment if |
4619
|
it finds that the circumstance or circumstances for which the |
4620
|
eligibility was revoked or for which the previous license or |
4621
|
appointment was revoked still exist or are likely to recur; if |
4622
|
an individual's license as agent or customer representative or |
4623
|
eligibility to hold same has been revoked upon the ground |
4624
|
specified in s. 626.611(12), the department or officeshall |
4625
|
refuse to grant or issue any new license or appointment so |
4626
|
applied for. |
4627
|
Section 84. Subsection (2) of section 626.661, Florida |
4628
|
Statutes, is amended to read: |
4629
|
626.661 Surrender of license.-- |
4630
|
(2) This section shall not be deemed to require the |
4631
|
surrender to the department or officeof any license unless such |
4632
|
surrender has been requested by the department or office. |
4633
|
Section 85. Section 626.681, Florida Statutes, is amended |
4634
|
to read: |
4635
|
626.681 Administrative fine in lieu of or in addition to |
4636
|
suspension, revocation, or refusal of license, appointment, or |
4637
|
disapproval.-- |
4638
|
(1) Except as to insurance agencies, if the department or |
4639
|
officefinds that one or more grounds exist for the suspension, |
4640
|
revocation, or refusal to issue, renew, or continue any license |
4641
|
or appointment issued under this chapter, or disapproval of a |
4642
|
continuing education course provider, instructor, school |
4643
|
official, or monitor groups, the department or officemay, in |
4644
|
its discretion, in lieu of or in addition to such suspension or |
4645
|
revocation, or in lieu of such refusal, or disapproval, and |
4646
|
except on a second offense or when such suspension, revocation, |
4647
|
or refusal is mandatory, impose upon the licensee, appointee, |
4648
|
course provider, instructor, school official, or monitor group |
4649
|
an administrative penalty in an amount up to $500 or, if the |
4650
|
department or officehas found willful misconduct or willful |
4651
|
violation on the part of the licensee, appointee, course |
4652
|
provider, instructor, school official, or monitor group up to |
4653
|
$3,500. The administrative penalty may, in the discretion of the |
4654
|
department or office, be augmented by an amount equal to any |
4655
|
commissions received by or accruing to the credit of the |
4656
|
licensee or appointee in connection with any transaction as to |
4657
|
which the grounds for suspension, revocation, or refusal |
4658
|
related. |
4659
|
(2) With respect to insurance agencies, if the department |
4660
|
finds that one or more grounds exist for the suspension, |
4661
|
revocation, or refusal to issue, renew, or continue any license |
4662
|
issued under this chapter, the department may, in its |
4663
|
discretion, in lieu of or in addition to such suspension or |
4664
|
revocation, or in lieu of such refusal, impose upon the licensee |
4665
|
an administrative penalty in an amount not to exceed $10,000 per |
4666
|
violation. The administrative penalty may, in the discretion of |
4667
|
the department, be augmented by an amount equal to any |
4668
|
commissions received by or accruing to the credit of the |
4669
|
licensee in connection with any transaction as to which the |
4670
|
grounds for suspension, revocation, or refusal related. |
4671
|
(3) The department or officemay allow the licensee, |
4672
|
appointee, or continuing education course provider, instructor, |
4673
|
school official, or monitor group a reasonable period, not to |
4674
|
exceed 30 days, within which to pay to the department or office |
4675
|
the amount of the penalty so imposed. If the licensee, |
4676
|
appointee, course provider, instructor, school official, or |
4677
|
monitor group fails to pay the penalty in its entirety to the |
4678
|
department or officewithin the period so allowed, the license, |
4679
|
appointments, approval, or status of that person shall stand |
4680
|
suspended or revoked or issuance, renewal, or continuation shall |
4681
|
be refused, as the case may be, upon expiration of such period. |
4682
|
Section 86. Section 626.691, Florida Statutes, is amended |
4683
|
to read: |
4684
|
626.691 Probation.-- |
4685
|
(1) If the department or officefinds that one or more |
4686
|
grounds exist for the suspension, revocation, or refusal to |
4687
|
renew or continue any license or appointment issued under this |
4688
|
part, the department or officemay, in its discretion, except |
4689
|
when an administrative fine is not permissible under s. 626.681 |
4690
|
or when such suspension, revocation, or refusal is mandatory, in |
4691
|
lieu of or in addition to such suspension or revocation, or in |
4692
|
lieu of such refusal, or in connection with any administrative |
4693
|
monetary penalty imposed under s. 626.681, place the offending |
4694
|
licensee or appointee on probation for a period, not to exceed 2 |
4695
|
years, as specified by the department or officein its order. |
4696
|
(2) As a condition to such probation or in connection |
4697
|
therewith, the department or officemay specify in its order |
4698
|
reasonable terms and conditions to be fulfilled by the |
4699
|
probationer during the probation period. If during the |
4700
|
probation period the department or officehas good cause to |
4701
|
believe that the probationer has violated a term or condition, |
4702
|
it shall suspend, revoke, or refuse to issue, renew, or continue |
4703
|
the license or appointment of the probationer, as upon the |
4704
|
original grounds referred to in subsection (1). |
4705
|
Section 87. Section 626.692, Florida Statutes, is amended |
4706
|
to read: |
4707
|
626.692 Restitution.--If any ground exists for the |
4708
|
suspension, revocation, or refusal of a license or appointment, |
4709
|
the department or officemay, in addition to any other penalty |
4710
|
authorized under this chapter, order the licensee to pay |
4711
|
restitution to any person who has been deprived of money by the |
4712
|
licensee's misappropriation, conversion, or unlawful withholding |
4713
|
of moneys belonging to insurers, insureds, beneficiaries, or |
4714
|
others. In no instance shall the amount of restitution required |
4715
|
to be paid under this section exceed the amount of money |
4716
|
misappropriated, converted, or unlawfully withheld. Nothing in |
4717
|
this section limits or restricts a person's right to seek other |
4718
|
remedies as provided for by law. |
4719
|
Section 88. Section 626.7315, Florida Statutes, is amended |
4720
|
to read: |
4721
|
626.7315 Prohibition against the unlicensed transaction of |
4722
|
general lines insurance.--With respect to any line of authority |
4723
|
as defined in s. 626.015(6)(7), no individual shall, unless |
4724
|
licensed as a general lines agent: |
4725
|
(1) Solicit insurance or procure applications therefor; |
4726
|
(2) In this state, receive or issue a receipt for any |
4727
|
money on account of or for any insurer, or receive or issue a |
4728
|
receipt for money from other persons to be transmitted to any |
4729
|
insurer for a policy, contract, or certificate of insurance or |
4730
|
any renewal thereof, even though the policy, certificate, or |
4731
|
contract is not signed by him or her as agent or representative |
4732
|
of the insurer; |
4733
|
(3) Directly or indirectly represent himself or herself to |
4734
|
be an agent of any insurer or as an agent, to collect or forward |
4735
|
any insurance premium, or to solicit, negotiate, effect, |
4736
|
procure, receive, deliver, or forward, directly or indirectly, |
4737
|
any insurance contract or renewal thereof or any endorsement |
4738
|
relating to an insurance contract, or attempt to effect the |
4739
|
same, of property or insurable business activities or interests, |
4740
|
located in this state; |
4741
|
(4) In this state, engage or hold himself or herself out |
4742
|
as engaging in the business of analyzing or abstracting |
4743
|
insurance policies or of counseling or advising or giving |
4744
|
opinions, other than as a licensed attorney at law, relative to |
4745
|
insurance or insurance contracts, for fee, commission, or other |
4746
|
compensation, other than as a salaried bona fide full-time |
4747
|
employee so counseling and advising his or her employer relative |
4748
|
to the insurance interests of the employer and of the |
4749
|
subsidiaries or business affiliates of the employer; |
4750
|
(5) In any way, directly or indirectly, make or cause to |
4751
|
be made, or attempt to make or cause to be made, any contract of |
4752
|
insurance for or on account of any insurer; |
4753
|
(6) Solicit, negotiate, or in any way, directly or |
4754
|
indirectly, effect insurance contracts, if a member of a |
4755
|
partnership or association, or a stockholder, officer, or agent |
4756
|
of a corporation which holds an agency appointment from any |
4757
|
insurer; or |
4758
|
(7) Receive or transmit applications for suretyship, or |
4759
|
receive for delivery bonds founded on applications forwarded |
4760
|
from this state, or otherwise procure suretyship to be effected |
4761
|
by a surety insurer upon the bonds of persons in this state or |
4762
|
upon bonds given to persons in this state. |
4763
|
Section 89. Subsection (3) of section 626.732, Florida |
4764
|
Statutes, is amended to read: |
4765
|
626.732 Requirement as to knowledge, experience, or |
4766
|
instruction.-- |
4767
|
(3) An individual who was or became qualified to sit for |
4768
|
an agent's, customer representative's, or adjuster's examination |
4769
|
at or during the time he or she was employed by the department |
4770
|
or officeand who, while so employed, was employed in |
4771
|
responsible insurance duties as a full-time bona fide employee |
4772
|
shall be permitted to take an examination if application for |
4773
|
such examination is made within 90 days after the date of |
4774
|
termination of his or her employment with the department or |
4775
|
office. |
4776
|
Section 90. Section 626.742, Florida Statutes, is amended |
4777
|
to read: |
4778
|
626.742 Nonresident agents; service of process.-- |
4779
|
(1) Each licensed nonresident agent shall appoint the |
4780
|
Chief Financial OfficerInsurance Commissioner and Treasureras |
4781
|
his or her attorney to receive service of legal process issued |
4782
|
against the agent in this state, upon causes of action arising |
4783
|
within this state out of transactions under the agent's license |
4784
|
and appointment. Service upon the Chief Financial Officer |
4785
|
Insurance Commissioner and Treasureras attorney shall |
4786
|
constitute effective legal service upon the agent. |
4787
|
(2) The appointment of the Chief Financial Officer |
4788
|
Insurance Commissioner and Treasurerfor service of process |
4789
|
shall be irrevocable for as long as there could be any cause of |
4790
|
action against the agent arising out of his or her insurance |
4791
|
transactions in this state. |
4792
|
(3) Duplicate copies of such legal process against such |
4793
|
agent shall be served upon the Chief Financial OfficerInsurance |
4794
|
Commissioner and Treasurerby a person competent to serve a |
4795
|
summons. |
4796
|
(4) Upon receiving such service, the Chief Financial |
4797
|
OfficerInsurance Commissioner and Treasurershall forthwith |
4798
|
send one of the copies of the process, by registered mail with |
4799
|
return receipt requested, to the defendant agent at his or her |
4800
|
last address of record with the department. |
4801
|
(5) The Chief Financial OfficerInsurance Commissioner and |
4802
|
Treasurershall keep a record of the day and hour of service |
4803
|
upon him or her of all such legal process. |
4804
|
Section 91. Subsections (4) and (7) of section 626.7451, |
4805
|
Florida Statutes, are amended to read: |
4806
|
626.7451 Managing general agents; required contract |
4807
|
provisions.--No person acting in the capacity of a managing |
4808
|
general agent shall place business with an insurer unless there |
4809
|
is in force a written contract between the parties which sets |
4810
|
forth the responsibility for a particular function, specifies |
4811
|
the division of responsibilities, and contains the following |
4812
|
minimum provisions: |
4813
|
(4) Separate records of business written by the managing |
4814
|
general agent shall be maintained unless the managing general |
4815
|
agent is a controlled or controlling person. The insurer shall |
4816
|
have access and the right to copy all accounts and records |
4817
|
related to its business in a form usable by the insurer, and the |
4818
|
department and officeshall have access to all books, bank |
4819
|
accounts, and records of the managing general agent in a form |
4820
|
usable to the department and office. The records shall be |
4821
|
retained according to s. 626.561. |
4822
|
(7) If the contract permits the managing general agent to |
4823
|
settle claims on behalf of the insurer: |
4824
|
(a) All claims must be reported to the company in a timely |
4825
|
manner and all claims must be adjusted by properly licensed |
4826
|
persons. |
4827
|
(b) Notice shall be sent by the managing general agent to |
4828
|
the insurer as soon as it becomes known that the claim: |
4829
|
1. Exceeds the limit set by the insurer; |
4830
|
2. Involves a coverage dispute; |
4831
|
3. Exceeds the managing general agent's claims settlement |
4832
|
authority; |
4833
|
4. Is open for more than 6 months; or |
4834
|
5. Is closed by payment of an amount set by the office |
4835
|
departmentor an amount set by the insurer, whichever is less. |
4836
|
(c) All claims files shall be the joint property of the |
4837
|
insurer and managing general agent. However, upon an order of |
4838
|
liquidation of the insurer the claims and related application |
4839
|
files shall become the sole property of the insurer or its |
4840
|
estate. The managing general agent shall have reasonable access |
4841
|
to and the right to copy the files on a timely basis. |
4842
|
(d) Any settlement authority granted to the managing |
4843
|
general agent may be terminated for cause upon the insurer's |
4844
|
written notice to the managing general agent or upon the |
4845
|
termination of the contract. The insurer may suspend the |
4846
|
settlement authority during the pendency of any dispute |
4847
|
regarding the cause for termination. |
4848
|
|
4849
|
For the purposes of this section and ss. 626.7453 and 626.7454, |
4850
|
the term "controlling person" or "controlling" has the meaning |
4851
|
set forth in s. 625.012(5)(b)1., and the term "controlled |
4852
|
person" or "controlled" has the meaning set forth in s. |
4853
|
625.012(5)(b)2. |
4854
|
Section 92. Subsections (1), (5), and (6) of section |
4855
|
626.7454, Florida Statutes, are amended to read: |
4856
|
626.7454 Managing general agents; duties of insurers.-- |
4857
|
(1) The insurer shall have on file for each managing |
4858
|
general agent with which it has done business an independent |
4859
|
financial examination in a form acceptable to the office |
4860
|
department. |
4861
|
(5) Within 30 days after entering into or terminating a |
4862
|
contract with a managing general agent, the insurer shall |
4863
|
provide written notification of the appointment or termination |
4864
|
to the department and office. Notices of appointment of a |
4865
|
managing general agent shall include a statement of duties which |
4866
|
the applicant is expected to perform on behalf of the insurer, |
4867
|
the lines of insurance for which the applicant is to be |
4868
|
authorized to act, and any other information the department or |
4869
|
officemay request. |
4870
|
(6) An insurer shall review its books and records on a |
4871
|
quarterly basis to determine if any producer has become a |
4872
|
managing general agent as defined in s. 626.015. If the insurer |
4873
|
determines that a producer has become a managing general agent, |
4874
|
the insurer shall promptly notify the producer and the |
4875
|
department and officeof such determination and the insurer and |
4876
|
producer must fully comply with the provisions of this section |
4877
|
and ss. 626.7451, 626.7452, and 626.7453 within 30 days after |
4878
|
such determination. |
4879
|
|
4880
|
|
4881
|
Subsections (1), (3), and (4) do not apply to a managing |
4882
|
general agent that is a controlled or controlling person. |
4883
|
Section 93. Subsections (6), (7), and (8) of section |
4884
|
626.7491, Florida Statutes, are amended to read: |
4885
|
626.7491 Business transacted with producer controlled |
4886
|
property and casualty insurer.-- |
4887
|
(6) AUDIT COMMITTEE.--Every controlled insurer shall have |
4888
|
an audit committee of the board of directors composed of |
4889
|
independent directors. The audit committee shall annually meet |
4890
|
with management, the insurer's independent certified public |
4891
|
accountants, and an independent casualty actuary or other |
4892
|
independent loss reserve specialist acceptable to the office |
4893
|
departmentto review the adequacy of the insurer's loss |
4894
|
reserves. |
4895
|
(7) REPORTING REQUIREMENTS.-- |
4896
|
(a) In addition to any other required loss reserve |
4897
|
certification, the controlled insurer shall, on April 1 of each |
4898
|
year, file with the officedepartmentthe opinion of an |
4899
|
independent casualty actuary, or such other independent loss |
4900
|
reserve specialist acceptable to the officedepartment, |
4901
|
reporting loss ratios for each line of business written and |
4902
|
attesting to the adequacy of loss reserves established for |
4903
|
losses incurred and outstanding as of the year end, including |
4904
|
incurred but not reported losses, on business placed by the |
4905
|
producer. |
4906
|
(b) The controlled insurer shall annually report to the |
4907
|
officedepartmentthe amount of commissions paid to the |
4908
|
producer, the percentage such amount represents of the net |
4909
|
premiums written, and comparable amounts and percentages paid to |
4910
|
noncontrolling producers for placements of the same kinds of |
4911
|
insurance. |
4912
|
(8) PENALTIES.-- |
4913
|
(a) If the department believes that the controlling |
4914
|
producer or any other person has not materially complied with |
4915
|
this section, or any rule adopted or order issued hereunder, the |
4916
|
department may order the controlling producer to cease placing |
4917
|
business with the controlled insurer. |
4918
|
(b) If, due to such material noncompliance, the controlled |
4919
|
insurer or any policyholder thereof has suffered any loss or |
4920
|
damage, the department or officemay maintain a civil action or |
4921
|
intervene in an action brought by or on behalf of the insurer or |
4922
|
policyholder for recovery of compensatory damages for the |
4923
|
benefit of the insurer or policyholder or other appropriate |
4924
|
relief. |
4925
|
(c) If an order for liquidation or rehabilitation of the |
4926
|
controlled insurer has been entered pursuant to chapter 631 and |
4927
|
the receiver appointed under such order believes that the |
4928
|
controlling producer or any other person has not materially |
4929
|
complied with this section or any rule adopted or order issued |
4930
|
hereunder and the insurer has suffered any loss or damage |
4931
|
therefrom, the receiver may maintain a civil action for recovery |
4932
|
of damages or other appropriate sanctions for the benefit of the |
4933
|
insurer. |
4934
|
(d) Nothing contained in this section shall affect the |
4935
|
right of the department or officeto impose any other penalties |
4936
|
provided for in the Florida Insurance Code. |
4937
|
(e) Nothing contained in this section is intended to or |
4938
|
shall in any manner alter or affect the rights of policyholders, |
4939
|
claimants, creditors, or other third parties. |
4940
|
Section 94. Paragraph (e) of subsection (3) and |
4941
|
subsections (11) and (12) of section 626.7492, Florida Statutes, |
4942
|
are amended to read: |
4943
|
626.7492 Reinsurance intermediaries.-- |
4944
|
(3) LICENSURE.-- |
4945
|
(e) If the applicant for a reinsurance intermediary |
4946
|
license is a nonresident, the applicant, as a condition |
4947
|
precedent to receiving or holding a license, must designate the |
4948
|
Chief Financial OfficerInsurance Commissioneras agent for |
4949
|
service of process in the manner, and with the same legal |
4950
|
effect, provided for by this section for designation of service |
4951
|
of process upon unauthorized insurers. Such applicant shall also |
4952
|
furnish the department with the name and address of a resident |
4953
|
of this state upon whom notices or orders of the department or |
4954
|
process affecting the nonresident reinsurance intermediary may |
4955
|
be served. The licensee shall promptly notify the department in |
4956
|
writing of each change in its designated agent for service of |
4957
|
process, and the change shall not become effective until |
4958
|
acknowledged by the department. |
4959
|
(11) PENALTIES AND LIABILITIES.-- |
4960
|
(a) A reinsurance intermediary found by the department, or |
4961
|
an insurer, or reinsurer found by the office,departmentto be |
4962
|
in violation of any provision of this section must: |
4963
|
1. For each separate violation pay a penalty in an amount |
4964
|
not to exceed $5,000; |
4965
|
2. Be subject to revocation or suspension of its license; |
4966
|
and |
4967
|
3. If a violation was committed by the reinsurance |
4968
|
intermediary, the reinsurance intermediary must make restitution |
4969
|
to the insurer, reinsurer, rehabilitator, or liquidator of the |
4970
|
insurer or reinsurer for the net losses incurred by the insurer |
4971
|
or reinsurer attributable to the violation. |
4972
|
(b) Nothing contained in this section shall affect the |
4973
|
right of the office ordepartment to impose any other penalties |
4974
|
provided in the Florida Insurance Code. |
4975
|
(c) Nothing contained in this section is intended to or |
4976
|
shall in any manner limit or restrict the rights of |
4977
|
policyholders, claimants, creditors, or other third parties or |
4978
|
confer any rights to these persons. |
4979
|
(12) No insurer or reinsurer may continue to use the |
4980
|
services of a reinsurance intermediary on or after April 8, |
4981
|
1992, unless such use is in compliance with this section. |
4982
|
Section 95. Subsection (5) of section 626.752, Florida |
4983
|
Statutes, is amended to read: |
4984
|
626.752 Exchange of business.-- |
4985
|
(5) Within 15 days after the last day of each month, any |
4986
|
insurer accepting business under this section shall report to |
4987
|
the department the name, address, telephone number, and social |
4988
|
security number of each agent from which the insurer received |
4989
|
more than 24 personal lines risks during the calendar year, |
4990
|
except for risks being removed from the Citizens Property |
4991
|
Insurance CorporationResidential Property and Casualty Joint |
4992
|
Underwriting Associationand placed with that insurer by a |
4993
|
brokering agent. Once the insurer has reported pursuant to this |
4994
|
subsection an agent's name to the department, additional reports |
4995
|
on the same agent shall not be required. However, the fee set |
4996
|
forth in s. 624.501 shall be paid for the agent by the insurer |
4997
|
for each year until the insurer notifies the department that the |
4998
|
insurer is no longer accepting business from the agent pursuant |
4999
|
to this section. The insurer may require that the agent |
5000
|
reimburse the insurer for the fee. |
5001
|
Section 96. Subsection (2) of section 626.7845, Florida |
5002
|
Statutes, is amended to read: |
5003
|
626.7845 Prohibition against unlicensed transaction of |
5004
|
life insurance.-- |
5005
|
(2) Except as provided in s. 626.112(6), with respect to |
5006
|
any line of authority specified in s. 626.015(11)(12), no |
5007
|
individual shall, unless licensed as a life agent: |
5008
|
(a) Solicit insurance or annuities or procure |
5009
|
applications; or |
5010
|
(b) In this state, engage or hold himself or herself out |
5011
|
as engaging in the business of analyzing or abstracting |
5012
|
insurance policies or of counseling or advising or giving |
5013
|
opinions to persons relative to insurance or insurance contracts |
5014
|
other than: |
5015
|
1. As a consulting actuary advising an insurer; or |
5016
|
2. As to the counseling and advising of labor unions, |
5017
|
associations, trustees, employers, or other business entities, |
5018
|
the subsidiaries and affiliates of each, relative to their |
5019
|
interests and those of their members or employees under |
5020
|
insurance benefit plans. |
5021
|
Section 97. Section 626.7851, Florida Statutes, is amended |
5022
|
to read: |
5023
|
626.7851 Requirement as to knowledge, experience, or |
5024
|
instruction.--No applicant for a license as a life agent, except |
5025
|
for a chartered life underwriter (CLU), shall be qualified or |
5026
|
licensed unless within the 4 years immediately preceding the |
5027
|
date the application for a license is filed with the department |
5028
|
he or she has: |
5029
|
(1) Successfully completed 40 hours of classroom courses |
5030
|
in insurance satisfactory to the department at a school or |
5031
|
college, or extension division thereof, or other authorized |
5032
|
course of study, approved by the department. Courses must |
5033
|
include instruction on the subject matter of unauthorized |
5034
|
entities engaging in the business of insurance, to include the |
5035
|
Florida Nonprofit Multiple-Employer Welfare Arrangement Act and |
5036
|
the Employee Retirement Income Security Act, 29 U.S.C. ss. 1001 |
5037
|
et seq., as it relates to the provision of life insurance by |
5038
|
employers to their employees and the regulation thereof; |
5039
|
(2) Successfully completed a correspondence course in |
5040
|
insurance satisfactory to the department and regularly offered |
5041
|
by accredited institutions of higher learning in this state, |
5042
|
approved by the department. Courses must include instruction on |
5043
|
the subject matter of unauthorized entities engaging in the |
5044
|
business of insurance, to include the Florida Nonprofit |
5045
|
Multiple-Employer Welfare Arrangement Act and the Employee |
5046
|
Retirement Income Security Act, 29 U.S.C. ss. 1001 et seq., as |
5047
|
it relates to the provision of life insurance by employers to |
5048
|
their employees and the regulation thereof; |
5049
|
(3) Held an active license in life, or life and health, |
5050
|
insurance in another state. This provision may not be utilized |
5051
|
unless the other state grants reciprocal treatment to licensees |
5052
|
formerly licensed in Florida; or |
5053
|
(4) Been employed by the department or officefor at least |
5054
|
1 year, full time in life or life and health insurance |
5055
|
regulatory matters and who was not terminated for cause, and |
5056
|
application for examination is made within 90 days after the |
5057
|
date of termination of his or her employment with the department |
5058
|
or office. |
5059
|
Section 98. Section 626.8305, Florida Statutes, is amended |
5060
|
to read: |
5061
|
626.8305 Prohibition against the unlicensed transaction of |
5062
|
health insurance.--Except as provided in s. 626.112(6), with |
5063
|
respect to any line of authority specified in s. 626.015(7)(8), |
5064
|
no individual shall, unless licensed as a health agent: |
5065
|
(1) Solicit insurance or procure applications; or |
5066
|
(2) In this state, engage or hold himself or herself out |
5067
|
as engaging in the business of analyzing or abstracting |
5068
|
insurance policies or of counseling or advising or giving |
5069
|
opinions to persons relative to insurance contracts other than: |
5070
|
(a) As a consulting actuary advising insurers; or |
5071
|
(b) As to the counseling and advising of labor unions, |
5072
|
associations, trustees, employers, or other business entities, |
5073
|
the subsidiaries and affiliates of each, relative to their |
5074
|
interests and those of their members or employees under |
5075
|
insurance benefit plans. |
5076
|
Section 99. Subsection (4) of section 626.8311, Florida |
5077
|
Statutes, is amended to read: |
5078
|
626.8311 Requirement as to knowledge, experience, or |
5079
|
instruction.--No applicant for a license as a health agent, |
5080
|
except for a chartered life underwriter (CLU), shall be |
5081
|
qualified or licensed unless within the 4 years immediately |
5082
|
preceding the date the application for license is filed with the |
5083
|
department he or she has: |
5084
|
(4) Been employed by the department or officefor at least |
5085
|
1 year, full time in health insurance regulatory matters and who |
5086
|
was not terminated for cause, and application for examination is |
5087
|
made within 90 days after the date of termination of his or her |
5088
|
employment with the department or office. |
5089
|
Section 100. Subsection (1) of section 626.8427, Florida |
5090
|
Statutes, is amended to read: |
5091
|
626.8427 Number of applications for licensure required; |
5092
|
exemption; effect of expiration of license.-- |
5093
|
(1) After a license as a title insurance agent has been |
5094
|
issued to a title insurance agent, the agent is not required to |
5095
|
file another license application for a similar license, |
5096
|
irrespective of the number of insurers to be represented by the |
5097
|
agent, unless: |
5098
|
(a) The agent is specifically ordered by the department to |
5099
|
complete a new application; or |
5100
|
(b) During any period of 48 months since the filing of the |
5101
|
original license application, the agent was not appointed, |
5102
|
unless in the case of individuals the failure to be so appointed |
5103
|
was due to military service, in which event the period within |
5104
|
which a new application is not required may, in the discretion |
5105
|
of the department of Insurance, be extended for 12 months |
5106
|
following the date of discharge from military service if the |
5107
|
military service does not exceed 3 years, but in no event shall |
5108
|
the period be extended under this clause for a period of more |
5109
|
than 6 years from the date of filing the original application. |
5110
|
Section 101. Subsections (1) and (3) of section 626.8463, |
5111
|
Florida Statutes, are amended to read: |
5112
|
626.8463 Witnesses and evidence.-- |
5113
|
(1) As to the subject of any examination, investigation, |
5114
|
or hearing being conducted by him or her under s. 624.5015, ss. |
5115
|
626.8417-626.847, or s. 627.791, an examiner appointed by the |
5116
|
department or officeof Insurancemay administer oaths, examine |
5117
|
and cross-examine witnesses, and receive oral and documentary |
5118
|
evidence and shall have the power to subpoena witnesses, compel |
5119
|
their attendance and testimony, and require by subpoena the |
5120
|
production of books, papers, records, files, correspondence, |
5121
|
documents, or other evidence which the examiner deems relevant |
5122
|
to the inquiry. |
5123
|
(3) If a person refuses to comply with any such subpoena |
5124
|
or to testify as to any matter concerning which the person may |
5125
|
be lawfully interrogated, the circuit court in and for Leon |
5126
|
County, or the county in which such examination, investigation, |
5127
|
or hearing is being conducted, or the county in which such |
5128
|
person resides, upon application by the department or office, |
5129
|
may issue an order requiring such person to comply with the |
5130
|
subpoena and to testify. A person who fails to obey such an |
5131
|
order of the court may be punished by the court for contempt. |
5132
|
Section 102. Section 626.8467, Florida Statutes, is |
5133
|
amended to read: |
5134
|
626.8467 Testimony compelled; immunity from prosecution.-- |
5135
|
(1) If a person asks to be excused from attending or |
5136
|
testifying or from producing any books, papers, records, |
5137
|
contracts, documents, or other evidence in connection with any |
5138
|
examination, hearing, or investigation being conducted under s. |
5139
|
624.5015, ss. 626.8417-626.847, or s. 627.791 by the department |
5140
|
or officeor its examiner on the ground that the testimony or |
5141
|
evidence required of the person may tend to incriminate him or |
5142
|
her or subject him or her to a penalty or forfeiture and |
5143
|
notwithstanding is directed to give such testimony or produce |
5144
|
such evidence, the person must, if so directed by the Department |
5145
|
of Financial ServicesInsuranceand the Department of Legal |
5146
|
Affairs or by the office and the Department of Legal Affairs, |
5147
|
nonetheless comply with such direction, but he or she shall not |
5148
|
thereafter be prosecuted or subjected to any penalty or |
5149
|
forfeiture for or on account of any transaction, matter, or |
5150
|
thing concerning which he or she may have so testified or |
5151
|
produced evidence, and no testimony so given or evidence |
5152
|
produced shall be received against the person upon any criminal |
5153
|
action, investigation, or proceeding. However, a person so |
5154
|
testifying shall not be exempt from prosecution or punishment |
5155
|
for any perjury committed by him or her in such testimony, and |
5156
|
the testimony or evidence so given or produced shall be |
5157
|
admissible against him or her upon any criminal action, |
5158
|
investigation, or proceeding concerning such perjury; and such |
5159
|
person shall not be exempt from the refusal, suspension, or |
5160
|
revocation of any license or appointment, permission, or |
5161
|
authority conferred or to be conferred pursuant to s. 624.5015, |
5162
|
ss. 626.8417-626.847, or s. 627.791. |
5163
|
(2) Any such person may execute, acknowledge, and file |
5164
|
within the office of the Department of Financial Services or |
5165
|
the office, as appropriate,Insurancea statement expressly |
5166
|
waiving such immunity or privilege with respect to any |
5167
|
transaction, matter, or thing specified in the statement, and |
5168
|
thereupon the testimony of such person or such evidence in |
5169
|
relation to such transaction, matter, or thing may be received |
5170
|
or produced before any judge or justice, court, tribunal, or |
5171
|
grand jury or otherwise and, if so received or produced, such |
5172
|
person shall not be entitled to any immunity or privilege on |
5173
|
account of any testimony he or she may so give or evidence so |
5174
|
produced. |
5175
|
Section 103. Section 626.847, Florida Statutes, is amended |
5176
|
to read: |
5177
|
626.847 Penalty for refusal to testify.--A person who |
5178
|
refuses or fails, without lawful cause, to testify relative to |
5179
|
the affairs of any title insurer or other person when subpoenaed |
5180
|
under s. 626.8463 and requested by the department or officeof |
5181
|
Insuranceto so testify is guilty of a misdemeanor of the second |
5182
|
degree and, upon conviction, is punishable as provided in s. |
5183
|
775.082 or s. 775.083. |
5184
|
Section 104. Subsection (3) of section 626.8473, Florida |
5185
|
Statutes, is amended to read: |
5186
|
626.8473 Escrow; trust fund.-- |
5187
|
(3) All funds received by a title insurance agent to be |
5188
|
held in trust shall be immediately placed in a financial |
5189
|
institution that is located within this state and is a member of |
5190
|
the Federal Deposit Insurance Corporation or the National Credit |
5191
|
Union Share Insurance Fund. These funds shall be invested in an |
5192
|
escrow account in accordance with the investment requirements |
5193
|
and standards established for deposits and investments of state |
5194
|
funds in s. 17.5718.10, where the funds shall be kept until |
5195
|
disbursement thereof is properly authorized. |
5196
|
Section 105. Section 626.8582, Florida Statutes, is |
5197
|
amended to read: |
5198
|
626.8582 "Nonresident public adjuster" defined.--A |
5199
|
"nonresident public adjuster" is a person who: |
5200
|
(1) Is not a resident of this state; |
5201
|
(2) Is a currently licensed public adjuster in his or her |
5202
|
state of residence for the type or kinds of insurance for which |
5203
|
the licensee intends to adjust claims in this state or, if a |
5204
|
resident of a state that does not license public adjusters, has |
5205
|
passed the office'sdepartment'sadjuster examination as |
5206
|
prescribed in s. 626.8732(1)(b); and |
5207
|
(3) Is a self-employed public adjuster or associated with |
5208
|
or employed by a public adjusting firm or other public adjuster. |
5209
|
Section 106. Section 626.8584, Florida Statutes, is |
5210
|
amended to read: |
5211
|
626.8584 "Nonresident independent adjuster" defined.--A |
5212
|
"nonresident independent adjuster" is a person who: |
5213
|
(1) Is not a resident of this state; |
5214
|
(2) Is a currently licensed independent adjuster in his or |
5215
|
her state of residence for the type or kinds of insurance for |
5216
|
which the licensee intends to adjust claims in this state or, if |
5217
|
a resident of a state that does not license independent |
5218
|
adjusters, has passed the office'sdepartment'sadjuster |
5219
|
examination as prescribed in s. 626.8734(1)(b); and |
5220
|
(3) Is a self-employed independent adjuster or associated |
5221
|
with or employed by an independent adjusting firm or other |
5222
|
independent adjuster. |
5223
|
Section 107. Section 626.859, Florida Statutes, is amended |
5224
|
to read: |
5225
|
626.859 "Catastrophe" or "emergency" adjuster defined.--A |
5226
|
"catastrophe" or "emergency" adjuster is a person who is not a |
5227
|
licensed adjuster under this part, but who has been designated |
5228
|
and certified to the officedepartmentby insurers as qualified |
5229
|
to adjust claims, losses, or damages under policies or contracts |
5230
|
of insurance issued by such insurer, and whom the office |
5231
|
departmentmay license, in the event of a catastrophe or |
5232
|
emergency, for the purposes and under the conditions which the |
5233
|
officedepartmentshall fix and for the period of the emergency |
5234
|
as the officedepartmentshall determine, to adjust claims, |
5235
|
losses, or damages under the policies of insurance issued by the |
5236
|
insurers. |
5237
|
Section 108. Subsection (2) of section 626.861, Florida |
5238
|
Statutes, is amended to read: |
5239
|
626.861 Insurer's officers, insurer's employees, |
5240
|
reciprocal insurer's representatives; adjustments by.-- |
5241
|
(2) If any such officer, employee, attorney, or agent in |
5242
|
connection with the adjustment of any such claim, loss, or |
5243
|
damage engages in any of the misconduct described in or |
5244
|
contemplated by s. 626.611(6), the officedepartmentmay suspend |
5245
|
or revoke the insurer's certificate of authority. |
5246
|
Section 109. Subsection (2) of section 626.863, Florida |
5247
|
Statutes, is amended to read: |
5248
|
626.863 Licensed independent adjusters required; insurers' |
5249
|
responsibility.-- |
5250
|
(2) Before referring any claim or loss, the insurer shall |
5251
|
ascertain from the officedepartmentwhether the proposed |
5252
|
independent adjuster is currently licensed and appointed as |
5253
|
such. Having once ascertained that a particular person is so |
5254
|
licensed and appointed, the insurer may assume that he or she |
5255
|
will continue to be so licensed and appointed until the insurer |
5256
|
has knowledge, or receives information from the office |
5257
|
department, to the contrary. |
5258
|
Section 110. Section 626.865, Florida Statutes, is amended |
5259
|
to read: |
5260
|
626.865 Public adjuster's qualifications, bond.-- |
5261
|
(1) The officedepartmentshall issue a license to an |
5262
|
applicant for a public adjuster's license upon determining that |
5263
|
the applicant has paid the applicable fees specified in s. |
5264
|
624.501 and possesses the following qualifications: |
5265
|
(a) Is a natural person at least 18 years of age. |
5266
|
(b) Is a bona fide resident of this state. |
5267
|
(c) Is trustworthy and has such business reputation as |
5268
|
would reasonably assure that the applicant will conduct his or |
5269
|
her business as insurance adjuster fairly and in good faith and |
5270
|
without detriment to the public. |
5271
|
(d) Has had sufficient experience, training, or |
5272
|
instruction concerning the adjusting of damages or losses under |
5273
|
insurance contracts, other than life and annuity contracts, is |
5274
|
sufficiently informed as to the terms and effects of the |
5275
|
provisions of those types of insurance contracts, and possesses |
5276
|
adequate knowledge of the laws of this state relating to such |
5277
|
contracts as to enable and qualify him or her to engage in the |
5278
|
business of insurance adjuster fairly and without injury to the |
5279
|
public or any member thereof with whom the applicant may have |
5280
|
business as a public adjuster. |
5281
|
(e) Has passed any required written examination. |
5282
|
(2) At the time of application for license as a public |
5283
|
adjuster, the applicant shall file with the officedepartmenta |
5284
|
bond executed and issued by a surety insurer authorized to |
5285
|
transact such business in this state, in the amount of $50,000, |
5286
|
conditioned for the faithful performance of his or her duties as |
5287
|
a public adjuster under the license applied for. The bond shall |
5288
|
be in favor of the officedepartmentand shall specifically |
5289
|
authorize recovery by the officedepartmentof the damages |
5290
|
sustained in case the licensee is guilty of fraud or unfair |
5291
|
practices in connection with his or her business as public |
5292
|
adjuster. The aggregate liability of the surety for all such |
5293
|
damages shall in no event exceed the amount of the bond. Such |
5294
|
bond shall not be terminated unless at least 30 days' written |
5295
|
notice is given to the licensee and filed with the office |
5296
|
department. |
5297
|
Section 111. Section 626.866, Florida Statutes, is amended |
5298
|
to read: |
5299
|
626.866 Independent adjuster's qualifications.--The office |
5300
|
departmentshall issue a license to an applicant for an |
5301
|
independent adjuster's license upon determining that the |
5302
|
applicable license fee specified in s. 624.501 has been paid and |
5303
|
that the applicant possesses the following qualifications: |
5304
|
(1) Is a natural person at least 18 years of age. |
5305
|
(2) Is a bona fide resident of this state. |
5306
|
(3) Is trustworthy and has such business reputation as |
5307
|
would reasonably assure that the applicant will conduct his or |
5308
|
her business as insurance adjuster fairly and in good faith and |
5309
|
without detriment to the public. |
5310
|
(4) Has had sufficient experience, training, or |
5311
|
instruction concerning the adjusting of damage or loss under |
5312
|
insurance contracts, other than life and annuity contracts, is |
5313
|
sufficiently informed as to the terms and the effects of the |
5314
|
provisions of such types of contracts, and possesses adequate |
5315
|
knowledge of the insurance laws of this state relating to such |
5316
|
contracts as to enable and qualify him or her to engage in the |
5317
|
business of insurance adjuster fairly and without injury to the |
5318
|
public or any member thereof with whom he or she may have |
5319
|
relations as an insurance adjuster and to adjust all claims in |
5320
|
accordance with the policy or contract and the insurance laws of |
5321
|
this state. |
5322
|
(5) Has passed any required written examination. |
5323
|
Section 112. Section 626.867, Florida Statutes, is amended |
5324
|
to read: |
5325
|
626.867 Company employee adjuster's qualifications.--The |
5326
|
officedepartmentshall issue a license to an applicant for a |
5327
|
company employee adjuster's license upon determining that the |
5328
|
applicable license fee specified in s. 624.501 has been paid and |
5329
|
that the applicant possesses the following qualifications: |
5330
|
(1) Is a natural person at least 18 years of age. |
5331
|
(2) Is a bona fide resident of this state. |
5332
|
(3) Is trustworthy and has such business reputation as |
5333
|
would reasonably assure that the applicant will conduct his or |
5334
|
her business as insurance adjuster fairly and in good faith and |
5335
|
without detriment to the public. |
5336
|
(4) Has had sufficient experience, training, or |
5337
|
instruction concerning the adjusting of damage or loss of risks |
5338
|
described in his or her application, is sufficiently informed as |
5339
|
to the terms and the effects of the provisions of insurance |
5340
|
contracts covering such risks, and possesses adequate knowledge |
5341
|
of the insurance laws of this state relating to such insurance |
5342
|
contracts as to enable and qualify him or her to engage in such |
5343
|
business as insurance adjuster fairly and without injury to the |
5344
|
public or any member thereof with whom he or she may have |
5345
|
relations as an insurance adjuster and to adjust all claims in |
5346
|
accordance with the policy or contract and the insurance laws of |
5347
|
this state. |
5348
|
(5) Has passed any required written examination. |
5349
|
Section 113. Subsection (5) of section 626.869, Florida |
5350
|
Statutes, is amended to read: |
5351
|
626.869 License, adjusters.-- |
5352
|
(5) Any person holding a license for 24 consecutive months |
5353
|
or longer and who engages in adjusting workers' compensation |
5354
|
insurance must, beginning in their birth month and every 2 years |
5355
|
thereafter, have completed 24 hours of courses, 2 hours of which |
5356
|
relate to ethics, in subjects designed to inform the licensee |
5357
|
regarding the current workers' compensation laws of this state, |
5358
|
so as to enable him or her to engage in business as a workers' |
5359
|
compensation insurance adjuster fairly and without injury to the |
5360
|
public and to adjust all claims in accordance with the policy or |
5361
|
contract and the workers' compensation laws of this state. In |
5362
|
order to qualify as an eligible course under this subsection, |
5363
|
the course must: |
5364
|
(a) Have a course outline approved by the office |
5365
|
department. |
5366
|
(b) Be taught at a school training facility or other |
5367
|
location approved by the officedepartment. |
5368
|
(c) Be taught by instructors with at least 5 years of |
5369
|
experience in the area of workers' compensation, general lines |
5370
|
of insurance, or other persons approved by the office |
5371
|
department. However, a member of The Florida Bar is exempt from |
5372
|
the 5 years' experience requirement. |
5373
|
(d) Furnish the attendee a certificate of completion. The |
5374
|
course provider shall send a roster to the officedepartmentin |
5375
|
a format prescribed by the commissiondepartment. |
5376
|
Section 114. Section 626.8695, Florida Statutes, is |
5377
|
amended to read: |
5378
|
626.8695 Primary adjuster.-- |
5379
|
(1) Each person operating an adjusting firm and each |
5380
|
location of a multiple location adjusting firm must designate a |
5381
|
primary adjuster for each such firm or location and must file |
5382
|
with the officedepartmentthe name of such primary adjuster and |
5383
|
the address of the firm or location where he or she is the |
5384
|
primary adjuster, on a form approved by the commission |
5385
|
department. The designation of the primary adjuster may be |
5386
|
changed at the option of the adjusting firm. Any such change is |
5387
|
effective upon notification to the officedepartment. Notice of |
5388
|
change must be sent to the officedepartmentwithin 30 days |
5389
|
after such change. |
5390
|
(2)(a) For purposes of this section, a "primary adjuster" |
5391
|
is the licensed adjuster who is responsible for the hiring and |
5392
|
supervision of all individuals within an adjusting firm location |
5393
|
who deal with the public and who acts in the capacity of a |
5394
|
public adjuster as defined in s. 626.854, or an independent |
5395
|
adjuster as defined in s. 626.855. An adjuster may be |
5396
|
designated as a primary adjuster for only one adjusting firm |
5397
|
location. |
5398
|
(b) For purposes of this section, an "adjusting firm" is a |
5399
|
location where an independent or public adjuster is engaged in |
5400
|
the business of insurance. |
5401
|
(3) The officedepartmentmay suspend or revoke the |
5402
|
license of the primary adjuster if the adjusting firm employs |
5403
|
any person who has had a license denied or any person whose |
5404
|
license is currently suspended or revoked. However, if a person |
5405
|
has been denied a license for failure to pass a required |
5406
|
examination, he or she may be employed to perform clerical or |
5407
|
administrative functions for which licensure is not required. |
5408
|
(4) The primary adjuster in an unincorporated adjusting |
5409
|
firm, or the primary adjuster in an incorporated adjusting firm |
5410
|
in which no officer, director, or stockholder is an adjuster, is |
5411
|
responsible and accountable for the acts of salaried employees |
5412
|
under his or her direct supervision and control while acting on |
5413
|
behalf of the adjusting firm. Nothing in this section renders |
5414
|
any person criminally liable or subject to any disciplinary |
5415
|
proceedings for any act unless the person personally committed |
5416
|
or knew or should have known of the act and of the facts |
5417
|
constituting a violation of this code. |
5418
|
(5) The officedepartmentmay suspend or revoke the |
5419
|
license of any adjuster who is employed by a person whose |
5420
|
license is currently suspended or revoked. |
5421
|
(6) An adjusting firm location may not conduct the |
5422
|
business of insurance unless a primary adjuster is designated. |
5423
|
Failure of the person operating the adjusting firm to designate |
5424
|
a primary adjuster for the firm, or for each location, as |
5425
|
applicable, on a form prescribed by the commissiondepartment |
5426
|
within 30 days after inception of the firm or change of primary |
5427
|
adjuster designation, constitutes grounds for requiring the |
5428
|
adjusting firm to obtain an adjusting firm license pursuant to |
5429
|
s. 626.8696. |
5430
|
(7) Any adjusting firm may request, on a form prescribed |
5431
|
by the commissiondepartment, verification from the office |
5432
|
departmentof any person's current licensure status. If a |
5433
|
request is mailed to the officedepartmentwithin 5 working days |
5434
|
after the date an adjuster is hired, and the officedepartment |
5435
|
subsequently notifies the adjusting firm that an employee's |
5436
|
license is currently suspended, revoked, or has been denied, the |
5437
|
license of the primary adjuster shall not be revoked or |
5438
|
suspended if the unlicensed person is immediately dismissed from |
5439
|
employment as an adjuster with the firm. |
5440
|
Section 115. Subsections (1) and (5) of section 626.8696, |
5441
|
Florida Statutes, are amended to read: |
5442
|
626.8696 Application for adjusting firm license.-- |
5443
|
(1) The application for an adjusting firm license must |
5444
|
include: |
5445
|
(a) The name of each majority owner, partner, officer, and |
5446
|
director of the adjusting firm. |
5447
|
(b) The resident address of each person required to be |
5448
|
listed in the application under paragraph (a). |
5449
|
(c) The name of the adjusting firm and its principal |
5450
|
business address. |
5451
|
(d) The location of each adjusting firm office and the |
5452
|
name under which each office conducts or will conduct business. |
5453
|
(e) Any additional information which the commission |
5454
|
departmentmay require. |
5455
|
(5) An adjusting firm required to be licensed pursuant to |
5456
|
s. 626.8695 must remain so licensed for a period of 3 years from |
5457
|
the date of licensure, unless the license is suspended or |
5458
|
revoked. The officedepartmentmay suspend or revoke the |
5459
|
adjusting firm's authority to do business for activities |
5460
|
occurring during the time the firm is licensed, regardless of |
5461
|
whether the licensing period has terminated. |
5462
|
Section 116. Section 626.8697, Florida Statutes, is |
5463
|
amended to read: |
5464
|
626.8697 Grounds for refusal, suspension, or revocation of |
5465
|
adjusting firm license.-- |
5466
|
(1) The officedepartmentshall deny, suspend, revoke, or |
5467
|
refuse to continue the license of any adjusting firm if it |
5468
|
finds, as to any adjusting firm or as to any majority owner, |
5469
|
partner, manager, director, officer, or other person who manages |
5470
|
or controls the firm, that any of the following grounds exist: |
5471
|
(a) Lack by the firm of one or more of the qualifications |
5472
|
for the license as specified in this code. |
5473
|
(b) Material misstatement, misrepresentation, or fraud in |
5474
|
obtaining the license or in attempting to obtain the license. |
5475
|
(2) The officedepartmentmay, in its discretion, deny, |
5476
|
suspend, revoke, or refuse to continue the license of any |
5477
|
adjusting firm if it finds that any of the following applicable |
5478
|
grounds exist with respect to the firm or any owner, partner, |
5479
|
manager, director, officer, or other person who is otherwise |
5480
|
involved in the operation of the firm: |
5481
|
(a) Any cause for which issuance of the license could have |
5482
|
been refused had it then existed and been known to the office |
5483
|
department. |
5484
|
(b) Violation of any provision of this code or of any |
5485
|
other law applicable to the business of insurance. |
5486
|
(c) Violation of any order or rule of the office or |
5487
|
commissiondepartment. |
5488
|
(d) An owner, partner, manager, director, officer, or |
5489
|
other person who manages or controls the firm having been found |
5490
|
guilty of or having pleaded guilty or nolo contendere to a |
5491
|
felony or a crime punishable by imprisonment of 1 year or more |
5492
|
under the laws of the United States or of any state or under the |
5493
|
laws of any other country, without regard to whether |
5494
|
adjudication was made or withheld by the court. |
5495
|
(e) Failure to inform the officedepartmentin writing |
5496
|
within 30 days after a pleading by an owner, partner, manager, |
5497
|
director, officer, or other person managing or controlling the |
5498
|
firm of guilty or nolo contendere to, or being convicted or |
5499
|
found guilty of, any felony or a crime punishable by |
5500
|
imprisonment of 1 year or more under the laws of the United |
5501
|
States or of any state, or under the laws of any other country, |
5502
|
without regard to whether adjudication was made or withheld by |
5503
|
the court. |
5504
|
(f) Knowingly aiding, assisting, procuring, advising, or |
5505
|
abetting any person in the violation of or to violate a |
5506
|
provision of the insurance code or any order or rule of the |
5507
|
office or commissiondepartment. |
5508
|
(g) Knowingly employing any individual in a managerial |
5509
|
capacity or in a capacity dealing with the public who is under |
5510
|
an order of revocation or suspension issued by the office |
5511
|
department. |
5512
|
(h) Committing any of the following acts with such a |
5513
|
frequency as to have made the operation of the adjusting firm |
5514
|
hazardous to the insurance-buying public or other persons: |
5515
|
1. Misappropriation, conversion, or unlawful or |
5516
|
unreasonable withholding of moneys belonging to insurers or |
5517
|
insureds or beneficiaries or claimants or to others and received |
5518
|
in the conduct of business under the license. |
5519
|
2. Misrepresentation or deception with regard to the |
5520
|
business of insurance, dissemination of information, or |
5521
|
advertising. |
5522
|
3. Demonstrated lack of fitness or trustworthiness to |
5523
|
engage in the business of insurance adjusting arising out of |
5524
|
activities related to insurance adjusting or the adjusting firm. |
5525
|
(i) Failure to appoint a primary adjuster. |
5526
|
(3) In lieu of discretionary refusal, suspension, or |
5527
|
revocation of an adjusting firm's license, the officedepartment |
5528
|
may impose an administrative penalty of up to $1,000 for each |
5529
|
violation or ground provided under this section, not to exceed |
5530
|
an aggregate amount of $10,000 for all violations or grounds. |
5531
|
(4) If any adjusting firm, having been licensed, |
5532
|
thereafter has such license revoked or suspended, the firm shall |
5533
|
terminate all adjusting activities while the license is revoked |
5534
|
or suspended. |
5535
|
Section 117. Section 626.8698, Florida Statutes, is |
5536
|
amended to read: |
5537
|
626.8698 Disciplinary guidelines for public |
5538
|
adjusters.--The officedepartmentmay deny, suspend, or revoke |
5539
|
the license of a public adjuster, and administer a fine not to |
5540
|
exceed $5,000 per act, for any of the following: |
5541
|
(1) Violating any provision of this chapter or a rule or |
5542
|
order of the office or commissiondepartment; |
5543
|
(2) Receiving payment or anything of value as a result of |
5544
|
an unfair or deceptive practice; |
5545
|
(3) Receiving or accepting any fee, kickback, or other |
5546
|
thing of value pursuant to any agreement or understanding, oral |
5547
|
or otherwise; entering into a split-fee arrangement with another |
5548
|
person who is not a public adjuster; or being otherwise paid or |
5549
|
accepting payment for services that have not been performed; |
5550
|
(4) Violating s. 316.066 or s. 817.234; |
5551
|
(5) Soliciting or otherwise taking advantage of a person |
5552
|
who is vulnerable, emotional, or otherwise upset as the result |
5553
|
of a trauma, accident, or other similar occurrence; or |
5554
|
(6) Violating any ethical rule of the commission |
5555
|
department. |
5556
|
Section 118. Section 626.870, Florida Statutes, is amended |
5557
|
to read: |
5558
|
626.870 Application for license.-- |
5559
|
(1) Application for a license under this part shall be |
5560
|
made as provided in s. 626.171 and related sections of this |
5561
|
code. |
5562
|
(2) The commissiondepartmentshall so prepare the form of |
5563
|
the application as to elicit and require from the applicant the |
5564
|
information necessary to enable the officedepartmentto |
5565
|
determine whether the applicant possesses the qualifications |
5566
|
prerequisite to issuance of the license to the applicant. |
5567
|
(3) The commissiondepartmentmay, in its discretion, |
5568
|
require that the application be supplemented by the certificate |
5569
|
or affidavit of such person or persons as it deems necessary for |
5570
|
its determination of the applicant's residence, business |
5571
|
reputation, and reputation for trustworthiness. The commission |
5572
|
department shall prescribe and the officemay furnish the forms |
5573
|
for such certificates and affidavits. |
5574
|
Section 119. Section 626.871, Florida Statutes, is amended |
5575
|
to read: |
5576
|
626.871 Reappointment after military service.--The office |
5577
|
departmentmay, without requiring a further written examination, |
5578
|
issue an appointment as an adjuster to a formerly licensed and |
5579
|
appointed adjuster of this state who held a current adjuster's |
5580
|
appointment at the time of entering service in the Armed Forces |
5581
|
of the United States, subject to the following conditions: |
5582
|
(1) The period of military service must not have been in |
5583
|
excess of 3 years; |
5584
|
(2) The application for the appointment must be filed with |
5585
|
the officedepartmentand the applicable fee paid, within 12 |
5586
|
months following the date of honorable discharge of the |
5587
|
applicant from the military service; and |
5588
|
(3) The new appointment will be of the same type and class |
5589
|
as that currently effective at the time the applicant entered |
5590
|
military service; but, if such type and class of appointment is |
5591
|
not being currently issued under this code, the new appointment |
5592
|
shall be of that type and class or classes most closely |
5593
|
resembling those of the former appointment. |
5594
|
Section 120. Subsections (1) and (5) of section 626.872, |
5595
|
Florida Statutes, are amended to read: |
5596
|
626.872 Temporary license.-- |
5597
|
(1) The officedepartmentmay, in its discretion, issue a |
5598
|
temporary license as an independent adjuster or as a company |
5599
|
employee adjuster, subject to the following conditions: |
5600
|
(a) The applicant must be an employee of an adjuster |
5601
|
currently licensed by the officedepartment, an employee of an |
5602
|
authorized insurer, or an employee of an established adjusting |
5603
|
firm or corporation which is supervised by a currently licensed |
5604
|
independent adjuster. |
5605
|
(b) The application must be accompanied by a certificate |
5606
|
of employment and a report as to the applicant's integrity and |
5607
|
moral character on a form prescribed by the commission |
5608
|
departmentand executed by the employer. |
5609
|
(c) The applicant must be a natural person of at least 18 |
5610
|
years of age, must be a bona fide resident of this state, must |
5611
|
be trustworthy, and must have such business reputation as would |
5612
|
reasonably assure that the applicant will conduct his or her |
5613
|
business as an adjuster fairly and in good faith and without |
5614
|
detriment to the public. |
5615
|
(d) The applicant's employer is responsible for the |
5616
|
adjustment acts of any licensee under this section. |
5617
|
(e) The applicable license fee specified must be paid |
5618
|
before issuance of the temporary license. |
5619
|
(f) The temporary license shall be effective for a period |
5620
|
of 1 year, but subject to earlier termination at the request of |
5621
|
the employer, or if the licensee fails to take an examination as |
5622
|
an independent adjuster or company employee adjuster within 6 |
5623
|
months after issuance of the temporary license, or if suspended |
5624
|
or revoked by the officedepartment. |
5625
|
(5) The officedepartmentshall not issue a temporary |
5626
|
license as an independent adjuster or as a company employee |
5627
|
adjuster to any individual who has ever held such a license in |
5628
|
this state. |
5629
|
Section 121. Subsection (1) of section 626.873, Florida |
5630
|
Statutes, is amended to read: |
5631
|
626.873 Nonresident company employee adjusters.-- |
5632
|
(1) The officedepartmentshall, upon application |
5633
|
therefor, issue a license to an applicant for a nonresident |
5634
|
adjuster's license upon determining that the applicant has paid |
5635
|
the applicable license fees required under s. 624.501 and: |
5636
|
(a) Is a currently licensed insurance adjuster in his or |
5637
|
her home state, if such state requires a license. |
5638
|
(b) Is an employee of an insurer, or a wholly owned |
5639
|
subsidiary of an insurer, admitted to do business in this state. |
5640
|
(c) Has filed a certificate or letter of authorization |
5641
|
from the insurance department of his or her home state, if such |
5642
|
state requires an adjuster to be licensed, stating that he or |
5643
|
she holds a current license or authorization to adjust insurance |
5644
|
losses. Such certificate or authorization must be signed by the |
5645
|
insurance commissioner, or his or her deputy, of the adjuster's |
5646
|
home state and must reflect whether or not the adjuster has ever |
5647
|
had his or her license or authorization in the adjuster's home |
5648
|
state suspended or revoked and, if such is the case, the reason |
5649
|
for such action. |
5650
|
Section 122. Section 626.8732, Florida Statutes, is |
5651
|
amended to read: |
5652
|
626.8732 Nonresident public adjuster's qualifications, |
5653
|
bond.-- |
5654
|
(1) The officedepartmentshall, upon application |
5655
|
therefor, issue a license to an applicant for a nonresident |
5656
|
public adjuster's license upon determining that the applicant |
5657
|
has paid the applicable license fees required under s. 624.501 |
5658
|
and: |
5659
|
(a) Is a natural person at least 18 years of age. |
5660
|
(b) Has passed to the satisfaction of the office |
5661
|
departmenta written Florida public adjuster's examination of |
5662
|
the scope prescribed in s. 626.241(6); however, the requirement |
5663
|
for such an examination does not apply to any of the following: |
5664
|
1. An applicant who is licensed as a resident public |
5665
|
adjuster in his or her state of residence, when that state |
5666
|
requires the passing of a written examination in order to obtain |
5667
|
the license and a reciprocal agreement with the appropriate |
5668
|
official of that state has been entered into by the office |
5669
|
department; or |
5670
|
2. An applicant who is licensed as a nonresident public |
5671
|
adjuster in a state other than his or her state of residence |
5672
|
when the state of licensure requires the passing of a written |
5673
|
examination in order to obtain the license and a reciprocal |
5674
|
agreement with the appropriate official of the state of |
5675
|
licensure has been entered into by the officedepartment. |
5676
|
(c) Is self-employed as a public adjuster or associated |
5677
|
with or employed by a public adjusting firm or other public |
5678
|
adjuster. Applicants licensed as nonresident public adjusters |
5679
|
under this section must be appointed as such in accordance with |
5680
|
the provisions of ss. 626.112 and 626.451. Appointment fees in |
5681
|
the amount specified in s. 624.501 must be paid to the office |
5682
|
departmentin advance. The appointment of a nonresident public |
5683
|
adjuster shall continue in force until suspended, revoked, or |
5684
|
otherwise terminated, but subject to biennial renewal or |
5685
|
continuation by the licensee in accordance with procedures |
5686
|
prescribed in s. 626.381 for licensees in general. |
5687
|
(d) Is trustworthy and has such business reputation as |
5688
|
would reasonably assure that he or she will conduct his or her |
5689
|
business as a nonresident public adjuster fairly and in good |
5690
|
faith and without detriment to the public. |
5691
|
(e) Has had sufficient experience, training, or |
5692
|
instruction concerning the adjusting of damages or losses under |
5693
|
insurance contracts, other than life and annuity contracts; is |
5694
|
sufficiently informed as to the terms and effects of the |
5695
|
provisions of those types of insurance contracts; and possesses |
5696
|
adequate knowledge of the laws of this state relating to such |
5697
|
contracts as to enable and qualify him or her to engage in the |
5698
|
business of insurance adjuster fairly and without injury to the |
5699
|
public or any member thereof with whom he or she may have |
5700
|
business as a public adjuster. |
5701
|
(2) The applicant shall furnish the following with his or |
5702
|
her application: |
5703
|
(a) A complete set of his or her fingerprints. The |
5704
|
applicant's fingerprints must be certified by an authorized law |
5705
|
enforcement officer. The officedepartmentmay not authorize an |
5706
|
applicant to take the required examination or issue a |
5707
|
nonresident public adjuster's license to the applicant until the |
5708
|
officedepartmenthas received a report from the Florida |
5709
|
Department of Law Enforcement and the Federal Bureau of |
5710
|
Investigation relative to the existence or nonexistence of a |
5711
|
criminal history report based on the applicant's fingerprints. |
5712
|
(b) If currently licensed as a resident public adjuster in |
5713
|
the applicant's state of residence, a certificate or letter of |
5714
|
authorization from the licensing authority of the applicant's |
5715
|
state of residence, stating that the applicant holds a current |
5716
|
or comparable license to act as a public adjuster. The |
5717
|
certificate or letter of authorization must be signed by the |
5718
|
insurance commissioner or his or her deputy or the appropriate |
5719
|
licensing official and must disclose whether the adjuster has |
5720
|
ever had any license or eligibility to hold any license |
5721
|
declined, denied, suspended, revoked, or placed on probation or |
5722
|
whether an administrative fine or penalty has been levied |
5723
|
against the adjuster and, if so, the reason for the action. |
5724
|
(c) If the applicant's state of residence does not require |
5725
|
licensure as a public adjuster and the applicant has been |
5726
|
licensed as a resident insurance adjuster, agent, broker, or |
5727
|
other insurance representative in his or her state of residence |
5728
|
or any other state within the past 3 years, a certificate or |
5729
|
letter of authorization from the licensing authority stating |
5730
|
that the applicant holds or has held a license to act as such an |
5731
|
insurance adjuster, agent, or other insurance representative. |
5732
|
The certificate or letter of authorization must be signed by the |
5733
|
insurance commissioner or his or her deputy or the appropriate |
5734
|
licensing official and must disclose whether or not the |
5735
|
adjuster, agent, or other insurance representative has ever had |
5736
|
any license or eligibility to hold any license declined, denied, |
5737
|
suspended, revoked, or placed on probation or whether an |
5738
|
administrative fine or penalty has been levied against the |
5739
|
adjuster and, if so, the reason for the action. |
5740
|
(3) At the time of application for license as a |
5741
|
nonresident public adjuster, the applicant shall file with the |
5742
|
officedepartmenta bond executed and issued by a surety insurer |
5743
|
authorized to transact surety business in this state, in the |
5744
|
amount of $50,000, conditioned for the faithful performance of |
5745
|
his or her duties as a nonresident public adjuster under the |
5746
|
license applied for. The bond must be in favor of the office |
5747
|
department and must specifically authorize recovery by the |
5748
|
officedepartmentof the damages sustained if the licensee |
5749
|
commits fraud or unfair practices in connection with his or her |
5750
|
business as nonresident public adjuster. The aggregate liability |
5751
|
of the surety for all the damages may not exceed the amount of |
5752
|
the bond. The bond may not be terminated unless at least 30 |
5753
|
days' written notice is given to the licensee and filed with the |
5754
|
officedepartment. |
5755
|
(4) The usual and customary records pertaining to |
5756
|
transactions under the license of a nonresident public adjuster |
5757
|
must be retained for at least 3 years after completion of the |
5758
|
adjustment and must be made available in this state to the |
5759
|
officedepartmentupon request. The failure of a nonresident |
5760
|
public adjuster to properly maintain records and make them |
5761
|
available to the officedepartmentupon request constitutes |
5762
|
grounds for the immediate suspension of the license issued under |
5763
|
this section. |
5764
|
(5) After licensure as a nonresident public adjuster, as a |
5765
|
condition of doing business in this state, the licensee must |
5766
|
annually on or before January 1, on a form prescribed by the |
5767
|
commissiondepartment, submit an affidavit certifying that the |
5768
|
licensee is familiar with and understands the insurance code and |
5769
|
rules adopted thereunder and the provisions of the contracts |
5770
|
negotiated or to be negotiated. Compliance with this filing |
5771
|
requirement is a condition precedent to the issuance, |
5772
|
continuation, reinstatement, or renewal of a nonresident public |
5773
|
adjuster's appointment. |
5774
|
Section 123. Subsections (1), (3), and (4) of section |
5775
|
626.8734, Florida Statutes, are amended to read: |
5776
|
626.8734 Nonresident independent adjuster's |
5777
|
qualifications.-- |
5778
|
(1) The officedepartmentshall, upon application |
5779
|
therefor, issue a license to an applicant for a nonresident |
5780
|
independent adjuster's license upon determining that the |
5781
|
applicant has paid the applicable license fees required under s. |
5782
|
624.501 and: |
5783
|
(a) Is a natural person at least 18 years of age. |
5784
|
(b) Has passed to the satisfaction of the office |
5785
|
departmenta written Florida independent adjuster's examination |
5786
|
of the scope prescribed in s. 626.241(6); however, the |
5787
|
requirement for the examination does not apply to any of the |
5788
|
following: |
5789
|
1. An applicant who is licensed as a resident independent |
5790
|
adjuster in his or her state of residence when that state |
5791
|
requires the passing of a written examination in order to obtain |
5792
|
the license and a reciprocal agreement with the appropriate |
5793
|
official of that state has been entered into by the office |
5794
|
department; or |
5795
|
2. An applicant who is licensed as a nonresident |
5796
|
independent adjuster in a state other than his or her state of |
5797
|
residence when the state of licensure requires the passing of a |
5798
|
written examination in order to obtain the license and a |
5799
|
reciprocal agreement with the appropriate official of the state |
5800
|
of licensure has been entered into by the officedepartment. |
5801
|
(c) Is self-employed or associated with or employed by an |
5802
|
independent adjusting firm or other independent adjuster. |
5803
|
Applicants licensed as nonresident independent adjusters under |
5804
|
this section must be appointed as such in accordance with the |
5805
|
provisions of ss. 626.112 and 626.451. Appointment fees in the |
5806
|
amount specified in s. 624.501 must be paid to the office |
5807
|
departmentin advance. The appointment of a nonresident |
5808
|
independent adjuster shall continue in force until suspended, |
5809
|
revoked, or otherwise terminated, but subject to biennial |
5810
|
renewal or continuation by the licensee in accordance with |
5811
|
procedures prescribed in s. 626.381 for licensees in general. |
5812
|
(d) Is trustworthy and has such business reputation as |
5813
|
would reasonably assure that he or she will conduct his or her |
5814
|
business as a nonresident independent adjuster fairly and in |
5815
|
good faith and without detriment to the public. |
5816
|
(e) Has had sufficient experience, training, or |
5817
|
instruction concerning the adjusting of damages or losses under |
5818
|
insurance contracts, other than life and annuity contracts; is |
5819
|
sufficiently informed as to the terms and effects of the |
5820
|
provisions of those types of insurance contracts; and possesses |
5821
|
adequate knowledge of the laws of this state relating to such |
5822
|
contracts as to enable and qualify him or her to engage in the |
5823
|
business of insurance adjuster fairly and without injury to the |
5824
|
public or any member thereof with whom he or she may have |
5825
|
business as an independent adjuster. |
5826
|
(3) The usual and customary records pertaining to |
5827
|
transactions under the license of a nonresident independent |
5828
|
adjuster must be retained for at least 3 years after completion |
5829
|
of the adjustment and must be made available in this state to |
5830
|
the officedepartmentupon request. The failure of a nonresident |
5831
|
independent adjuster to properly maintain records and make them |
5832
|
available to the officedepartmentupon request constitutes |
5833
|
grounds for the immediate suspension of the license issued under |
5834
|
this section. |
5835
|
(4) After licensure as a nonresident independent adjuster, |
5836
|
as a condition of doing business in this state, the licensee |
5837
|
must annually on or before January 1, on a form prescribed by |
5838
|
the commissiondepartment, submit an affidavit certifying that |
5839
|
the licensee is familiar with and understands the insurance laws |
5840
|
and administrative rules of this state and the provisions of the |
5841
|
contracts negotiated or to be negotiated. Compliance with this |
5842
|
filing requirement is a condition precedent to the issuance, |
5843
|
continuation, reinstatement, or renewal of a nonresident |
5844
|
independent adjuster's appointment. |
5845
|
Section 124. Section 626.8736, Florida Statutes, is |
5846
|
amended to read: |
5847
|
626.8736 Nonresident independent or public adjusters; |
5848
|
service of process.-- |
5849
|
(1) Each licensed nonresident independent or public |
5850
|
adjuster shall appoint the Chief Financial OfficerInsurance |
5851
|
Commissioner and Treasurerand his or her successors in office |
5852
|
as his or her attorney to receive service of legal process |
5853
|
issued against the nonresident independent or public adjuster in |
5854
|
this state, upon causes of action arising within this state out |
5855
|
of transactions under his license and appointment. Service upon |
5856
|
the Chief Financial OfficerInsurance Commissioner and Treasurer |
5857
|
as attorney shall constitute effective legal service upon the |
5858
|
nonresident independent or public adjuster. |
5859
|
(2) The appointment of the Chief Financial Officer |
5860
|
Insurance Commissioner and Treasurerfor service of process |
5861
|
shall be irrevocable for as long as there could be any cause of |
5862
|
action against the nonresident independent or public adjuster |
5863
|
arising out of his or her insurance transactions in this state. |
5864
|
(3) Duplicate copies of legal process against the |
5865
|
nonresident independent or public adjuster shall be served upon |
5866
|
the Chief Financial OfficerInsurance Commissioner and Treasurer |
5867
|
by a person competent to serve a summons. |
5868
|
(4) Upon receiving the service, the Chief Financial |
5869
|
OfficerInsurance Commissioner and Treasurershall forthwith |
5870
|
send one of the copies of the process, by registered mail with |
5871
|
return receipt requested, to the defendant nonresident |
5872
|
independent or public adjuster at his or her last address of |
5873
|
record with the officedepartment. |
5874
|
(5) The Chief Financial OfficerInsurance Commissioner and |
5875
|
Treasurershall keep a record of the day and hour of service |
5876
|
upon him or her of all legal process received under this |
5877
|
section. |
5878
|
Section 125. Section 626.8738, Florida Statutes, is |
5879
|
amended to read: |
5880
|
626.8738 Penalty for violation.--In addition to any other |
5881
|
remedy imposed pursuant to this code, any person who acts as a |
5882
|
resident or nonresident public adjuster or holds himself or |
5883
|
herself out to be a public adjuster to adjust claims in this |
5884
|
state, without being licensed by the officedepartmentas a |
5885
|
public adjuster and appointed as a public adjuster, commits a |
5886
|
felony of the third degree, punishable as provided in s. |
5887
|
775.082, s. 775.083, or s. 775.084. Each act in violation of |
5888
|
this section constitutes a separate offense. |
5889
|
Section 126. Section 626.874, Florida Statutes, is amended |
5890
|
to read: |
5891
|
626.874 Catastrophe or emergency adjusters.-- |
5892
|
(1) In the event of a catastrophe or emergency, the office |
5893
|
departmentmay issue a license, for the purposes and under the |
5894
|
conditions which it shall fix and for the period of emergency as |
5895
|
it shall determine, to persons who are residents or nonresidents |
5896
|
of this state and who are not licensed adjusters under this part |
5897
|
but who have been designated and certified to it as qualified to |
5898
|
act as adjusters by independent resident adjusters or by an |
5899
|
authorized insurer or by a licensed general lines agent to |
5900
|
adjust claims, losses, or damages under policies or contracts of |
5901
|
insurance issued by such insurers. The fee for the license |
5902
|
shall be as provided in s. 624.501(12)(c). |
5903
|
(2) If any person not a licensed adjuster who has been |
5904
|
permitted to adjust such losses, claims, or damages under the |
5905
|
conditions and circumstances set forth in subsection (1), |
5906
|
engages in any of the misconduct described in or contemplated by |
5907
|
ss. 626.611 and 626.621, the officedepartment, without notice |
5908
|
and hearing, shall be authorized to issue its order denying such |
5909
|
person the privileges granted under this section; and thereafter |
5910
|
it shall be unlawful for any such person to adjust any such |
5911
|
losses, claims, or damages in this state. |
5912
|
Section 127. Section 626.878, Florida Statutes, is amended |
5913
|
to read: |
5914
|
626.878 Rules; code of ethics.--An adjuster shall |
5915
|
subscribe to the code of ethics specified in the rules of the |
5916
|
commissiondepartment. |
5917
|
Section 128. Paragraphs (d) and (m) of subsection (1) of |
5918
|
section 626.88, Florida Statutes, are amended to read: |
5919
|
626.88 Definitions of "administrator" and "insurer".-- |
5920
|
(1) For the purposes of this part, an "administrator" is |
5921
|
any person who directly or indirectly solicits or effects |
5922
|
coverage of, collects charges or premiums from, or adjusts or |
5923
|
settles claims on residents of this state in connection with |
5924
|
authorized commercial self-insurance funds or with insured or |
5925
|
self-insured programs which provide life or health insurance |
5926
|
coverage or coverage of any other expenses described in s. |
5927
|
624.33(1) or any person who, through a health care risk contract |
5928
|
as defined in s. 641.234 with an insurer or health maintenance |
5929
|
organization, provides billing and collection services to health |
5930
|
insurers and health maintenance organizations on behalf of |
5931
|
health care providers, other than any of the following persons: |
5932
|
(d) A health care services plan, health maintenance |
5933
|
organization, professional service plan corporation, or person |
5934
|
in the business of providing continuing care, possessing a valid |
5935
|
certificate of authority issued by the officedepartment, and |
5936
|
the sales representatives thereof, if the activities of such |
5937
|
entity are limited to the activities permitted under the |
5938
|
certificate of authority. |
5939
|
(m) A person approved by the department of Insurancewho |
5940
|
administers only self-insured workers' compensation plans. |
5941
|
|
5942
|
|
5943
|
A person who provides billing and collection services to health |
5944
|
insurers and health maintenance organizations on behalf of |
5945
|
health care providers shall comply with the provisions of ss. |
5946
|
627.6131, 641.3155, and 641.51(4). |
5947
|
Section 129. Section 626.8805, Florida Statutes, is |
5948
|
amended to read: |
5949
|
626.8805 Certificate of authority to act as |
5950
|
administrator.-- |
5951
|
(1) It is unlawful for any person to act as or hold |
5952
|
himself or herself out to be an administrator in this state |
5953
|
without a valid certificate of authority issued by the office |
5954
|
departmentpursuant to ss. 626.88-626.894. To qualify for and |
5955
|
hold authority to act as an administrator in this state, an |
5956
|
administrator must otherwise be in compliance with this code and |
5957
|
with its organizational agreement. The failure of any person to |
5958
|
hold such a certificate while acting as an administrator shall |
5959
|
subject such person to a fine of not less than $5,000 or more |
5960
|
than $10,000 for each violation. |
5961
|
(2) The administrator shall file with the office |
5962
|
departmentan application for a certificate of authority upon a |
5963
|
form to be adopted by the commission and furnished by the office |
5964
|
department, which application shall include or have attached the |
5965
|
following information and documents: |
5966
|
(a) All basic organizational documents of the |
5967
|
administrator, such as the articles of incorporation, articles |
5968
|
of association, partnership agreement, trade name certificate, |
5969
|
trust agreement, shareholder agreement, and other applicable |
5970
|
documents, and all amendments to those documents. |
5971
|
(b) The bylaws, rules, and regulations or similar |
5972
|
documents regulating the conduct or the internal affairs of the |
5973
|
administrator. |
5974
|
(c) The names, addresses, official positions, and |
5975
|
professional qualifications of the individuals who are |
5976
|
responsible for the conduct of the affairs of the administrator, |
5977
|
including all members of the board of directors, board of |
5978
|
trustees, executive committee, or other governing board or |
5979
|
committee, the principal officers in the case of a corporation, |
5980
|
the partners or members in the case of a partnership or |
5981
|
association, and any other person who exercises control or |
5982
|
influence over the affairs of the administrator. |
5983
|
(d) Annual statements or reports for the 3 most recent |
5984
|
years, or such other information as the officedepartmentmay |
5985
|
require in order to review the current financial condition of |
5986
|
the applicant. |
5987
|
(e) If the applicant is not currently acting as an |
5988
|
administrator, a statement of the amounts and sources of the |
5989
|
funds available for organization expenses and the proposed |
5990
|
arrangements for reimbursement and compensation of incorporators |
5991
|
or other principals. |
5992
|
(3) The applicant shall make available for inspection by |
5993
|
the officedepartmentcopies of all contracts with insurers or |
5994
|
other persons utilizing the services of the administrator. |
5995
|
(4) The officedepartmentshall not issue a certificate of |
5996
|
authority if it determines that the administrator or any |
5997
|
principal thereof is not competent, trustworthy, financially |
5998
|
responsible, or of good personal and business reputation or has |
5999
|
had an insurance license denied for cause by any state. |
6000
|
(5) A certificate of authority issued under this section |
6001
|
shall remain valid, unless suspended or revoked by the office |
6002
|
department, so long as the certificateholder continues in |
6003
|
business in this state. |
6004
|
(6) A certificate of authority issued under this section |
6005
|
shall indicate that the administrator is authorized to |
6006
|
administer commercial self-insurance funds or life and health |
6007
|
programs or both, except that a certificate of authority issued |
6008
|
prior to October 1, 1988, does not authorize the administration |
6009
|
of commercial self-insurance funds. |
6010
|
Section 130. Section 626.8809, Florida Statutes, is |
6011
|
amended to read: |
6012
|
626.8809 Fidelity bond.--An administrator shall have and |
6013
|
keep in full force and effect a fidelity bond equal to at least |
6014
|
10 percent of the amount of the funds handled or managed |
6015
|
annually by the administrator. However, the officedepartment |
6016
|
may not require a bond greater than $500,000 unless the office |
6017
|
department, after due notice to all interested parties and |
6018
|
opportunity for hearing and after consideration of the record, |
6019
|
requires an amount in excess of $500,000 but not more than 10 |
6020
|
percent of the amount of the funds handled or managed annually |
6021
|
by the administrator. |
6022
|
Section 131. Section 626.8814, Florida Statutes, is |
6023
|
amended to read: |
6024
|
626.8814 Disclosure of ownership or affiliation.--Each |
6025
|
administrator shall identify to the officedepartmentany |
6026
|
ownership interest or affiliation of any kind with any insurance |
6027
|
company responsible for providing benefits directly or through |
6028
|
reinsurance to any plan for which the administrator provides |
6029
|
administrative services. |
6030
|
Section 132. Subsection (2) of section 626.884, Florida |
6031
|
Statutes, is amended to read: |
6032
|
626.884 Maintenance of records by administrator; access; |
6033
|
confidentiality.-- |
6034
|
(2) The officedepartmentshall have access to books and |
6035
|
records maintained by the administrator for the purpose of |
6036
|
examination, audit, and inspection. Information contained in |
6037
|
such books and records is confidential and exempt from the |
6038
|
provisions of s. 119.07(1) if the disclosure of such information |
6039
|
would reveal a trade secret as defined in s. 688.002. However, |
6040
|
the officedepartmentmay use such information in any proceeding |
6041
|
instituted against the administrator. |
6042
|
Section 133. Subsections (1) and (3) of section 626.89, |
6043
|
Florida Statutes, are amended to read: |
6044
|
626.89 Annual financial statement and filing fee; notice |
6045
|
of change of ownership.-- |
6046
|
(1) Each authorized administrator shall file with the |
6047
|
officedepartmenta full and true statement of its financial |
6048
|
condition, transactions, and affairs. The statement shall be |
6049
|
filed annually on or before March 1 or within such extension of |
6050
|
time therefor as the officedepartmentfor good cause may have |
6051
|
granted and shall be for the preceding calendar year. The |
6052
|
statement shall be in such form and contain such matters as the |
6053
|
commissiondepartmentprescribes and shall be verified by at |
6054
|
least two officers of such administrator. |
6055
|
(3) In addition, the administrator shall immediately |
6056
|
notify the officedepartmentof any material change in its |
6057
|
ownership. |
6058
|
Section 134. Section 626.891, Florida Statutes, is amended |
6059
|
to read: |
6060
|
626.891 Grounds for suspension or revocation of |
6061
|
certificate of authority.-- |
6062
|
(1) The certificate of authority of an administrator shall |
6063
|
be suspended or revoked if the officedepartmentdetermines that |
6064
|
the administrator: |
6065
|
(a) Is in an unsound financial condition; |
6066
|
(b) Has used or is using such methods or practices in the |
6067
|
conduct of its business so as to render its further transaction |
6068
|
of business in this state hazardous or injurious to insured |
6069
|
persons or the public; or |
6070
|
(c) Has failed to pay any judgment rendered against it in |
6071
|
this state within 60 days after the judgment has become final. |
6072
|
(2) The officedepartmentmay, in its discretion, suspend |
6073
|
or revoke the certificate of authority of an administrator if it |
6074
|
finds that the administrator: |
6075
|
(a) Has violated any lawful rule or order of the |
6076
|
commission or officedepartmentor any provision of this |
6077
|
chapter; |
6078
|
(b) Has refused to be examined or to produce its accounts, |
6079
|
records, and files for examination, or if any of its officers |
6080
|
has refused to give information with respect to its affairs or |
6081
|
has refused to perform any other legal obligation as to such |
6082
|
examination, when required by the officedepartment; |
6083
|
(c) Has, without just cause, refused to pay proper claims |
6084
|
or perform services arising under its contracts or has, without |
6085
|
just cause, compelled insured persons to accept less than the |
6086
|
amount due them or to employ attorneys or bring suit against the |
6087
|
administrator to secure full payment or settlement of such |
6088
|
claims; |
6089
|
(d) Is or was affiliated with and under the same general |
6090
|
management or interlocking directorate or ownership as another |
6091
|
administrator which transacts business in this state without |
6092
|
having a certificate of authority; |
6093
|
(e) At any time fails to meet any qualification for which |
6094
|
issuance of the certificate could have been refused had such |
6095
|
failure then existed and been known to the officedepartment; |
6096
|
(f) Has been convicted of, or has entered a plea of guilty |
6097
|
or nolo contendere to, a felony relating to the business of |
6098
|
insurance or insurance administration in this state or in any |
6099
|
other state without regard to whether adjudication was withheld; |
6100
|
or |
6101
|
(g) Is under suspension or revocation in another state. |
6102
|
(3) The officedepartmentmay, pursuant to s. 120.60, in |
6103
|
its discretion and without advance notice or hearing thereon, |
6104
|
immediately suspend the certificate of any administrator if it |
6105
|
finds that one or more of the following circumstances exist: |
6106
|
(a) The administrator is insolvent or impaired. |
6107
|
(b) The fidelity bond required by s. 626.8809 is not |
6108
|
maintained. |
6109
|
(c) A proceeding for receivership, conservatorship, |
6110
|
rehabilitation, or other delinquency proceeding regarding the |
6111
|
administrator has been commenced in any state. |
6112
|
(d) The financial condition or business practices of the |
6113
|
administrator otherwise pose an imminent threat to the public |
6114
|
health, safety, or welfare of the residents of this state. |
6115
|
(4) The violation of this part by any insurer shall be a |
6116
|
ground for suspension or revocation of the certificate of |
6117
|
authority of that insurer in this state. |
6118
|
Section 135. Section 626.892, Florida Statutes, is amended |
6119
|
to read: |
6120
|
626.892 Order of suspension or revocation of certificate |
6121
|
of authority; notice.-- |
6122
|
(1) The suspension or revocation of a certificate of |
6123
|
authority of an administrator shall be effected by order of the |
6124
|
officedepartmentmailed to the administrator by registered or |
6125
|
certified mail. |
6126
|
(2) In its discretion, the officedepartmentmay cause |
6127
|
notice of any such revocation or suspension to be published in |
6128
|
one or more newspapers of general circulation published in this |
6129
|
state. |
6130
|
Section 136. Subsections (1), (3), and (4) of section |
6131
|
626.894, Florida Statutes, are amended to read: |
6132
|
626.894 Administrative fine in lieu of suspension or |
6133
|
revocation.-- |
6134
|
(1) If the officedepartmentfinds that one or more |
6135
|
grounds exist for the suspension or revocation of a certificate |
6136
|
of authority issued under this part, the officedepartmentmay, |
6137
|
in lieu of such suspension or revocation, impose a fine upon the |
6138
|
administrator. |
6139
|
(3) With respect to any knowing and willful violation of a |
6140
|
lawful order or rule of the office or commissiondepartmentor a |
6141
|
provision of this part, the officedepartmentmay impose a fine |
6142
|
upon the administrator in an amount not to exceed $5,000 for |
6143
|
each such violation. In no event may such fine exceed an |
6144
|
aggregate amount of $25,000 for all knowing and willful |
6145
|
violations arising out of the same action. In addition to such |
6146
|
fine, the administrator shall make restitution when due in |
6147
|
accordance with the provisions of subsection (2). |
6148
|
(4) The failure of an administrator to make restitution |
6149
|
when due as required under this section constitutes a willful |
6150
|
violation of this part. However, if an administrator in good |
6151
|
faith is uncertain as to whether any restitution is due or as to |
6152
|
the amount of restitution due, it shall promptly notify the |
6153
|
officedepartmentof the circumstances; and the failure to make |
6154
|
restitution pending a determination of whether restitution is |
6155
|
due or the amount of restitution due will not constitute a |
6156
|
violation of this part. |
6157
|
Section 137. Section 626.895, Florida Statutes, is amended |
6158
|
to read: |
6159
|
626.895 Definition of "service company" or "service |
6160
|
agent".--For the purpose of this part, a "service company" is |
6161
|
any business entity which has met all the requirements of ss. |
6162
|
626.895-626.899, which does not control funds, and which has |
6163
|
obtained officedepartmentapproval to contract with self- |
6164
|
insurers or multiple-employer welfare arrangements for the |
6165
|
purpose of providing all or any part of the services necessary |
6166
|
to establish and maintain a multiple-employer welfare |
6167
|
arrangement as defined in s. 624.437(1). The term "service |
6168
|
agent" is synonymous with the term "service company" as used in |
6169
|
this part. |
6170
|
Section 138. Subsection (3) of section 626.896, Florida |
6171
|
Statutes, is amended to read: |
6172
|
626.896 Servicing requirements for self-insurers and |
6173
|
multiple-employer welfare arrangements.-- |
6174
|
(3) It is the responsibility of the self-insurer or |
6175
|
multiple-employer welfare arrangement to notify the office |
6176
|
departmentwithin 90 days of changing its method of fulfilling |
6177
|
its servicing requirements from those which were previously |
6178
|
filed with the officedepartment. |
6179
|
Section 139. Subsection (2) of section 626.897, Florida |
6180
|
Statutes, is amended to read: |
6181
|
626.897 Application for authorization to act as service |
6182
|
company; bond.-- |
6183
|
(2) Any business desiring to act as a service company for |
6184
|
individual self-insurers or multiple-employer welfare |
6185
|
arrangements shall be approved by the officedepartment. Any |
6186
|
business acting as a service company prior to October 1, 1983, |
6187
|
will be approved as a service company upon complying with the |
6188
|
filing requirements of this section and s. 626.898. The failure |
6189
|
of any person to obtain such approval while acting as a service |
6190
|
company shall subject such person to a fine of not less than |
6191
|
$5,000 or more than $10,000 for each violation. |
6192
|
Section 140. Subsections (3) and (10) of section 626.898, |
6193
|
Florida Statutes, are amended to read: |
6194
|
626.898 Requirements for retaining authorization as |
6195
|
service company; recertification.-- |
6196
|
(3)(a) Each service company shall maintain at one or more |
6197
|
locations within this state copies of all contracts with each |
6198
|
self-insurer or multiple-employer welfare arrangement that it |
6199
|
services and records relating thereto which are sufficient in |
6200
|
type and quantity to verify the accuracy and completeness of all |
6201
|
reports and documents submitted to the officedepartment |
6202
|
pursuant to this part. In the event that the service company has |
6203
|
its records distributed in multiple locations, it shall inform |
6204
|
the officedepartmentas to the location of each type of record, |
6205
|
as well as the location of specific records for the self- |
6206
|
insurers or multiple-employer welfare arrangements it services. |
6207
|
(b) These records shall be open to inspection by |
6208
|
representatives of the officedepartmentduring regular business |
6209
|
hours. All records shall be retained according to the schedule |
6210
|
adopted by the commissiondepartmentfor similar documents. The |
6211
|
location of these records shall be made known to the office |
6212
|
departmentas necessary. |
6213
|
(10) Each service company shall identify to the office |
6214
|
departmentany ownership interest or affiliation of any kind |
6215
|
with any insurance company responsible directly or through |
6216
|
reinsurance for providing benefits to any plan for which it |
6217
|
provides services. |
6218
|
Section 141. Section 626.899, Florida Statutes, is amended |
6219
|
to read: |
6220
|
626.899 Withdrawal of authorization as service |
6221
|
company.--The failure to comply with any provision of ss. |
6222
|
626.895-626.899 or with any rule or any order of the commission |
6223
|
or officedepartmentwithin the time prescribed shall be |
6224
|
considered good cause for withdrawal of the certificate of |
6225
|
approval. The officedepartmentshall by registered or |
6226
|
certified mail give to the service company prior written notice |
6227
|
of such withdrawal. The service company shall have 30 days from |
6228
|
the date of mailing to request a hearing. The failure to |
6229
|
request a hearing within the time prescribed shall result in the |
6230
|
withdrawal becoming effective 45 days from the date of mailing |
6231
|
of the original notice. In no event shall the withdrawal of the |
6232
|
certificate of approval be effective prior to the date upon |
6233
|
which a hearing, if requested, is scheduled. Copies of such |
6234
|
notice of withdrawal of a certificate of approval shall be |
6235
|
furnished by the officedepartmentto each self-funded program |
6236
|
serviced. |
6237
|
Section 142. Subsection (4) of section 626.901, Florida |
6238
|
Statutes, is amended to read: |
6239
|
626.901 Representing or aiding unauthorized insurer |
6240
|
prohibited.-- |
6241
|
(4) This section does not apply to: |
6242
|
(a) Matters authorized to be done by the officedepartment |
6243
|
under the Unauthorized Insurers Process Law, ss. 626.904- |
6244
|
626.912. |
6245
|
(b) Surplus lines insurance when written pursuant to the |
6246
|
Surplus Lines Law, ss. 626.913-626.937. |
6247
|
(c) Transactions as to which a certificate of authority is |
6248
|
not required of an insurer, as stated in s. 624.402. |
6249
|
(d) Independently procured coverage written pursuant to s. |
6250
|
626.938. |
6251
|
Section 143. Section 626.906, Florida Statutes, is amended |
6252
|
to read: |
6253
|
626.906 Acts constituting Chief Financial Officer |
6254
|
Insurance Commissioner and Treasureras process agent.--Any of |
6255
|
the following acts in this state, effected by mail or otherwise, |
6256
|
by an unauthorized foreign insurer, alien insurer, or person |
6257
|
representing or aiding such an insurer is equivalent to and |
6258
|
shall constitute an appointment by such insurer or person |
6259
|
representing or aiding such insurer of the Chief Financial |
6260
|
OfficerInsurance Commissioner and Treasurer, and his or her |
6261
|
successor or successors in office,to be its true and lawful |
6262
|
attorney, upon whom may be served all lawful process in any |
6263
|
action, suit, or proceeding instituted by or on behalf of an |
6264
|
insured or beneficiary, arising out of any such contract of |
6265
|
insurance; and any such act shall be signification of the |
6266
|
insurer's or person's agreement that such service of process is |
6267
|
of the same legal force and validity as personal service of |
6268
|
process in this state upon such insurer or person representing |
6269
|
or aiding such insurer: |
6270
|
(1) The issuance or delivery of contracts of insurance to |
6271
|
residents of this state or to corporations authorized to do |
6272
|
business therein; |
6273
|
(2) The solicitation of applications for such contracts; |
6274
|
(3) The collection of premiums, membership fees, |
6275
|
assessments, or other considerations for such contracts; or |
6276
|
(4) Any other transaction of insurance. |
6277
|
Section 144. Subsection (1) of section 626.907, Florida |
6278
|
Statutes, is amended to read: |
6279
|
626.907 Service of process; judgment by default.-- |
6280
|
(1) Service of process upon an insurer or person |
6281
|
representing or aiding such insurer pursuant to s. 626.906 shall |
6282
|
be made by delivering to and leaving with the Chief Financial |
6283
|
OfficerInsurance Commissioner and Treasureror some person in |
6284
|
apparent charge of his or her office two copies thereof. The |
6285
|
Chief Financial OfficerInsurance Commissioner and Treasurer |
6286
|
shall forthwith mail by registered mail one of the copies of |
6287
|
such process to the defendant at the defendant's last known |
6288
|
principal place of business and shall keep a record of all |
6289
|
process so served upon him or her. The service of process is |
6290
|
sufficient, provided notice of such service and a copy of the |
6291
|
process are sent within 10 days thereafter by registered mail by |
6292
|
plaintiff or plaintiff's attorney to the defendant at the |
6293
|
defendant's last known principal place of business, and the |
6294
|
defendant's receipt, or receipt issued by the post office with |
6295
|
which the letter is registered, showing the name of the sender |
6296
|
of the letter and the name and address of the person to whom the |
6297
|
letter is addressed, and the affidavit of the plaintiff or |
6298
|
plaintiff's attorney showing a compliance herewith are filed |
6299
|
with the clerk of the court in which the action is pending on or |
6300
|
before the date the defendant is required to appear, or within |
6301
|
such further time as the court may allow. |
6302
|
Section 145. Section 626.909, Florida Statutes, is amended |
6303
|
to read: |
6304
|
626.909 Jurisdiction of office anddepartment; service of |
6305
|
process on Secretary of State.-- |
6306
|
(1) The Legislature hereby declares that it is a subject |
6307
|
of concern that the purpose of the Unauthorized Insurers Process |
6308
|
Law as expressed in s. 626.905 may be denied by the possibility |
6309
|
that the right of service of process provided for in that law |
6310
|
may be restricted only to those actions, suits, or proceedings |
6311
|
brought by insureds or beneficiaries. It therefore declares that |
6312
|
it is the intent of s. 626.905 that it is the obligation and |
6313
|
duty of the state to protect its residents and also proceed |
6314
|
under this law through the office ordepartment in the courts of |
6315
|
this state. It further declares that it is also the intent of |
6316
|
the Legislature to subject unauthorized insurers and persons |
6317
|
representing or aiding such insurers to the jurisdiction of the |
6318
|
office ordepartment in proceedings, examinations, or hearings |
6319
|
before it as provided for in this code. |
6320
|
(2) In addition to the procedure for service of process on |
6321
|
unauthorized insurers or persons representing or aiding such |
6322
|
insurers contained in ss. 626.906 and 626.907, the office or |
6323
|
department shall have the right to bring any action, suit, or |
6324
|
proceeding in the name of the state or conduct any proceeding, |
6325
|
examination, or hearing provided for in this code against any |
6326
|
unauthorized insurer or person representing or aiding such |
6327
|
insurer for violation of any lawful order of the office or |
6328
|
department or any provision of this code, specifically including |
6329
|
but not limited to the regulation of trade practices provided |
6330
|
for in part IX of this chapter, if the insurer or person |
6331
|
representing or aiding such insurer transacts insurance in this |
6332
|
state as defined in ss. 624.10 and 626.906 and the insurer does |
6333
|
not transact such business under a subsisting certificate of |
6334
|
authority as required by s. 624.401. In the event the |
6335
|
transaction of business is done by mail, the venue of the act is |
6336
|
at the point where the matter transmitted by mail is delivered |
6337
|
and takes effect. |
6338
|
(3) In addition to the right of action, suit, or |
6339
|
proceeding authorized by subsection (2), the office or |
6340
|
department shall have the right to bring a civil action in the |
6341
|
name of the state, as parens patriae on behalf of any insured, |
6342
|
beneficiary of any insured, claimant or dependent, or any other |
6343
|
person or class of persons injured as a result of the |
6344
|
transaction of any insurance business as defined in s. 626.906 |
6345
|
by any unauthorized insurer, as defined in s. 624.09 who is also |
6346
|
an ineligible insurer as set forth in ss. 626.917 and 626.918, |
6347
|
or any person who represents or aids any unauthorized insurer, |
6348
|
in violation of s. 626.901, to recover actual damages on behalf |
6349
|
of individuals who were residents at the time the transaction |
6350
|
occurred and the cost of such suit, including a reasonable |
6351
|
attorney's fee. The court shall exclude from the amount of |
6352
|
monetary relief awarded in such action any amount of monetary |
6353
|
relief which duplicates amounts which have been awarded for the |
6354
|
same injury. |
6355
|
(4) Transaction of business in this state, as so defined, |
6356
|
by any unauthorized insurer or person representing or aiding |
6357
|
such insurer shall be deemed consent by the insurer or person |
6358
|
representing or aiding such insurer to the jurisdiction of the |
6359
|
office ordepartment in proceedings, examinations, and hearings |
6360
|
before it as provided for in this code and shall constitute an |
6361
|
irrevocable appointment by the insurer or person representing or |
6362
|
aiding such insurer of the Secretary of State and his or her |
6363
|
successor or successors in office as its true and lawful |
6364
|
attorney upon whom may be served all lawful process in any |
6365
|
action, suit, or proceeding in any court by the office or |
6366
|
department or by the state and upon whom may be served all |
6367
|
notices and orders of the office ordepartment arising out of |
6368
|
any such transaction of business; and such transaction of |
6369
|
business shall constitute the agreement of the insurer or person |
6370
|
representing or aiding such insurer that any such process |
6371
|
against it or any such notice or order which is so served shall |
6372
|
be of the same legal force and validity as if served personally |
6373
|
within this state on the insurer or person representing or |
6374
|
aiding such insurer. Service of process shall be in accordance |
6375
|
with and in the same manner as now provided for service of |
6376
|
process upon nonresidents under the provision of s. 48.161, and |
6377
|
service of process shall also be valid if made as provided in s. |
6378
|
626.907(2). |
6379
|
(5) No plaintiff shall be entitled to a judgment by |
6380
|
default or a decree pro confesso under this section until the |
6381
|
expiration of 30 days after date of the filing of the affidavit |
6382
|
of compliance. |
6383
|
(6) Nothing in this section shall limit or abridge the |
6384
|
right to serve any process, notice, orders, or demand upon the |
6385
|
insurer or person representing or aiding such insurer in any |
6386
|
other manner now or hereafter permitted by law. |
6387
|
(7) Nothing in this section shall apply as to surplus |
6388
|
lines insurance when written pursuant to the Surplus Lines Law, |
6389
|
ss. 626.913-626.937, or as to transactions as to which a |
6390
|
certificate of authority is not required of the insurer, as |
6391
|
stated in s. 624.402. |
6392
|
Section 146. Section 626.910, Florida Statutes, is amended |
6393
|
to read: |
6394
|
626.910 Penalty for violation by unauthorized insurers and |
6395
|
persons representing or aiding such insurers.--Any unauthorized |
6396
|
insurer or person representing or aiding such insurer |
6397
|
transacting insurance in this state and subject to service of |
6398
|
process as referred to in s. 626.909 shall forfeit and pay to |
6399
|
the state a civil penalty of not more than $1,000 for each |
6400
|
nonwillful violation, or not more than $10,000 for each willful |
6401
|
violation, of any lawful order of the office ordepartment or |
6402
|
any provision of this code. |
6403
|
Section 147. Section 626.912, Florida Statutes, is amended |
6404
|
to read: |
6405
|
626.912 Exemptions from ss. 626.904-626.911.--The |
6406
|
provisions of ss. 626.904-626.911 do not apply to any action, |
6407
|
suit, or proceeding against any unauthorized foreign insurer, |
6408
|
alien insurer, or person representing or aiding such an insurer |
6409
|
arising out of any contract of insurance: |
6410
|
(1) Covering reinsurance, wet marine and transportation, |
6411
|
commercial aircraft, or railway insurance risks; |
6412
|
(2) Against legal liability arising out of the ownership, |
6413
|
operation, or maintenance of any property having a permanent |
6414
|
situs outside this state; |
6415
|
(3) Against loss of or damage to any property having a |
6416
|
permanent situs outside this state; or |
6417
|
(4) Issued under and in accordance with the Surplus Lines |
6418
|
Law, when such insurer or person representing or aiding such |
6419
|
insurer enters a general appearance or when such contract of |
6420
|
insurance contains a provision designating the Chief Financial |
6421
|
OfficerInsurance Commissioner and Treasurer and his or her |
6422
|
successor or successors inoffice or designating a Florida |
6423
|
resident agent to be the true and lawful attorney of such |
6424
|
unauthorized insurer or person representing or aiding such |
6425
|
insurer upon whom may be served all lawful process in any |
6426
|
action, suit, or proceeding instituted by or on behalf of an |
6427
|
insured or person representing or aiding such insurer or |
6428
|
beneficiary arising out of any such contract of insurance; and |
6429
|
service of process effected on such Chief Financial Officer |
6430
|
Insurance Commissioner and Treasurer, his or her successor or |
6431
|
successors in office,or such resident agent shall be deemed to |
6432
|
confer complete jurisdiction over such unauthorized insurer or |
6433
|
person representing or aiding such insurer in such action. |
6434
|
Section 148. Subsection (2) of section 626.914, Florida |
6435
|
Statutes, is amended to read: |
6436
|
626.914 Definitions.--As used in this Surplus Lines Law, |
6437
|
the term: |
6438
|
(2) "Eligible surplus lines insurer" means an unauthorized |
6439
|
insurer which has been made eligible by the officedepartmentto |
6440
|
issue insurance coverage under this Surplus Lines Law. |
6441
|
Section 149. Subsections (1) and (2) of section 626.916, |
6442
|
Florida Statutes, are amended to read: |
6443
|
626.916 Eligibility for export.-- |
6444
|
(1) No insurance coverage shall be eligible for export |
6445
|
unless it meets all of the following conditions: |
6446
|
(a) The full amount of insurance required must not be |
6447
|
procurable, after a diligent effort has been made by the |
6448
|
producing agent to do so, from among the insurers authorized to |
6449
|
transact and actually writing that kind and class of insurance |
6450
|
in this state, and the amount of insurance exported shall be |
6451
|
only the excess over the amount so procurable from authorized |
6452
|
insurers. Surplus lines agents must verify that a diligent |
6453
|
effort has been made by requiring a properly documented |
6454
|
statement of diligent effort from the retail or producing agent. |
6455
|
However, to be in compliance with the diligent effort |
6456
|
requirement, the surplus lines agent's reliance must be |
6457
|
reasonable under the particular circumstances surrounding the |
6458
|
export of that particular risk. Reasonableness shall be assessed |
6459
|
by taking into account factors which include, but are not |
6460
|
limited to, a regularly conducted program of verification of the |
6461
|
information provided by the retail or producing agent. |
6462
|
Declinations must be documented on a risk-by-risk basis. If it |
6463
|
is not possible to obtain the full amount of insurance required |
6464
|
by layering the risk, it is permissible to export the full |
6465
|
amount. |
6466
|
(b) The premium rate at which the coverage is exported |
6467
|
shall not be lower than that rate applicable, if any, in actual |
6468
|
and current use by a majority of the authorized insurers for the |
6469
|
same coverage on a similar risk. |
6470
|
(c) The policy or contract form under which the insurance |
6471
|
is exported shall not be more favorable to the insured as to the |
6472
|
coverage or rate than under similar contracts on file and in |
6473
|
actual current use in this state by the majority of authorized |
6474
|
insurers actually writing similar coverages on similar risks; |
6475
|
except that a coverage may be exported under a unique form of |
6476
|
policy designed for use with respect to a particular subject of |
6477
|
insurance if a copy of such form is filed with the office |
6478
|
departmentby the surplus lines agent desiring to use the same |
6479
|
and is subject to the disapproval of the officedepartment |
6480
|
within 10 days of filing such form exclusive of Saturdays, |
6481
|
Sundays, and legal holidays if it finds that the use of such |
6482
|
special form is not reasonably necessary for the principal |
6483
|
purposes of the coverage or that its use would be contrary to |
6484
|
the purposes of this Surplus Lines Law with respect to the |
6485
|
reasonable protection of authorized insurers from unwarranted |
6486
|
competition by unauthorized insurers. |
6487
|
(d) Except as to extended coverage in connection with fire |
6488
|
insurance policies and except as to windstorm insurance, the |
6489
|
policy or contract under which the insurance is exported shall |
6490
|
not provide for deductible amounts, in determining the existence |
6491
|
or extent of the insurer's liability, other than those available |
6492
|
under similar policies or contracts in actual and current use by |
6493
|
one or more authorized insurers. |
6494
|
(2) The commissiondepartment may by rulerules and |
6495
|
regulationsdeclare eligible for export generally, and |
6496
|
notwithstanding the provisions of paragraphs (a), (b), (c), and |
6497
|
(d) of subsection (1), any class or classes of insurance |
6498
|
coverage or risk for which it finds, after a hearing, that there |
6499
|
is no reasonable or adequate market among authorized insurers. |
6500
|
Any such rules and regulationsshall continue in effect during |
6501
|
the existence of the conditions upon which predicated, but |
6502
|
subject to termination by the commissiondepartment. |
6503
|
Section 150. Subsection (1) of section 626.917, Florida |
6504
|
Statutes, is amended to read: |
6505
|
626.917 Eligibility for export; wet marine and |
6506
|
transportation, aviation risks.-- |
6507
|
(1) Insurance coverage of wet marine and transportation |
6508
|
risks, as defined in this code in s. 624.607(2), or aviation |
6509
|
risks, including airport and products liability incidental |
6510
|
thereto and hangarkeeper's liability, may be exported under the |
6511
|
following conditions: |
6512
|
(a) The insurance must be placed only by or through a |
6513
|
licensed Florida surplus lines agent; and |
6514
|
(b) The insurer must be one made eligible by the office |
6515
|
departmentspecifically for such coverages, based upon |
6516
|
information furnished by the insurer and indicating that the |
6517
|
insurer is well able to meet its financial obligations. |
6518
|
Section 151. Section 626.918, Florida Statutes, is amended |
6519
|
to read: |
6520
|
626.918 Eligible surplus lines insurers.-- |
6521
|
(1) No surplus lines agent shall place any coverage with |
6522
|
any unauthorized insurer which is not then an eligible surplus |
6523
|
lines insurer, except as permitted under subsections (5) and |
6524
|
(6). |
6525
|
(2) No unauthorized insurer shall be or become an eligible |
6526
|
surplus lines insurer unless made eligible by the office |
6527
|
departmentin accordance with the following conditions: |
6528
|
(a) Eligibility of the insurer must be requested in |
6529
|
writing by the Florida Surplus Lines Service Office; |
6530
|
(b) The insurer must be currently an authorized insurer in |
6531
|
the state or country of its domicile as to the kind or kinds of |
6532
|
insurance proposed to be so placed and must have been such an |
6533
|
insurer for not less than the 3 years next preceding or must be |
6534
|
the wholly owned subsidiary of such authorized insurer or must |
6535
|
be the wholly owned subsidiary of an already eligible surplus |
6536
|
lines insurer as to the kind or kinds of insurance proposed for |
6537
|
a period of not less than the 3 years next preceding. However, |
6538
|
the officedepartmentmay waive the 3-year requirement if the |
6539
|
insurer provides a product or service not readily available to |
6540
|
the consumers of this state or has operated successfully for a |
6541
|
period of at least 1 year next preceding and has capital and |
6542
|
surplus of not less than $25 million; |
6543
|
(c) Before granting eligibility, the requesting surplus |
6544
|
lines agent or the insurer shall furnish the officedepartment |
6545
|
with a duly authenticated copy of its current annual financial |
6546
|
statement in the English language and with all monetary values |
6547
|
therein expressed in United States dollars, at an exchange rate |
6548
|
(in the case of statements originally made in the currencies of |
6549
|
other countries) then-current and shown in the statement, and |
6550
|
with such additional information relative to the insurer as the |
6551
|
officedepartmentmay request; |
6552
|
(d)1. The insurer must have and maintain surplus as to |
6553
|
policyholders of not less than $15 million; in addition, an |
6554
|
alien insurer must also have and maintain in the United States a |
6555
|
trust fund for the protection of all its policyholders in the |
6556
|
United States under terms deemed by the officedepartmentto be |
6557
|
reasonably adequate, in an amount not less than $5.4 million. |
6558
|
Any such surplus as to policyholders or trust fund shall be |
6559
|
represented by investments consisting of eligible investments |
6560
|
for like funds of like domestic insurers under part II of |
6561
|
chapter 625 provided, however, that in the case of an alien |
6562
|
insurance company, any such surplus as to policyholders may be |
6563
|
represented by investments permitted by the domestic regulator |
6564
|
of such alien insurance company if such investments are |
6565
|
substantially similar in terms of quality, liquidity, and |
6566
|
security to eligible investments for like funds of like domestic |
6567
|
insurers under part II of chapter 625; |
6568
|
2. For those surplus lines insurers that were eligible on |
6569
|
January 1, 1994, and that maintained their eligibility |
6570
|
thereafter, the required surplus as to policyholders shall be: |
6571
|
a. On December 31, 1994, and until December 30, 1995, $2.5 |
6572
|
million. |
6573
|
b. On December 31, 1995, and until December 30, 1996, $3.5 |
6574
|
million. |
6575
|
c. On December 31, 1996, and until December 30, 1997, $4.5 |
6576
|
million. |
6577
|
d. On December 31, 1997, and until December 30, 1998, $5.5 |
6578
|
million. |
6579
|
e. On December 31, 1998, and until December 30, 1999, $6.5 |
6580
|
million. |
6581
|
f. On December 31, 1999, and until December 30, 2000, $8 |
6582
|
million. |
6583
|
g. On December 31, 2000, and until December 30, 2001, $9.5 |
6584
|
million. |
6585
|
h. On December 31, 2001, and until December 30, 2002, $11 |
6586
|
million. |
6587
|
i. On December 31, 2002, and until December 30, 2003, $13 |
6588
|
million. |
6589
|
j. On December 31, 2003, and thereafter, $15 million. |
6590
|
3. The capital and surplus requirements as set forth in |
6591
|
subparagraph 2. do not apply in the case of an insurance |
6592
|
exchange created by the laws of individual states, where the |
6593
|
exchange maintains capital and surplus pursuant to the |
6594
|
requirements of that state, or maintains capital and surplus in |
6595
|
an amount not less than $50 million in the aggregate. For an |
6596
|
insurance exchange which maintains funds in the amount of at |
6597
|
least $12 million for the protection of all insurance exchange |
6598
|
policyholders, each individual syndicate shall maintain minimum |
6599
|
capital and surplus in an amount not less than $3 million. If |
6600
|
the insurance exchange does not maintain funds in the amount of |
6601
|
at least $12 million for the protection of all insurance |
6602
|
exchange policyholders, each individual syndicate shall meet the |
6603
|
minimum capital and surplus requirements set forth in |
6604
|
subparagraph 2.; |
6605
|
4. A surplus lines insurer which is a member of an |
6606
|
insurance holding company that includes a member which is a |
6607
|
Florida domestic insurer as set forth in its holding company |
6608
|
registration statement, as set forth in s. 628.801 and rules |
6609
|
adopted thereunder, may elect to maintain surplus as to |
6610
|
policyholders in an amount equal to the requirements of s. |
6611
|
624.408, subject to the requirement that the surplus lines |
6612
|
insurer shall at all times be in compliance with the |
6613
|
requirements of chapter 625. |
6614
|
|
6615
|
|
6616
|
The election shall be submitted to the officedepartmentand |
6617
|
shall be effective upon the office'sdepartment'sbeing |
6618
|
satisfied that the requirements of subparagraph 4. have been |
6619
|
met. The initial date of election shall be the date of office |
6620
|
departmentapproval. The election approval application shall be |
6621
|
on a form adopted by commissiondepartment rule. The office |
6622
|
departmentmay approve an election form submitted pursuant to |
6623
|
subparagraph 4. only if it was on file with the former |
6624
|
Department of Insurancebefore February 28, 1998; |
6625
|
(e) The insurer must be of good reputation as to the |
6626
|
providing of service to its policyholders and the payment of |
6627
|
losses and claims; |
6628
|
(f) The insurer must be eligible, as for authority to |
6629
|
transact insurance in this state, under s. 624.404(3); and |
6630
|
(g) This subsection does not apply as to unauthorized |
6631
|
insurers made eligible under s. 626.917 as to wet marine and |
6632
|
aviation risks. |
6633
|
(3) The officedepartmentshall from time to time publish |
6634
|
a list of all currently eligible surplus lines insurers and |
6635
|
shall mail a copy thereof to each licensed surplus lines agent |
6636
|
at his or her office of record with the officedepartment. |
6637
|
(4) This section shall not be deemed to cast upon the |
6638
|
officedepartmentany duty or responsibility to determine the |
6639
|
actual financial condition or claims practices of any |
6640
|
unauthorized insurer; and the status of eligibility, if granted |
6641
|
by the officedepartment, shall indicate only that the insurer |
6642
|
appears to be sound financially and to have satisfactory claims |
6643
|
practices and that the officedepartmenthas no credible |
6644
|
evidence to the contrary. |
6645
|
(5) When it appears that any particular insurance risk |
6646
|
which is eligible for export, but on which insurance coverage, |
6647
|
in whole or in part, is not procurable from the eligible surplus |
6648
|
lines insurers, after a search of eligible surplus lines |
6649
|
insurers, then the surplus lines agent may file a supplemental |
6650
|
signed statement setting forth such facts and advising the |
6651
|
officedepartmentthat such part of the risk as shall be |
6652
|
unprocurable, as aforesaid, is being placed with named |
6653
|
unauthorized insurers, in the amounts and percentages set forth |
6654
|
in the statement. Such named unauthorized insurer shall, |
6655
|
however, before accepting any risk in this state, deposit with |
6656
|
the department cash or securities acceptable to the office and |
6657
|
department of the market value of $50,000 for each individual |
6658
|
risk, contract, or certificate, which deposit shall be held by |
6659
|
the department for the benefit of Florida policyholders only; |
6660
|
and the surplus lines agent shall procure from such unauthorized |
6661
|
insurer and file with the officedepartmenta certified copy of |
6662
|
its statement of condition as of the close of the last calendar |
6663
|
year. If such statement reveals, including both capital and |
6664
|
surplus, net assets of at least that amount required for |
6665
|
licensure of a domestic insurer, then the surplus lines agent |
6666
|
may proceed to consummate such contract of insurance. Whenever |
6667
|
any insurance risk, or any part thereof, is placed with an |
6668
|
unauthorized insurer, as provided herein, the policy, binder, or |
6669
|
cover note shall contain a statement signed by the insured and |
6670
|
the agent with the following notation: "The insured is aware |
6671
|
that certain insurers participating in this risk have not been |
6672
|
approved to transact business in Florida nor have they been |
6673
|
declared eligible as surplus lines insurers by the Office of |
6674
|
Insurance RegulationDepartment of Insuranceof Florida. The |
6675
|
placing of such insurance by a duly licensed surplus lines agent |
6676
|
in Florida shall not be construed as approval of such insurer by |
6677
|
the Office of Insurance RegulationDepartment of Insuranceof |
6678
|
Florida. Consequently, the insured is aware that the insured |
6679
|
has severely limited the assistance available under the |
6680
|
insurance laws of Florida. The insured is further aware that he |
6681
|
or she may be charged a reasonable per policy fee, as provided |
6682
|
in s. 626.916(4), Florida Statutes, for each policy certified |
6683
|
for export." All other provisions of this code shall apply to |
6684
|
such placement the same as if such risks were placed with an |
6685
|
eligible surplus lines insurer. |
6686
|
(6) When any particular insurance risk subject to |
6687
|
subsection (5) is eligible for placement with an unauthorized |
6688
|
insurer and not more than 12.5 percent of the risk is so |
6689
|
subject, the officeDepartment of Insurancemay, at its |
6690
|
discretion, permit the agent to obtain from the insured a signed |
6691
|
statement as indicated in subsection (5). All other provisions |
6692
|
of this code apply to such placement the same as if such risks |
6693
|
were placed with an eligible surplus lines insurer. |
6694
|
Section 152. Section 626.919, Florida Statutes, is amended |
6695
|
to read: |
6696
|
626.919 Withdrawal of eligibility; surplus lines |
6697
|
insurer.-- |
6698
|
(1) If at any time the officedepartmenthas reason to |
6699
|
believe that any unauthorized insurer then on the list of |
6700
|
eligible surplus lines insurers is insolvent or in unsound |
6701
|
financial condition, or does not make reasonable prompt payment |
6702
|
of just losses and claims in this state, or that it is no longer |
6703
|
eligible under the conditions therefor provided in s. 626.918, |
6704
|
it shall withdraw the eligibility of the insurer to insure |
6705
|
surplus lines risks in this state. |
6706
|
(2) If the officedepartmentfinds that an insurer |
6707
|
currently eligible as a surplus lines insurer has willfully |
6708
|
violated the laws of this state or a rule of the commission |
6709
|
department, it may, in its discretion, withdraw the eligibility |
6710
|
of the insurer to insure surplus lines risks in this state. |
6711
|
(3) The officedepartmentshall promptly mail notice of |
6712
|
all such withdrawals of eligibility to each surplus lines agent |
6713
|
at his or her address of record with the department. |
6714
|
Section 153. Subsection (8) of section 626.921, Florida |
6715
|
Statutes, is amended to read: |
6716
|
626.921 Florida Surplus Lines Service Office.-- |
6717
|
(8)(a) Information furnished to the department under s. |
6718
|
626.923 or contained in the records subject to examination by |
6719
|
the department under s. 626.930 is confidential and exempt from |
6720
|
the provisions of s. 119.07(1) and s. 24(a), Art. I of the State |
6721
|
Constitution if the disclosure of the information would reveal |
6722
|
information specific to a particular policy or policyholder. |
6723
|
The exemption does not apply to any proceeding instituted by the |
6724
|
department or officeagainst an agent or insurer. |
6725
|
(b) Information furnished to the Florida Surplus Lines |
6726
|
Service Office under the Surplus Lines Law is confidential and |
6727
|
exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I |
6728
|
of the State Constitution if the disclosure of the information |
6729
|
would reveal information specific to a particular policy or |
6730
|
policyholder. This exemption does not prevent the disclosure of |
6731
|
any information by the Florida Surplus Lines Service Office to |
6732
|
the department, but the exemption applies to records obtained by |
6733
|
the department from the Florida Surplus Lines Service Office. |
6734
|
The exemption does not apply to any proceeding instituted by the |
6735
|
department or officeagainst an agent or insurer. This paragraph |
6736
|
is subject to the Open Government Sunset Review Act of 1995 in |
6737
|
accordance with s. 119.15, and shall stand repealed on October |
6738
|
2, 2006, unless reviewed and saved from repeal through |
6739
|
reenactment by the Legislature. |
6740
|
Section 154. Subsection (5) of section 626.931, Florida |
6741
|
Statutes, is amended to read: |
6742
|
626.931 Agent affidavit and insurer reporting |
6743
|
requirements.-- |
6744
|
(5) The department mayInsurance Commissioner shall have |
6745
|
the authority towaive the filing requirements described in |
6746
|
subsections(3) and (4). |
6747
|
Section 155. Subsections (2) and (5) of section 626.932, |
6748
|
Florida Statutes, are amended to read: |
6749
|
626.932 Surplus lines tax.-- |
6750
|
(2)(a) The surplus lines agent shall make payable to the |
6751
|
department of Insurancethe tax related to each calendar |
6752
|
quarter's business as reported to the Florida Surplus Lines |
6753
|
Service Office, and remit the tax to the Florida Surplus Lines |
6754
|
Service Office at the same time as provided for the filing of |
6755
|
the quarterly affidavit, under s. 626.931. The Florida Surplus |
6756
|
Lines Service Office shall forward to the department the taxes |
6757
|
and any interest collected pursuant to paragraph (b), within 10 |
6758
|
days of receipt. |
6759
|
(b) The agent shall pay interest on the amount of any |
6760
|
delinquent tax due, at the rate of 9 percent per year, |
6761
|
compounded annually, beginning the day the amount becomes |
6762
|
delinquent. |
6763
|
(5) The department shall deposit 55 percent of all taxes |
6764
|
collected under this section to the credit of the Insurance |
6765
|
Commissioner'sRegulatory Trust Fund. Forty-five percent of all |
6766
|
taxes collected under this section shall be deposited into the |
6767
|
General Revenue Fund. |
6768
|
Section 156. Section 626.936, Florida Statutes, is amended |
6769
|
to read: |
6770
|
626.936 Failure to file reports or pay tax or service fee; |
6771
|
administrative penalty.-- |
6772
|
(1) Any licensed surplus lines agent who neglects to file |
6773
|
a report or an affidavit in the form and within the time |
6774
|
required or provided for in the Surplus Lines Law may be fined |
6775
|
up to $50 per day for each day the neglect continues, beginning |
6776
|
the day after the report or affidavit was due until the date the |
6777
|
report or affidavit is received. All sums collected under this |
6778
|
section shall be deposited into the Insurance Commissioner's |
6779
|
Regulatory Trust Fund. |
6780
|
(2) Any licensed surplus lines agent who neglects to pay |
6781
|
the taxes or service fees as required under the Surplus Lines |
6782
|
Law and within the time required may be fined up to $500 per day |
6783
|
for each day the failure to pay continues, beginning the day |
6784
|
after the tax or service fees were due. The agent shall pay |
6785
|
interest on the amount of any delinquent tax due, at the rate of |
6786
|
9 percent per year, compounded annually, beginning the day the |
6787
|
amount becomes delinquent. The department shall deposit all |
6788
|
sums collected under this section into the Insurance |
6789
|
Commissioner'sRegulatory Trust Fund. |
6790
|
Section 157. Section 626.9361, Florida Statutes, is |
6791
|
amended to read: |
6792
|
626.9361 Failure to file report; administrative |
6793
|
penalty.--Any eligible surplus lines insurer who fails to file a |
6794
|
report in the form and within the time required or provided for |
6795
|
in the Surplus Lines Law may be fined up to $500 per day for |
6796
|
each day such failure continues, beginning the day after the |
6797
|
report was due, until the date the report is received. Failure |
6798
|
to file a report may also result in withdrawal of eligibility as |
6799
|
a surplus lines insurer in this state. All sums collected by the |
6800
|
department under this section shall be deposited into the |
6801
|
Insurance Commissioner'sRegulatory Trust Fund. |
6802
|
Section 158. Subsections (2), (3), and (4) of section |
6803
|
626.937, Florida Statutes, are amended to read: |
6804
|
626.937 Actions against insurer; service of process.-- |
6805
|
(2) The unauthorized insurer accepting the risk or issuing |
6806
|
the policy shall be deemed thereby to have authorized service of |
6807
|
process against it in the manner and to the effect as provided |
6808
|
in this section, and to have appointed the Chief Financial |
6809
|
OfficerInsurance Commissioner and Treasureras its agent for |
6810
|
service of process issuing upon any cause of action arising in |
6811
|
this state under any such policy, contract, or insurance. |
6812
|
(3) Each unauthorized insurer requesting eligibility |
6813
|
pursuant to s. 626.918 shall file with the department its |
6814
|
appointment of the Chief Financial OfficerInsurance |
6815
|
Commissioner and Treasurer and his or her successors in office, |
6816
|
on a form as furnished by the department, as its attorney to |
6817
|
receive service of all legal process issued against it in any |
6818
|
civil action or proceeding in this state, and agreeing that |
6819
|
process so served shall be valid and binding upon the insurer. |
6820
|
The appointment shall be irrevocable, shall bind the insurer and |
6821
|
any successor in interest as to the assets or liabilities of the |
6822
|
insurer, and shall remain in effect as long as there is |
6823
|
outstanding in this state any obligation or liability of the |
6824
|
insurer resulting from its insurance transactions therein. |
6825
|
(4) At the time of such appointment of the Chief Financial |
6826
|
OfficerInsurance Commissioner and Treasureras its process |
6827
|
agent, the insurer shall file with the department designation of |
6828
|
the name and address of the person to whom process against it |
6829
|
served upon the Chief Financial OfficerInsurance Commissioner |
6830
|
and Treasureris to be forwarded. The insurer may change the |
6831
|
designation at any time by a new filing. |
6832
|
Section 159. Subsections (3) and (7) of section 626.938, |
6833
|
Florida Statutes, are amended to read: |
6834
|
626.938 Report and tax of independently procured |
6835
|
coverages.-- |
6836
|
(3) For the general support of the government of this |
6837
|
state, there is levied upon the obligation, chose in action, or |
6838
|
right represented by the premium charged for such insurance a |
6839
|
tax at the rate of 5 percent of the gross amount of such premium |
6840
|
and a 0.3 percent service fee pursuant to s. 626.9325. The |
6841
|
insured shall withhold the amount of the tax and service fee |
6842
|
from the amount of premium charged by and otherwise payable to |
6843
|
the insurer for such insurance. Within 30 days after the |
6844
|
insurance is procured, continued, or renewed, and simultaneously |
6845
|
with the filing of the report provided for in subsection (1) |
6846
|
with the Florida Surplus Lines Service Office, the insured shall |
6847
|
make payable to the department of Insurancethe amount of the |
6848
|
tax and make payable to the Florida Surplus Lines Service Office |
6849
|
the amount of the service fee. The insured shall remit the tax |
6850
|
and the service fee to the Florida Surplus Lines Service Office. |
6851
|
The Florida Surplus Lines Service Office shall forward to the |
6852
|
department the taxes, and any interest collected pursuant to |
6853
|
subsection (5), within 10 days after receipt. |
6854
|
(7) The department shall deposit 55 percent of all taxes |
6855
|
and interest collected under this section to the credit of the |
6856
|
Insurance Commissioner'sRegulatory Trust Fund. Forty-five |
6857
|
percent of all taxes and interest collected under this section |
6858
|
shall be deposited into the General Revenue Fund. |
6859
|
Section 160. Section 626.9511, Florida Statutes, is |
6860
|
amended to read: |
6861
|
626.9511 Definitions.--When used in this part: |
6862
|
(1) "Person" means any individual, corporation, |
6863
|
association, partnership, reciprocal exchange, interinsurer, |
6864
|
Lloyds insurer, fraternal benefit society, or business trust or |
6865
|
any entity involved in the business of insurance. |
6866
|
(2) "Department" means the Department of Insurance of this |
6867
|
state. |
6868
|
(2)(3)"Insurance policy" or "insurance contract" means a |
6869
|
written contract of, or a written agreement for or effecting, |
6870
|
insurance, or the certificate thereof, by whatever name called, |
6871
|
and includes all clauses, riders, endorsements, and papers which |
6872
|
are a part thereof. |
6873
|
Section 161. Paragraphs (h), (o), (w), and (aa) of |
6874
|
subsection (1) of section 626.9541, Florida Statutes, are |
6875
|
amended to read: |
6876
|
626.9541 Unfair methods of competition and unfair or |
6877
|
deceptive acts or practices defined.-- |
6878
|
(1) UNFAIR METHODS OF COMPETITION AND UNFAIR OR DECEPTIVE |
6879
|
ACTS.--The following are defined as unfair methods of |
6880
|
competition and unfair or deceptive acts or practices: |
6881
|
(h) Unlawful rebates.-- |
6882
|
1. Except as otherwise expressly provided by law, or in an |
6883
|
applicable filing with the officedepartment, knowingly: |
6884
|
a. Permitting, or offering to make, or making, any |
6885
|
contract or agreement as to such contract other than as plainly |
6886
|
expressed in the insurance contract issued thereon; |
6887
|
b. Paying, allowing, or giving, or offering to pay, allow, |
6888
|
or give, directly or indirectly, as inducement to such insurance |
6889
|
contract, any unlawful rebate of premiums payable on the |
6890
|
contract, any special favor or advantage in the dividends or |
6891
|
other benefits thereon, or any valuable consideration or |
6892
|
inducement whatever not specified in the contract; |
6893
|
c. Giving, selling, or purchasing, or offering to give, |
6894
|
sell, or purchase, as inducement to such insurance contract or |
6895
|
in connection therewith, any stocks, bonds, or other securities |
6896
|
of any insurance company or other corporation, association, or |
6897
|
partnership, or any dividends or profits accrued thereon, or |
6898
|
anything of value whatsoever not specified in the insurance |
6899
|
contract. |
6900
|
2. Nothing in paragraph (g) or subparagraph 1. of this |
6901
|
paragraph shall be construed as including within the definition |
6902
|
of discrimination or unlawful rebates: |
6903
|
a. In the case of any contract of life insurance or life |
6904
|
annuity, paying bonuses to all policyholders or otherwise |
6905
|
abating their premiums in whole or in part out of surplus |
6906
|
accumulated from nonparticipating insurance; provided that any |
6907
|
such bonuses or abatement of premiums is fair and equitable to |
6908
|
all policyholders and for the best interests of the company and |
6909
|
its policyholders. |
6910
|
b. In the case of life insurance policies issued on the |
6911
|
industrial debit plan, making allowance to policyholders who |
6912
|
have continuously for a specified period made premium payments |
6913
|
directly to an office of the insurer in an amount which fairly |
6914
|
represents the saving in collection expenses. |
6915
|
c. Readjustment of the rate of premium for a group |
6916
|
insurance policy based on the loss or expense thereunder, at the |
6917
|
end of the first or any subsequent policy year of insurance |
6918
|
thereunder, which may be made retroactive only for such policy |
6919
|
year. |
6920
|
d. Issuance of life insurance policies or annuity |
6921
|
contracts at rates less than the usual rates of premiums for |
6922
|
such policies or contracts, as group insurance or employee |
6923
|
insurance as defined in this code. |
6924
|
e. Issuing life or disability insurance policies on a |
6925
|
salary savings, bank draft, preauthorized check, payroll |
6926
|
deduction, or other similar plan at a reduced rate reasonably |
6927
|
related to the savings made by the use of such plan. |
6928
|
3.a. No title insurer, or any member, employee, attorney, |
6929
|
agent, agency, or solicitor thereof, shall pay, allow, or give, |
6930
|
or offer to pay, allow, or give, directly or indirectly, as |
6931
|
inducement to title insurance, or after such insurance has been |
6932
|
effected, any rebate or abatement of the agent's, agency's, or |
6933
|
title insurer's share of the premium or any charge for related |
6934
|
title services below the cost for providing such services, or |
6935
|
provide any special favor or advantage, or any monetary |
6936
|
consideration or inducement whatever. Nothing herein contained |
6937
|
shall preclude an abatement in an attorney's fee charged for |
6938
|
legal services. |
6939
|
b. Nothing in this subparagraph shall be construed as |
6940
|
prohibiting the payment of fees to attorneys at law duly |
6941
|
licensed to practice law in the courts of this state, for |
6942
|
professional services, or as prohibiting the payment of earned |
6943
|
portions of the premium to duly appointed agents or agencies who |
6944
|
actually perform services for the title insurer. |
6945
|
c. No insured named in a policy, or any other person |
6946
|
directly or indirectly connected with the transaction involving |
6947
|
the issuance of such policy, including, but not limited to, any |
6948
|
mortgage broker, real estate broker, builder, or attorney, any |
6949
|
employee, agent, agency, or representative thereof, or any other |
6950
|
person whatsoever, shall knowingly receive or accept, directly |
6951
|
or indirectly, any rebate or abatement of said charge, or any |
6952
|
monetary consideration or inducement, other than as set forth in |
6953
|
sub-subparagraph b. |
6954
|
(o) Illegal dealings in premiums; excess or reduced |
6955
|
charges for insurance.-- |
6956
|
1. Knowingly collecting any sum as a premium or charge for |
6957
|
insurance, which is not then provided, or is not in due course |
6958
|
to be provided, subject to acceptance of the risk by the |
6959
|
insurer, by an insurance policy issued by an insurer as |
6960
|
permitted by this code. |
6961
|
2. Knowingly collecting as a premium or charge for |
6962
|
insurance any sum in excess of or less than the premium or |
6963
|
charge applicable to such insurance, in accordance with the |
6964
|
applicable classifications and rates as filed with and approved |
6965
|
by the officedepartment, and as specified in the policy; or, in |
6966
|
cases when classifications, premiums, or rates are not required |
6967
|
by this code to be so filed and approved, premiums and charges |
6968
|
in excess of or less than those specified in the policy and as |
6969
|
fixed by the insurer. This provision shall not be deemed to |
6970
|
prohibit the charging and collection, by surplus lines agents |
6971
|
licensed under part VIII of this chapter, of the amount of |
6972
|
applicable state and federal taxes, or fees as authorized by s. |
6973
|
626.916(4), in addition to the premium required by the insurer |
6974
|
or the charging and collection, by licensed agents, of the exact |
6975
|
amount of any discount or other such fee charged by a credit |
6976
|
card facility in connection with the use of a credit card, as |
6977
|
authorized by subparagraph (q)3., in addition to the premium |
6978
|
required by the insurer. This subparagraph shall not be |
6979
|
construed to prohibit collection of a premium for a universal |
6980
|
life or a variable or indeterminate value insurance policy made |
6981
|
in accordance with the terms of the contract. |
6982
|
3.a. Imposing or requesting an additional premium for a |
6983
|
policy of motor vehicle liability, personal injury protection, |
6984
|
medical payment, or collision insurance or any combination |
6985
|
thereof or refusing to renew the policy solely because the |
6986
|
insured was involved in a motor vehicle accident unless the |
6987
|
insurer's file contains information from which the insurer in |
6988
|
good faith determines that the insured was substantially at |
6989
|
fault in the accident. |
6990
|
b. An insurer which imposes and collects such a surcharge |
6991
|
or which refuses to renew such policy shall, in conjunction with |
6992
|
the notice of premium due or notice of nonrenewal, notify the |
6993
|
named insured that he or she is entitled to reimbursement of |
6994
|
such amount or renewal of the policy under the conditions listed |
6995
|
below and will subsequently reimburse him or her or renew the |
6996
|
policy, if the named insured demonstrates that the operator |
6997
|
involved in the accident was: |
6998
|
(I) Lawfully parked; |
6999
|
(II) Reimbursed by, or on behalf of, a person responsible |
7000
|
for the accident or has a judgment against such person; |
7001
|
(III) Struck in the rear by another vehicle headed in the |
7002
|
same direction and was not convicted of a moving traffic |
7003
|
violation in connection with the accident; |
7004
|
(IV) Hit by a "hit-and-run" driver, if the accident was |
7005
|
reported to the proper authorities within 24 hours after |
7006
|
discovering the accident; |
7007
|
(V) Not convicted of a moving traffic violation in |
7008
|
connection with the accident, but the operator of the other |
7009
|
automobile involved in such accident was convicted of a moving |
7010
|
traffic violation; |
7011
|
(VI) Finally adjudicated not to be liable by a court of |
7012
|
competent jurisdiction; |
7013
|
(VII) In receipt of a traffic citation which was dismissed |
7014
|
or nolle prossed; or |
7015
|
(VIII) Not at fault as evidenced by a written statement |
7016
|
from the insured establishing facts demonstrating lack of fault |
7017
|
which are not rebutted by information in the insurer's file from |
7018
|
which the insurer in good faith determines that the insured was |
7019
|
substantially at fault. |
7020
|
c. In addition to the other provisions of this |
7021
|
subparagraph, an insurer may not fail to renew a policy if the |
7022
|
insured has had only one accident in which he or she was at |
7023
|
fault within the current 3-year period. However, an insurer may |
7024
|
nonrenew a policy for reasons other than accidents in accordance |
7025
|
with s. 627.728. This subparagraph does not prohibit nonrenewal |
7026
|
of a policy under which the insured has had three or more |
7027
|
accidents, regardless of fault, during the most recent 3-year |
7028
|
period. |
7029
|
4. Imposing or requesting an additional premium for, or |
7030
|
refusing to renew, a policy for motor vehicle insurance solely |
7031
|
because the insured committed a noncriminal traffic infraction |
7032
|
as described in s. 318.14 unless the infraction is: |
7033
|
a. A second infraction committed within an 18-month |
7034
|
period, or a third or subsequent infraction committed within a |
7035
|
36-month period. |
7036
|
b. A violation of s. 316.183, when such violation is a |
7037
|
result of exceeding the lawful speed limit by more than 15 miles |
7038
|
per hour. |
7039
|
5. Upon the request of the insured, the insurer and |
7040
|
licensed agent shall supply to the insured the complete proof of |
7041
|
fault or other criteria which justifies the additional charge or |
7042
|
cancellation. |
7043
|
6. No insurer shall impose or request an additional |
7044
|
premium for motor vehicle insurance, cancel or refuse to issue a |
7045
|
policy, or refuse to renew a policy because the insured or the |
7046
|
applicant is a handicapped or physically disabled person, so |
7047
|
long as such handicap or physical disability does not |
7048
|
substantially impair such person's mechanically assisted driving |
7049
|
ability. |
7050
|
7. No insurer may cancel or otherwise terminate any |
7051
|
insurance contract or coverage, or require execution of a |
7052
|
consent to rate endorsement, during the stated policy term for |
7053
|
the purpose of offering to issue, or issuing, a similar or |
7054
|
identical contract or coverage to the same insured with the same |
7055
|
exposure at a higher premium rate or continuing an existing |
7056
|
contract or coverage with the same exposure at an increased |
7057
|
premium. |
7058
|
8. No insurer may issue a nonrenewal notice on any |
7059
|
insurance contract or coverage, or require execution of a |
7060
|
consent to rate endorsement, for the purpose of offering to |
7061
|
issue, or issuing, a similar or identical contract or coverage |
7062
|
to the same insured at a higher premium rate or continuing an |
7063
|
existing contract or coverage at an increased premium without |
7064
|
meeting any applicable notice requirements. |
7065
|
9. No insurer shall, with respect to premiums charged for |
7066
|
motor vehicle insurance, unfairly discriminate solely on the |
7067
|
basis of age, sex, marital status, or scholastic achievement. |
7068
|
10. Imposing or requesting an additional premium for motor |
7069
|
vehicle comprehensive or uninsured motorist coverage solely |
7070
|
because the insured was involved in a motor vehicle accident or |
7071
|
was convicted of a moving traffic violation. |
7072
|
11. No insurer shall cancel or issue a nonrenewal notice |
7073
|
on any insurance policy or contract without complying with any |
7074
|
applicable cancellation or nonrenewal provision required under |
7075
|
the Florida Insurance Code. |
7076
|
12. No insurer shall impose or request an additional |
7077
|
premium, cancel a policy, or issue a nonrenewal notice on any |
7078
|
insurance policy or contract because of any traffic infraction |
7079
|
when adjudication has been withheld and no points have been |
7080
|
assessed pursuant to s. 318.14(9) and (10). However, this |
7081
|
subparagraph does not apply to traffic infractions involving |
7082
|
accidents in which the insurer has incurred a loss due to the |
7083
|
fault of the insured. |
7084
|
(w) Soliciting or accepting new or renewal insurance risks |
7085
|
by insolvent or impaired insurer prohibited; penalty.-- |
7086
|
1. Whether or not delinquency proceedings as to the |
7087
|
insurer have been or are to be initiated, but while such |
7088
|
insolvency or impairment exists, no director or officer of an |
7089
|
insurer, except with the written permission of the office |
7090
|
Department of Insurance, shall authorize or permit the insurer |
7091
|
to solicit or accept new or renewal insurance risks in this |
7092
|
state after such director or officer knew, or reasonably should |
7093
|
have known, that the insurer was insolvent or impaired. |
7094
|
"Impaired" includes impairment of capital or surplus, as defined |
7095
|
in s. 631.011(12) and (13). |
7096
|
2. Any such director or officer, upon conviction of a |
7097
|
violation of this paragraph, is guilty of a felony of the third |
7098
|
degree, punishable as provided in s. 775.082, s. 775.083, or s. |
7099
|
775.084. |
7100
|
(aa) Churning.-- |
7101
|
1. Churning is the practice whereby policy values in an |
7102
|
existing life insurance policy or annuity contract, including, |
7103
|
but not limited to, cash, loan values, or dividend values, and |
7104
|
in any riders to that policy or contract, are utilized to |
7105
|
purchase another insurance policy or annuity contract with that |
7106
|
same insurer for the purpose of earning additional premiums, |
7107
|
fees, commissions, or other compensation: |
7108
|
a. Without an objectively reasonable basis for believing |
7109
|
that the replacement or extraction will result in an actual and |
7110
|
demonstrable benefit to the policyholder; |
7111
|
b. In a fashion that is fraudulent, deceptive, or |
7112
|
otherwise misleading or that involves a deceptive omission; |
7113
|
c. Effective October 1, 1995,When the applicant is not |
7114
|
informed that the policy values including cash values, |
7115
|
dividends, and other assets of the existing policy or contract |
7116
|
will be reduced, forfeited, or utilized in the purchase of the |
7117
|
replacing or additional policy or contract, if this is the case; |
7118
|
or |
7119
|
d. Effective October 1, 1995,Without informing the |
7120
|
applicant that the replacing or additional policy or contract |
7121
|
will not be a paid-up policy or that additional premiums will be |
7122
|
due, if this is the case. |
7123
|
|
7124
|
|
7125
|
Churning by an insurer or an agent is an unfair method of |
7126
|
competition and an unfair or deceptive act or practice. |
7127
|
2. Effective October 1, 1995,Each insurer shall comply |
7128
|
with sub-subparagraphs 1.c. and 1.d. by disclosing to the |
7129
|
applicant at the time of the offer on a form designed and |
7130
|
adopted by rule by the commissiondepartmentif, how, and the |
7131
|
extent to which the policy or contract values (including cash |
7132
|
value, dividends, and other assets) of a previously issued |
7133
|
policy or contract will be used to purchase a replacing or |
7134
|
additional policy or contract with the same insurer. The form |
7135
|
shall include disclosure of the premium, the death benefit of |
7136
|
the proposed replacing or additional policy, and the date when |
7137
|
the policy values of the existing policy or contract will be |
7138
|
insufficient to pay the premiums of the replacing or additional |
7139
|
policy or contract. |
7140
|
3. Effective October 1, 1995,Each insurer shall adopt |
7141
|
written procedures to reasonably avoid churning of policies or |
7142
|
contracts that it has issued, and failure to adopt written |
7143
|
procedures sufficient to reasonably avoid churning shall be an |
7144
|
unfair method of competition and an unfair or deceptive act or |
7145
|
practice. |
7146
|
Section 162. Subsections (3), (5), (7), (8), (10), and |
7147
|
(11) of section 626.9543, Florida Statutes, are amended to read: |
7148
|
626.9543 Holocaust victims.-- |
7149
|
(3) DEFINITIONS.--For the purpose of this section, the |
7150
|
term: |
7151
|
(a) "Department" means the Department of Insurance. |
7152
|
(a)(b)"Holocaust victim" means any person who lost his or |
7153
|
her life or property as a result of discriminatory laws, |
7154
|
policies, or actions targeted against discrete groups of persons |
7155
|
between 1920 and 1945, inclusive, in Nazi Germany, areas |
7156
|
occupied by Nazi Germany, or countries allied with Nazi Germany. |
7157
|
(b)(c)"Insurance policy" means, but is not limited to, |
7158
|
life insurance, property insurance, or education policies. |
7159
|
(c)(d)"Legal relationship" means any parent, subsidiary, |
7160
|
or affiliated company with an insurer doing business in this |
7161
|
state. |
7162
|
(d)(e)"Proceeds" means the face or other payout value of |
7163
|
policies and annuities plus reasonable interest to date of |
7164
|
payments without diminution for wartime or immediate postwar |
7165
|
currency devaluation. |
7166
|
(5) PROOF OF A CLAIM.--Any insurer doing business in this |
7167
|
state, in receipt of a claim from a Holocaust victim or from a |
7168
|
beneficiary, descendant, or heir of a Holocaust victim, shall: |
7169
|
(a) Diligently and expeditiously investigate all such |
7170
|
claims. |
7171
|
(b) Allow such claimants to meet a reasonable, not unduly |
7172
|
restrictive, standard of proof to substantiate a claim, pursuant |
7173
|
to standards established by rule of the commissiondepartment. |
7174
|
(c) Permit claims irrespective of any statute of |
7175
|
limitations or notice requirements imposed by any insurance |
7176
|
policy issued, provided the claim is submitted within 10 years |
7177
|
after the effective date of this section. |
7178
|
(7) REPORTS FROM INSURERS.--Any insurer doing business in |
7179
|
this state shall have an affirmative duty to ascertain to the |
7180
|
extent possible and report to the officedepartmentwithin 90 |
7181
|
days after the effective date of this section and annually |
7182
|
thereafter all efforts made and results of such efforts to |
7183
|
ascertain: |
7184
|
(a) Any legal relationship with an international insurer |
7185
|
that issued an insurance policy to a Holocaust victim between |
7186
|
1920 and 1945, inclusive. |
7187
|
(b) The number and total value of such policies. |
7188
|
(c) Any claim filed by a Holocaust victim, his or her |
7189
|
beneficiary, heir, or descendant that has been paid, denied |
7190
|
payment, or is pending. |
7191
|
(d) Attempts made by the insurer to locate the |
7192
|
beneficiaries of any such policies for which no claim of |
7193
|
benefits has been made. |
7194
|
(e) An explanation of any denial or pending payment of a |
7195
|
claim to a Holocaust victim, his or her beneficiary, heir, or |
7196
|
descendant. |
7197
|
(8) REPORTS TO THE LEGISLATURE.--The office anddepartment |
7198
|
shall jointlyreport to the Legislature 1 year after the |
7199
|
effective date of this section and annually thereafter: |
7200
|
(a) The number of insurers doing business in this state |
7201
|
which have a legal relationship with an international insurer |
7202
|
that could have issued a policy to a Holocaust victim between |
7203
|
1920 and 1945, inclusive. |
7204
|
(b) A list of all claims paid, denied, or pending to a |
7205
|
Holocaust victim, his or her beneficiary, heir, or descendant. |
7206
|
(c) A summary of the length of time for the processing and |
7207
|
disposition of a claim by the insurer. |
7208
|
(10) PRIVATE RIGHT OF ACTION.--An action to recover |
7209
|
damages caused by a violation of this section must be commenced |
7210
|
within 5 years after the cause of action has accrued. Any |
7211
|
person who shall sustain damages by the reason of a violation of |
7212
|
this section shall recover threefold the actual damages |
7213
|
sustained thereby, as well as costs not exceeding $50,000, and |
7214
|
reasonable attorneys' fees. At or before the commencement of |
7215
|
any civil action by a party, notice thereof shall be served upon |
7216
|
the officedepartment. |
7217
|
(11) RULES.--The commissiondepartment, by rule, shall |
7218
|
provide for the implementation of the provisions of this section |
7219
|
by establishing procedures and related forms for facilitating, |
7220
|
monitoring, and verifying compliance with this section and for |
7221
|
the establishment of a restitution program for Holocaust |
7222
|
victims, survivors, and their heirs and beneficiaries. |
7223
|
Section 163. Section 626.9545, Florida Statutes, is |
7224
|
amended to read: |
7225
|
626.9545 Improper charge identification incentive |
7226
|
program.--No section or provision of the Florida Insurance Code |
7227
|
shall be construed as prohibiting an insurer from establishing a |
7228
|
financial incentive program for remunerating a policyholder or |
7229
|
an insured person with a selected percentage or stated portion |
7230
|
of any health care charge identified by the policyholder or the |
7231
|
insured person as an error or overcharge if the health care |
7232
|
charge is recovered by the insurer. The financial incentive |
7233
|
program shall be written and shall be available for inspection |
7234
|
by the officedepartment. |
7235
|
Section 164. Subsection (5) of section 626.9551, Florida |
7236
|
Statutes, is amended to read: |
7237
|
626.9551 Favored agent or insurer; coercion of debtors.-- |
7238
|
(5) The department or officemay investigate the affairs |
7239
|
of any person to whom this section applies to determine whether |
7240
|
such person has violated this section. If a violation of this |
7241
|
section is found to have been committed knowingly, the person in |
7242
|
violation shall be subject to the same procedures and penalties |
7243
|
as provided in ss. 626.9571, 626.9581, 626.9591, and 626.9601. |
7244
|
Section 165. Section 626.9561, Florida Statutes, is |
7245
|
amended to read: |
7246
|
626.9561 Power of department and office.--The department |
7247
|
and office shall each have power within its respective |
7248
|
regulatory jurisdictionto examine and investigate the affairs |
7249
|
of every person involved in the business of insurance in this |
7250
|
state in order to determine whether such person has been or is |
7251
|
engaged in any unfair method of competition or in any unfair or |
7252
|
deceptive act or practice prohibited by s. 626.9521, and shall |
7253
|
each have the powers and duties specified in ss. 626.9571- |
7254
|
626.9601 in connection therewith. |
7255
|
Section 166. Section 626.9571, Florida Statutes, is |
7256
|
amended to read: |
7257
|
626.9571 Defined practices; hearings, witnesses, |
7258
|
appearances, production of books and service of process.-- |
7259
|
(1) Whenever the department or officehas reason to |
7260
|
believe that any person has engaged, or is engaging, in this |
7261
|
state in any unfair method of competition or any unfair or |
7262
|
deceptive act or practice as defined in s. 626.9541 or s. |
7263
|
626.9551 or is engaging in the business of insurance without |
7264
|
being properly licensed as required by this code and that a |
7265
|
proceeding by it in respect thereto would be to the interest of |
7266
|
the public, it shall conduct or cause to have conducted a |
7267
|
hearing in accordance with chapter 120. |
7268
|
(2) The department or office, a duly empowered hearing |
7269
|
officer, or an administrative law judge shall, during the |
7270
|
conduct of such hearing, have those powers enumerated in s. |
7271
|
120.569; however, the penalties for failure to comply with a |
7272
|
subpoena or with an order directing discovery shall be limited |
7273
|
to a fine not to exceed $1,000 per violation. |
7274
|
(3) Statements of charges, notices, and orders under this |
7275
|
act may be served by anyone duly authorized by the department or |
7276
|
office, either in the manner provided by law for service of |
7277
|
process in civil actions or by certifying and mailing a copy |
7278
|
thereof to the person affected by such statement, notice, order, |
7279
|
or other process at his or her or its residence or principal |
7280
|
office or place of business. The verified return by the person |
7281
|
so serving such statement, notice, order, or other process, |
7282
|
setting forth the manner of the service, shall be proof of the |
7283
|
same, and the return postcard receipt for such statement, |
7284
|
notice, order, or other process, certified and mailed as |
7285
|
aforesaid, shall be proof of service of the same. |
7286
|
Section 167. Section 626.9581, Florida Statutes, is |
7287
|
amended to read: |
7288
|
626.9581 Cease and desist and penalty orders.--After the |
7289
|
hearing provided in s. 626.9571, the department or officeshall |
7290
|
enter a final order in accordance with s. 120.569. If it is |
7291
|
determined that the person charged has engaged in an unfair or |
7292
|
deceptive act or practice or the unlawful transaction of |
7293
|
insurance, the department or officeshall also issue an order |
7294
|
requiring the violator to cease and desist from engaging in such |
7295
|
method of competition, act, or practice or the unlawful |
7296
|
transaction of insurance. Further, if the act or practice is a |
7297
|
violation of s. 626.9541 or s. 626.9551, the department or |
7298
|
officemay, at its discretion, order any one or more of the |
7299
|
following: |
7300
|
(1) Suspension or revocation of the person's certificate |
7301
|
of authority, license, or eligibility for any certificate of |
7302
|
authority or license, if he or she knew, or reasonably should |
7303
|
have known, he or she was in violation of this act. |
7304
|
(2) Such other relief as may be provided in the insurance |
7305
|
code. |
7306
|
Section 168. Section 626.9591, Florida Statutes, is |
7307
|
amended to read: |
7308
|
626.9591 Appeals from the department or office.--Any |
7309
|
person subject to an order of the department or officeunder s. |
7310
|
626.9581 or s. 626.9601 may obtain a review of such order by |
7311
|
filing an appeal therefrom in accordance with the provisions and |
7312
|
procedures for appeal from the orders of the department or |
7313
|
officein general under s. 120.68. |
7314
|
Section 169. Section 626.9601, Florida Statutes, is |
7315
|
amended to read: |
7316
|
626.9601 Penalty for violation of cease and desist |
7317
|
orders.--Any person who violates a cease and desist order of the |
7318
|
department or officeunder s. 626.9581 while such order is in |
7319
|
effect, after notice and hearing as provided in s. 626.9571, |
7320
|
shall be subject, at the discretion of the department or office, |
7321
|
to any one or more of the following: |
7322
|
(1) A monetary penalty of not more than $50,000 as to all |
7323
|
matters determined in such hearing. |
7324
|
(2) Suspension or revocation of such person's certificate |
7325
|
of authority, license, or eligibility to hold such certificate |
7326
|
of authority or license. |
7327
|
(3) Such other relief as may be provided in the insurance |
7328
|
code. |
7329
|
Section 170. Section 626.9611, Florida Statutes, is |
7330
|
amended to read: |
7331
|
626.9611 Rules.--The department or commissionmay, in |
7332
|
accordance with chapter 120, adoptpromulgatereasonable rules |
7333
|
as are necessary or proper to identify specific methods of |
7334
|
competition or acts or practices which are prohibited by s. |
7335
|
626.9541 or s. 626.9551, but the rules shall not enlarge upon or |
7336
|
extend the provisions of ss. 626.9541 and 626.9551. |
7337
|
Section 171. Section 626.9621, Florida Statutes, is |
7338
|
amended to read: |
7339
|
626.9621 Provisions of part additional to existing |
7340
|
law.--The powers vested in the department, commission, and |
7341
|
officeby this part shall be additional to any other powers to |
7342
|
enforce any penalties, fines, or forfeitures authorized by law. |
7343
|
Section 172. Section 626.9631, Florida Statutes, is |
7344
|
amended to read: |
7345
|
626.9631 Civil liability.--The provisions of this part are |
7346
|
cumulative to rights under the general civil and common law, and |
7347
|
no action of the department, commission, or officeshall |
7348
|
abrogate such rights to damages or other relief in any court. |
7349
|
Section 173. Subsection (1) of section 626.9641, Florida |
7350
|
Statutes, is amended to read: |
7351
|
626.9641 Policyholders, bill of rights.-- |
7352
|
(1) The principles expressed in the following statements |
7353
|
shall serve as standards to be followed by the department, |
7354
|
commission, and office in exercising theiritspowers and |
7355
|
duties, in exercising administrative discretion, in dispensing |
7356
|
administrative interpretations of the law, and in adopting |
7357
|
promulgatingrules: |
7358
|
(a) Policyholders shall have the right to competitive |
7359
|
pricing practices and marketing methods that enable them to |
7360
|
determine the best value among comparable policies. |
7361
|
(b) Policyholders shall have the right to obtain |
7362
|
comprehensive coverage. |
7363
|
(c) Policyholders shall have the right to insurance |
7364
|
advertising and other selling approaches that provide accurate |
7365
|
and balanced information on the benefits and limitations of a |
7366
|
policy. |
7367
|
(d) Policyholders shall have a right to an insurance |
7368
|
company that is financially stable. |
7369
|
(e) Policyholders shall have the right to be serviced by a |
7370
|
competent, honest insurance agent or broker. |
7371
|
(f) Policyholders shall have the right to a readable |
7372
|
policy. |
7373
|
(g) Policyholders shall have the right to an insurance |
7374
|
company that provides an economic delivery of coverage and that |
7375
|
tries to prevent losses. |
7376
|
(h) Policyholders shall have the right to a balanced and |
7377
|
positive regulation by the department, commission, and office. |
7378
|
Section 174. Section 626.9651, Florida Statutes, is |
7379
|
amended to read: |
7380
|
626.9651 Privacy.--The department and commission shall |
7381
|
eachadopt rules consistent with other provisions of the Florida |
7382
|
Insurance Code to govern the use of a consumer's nonpublic |
7383
|
personal financial and health information. These rules must be |
7384
|
based on, consistent with, and not more restrictive than the |
7385
|
Privacy of Consumer Financial and Health Information Regulation, |
7386
|
adopted September 26, 2000, by the National Association of |
7387
|
Insurance Commissioners; however, the rules must permit the use |
7388
|
and disclosure of nonpublic personal health information for |
7389
|
scientific, medical, or public policy research, in accordance |
7390
|
with federal law. In addition, these rules must be consistent |
7391
|
with, and not more restrictive than, the standards contained in |
7392
|
Title V of the Gramm-Leach-Bliley Act of 1999, Pub. L. No. 106- |
7393
|
102. If the officedepartmentdetermines that a health insurer |
7394
|
or health maintenance organization is in compliance with, or is |
7395
|
actively undertaking compliance with, the consumer privacy |
7396
|
protection rules adopted by the United States Department of |
7397
|
Health and Human Services, in conformance with the Health |
7398
|
Insurance Portability and Affordability Act, that health insurer |
7399
|
or health maintenance organization is in compliance with this |
7400
|
section. |
7401
|
Section 175. Paragraph (e) of subsection (4) and |
7402
|
subsections (5) and (9) of section 626.989, Florida Statutes, |
7403
|
are amended to read: |
7404
|
626.989 Investigation by department or Division of |
7405
|
Insurance Fraud; compliance; immunity; confidential information; |
7406
|
reports to division; division investigator's power of arrest.-- |
7407
|
(4) |
7408
|
(e) The Chief Financial OfficerInsurance Commissionerand |
7409
|
any employee or agent of the department, commission, office,or |
7410
|
division, when acting without malice and in the absence of fraud |
7411
|
or bad faith, is not subject to civil liability for libel, |
7412
|
slander, or any other relevant tort, and no civil cause of |
7413
|
action of any nature exists against such person by virtue of the |
7414
|
execution of official activities or duties of the department, |
7415
|
commission, or officeunder this section or by virtue of the |
7416
|
publication of any report or bulletin related to the official |
7417
|
activities or duties of the department,or division, commission, |
7418
|
or officeunder this section. |
7419
|
(5) The office's and thedepartment's papers, documents, |
7420
|
reports, or evidence relative to the subject of an investigation |
7421
|
under this section are confidential and exempt from the |
7422
|
provisions of s. 119.07(1) until such investigation is completed |
7423
|
or ceases to be active. For purposes of this subsection, an |
7424
|
investigation is considered "active" while the investigation is |
7425
|
being conducted by the office ordepartment with a reasonable, |
7426
|
good faith belief that it could lead to the filing of |
7427
|
administrative, civil, or criminal proceedings. An investigation |
7428
|
does not cease to be active if the office ordepartment is |
7429
|
proceeding with reasonable dispatch and has a good faith belief |
7430
|
that action could be initiated by the office ordepartment or |
7431
|
other administrative or law enforcement agency. After an |
7432
|
investigation is completed or ceases to be active, portions of |
7433
|
records relating to the investigation shall remain exempt from |
7434
|
the provisions of s. 119.07(1) if disclosure would: |
7435
|
(a) Jeopardize the integrity of another active |
7436
|
investigation; |
7437
|
(b) Impair the safety and soundness of an insurer; |
7438
|
(c) Reveal personal financial information; |
7439
|
(d) Reveal the identity of a confidential source; |
7440
|
(e) Defame or cause unwarranted damage to the good name or |
7441
|
reputation of an individual or jeopardize the safety of an |
7442
|
individual; or |
7443
|
(f) Reveal investigative techniques or procedures. |
7444
|
Further, such papers, documents, reports, or evidence relative |
7445
|
to the subject of an investigation under this section shall not |
7446
|
be subject to discovery until the investigation is completed or |
7447
|
ceases to be active. Office, department,or division |
7448
|
investigators shall not be subject to subpoena in civil actions |
7449
|
by any court of this state to testify concerning any matter of |
7450
|
which they have knowledge pursuant to a pending insurance fraud |
7451
|
investigation by the division. |
7452
|
(9) In recognition of the complementary roles of |
7453
|
investigating instances of workers' compensation fraud and |
7454
|
enforcing compliance with the workers' compensation coverage |
7455
|
requirements under chapter 440, the department of Insuranceis |
7456
|
directed to prepare and submit a joint performance report to the |
7457
|
President of the Senate and the Speaker of the House of |
7458
|
Representatives by November 1, 2003, and then by November 1 |
7459
|
every 3 years thereafter, describing the results obtained in |
7460
|
achieving compliance with the workers' compensation coverage |
7461
|
requirements and reducing the incidence of workers' compensation |
7462
|
fraud. |
7463
|
Section 176. Subsection (1) of section 626.9892, Florida |
7464
|
Statutes, is amended to read: |
7465
|
626.9892 Anti-Fraud Reward Program; reporting of insurance |
7466
|
fraud.-- |
7467
|
(1) The Anti-Fraud Reward Program is hereby established |
7468
|
within the department, to be funded from the Insurance |
7469
|
Commissioner'sRegulatory Trust Fund. |
7470
|
Section 177. Paragraph (k) of subsection (5) of section |
7471
|
626.99, Florida Statutes, is amended to read: |
7472
|
626.99 Life insurance solicitation.-- |
7473
|
(5) GENERAL RULES RELATING TO SOLICITATION.-- |
7474
|
(k) If an appropriately licensed agent proposes to replace |
7475
|
a life insurance policy or an in-force annuity with a registered |
7476
|
securities product, preapplication notice requirements to the |
7477
|
departmentshall not apply. |
7478
|
Section 178. Section 626.9911, Florida Statutes, is |
7479
|
amended to read: |
7480
|
626.9911 Definitions.--As used in this act, the term: |
7481
|
(1) "Department" means the Department of Insurance. |
7482
|
(1)(2)"Independent third-party trustee or escrow agent" |
7483
|
means an attorney, certified public accountant, financial |
7484
|
institution, or other person providing escrow services under the |
7485
|
authority of a regulatory body. The term does not include any |
7486
|
person associated, affiliated, or under common control with a |
7487
|
viatical settlement provider or viatical settlement broker. |
7488
|
(2)(3)"Person" has the meaning specified in s. 1.01. |
7489
|
(3)(4)"Viatical settlement broker" means a person who, on |
7490
|
behalf of a viator and for a fee, commission, or other valuable |
7491
|
consideration, offers or attempts to negotiate viatical |
7492
|
settlement contracts between a viator resident in this state and |
7493
|
one or more viatical settlement providers. Notwithstanding the |
7494
|
manner in which the viatical settlement broker is compensated, a |
7495
|
viatical settlement broker is deemed to represent only the |
7496
|
viator and owes a fiduciary duty to the viator to act according |
7497
|
to the viator's instructions and in the best interest of the |
7498
|
viator. The term does not include an attorney, licensed |
7499
|
Certified Public Accountant, or investment adviser lawfully |
7500
|
registered with the department of Banking and Financeunder |
7501
|
chapter 517, who is retained to represent the viator and whose |
7502
|
compensation is paid directly by or at the direction and on |
7503
|
behalf of the viator. |
7504
|
(4)(5)"Viatical settlement contract" means a written |
7505
|
agreement entered into between a viatical settlement provider, |
7506
|
or its related provider trust, and a viator. The viatical |
7507
|
settlement contract includes an agreement to transfer ownership |
7508
|
or change the beneficiary designation of a life insurance policy |
7509
|
at a later date, regardless of the date that compensation is |
7510
|
paid to the viator. The agreement must establish the terms |
7511
|
under which the viatical settlement provider will pay |
7512
|
compensation or anything of value, which compensation or value |
7513
|
is less than the expected death benefit of the insurance policy |
7514
|
or certificate, in return for the viator's assignment, transfer, |
7515
|
sale, devise, or bequest of the death benefit or ownership of |
7516
|
all or a portion of the insurance policy or certificate of |
7517
|
insurance to the viatical settlement provider. A viatical |
7518
|
settlement contract also includes a contract for a loan or other |
7519
|
financial transaction secured primarily by an individual or |
7520
|
group life insurance policy, other than a loan by a life |
7521
|
insurance company pursuant to the terms of the life insurance |
7522
|
contract, or a loan secured by the cash value of a policy. |
7523
|
(5)(6)"Viatical settlement provider" means a person who, |
7524
|
in this state, from this state, or with a resident of this |
7525
|
state, effectuates a viatical settlement contract. The term |
7526
|
does not include: |
7527
|
(a) Any bank, savings bank, savings and loan association, |
7528
|
credit union, or other licensed lending institution that takes |
7529
|
an assignment of a life insurance policy as collateral for a |
7530
|
loan.; |
7531
|
(b) A life and health insurer that has lawfully issued a |
7532
|
life insurance policy that provides accelerated benefits to |
7533
|
terminally ill policyholders or certificateholders.; or |
7534
|
(c) Any natural person who enters into no more than one |
7535
|
viatical settlement contract with a viator in 1 calendar year, |
7536
|
unless such natural person has previously been licensed under |
7537
|
this act or is currently licensed under this act. |
7538
|
(d) A trust that meets the definition of a "related |
7539
|
provider trust." |
7540
|
(e) A viator in this state. |
7541
|
(f) A viatical settlement purchaser. |
7542
|
(g) A financing entity. |
7543
|
(6)(7)"Viator" means the owner of a life insurance policy |
7544
|
or a certificateholder under a group policy who enters or seeks |
7545
|
to enter into a viatical settlement contract. This term does not |
7546
|
include a viatical settlement purchaser or a viatical settlement |
7547
|
provider or any person acquiring a policy or interest in a |
7548
|
policy from a viatical settlement provider, nor does it include |
7549
|
an independent third-party trustee or escrow agent. |
7550
|
(7)(8)"Related provider trust" means a titling trust or |
7551
|
other trust established by a licensed viatical settlement |
7552
|
provider or financing entity for the sole purpose of holding the |
7553
|
ownership or beneficial interest in purchased policies in |
7554
|
connection with a financing transaction. The trust must have a |
7555
|
written agreement with a licensed viatical settlement provider |
7556
|
or financing entity under which the licensed viatical settlement |
7557
|
provider or financing entity is responsible for insuring |
7558
|
compliance with all statutory and regulatory requirements and |
7559
|
under which the trust agrees to make all records and files |
7560
|
relating to viatical settlement transactions available to the |
7561
|
officedepartmentas if those records and files were maintained |
7562
|
directly by the licensed viatical settlement provider. This term |
7563
|
does not include an independent third-party trustee or escrow |
7564
|
agent or a trust that does not enter into agreements with a |
7565
|
viator. A related provider trust shall be subject to all |
7566
|
provisions of this act that apply to the viatical settlement |
7567
|
provider who established the related provider trust, except s. |
7568
|
626.9912, which shall not be applicable. A viatical settlement |
7569
|
provider may establish no more than one related provider trust, |
7570
|
and the sole trustee of such related provider trust shall be the |
7571
|
viatical settlement provider licensed under s. 626.9912. The |
7572
|
name of the licensed viatical settlement provider shall be |
7573
|
included within the name of the related provider trust. |
7574
|
(8)(9)"Viatical settlement purchase agreement" means a |
7575
|
contract or agreement, entered into by a viatical settlement |
7576
|
purchaser, to which the viator is not a party, to purchase a |
7577
|
life insurance policy or an interest in a life insurance policy, |
7578
|
which is entered into for the purpose of deriving an economic |
7579
|
benefit. The term also includes purchases made by viatical |
7580
|
settlement purchasers from any person other than the provider |
7581
|
who effectuated the viatical settlement contract. |
7582
|
(9)(10)"Viatical settlement purchaser" means a person who |
7583
|
gives a sum of money as consideration for a life insurance |
7584
|
policy or an equitable or legal interest in the death benefits |
7585
|
of a life insurance policy that has been or will be the subject |
7586
|
of a viatical settlement contract, for the purpose of deriving |
7587
|
an economic benefit, including purchases made from any person |
7588
|
other than the provider who effectuated the viatical settlement |
7589
|
contract or an entity affiliated with the provider. The term |
7590
|
does not include a licensee under this part, an accredited |
7591
|
investor as defined in Rule 501, Regulation D of the Securities |
7592
|
Act Rules, or a qualified institutional buyer as defined by Rule |
7593
|
144(a) of the Federal Securities Act, a special purpose entity, |
7594
|
a financing entity, or a contingency insurer. The above |
7595
|
references to Rule 501, Regulation D and Rule 144(a) of the |
7596
|
Federal Securities Act are used strictly for defining purposes |
7597
|
and shall not be interpreted in any other manner. Any person who |
7598
|
claims to be an accredited investor shall sign an affidavit |
7599
|
stating that he or she is an accredited investor, the basis of |
7600
|
that claim, and that he or she understands that as an accredited |
7601
|
investor he or she will not be entitled to certain protections |
7602
|
of the Viatical Settlement Act. This affidavit must be kept with |
7603
|
other documents required to be maintained by this act. |
7604
|
(10)(11)"Viatical settlement sales agent" means a person |
7605
|
other than a licensed viatical settlement provider who arranges |
7606
|
the purchase through a viatical settlement purchase agreement of |
7607
|
a life insurance policy or an interest in a life insurance |
7608
|
policy. |
7609
|
(11)(12)"Viaticated policy" means a life insurance |
7610
|
policy, or a certificate under a group policy, which is the |
7611
|
subject of a viatical settlement contract. |
7612
|
(12)(13)"Related form" means any form, created by or on |
7613
|
behalf of a licensee, which a viator or viatical settlement |
7614
|
purchaser is required to sign or initial. The forms include, but |
7615
|
are not limited to, a power of attorney, a release of medical |
7616
|
information form, a suitability questionnaire, a disclosure |
7617
|
document, or any addendum, schedule, or amendment to a viatical |
7618
|
settlement contract or viatical settlement purchase agreement |
7619
|
considered necessary by a provider to effectuate a viatical |
7620
|
settlement transaction. |
7621
|
(13)(14)"Special purpose entity" means an entity |
7622
|
established by a licensed viatical settlement provider or by a |
7623
|
financing entity, which may be a corporation, partnership, |
7624
|
trust, limited liability company, or other similar entity formed |
7625
|
solely to provide, either directly or indirectly, access to |
7626
|
institutional capital markets to a viatical settlement provider |
7627
|
or financing entity. A special purpose entity shall not enter |
7628
|
into a viatical settlement contract or a viatical settlement |
7629
|
purchase agreement. |
7630
|
(14)(15)"Financing entity" means an underwriter, |
7631
|
placement agent, lender, purchaser of securities, or purchaser |
7632
|
of a policy or certificate from a viatical settlement provider, |
7633
|
credit enhancer, or any entity that has direct ownership in a |
7634
|
policy or certificate that is the subject of a viatical |
7635
|
settlement contract, but whose principal activity related to the |
7636
|
transaction is providing funds or credit enhancement to effect |
7637
|
the viatical settlement or the purchase of one or more viatical |
7638
|
policies and who has an agreement in writing with one or more |
7639
|
licensed viatical settlement providers to finance the |
7640
|
acquisition of viatical settlement contracts. The term does not |
7641
|
include a nonaccredited investor, a viatical settlement |
7642
|
purchaser, or other natural person. A financing entity may not |
7643
|
enter into a viatical settlement contract. |
7644
|
Section 179. Section 626.9912, Florida Statutes, is |
7645
|
amended to read: |
7646
|
626.9912 Viatical settlement provider license required; |
7647
|
application for license.-- |
7648
|
(1) A person may not perform the functions of a viatical |
7649
|
settlement provider as defined in this act or enter into or |
7650
|
solicit a viatical settlement contract without first having |
7651
|
obtained a license from the officedepartment. |
7652
|
(2) Application for a viatical settlement provider license |
7653
|
must be made to the officedepartmentby the applicant on a form |
7654
|
prescribed by the commissiondepartment, under oath and signed |
7655
|
by the applicant. The application must be accompanied by a fee |
7656
|
of $500. If the applicant is a corporation, the application must |
7657
|
be under oath and signed by the president and the secretary of |
7658
|
the corporation. |
7659
|
(3) In the application, the applicant must provide all of |
7660
|
the following: |
7661
|
(a) The applicant's full name, age, residence address, and |
7662
|
business address, and all occupations engaged in by the |
7663
|
applicant during the 5 years preceding the date of the |
7664
|
application. |
7665
|
(b) A copy of the applicant's basic organizational |
7666
|
documents, if any, including the articles of incorporation, |
7667
|
articles of association, partnership agreement, trust agreement, |
7668
|
or other similar documents, together with all amendments to such |
7669
|
documents. |
7670
|
(c) Copies of all bylaws, rules, regulations, or similar |
7671
|
documents regulating the conduct of the applicant's internal |
7672
|
affairs. |
7673
|
(d) A list showing the name, business and residence |
7674
|
addresses, and official position of each individual who is |
7675
|
responsible for conduct of the applicant's affairs, including, |
7676
|
but not limited to, any member of the applicant's board of |
7677
|
directors, board of trustees, executive committee, or other |
7678
|
governing board or committee and any other person or entity |
7679
|
owning or having the right to acquire 10 percent or more of the |
7680
|
voting securities of the applicant. |
7681
|
(e) With respect to each individual identified under |
7682
|
paragraph (d): |
7683
|
1. A sworn biographical statement on forms adopted by the |
7684
|
commission and supplied by the officedepartment. |
7685
|
2. A set of fingerprints on forms prescribed by the |
7686
|
commissiondepartment, certified by a law enforcement officer, |
7687
|
and accompanied by the fingerprinting fee specified in s. |
7688
|
624.501. |
7689
|
3. Authority for release of information relating to the |
7690
|
investigation of the individual's background. |
7691
|
(f) All applications, viatical settlement contract forms, |
7692
|
viatical settlement purchase agreement forms, escrow forms, and |
7693
|
other related forms proposed to be used by the applicant. |
7694
|
(g) Such other information as the commission or office |
7695
|
departmentdeems necessary to determine that the applicant and |
7696
|
the individuals identified under paragraph (d) are competent and |
7697
|
trustworthy and can lawfully and successfully act as a viatical |
7698
|
settlement provider. |
7699
|
(4) The officedepartmentmay not issue a license to an |
7700
|
entity other than a natural person if it is not satisfied that |
7701
|
all officers, directors, employees, stockholders, partners, and |
7702
|
any other persons who exercise or have the ability to exercise |
7703
|
effective control of the entity or who have the ability to |
7704
|
influence the transaction of business by the entity meet the |
7705
|
standards of this act and have not violated any provision of |
7706
|
this act or rules of the commissiondepartmentrelated to the |
7707
|
business of viatical settlement contracts or viatical settlement |
7708
|
purchase agreements. |
7709
|
(5) Upon the filing of a sworn application and the payment |
7710
|
of the license fee, the officedepartmentshall investigate each |
7711
|
applicant and may issue the applicant a license if the office |
7712
|
departmentfinds that the applicant: |
7713
|
(a) Has provided a detailed plan of operation. |
7714
|
(b) Is competent and trustworthy and intends to act in |
7715
|
good faith in the business authorized by the license applied |
7716
|
for. |
7717
|
(c) Has a good business reputation and has had experience, |
7718
|
training, or education that qualifies the applicant to conduct |
7719
|
the business authorized by the license applied for. |
7720
|
(d) If the applicant is a corporation, is a corporation |
7721
|
incorporated under the laws of this state, or is a foreign |
7722
|
corporation authorized to transact business in this state. |
7723
|
(e) Has designated the Chief Financial OfficerInsurance |
7724
|
Commissioner and Treasureras its agent for service of process. |
7725
|
(f) Has made the deposit required by s. 626.9913(3). |
7726
|
Section 180. Subsections (2) and (3) of section 626.9913, |
7727
|
Florida Statutes, are amended to read: |
7728
|
626.9913 Viatical settlement provider license continuance; |
7729
|
annual report; fees; deposit.-- |
7730
|
(2) Annually, on or before March 1, the viatical |
7731
|
settlement provider licensee shall file a statement containing |
7732
|
information the commissiondepartmentrequires and shall pay to |
7733
|
the officedepartmenta license fee in the amount of $500. A |
7734
|
viatical settlement provider shall include in all statements |
7735
|
filed with the officedepartmentall information requested by |
7736
|
the officedepartmentregarding a related provider trust |
7737
|
established by the viatical settlement provider. The office |
7738
|
departmentmay require more frequent reporting. Failure to |
7739
|
timely file the annual statement or to timely pay the license |
7740
|
fee is grounds for immediate suspension of the license. |
7741
|
(3) A viatical settlement provider licensee must deposit |
7742
|
and maintain deposited in trust with the department securities |
7743
|
eligible for deposit under s. 625.52, having at all times a |
7744
|
value of not less than $100,000. As an alternative to meeting |
7745
|
the $100,000 deposit requirement, the provider may deposit and |
7746
|
maintain deposited in trust with the department such securities |
7747
|
in the amount of $25,000 and post with the officedepartmenta |
7748
|
surety bond acceptable to the officedepartmentin the amount of |
7749
|
$75,000. |
7750
|
Section 181. Section 626.9914, Florida Statutes, is |
7751
|
amended to read: |
7752
|
626.9914 Suspension, revocation, or nonrenewal of viatical |
7753
|
settlement provider license; grounds; administrative fine.-- |
7754
|
(1) The officedepartmentshall suspend, revoke, or refuse |
7755
|
to renew the license of any viatical settlement provider if the |
7756
|
officedepartmentfinds that the licensee: |
7757
|
(a) Has made a misrepresentation in the application for |
7758
|
the license; |
7759
|
(b) Has engaged in fraudulent or dishonest practices, or |
7760
|
otherwise has been shown to be untrustworthy or incompetent to |
7761
|
act as a viatical settlement provider; |
7762
|
(c) Demonstrates a pattern of unreasonable payments to |
7763
|
viators; |
7764
|
(d) Has been found guilty of, or has pleaded guilty or |
7765
|
nolo contendere to, any felony, or a misdemeanor involving fraud |
7766
|
or moral turpitude, regardless of whether a judgment of |
7767
|
conviction has been entered by the court; |
7768
|
(e) Has issued viatical settlement contracts that have not |
7769
|
been approved pursuant to this act; |
7770
|
(f) Has failed to honor contractual obligations related to |
7771
|
the business of viatical settlement contracts; |
7772
|
(g) Deals in bad faith with viators; |
7773
|
(h) Has violated any provision of the insurance code or of |
7774
|
this act; |
7775
|
(i) Employs any person who materially influences the |
7776
|
licensee's conduct and who fails to meet the requirements of |
7777
|
this act; or |
7778
|
(j) No longer meets the requirements for initial |
7779
|
licensure. |
7780
|
(2) The officedepartmentmay, in lieu of or in addition |
7781
|
to any suspension or revocation, assess an administrative fine |
7782
|
not to exceed $2,500 for each nonwillful violation or $10,000 |
7783
|
for each willful violation by a viatical settlement provider |
7784
|
licensee. The officedepartmentmay also place a viatical |
7785
|
settlement provider licensee on probation for a period not to |
7786
|
exceed 2 years. |
7787
|
(3) If an employee of a viatical settlement provider |
7788
|
violates any provision of this act, the officedepartmentmay |
7789
|
take disciplinary action against such employee as if the |
7790
|
employee were licensed under this act, including suspending or |
7791
|
otherwise prohibiting the employee from performing the functions |
7792
|
of a viatical settlement provider or viatical settlement broker |
7793
|
as defined in this act. |
7794
|
(4) If a viatical settlement provider establishes a |
7795
|
related provider trust as permitted by this act, the viatical |
7796
|
settlement provider shall be liable and responsible for the |
7797
|
performance of all obligations of the related provider trust |
7798
|
under all viatical settlement contracts entered into by the |
7799
|
related provider trust, and for the compliance of the related |
7800
|
provider trust with all provisions of this act. Any violation of |
7801
|
this act by the related provider trust shall be deemed a |
7802
|
violation of this act by the viatical settlement provider as |
7803
|
well as the related provider trust. If the related provider |
7804
|
trust violates any provisions of this act, the officedepartment |
7805
|
may exercise all remedies set forth in this act for such |
7806
|
violations against the viatical settlement provider, as well as |
7807
|
the related provider trust. |
7808
|
Section 182. Subsections (1), (2), and (4) of section |
7809
|
626.9915, Florida Statutes, are amended to read: |
7810
|
626.9915 Effect of suspension or revocation of viatical |
7811
|
settlement provider license; duration of suspension; |
7812
|
reinstatement.-- |
7813
|
(1) When its license is suspended or revoked, the provider |
7814
|
must proceed, immediately following the effective date of the |
7815
|
suspension or revocation, to conclude the affairs it is |
7816
|
transacting under its license. The provider may not solicit, |
7817
|
negotiate, advertise, or effectuate new contracts. The office |
7818
|
departmentretains jurisdiction over the provider until all |
7819
|
contracts have been fulfilled or canceled or have expired. A |
7820
|
provider whose license is suspended or revoked may continue to |
7821
|
maintain and service viaticated policies subject to the approval |
7822
|
of the officedepartment. |
7823
|
(2) The suspension of the license of a viatical settlement |
7824
|
provider licensee may be for such period, not to exceed 2 years, |
7825
|
as determined by the officedepartment. The officedepartment |
7826
|
may shorten, rescind, or modify the suspension. |
7827
|
(4) If, upon expiration of the suspension order, the |
7828
|
license has not otherwise been terminated, the officedepartment |
7829
|
must reinstate the license only upon written request by the |
7830
|
suspended licensee unless the officedepartmentfinds that the |
7831
|
grounds giving rise to the suspension have not been removed or |
7832
|
that the licensee is otherwise not in compliance with the |
7833
|
requirements of this act. The officedepartmentshall give the |
7834
|
licensee notice of its findings no later than 90 days after |
7835
|
receipt of the request or upon expiration of the suspension |
7836
|
order, whichever occurs later. If a license is not reinstated |
7837
|
pursuant to the procedures set forth in this subsection, it |
7838
|
expires at the end of the suspension or on the date it otherwise |
7839
|
would have expired, whichever is sooner. |
7840
|
Section 183. Subsections (7), (8), and (9) of section |
7841
|
626.9916, Florida Statutes, are amended to read: |
7842
|
626.9916 Viatical settlement broker license required; |
7843
|
application for license.-- |
7844
|
(7) Upon the filing of a sworn application and the payment |
7845
|
of the license fee and all other applicable fees under this act, |
7846
|
the department shall investigate each applicant and may issue |
7847
|
the applicant a license if the department finds that the |
7848
|
applicant: |
7849
|
(a) Is competent and trustworthy and intends to act in |
7850
|
good faith in the business authorized by the license applied |
7851
|
for. |
7852
|
(b) Has a good business reputation and has had experience, |
7853
|
training, or education that qualifies the applicant to conduct |
7854
|
the business authorized by the license applied for. |
7855
|
(c) Except with respect to applicants for nonresident |
7856
|
licenses, is a bona fide resident of this state and actually |
7857
|
resides in this state at least 180 days a year. If an applicant |
7858
|
holds a similar license or an insurance agent's or broker's |
7859
|
license in another state at the time of applying for a license |
7860
|
under this section, the applicant may be found to meet the |
7861
|
residency requirement of this paragraph only after he or she |
7862
|
furnishes a letter of clearance satisfactory to the department |
7863
|
or other proof that the applicant's resident licenses have been |
7864
|
canceled or changed to nonresident status and that the applicant |
7865
|
is in good standing with the licensing authority. |
7866
|
(d) Is a corporation, a corporation incorporated under the |
7867
|
laws of this state, or a foreign corporation authorized to |
7868
|
transact business in this state. |
7869
|
(e) Has designated the Chief Financial OfficerInsurance |
7870
|
Commissioner and Treasureras its agent for service of process. |
7871
|
(8) An applicant for a nonresident viatical settlement |
7872
|
broker license must, in addition to designating the Chief |
7873
|
Financial OfficerInsurance Commissioner and Treasureras agent |
7874
|
for service of process as required by this section, also furnish |
7875
|
the department with the name and address of a resident of this |
7876
|
state upon whom notices or orders of the department or process |
7877
|
affecting the applicant or licensee may be served. After |
7878
|
issuance of the license, the licensee must also notify the |
7879
|
department of change of the person to receive such notices, |
7880
|
orders, or process; such change is not effective until |
7881
|
acknowledged by the department. |
7882
|
(9) Beginning July 1, 1997,The department may, by rule, |
7883
|
specify experience, educational, or other training standards |
7884
|
required for licensure under this section. |
7885
|
Section 184. Section 626.9919, Florida Statutes, is |
7886
|
amended to read: |
7887
|
626.9919 Notice of change of licensee address or |
7888
|
name.--Each viatical settlement provider licensee, viatical |
7889
|
settlement broker licensee, and viatical settlement sales agent |
7890
|
licensee must provide the office or department, as applicable, |
7891
|
at least 30 days' advance notice of any change in the licensee's |
7892
|
name, residence address, principal business address, or mailing |
7893
|
address. |
7894
|
Section 185. Section 626.9921, Florida Statutes, is |
7895
|
amended to read: |
7896
|
626.9921 Filing of forms; required procedures; approval.-- |
7897
|
(1) A viatical settlement contract form, viatical |
7898
|
settlement purchase agreement form, escrow form, or related form |
7899
|
may be used in this state only after the form has been filed |
7900
|
with the officedepartmentand only after the form has been |
7901
|
approved by the officedepartment. |
7902
|
(2) The viatical settlement contract form, viatical |
7903
|
settlement purchase agreement form, escrow form, or related form |
7904
|
must be filed with the officedepartmentat least 60 days before |
7905
|
its use. The form is considered approved on the 60th day after |
7906
|
its date of filing unless it has been previously disapproved by |
7907
|
the officedepartment. The officedepartmentmust disapprove a |
7908
|
viatical settlement contract form, viatical settlement purchase |
7909
|
agreement form, escrow form, or related form that is |
7910
|
unreasonable, contrary to the public interest, discriminatory, |
7911
|
or misleading or unfair to the viator or the purchaser. |
7912
|
(3) If a viatical settlement provider elects to use a |
7913
|
related provider trust in accordance with this act, the viatical |
7914
|
settlement provider shall file notice of its intention to use a |
7915
|
related provider trust with the officedepartment, including a |
7916
|
copy of the trust agreement of the related provider trust. The |
7917
|
organizational documents of the trust must be submitted to and |
7918
|
approved by the officedepartmentbefore the transacting of |
7919
|
business by the trust. |
7920
|
(4) The commissiondepartmentmay adopt, by rule, |
7921
|
standardized forms to be used by licensees, at the licensee's |
7922
|
option in place of separately approved forms. |
7923
|
Section 186. Section 626.9922, Florida Statutes, is |
7924
|
amended to read: |
7925
|
626.9922 Examination.-- |
7926
|
(1) The office ordepartment may examine the business and |
7927
|
affairs of any of its respective licensees or applicants |
7928
|
licensee or applicant for a license. The office ordepartment |
7929
|
may order any suchlicensee or applicant to produce any records, |
7930
|
books, files, advertising and solicitation materials, or other |
7931
|
information and may take statements under oath to determine |
7932
|
whether the licensee or applicant is in violation of the law or |
7933
|
is acting contrary to the public interest. The expenses |
7934
|
incurred in conducting any examination or investigation must be |
7935
|
paid by the licensee or applicant. Examinations and |
7936
|
investigations must be conducted as provided in chapter 624, and |
7937
|
licensees are subject to all applicable provisions of the |
7938
|
insurance code. |
7939
|
(2) All accounts, books and records, documents, files, |
7940
|
contracts, and other information relating to all transactions of |
7941
|
viatical settlement contracts or viatical settlement purchase |
7942
|
agreements must be maintained by the licensee for a period of at |
7943
|
least 3 years after the death of the insured and must be |
7944
|
available to the office ordepartment for inspection during |
7945
|
reasonable business hours. |
7946
|
(3) All such records or accurate copies of such records |
7947
|
must be maintained at the licensee's home office. As used in |
7948
|
this section, the term "home office" means the principal place |
7949
|
of business and any other single storage facility, the street |
7950
|
address of which shall be disclosed to the office ordepartment |
7951
|
within 20 days after its initial use, or within 20 days of the |
7952
|
effective date of this subsection. |
7953
|
(4) The originals of records required to be maintained |
7954
|
under this section must be made available to the office or |
7955
|
department for examination at the office's ordepartment's |
7956
|
request. |
7957
|
Section 187. Subsection (2) of section 626.99235, Florida |
7958
|
Statutes, is amended to read: |
7959
|
626.99235 Disclosures to viatical settlement purchasers; |
7960
|
misrepresentations.-- |
7961
|
(2) The viatical settlement provider and the viatical |
7962
|
settlement sales agent, themselves or through another person, |
7963
|
shall provide in writing the following disclosures to any |
7964
|
viatical settlement purchaser or purchaser prospect: |
7965
|
(a) That the return represented as being available under |
7966
|
the viatical settlement purchase agreement is directly tied to |
7967
|
the projected life span of one or more insureds. |
7968
|
(b) If a return is represented, the disclosure shall |
7969
|
indicate the projected life span of the insured or insureds |
7970
|
whose life or lives are tied to the return. |
7971
|
(c) If required by the terms of the viatical settlement |
7972
|
purchase agreement, that the viatical settlement purchaser shall |
7973
|
be responsible for the payment of insurance premiums on the life |
7974
|
of the insured, late or surrender fees, or other costs related |
7975
|
to the life insurance policy on the life of the insured or |
7976
|
insureds which may reduce the return. |
7977
|
(d) The amount of any trust fees, commissions, deductions, |
7978
|
or other expenses, if any, to be charged to the viatical |
7979
|
settlement purchaser. |
7980
|
(e) The name and address of the person responsible for |
7981
|
tracking the insured. |
7982
|
(f) That group policies may contain limitations or caps in |
7983
|
the conversion rights, that additional premiums may have to be |
7984
|
paid if the policy is converted, and that the party responsible |
7985
|
for the payment of such additional premiums shall be identified. |
7986
|
(g) That the life expectancy and rate of return are only |
7987
|
estimates and cannot be guaranteed. |
7988
|
(h) That the purchase of a viatical settlement contract |
7989
|
should not be considered a liquid purchase, since it is |
7990
|
impossible to predict the exact timing of its maturity and the |
7991
|
funds may not be available until the death of the insured. |
7992
|
(i) The name and address of the person with the |
7993
|
responsibility for paying the premium until the death of the |
7994
|
insured. |
7995
|
|
7996
|
|
7997
|
The written disclosure required under this subsection shall be |
7998
|
conspicuously displayed in any viatical settlement purchase |
7999
|
agreement, and in any solicitation material furnished to the |
8000
|
viatical settlement purchaser by such viatical settlement |
8001
|
provider, related provider trust, or person, and shall be in |
8002
|
contrasting color and in not less than 10-point type or no |
8003
|
smaller than the largest type on the page if larger than 10- |
8004
|
point type. The commission maydepartment is authorized toadopt |
8005
|
by rule the disclosure form to be used. The disclosures need not |
8006
|
be furnished in an invitation to inquire, the objective of which |
8007
|
is to create a desire to inquire further about entering into a |
8008
|
viatical settlement purchase agreement. The invitation to |
8009
|
inquire may not quote rates of return, may not include material |
8010
|
attendant to the execution of any specific viatical settlement |
8011
|
purchase agreement, and may not relate to any specific viator. |
8012
|
Section 188. Section 626.99245, Florida Statutes, is |
8013
|
amended to read: |
8014
|
626.99245 Conflict of regulation of viaticals.-- |
8015
|
(1) A viatical settlement provider who from this state |
8016
|
enters into a viatical settlement purchase agreement with a |
8017
|
purchaser who is a resident of another state that has enacted |
8018
|
statutes or adopted regulations governing viatical settlement |
8019
|
purchase agreements, shall be governed in the effectuation of |
8020
|
that viatical settlement purchase agreement by the statutes and |
8021
|
regulations of the purchaser's state of residence. If the state |
8022
|
in which the purchaser is a resident has not enacted statutes or |
8023
|
regulations governing viatical settlement purchase agreements, |
8024
|
the provider shall give the purchaser notice that neither |
8025
|
Florida nor his or her state regulates the transaction upon |
8026
|
which he or she is entering. For transactions in these states, |
8027
|
however, the viatical settlement provider is to maintain all |
8028
|
records required as if the transactions were executed in |
8029
|
Florida. However, the forms used in those states need not be |
8030
|
approved by the officedepartment. |
8031
|
(2) A viatical settlement provider who from this state |
8032
|
enters into a viatical settlement contract with a viator who is |
8033
|
a resident of another state that has enacted statutes or adopted |
8034
|
regulations governing viatical settlement contracts shall be |
8035
|
governed in the effectuation of that viatical settlement |
8036
|
contract by the statutes and regulations of the viator's state |
8037
|
of residence. If the state in which the viator is a resident has |
8038
|
not enacted statutes or regulations governing viatical |
8039
|
settlement agreements, the provider shall give the viator notice |
8040
|
that neither Florida nor his or her state regulates the |
8041
|
transaction upon which he or she is entering. For transactions |
8042
|
in those states, however, the viatical settlement provider is to |
8043
|
maintain all records required as if the transactions were |
8044
|
executed in Florida. The forms used in those states need not be |
8045
|
approved by the officedepartment. |
8046
|
(3) This section does not affect the requirement of ss. |
8047
|
626.9911(5)(6)and 626.9912(1) that a viatical settlement |
8048
|
provider doing business from this state must obtain a viatical |
8049
|
settlement license from the officedepartment. As used in this |
8050
|
subsection, the term "doing business from this state" includes |
8051
|
effectuating viatical settlement contracts and effectuating |
8052
|
viatical settlement purchase agreements from offices in this |
8053
|
state, regardless of the state of residence of the viator or the |
8054
|
viatical settlement purchaser. |
8055
|
Section 189. Section 626.9925, Florida Statutes, is |
8056
|
amended to read: |
8057
|
626.9925 Rules.--The commissiondepartmentmay adopt rules |
8058
|
to administer this act, including rules establishing standards |
8059
|
for evaluating advertising by licensees; rules providing for the |
8060
|
collection of data, for disclosures to viators or purchasers, |
8061
|
and for the reporting of life expectancies; and rules defining |
8062
|
terms used in this act and prescribing recordkeeping |
8063
|
requirements relating to executed viatical settlement contracts |
8064
|
and viatical settlement purchase agreements. |
8065
|
Section 190. Section 626.9926, Florida Statutes, is |
8066
|
amended to read: |
8067
|
626.9926 Rate regulation not authorized.--Nothing in this |
8068
|
act shall be construed to authorize the office ordepartment to |
8069
|
directly or indirectly regulate the amount paid as consideration |
8070
|
for entry into a viatical settlement contract or viatical |
8071
|
settlement purchase agreement. |
8072
|
Section 191. Subsection (2) of section 626.9927, Florida |
8073
|
Statutes, is amended to read: |
8074
|
626.9927 Unfair trade practices; cease and desist; |
8075
|
injunctions; civil remedy.-- |
8076
|
(2) In addition to the penalties and other enforcement |
8077
|
provisions of this act, if any person violates this act or any |
8078
|
rule implementing this act, the office or department, as |
8079
|
appropriate,may seek an injunction in the circuit court of the |
8080
|
county where the person resides or has a principal place of |
8081
|
business and may apply for temporary and permanent orders that |
8082
|
the office ordepartment determines necessary to restrain the |
8083
|
person from committing the violation. |
8084
|
Section 192. Section 626.99272, Florida Statutes, is |
8085
|
amended to read: |
8086
|
626.99272 Cease and desist orders and fines.-- |
8087
|
(1) The office or department as appropriatemay issue a |
8088
|
cease and desist order upon a person that violates any provision |
8089
|
of this part, any rule or order adopted by the commission, |
8090
|
office, ordepartment, or any written agreement entered into |
8091
|
with the office ordepartment. |
8092
|
(2) When the office ordepartment finds that such an |
8093
|
action presents an immediate danger to the public which requires |
8094
|
an immediate final order, it may issue an emergency cease and |
8095
|
desist order reciting with particularity the facts underlying |
8096
|
such findings. The emergency cease and desist order is effective |
8097
|
immediately upon service of a copy of the order on the |
8098
|
respondent and remains effective for 90 days. If the office or |
8099
|
department begins nonemergency cease and desist proceedings |
8100
|
under subsection(1), the emergency cease and desist order |
8101
|
remains effective, absent an order by an appellate court of |
8102
|
competent jurisdiction pursuant to s. 120.68, until the |
8103
|
conclusion of proceedings under ss. 120.569 and 120.57. |
8104
|
(3) The office ordepartment may impose and collect an |
8105
|
administrative fine not to exceed $10,000 for each nonwillful |
8106
|
violation and $25,000 for each willful violation of any |
8107
|
provision of this part. |
8108
|
Section 193. Section 626.99285, Florida Statutes, is |
8109
|
amended to read: |
8110
|
626.99285 Applicability of insurance code.--In addition to |
8111
|
other applicable provisions cited in the insurance code, the |
8112
|
office or department, as appropriate,has the authority granted |
8113
|
under ss. 624.310, 626.901, and 626.989 to regulate viatical |
8114
|
settlement providers, viatical settlement brokers, viatical |
8115
|
settlement sales agents, viatical settlement contracts, viatical |
8116
|
settlement purchase agreements, and viatical settlement |
8117
|
transactions. |
8118
|
Section 194. Section 626.99295, Florida Statutes, is |
8119
|
amended to read: |
8120
|
626.99295 Grace period.--An unlicensed viatical settlement |
8121
|
provider or viatical settlement broker that was legally |
8122
|
transacting business in this state on June 30, 2000, may |
8123
|
continue to transact such business, in the absence of any orders |
8124
|
by the office, department, or the former Department of Insurance |
8125
|
to the contrary, until the office or department, as applicable, |
8126
|
approves or disapproves the viatical settlement provider's |
8127
|
application for licensure if the viatical settlement provider or |
8128
|
viatical settlement broker filedfiles with the former |
8129
|
department an application for licensure no later than August 1, |
8130
|
2000, and if the viatical settlement provider or viatical |
8131
|
settlement broker complies with all other provisions of this |
8132
|
act. Any form for which former department approval wasis |
8133
|
required under this part must have beenbefiled by August 1, |
8134
|
2000, and may continue to be used until disapproved by the |
8135
|
office ordepartment. |
8136
|
Section 195. Paragraphs (a), (b), and (c) of subsection |
8137
|
(2) and paragraph (c) of subsection(3) of section 627.0628, |
8138
|
Florida Statutes, are amended to read: |
8139
|
627.0628 Florida Commission on Hurricane Loss Projection |
8140
|
Methodology.-- |
8141
|
(2) COMMISSION CREATED.-- |
8142
|
(a) There is created the Florida Commission on Hurricane |
8143
|
Loss Projection Methodology, which is assigned to the State |
8144
|
Board of Administration. For the purposes of this section, the |
8145
|
term "commission" means the Florida Commission on Hurricane Loss |
8146
|
Projection Methodology.The commission shall be administratively |
8147
|
housed within the State Board of Administration, but it shall |
8148
|
independently exercise the powers and duties specified in this |
8149
|
section. |
8150
|
(b) The commission shall consist of the following 11 |
8151
|
members: |
8152
|
1. The insurance consumer advocate. |
8153
|
2. The senior employee of the State Board of |
8154
|
Administration responsible for operationsChief Operating |
8155
|
Officerof the Florida Hurricane Catastrophe Fund. |
8156
|
3. The Executive Director of the Citizens Property |
8157
|
Insurance CorporationResidential Property and Casualty Joint |
8158
|
Underwriting Association. |
8159
|
4. The Director of the Division of Emergency Management of |
8160
|
the Department of Community Affairs. |
8161
|
5. The actuary member of the Florida Hurricane Catastrophe |
8162
|
Fund Advisory Council. |
8163
|
6. Six members appointed by the Chief Financial Officer |
8164
|
Insurance Commissioner, as follows: |
8165
|
a. An employee of the officeDepartment of Insurancewho |
8166
|
is an actuary responsible for property insurance rate filings. |
8167
|
b. An actuary who is employed full time by a property and |
8168
|
casualty insurer which was responsible for at least 1 percent of |
8169
|
the aggregate statewide direct written premium for homeowner's |
8170
|
insurance in the calendar year preceding the member's |
8171
|
appointment to the commission. |
8172
|
c. An expert in insurance finance who is a full time |
8173
|
member of the faculty of the State University System and who has |
8174
|
a background in actuarial science. |
8175
|
d. An expert in statistics who is a full time member of |
8176
|
the faculty of the State University System and who has a |
8177
|
background in insurance. |
8178
|
e. An expert in computer system design who is a full time |
8179
|
member of the faculty of the State University System. |
8180
|
f. An expert in meteorology who is a full time member of |
8181
|
the faculty of the State University System and who specializes |
8182
|
in hurricanes. |
8183
|
(c) Members designated under subparagraphs (b)1.-5. shall |
8184
|
serve on the commission as long as they maintain the respective |
8185
|
offices designated in subparagraphs (b)1.-5. Members appointed |
8186
|
by the Chief Financial OfficerInsurance Commissionerunder |
8187
|
subparagraph (b)6. shall serve on the commission until the end |
8188
|
of the term of office of the Chief Financial OfficerInsurance |
8189
|
Commissioner who appointed them, unless earlier removed by the |
8190
|
Chief Financial OfficerInsurance Commissionerfor cause. |
8191
|
Vacancies on the commission shall be filled in the same manner |
8192
|
as the original appointment. |
8193
|
(3) ADOPTION AND EFFECT OF STANDARDS AND GUIDELINES.-- |
8194
|
(c) With respect to a rate filing under s. 627.062, an |
8195
|
insurer may employ actuarial methods, principles, standards, |
8196
|
models, or output ranges found by the commission to be accurate |
8197
|
or reliable to determine hurricane loss factors for use in a |
8198
|
rate filing under s. 627.062, which findings and factors are |
8199
|
admissible and relevant in consideration of a rate filing by the |
8200
|
officedepartmentor in any arbitration or administrative or |
8201
|
judicial review. |
8202
|
Section 196. Paragraph (b) of subsection (2) and |
8203
|
subsections (5), (6), and (9) of section 627.0629, Florida |
8204
|
Statutes, are amended to read: |
8205
|
627.0629 Residential property insurance; rate filings.-- |
8206
|
(2) |
8207
|
(b) A rate filing for residential property insurance made |
8208
|
more than 150 days after approval by the officedepartmentof a |
8209
|
building code rating factor plan submitted by a statewide rating |
8210
|
organization shall include positive and negative rate factors |
8211
|
that reflect the manner in which building code enforcement in a |
8212
|
particular jurisdiction addresses risk of wind damage. The rate |
8213
|
filing shall include variations from standard rate factors on an |
8214
|
individual basis based on inspection of a particular structure |
8215
|
by a licensed home inspector. If an inspection is requested by |
8216
|
the insured, the insurer may require the insured to pay the |
8217
|
reasonable cost of the inspection. This paragraph applies to |
8218
|
structures constructed or renovated after the implementation of |
8219
|
this paragraph. |
8220
|
(5) In order to provide an appropriate transition period, |
8221
|
an insurer may, in its sole discretion, implement an approved |
8222
|
rate filing for residential property insurance over a period of |
8223
|
years. An insurer electing to phase in its rate filing must |
8224
|
provide an informational notice to the officedepartmentsetting |
8225
|
out its schedule for implementation of the phased-in rate |
8226
|
filing. |
8227
|
(6) An insurer may not write a residential property |
8228
|
insurance policy without providing windstorm coverage or |
8229
|
hurricane coverage as defined in s. 627.4025. This subsection |
8230
|
does not apply with respect to risks located in an area eligible |
8231
|
for coverage under the high-risk account of the Citizens |
8232
|
Property Insurance Corporation pursuant to s. 627.351(6)Florida |
8233
|
Windstorm Underwriting Association under s. 627.351(2). |
8234
|
(9) EVALUATION OF RESIDENTIAL PROPERTY STRUCTURAL |
8235
|
SOUNDNESS.-- |
8236
|
(a) It is the intent of the Legislature to provide a |
8237
|
program whereby homeowners may obtain an evaluation of the wind |
8238
|
resistance of their homes with respect to preventing damage from |
8239
|
hurricanes, together with a recommendation of reasonable steps |
8240
|
that may be taken to upgrade their homes to better withstand |
8241
|
hurricane force winds. |
8242
|
(b) To the extent that funds are provided for this purpose |
8243
|
in the General Appropriations Act, the Legislature hereby |
8244
|
authorizes the establishment of a program to be administered by |
8245
|
the Citizens Property Insurance Corporation for homeowners |
8246
|
insured in the high-risk accountFlorida Windstorm Underwriting |
8247
|
Association. |
8248
|
(c) The program shall provide grants to homeowners, for |
8249
|
the purpose of providing homeowner applicants with funds to |
8250
|
conduct an evaluation of the integrity of their homes with |
8251
|
respect to withstanding hurricane force winds, recommendations |
8252
|
to retrofit the homes to better withstand damage from such |
8253
|
winds, and the estimated cost to make the recommended retrofits. |
8254
|
(d) The Department of Community Affairs shall establish by |
8255
|
rule standards to govern the quality of the evaluation, the |
8256
|
quality of the recommendations for retrofitting, the eligibility |
8257
|
of the persons conducting the evaluation, and the selection of |
8258
|
applicants under the program. In establishing the rule, the |
8259
|
Department of Community Affairsshall consult with the advisory |
8260
|
committee to minimize the possibility of fraud or abuse in the |
8261
|
evaluation and retrofitting process, and to ensure that funds |
8262
|
spent by homeowners acting on the recommendations achieve |
8263
|
positive results. |
8264
|
(e) The Citizens Property Insurance CorporationFlorida |
8265
|
Windstorm Underwriting Associationshall identify areas of this |
8266
|
state with the greatest wind risk to residential properties and |
8267
|
recommend annually to the Department of Community Affairs |
8268
|
priority target areas for such evaluations and inclusion with |
8269
|
the associated residential construction mitigation program. |
8270
|
Section 197. Subsections (2) and (3) and paragraphs (a), |
8271
|
(b), (c), (e), (f), and (g) of subsection (4) of section |
8272
|
627.311, Florida Statutes, are amended to read: |
8273
|
627.311 Joint underwriters and joint reinsurers.-- |
8274
|
(2) If the officedepartmentfinds that any activity or |
8275
|
practice of any such group, association, or other organization |
8276
|
is unfair or unreasonable or otherwise inconsistent with the |
8277
|
provisions of this chapter, it may issue a written order |
8278
|
specifying in what respects such activity or practice is unfair |
8279
|
or unreasonable or otherwise inconsistent with the provisions of |
8280
|
this chapter, and requiring the discontinuance of such activity |
8281
|
or practice. |
8282
|
(3) The officedepartmentmay, after consultation with |
8283
|
insurers licensed to write automobile insurance in this state, |
8284
|
approve a joint underwriting plan for purposes of equitable |
8285
|
apportionment or sharing among insurers of automobile liability |
8286
|
insurance and other motor vehicle insurance, as an alternate to |
8287
|
the plan required in s. 627.351(1). All insurers authorized to |
8288
|
write automobile insurance in this state shall subscribe to the |
8289
|
plan and participate therein. The plan shall be subject to |
8290
|
continuous review by the officedepartmentwhich may at any time |
8291
|
disapprove the entire plan or any part thereof if it determines |
8292
|
that conditions have changed since prior approval and that in |
8293
|
view of the purposes of the plan changes are warranted. Any |
8294
|
disapproval by the officedepartmentshall be subject to the |
8295
|
provisions of chapter 120. If adopted, the plan and the |
8296
|
association created under the plan: |
8297
|
(a) Must be subject to all provisions of s. 627.351(1), |
8298
|
except apportionment of applicants. |
8299
|
(b) May provide for one or more designated insurers, able |
8300
|
and willing to provide policy and claims service, to act on |
8301
|
behalf of all other insurers to provide insurance for applicants |
8302
|
who are in good faith entitled to, but unable to, procure |
8303
|
insurance through the voluntary insurance market at standard |
8304
|
rates. |
8305
|
(c) Must provide that designated insurers will issue |
8306
|
policies of insurance and provide policyholder and claims |
8307
|
service on behalf of all insurers for the joint underwriting |
8308
|
association. |
8309
|
(d) Must provide for the equitable apportionment among |
8310
|
insurers of losses and expenses incurred. |
8311
|
(e) Must provide that the joint underwriting association |
8312
|
will operate subject to the supervision and approval of a board |
8313
|
of governors consisting of 11 individuals, including 1 who will |
8314
|
be elected as chair. Five members of the board must be appointed |
8315
|
by the Chief Financial OfficerInsurance Commissioner. Two of |
8316
|
the Chief Financial Officer'scommissioner'sappointees must be |
8317
|
chosen from the insurance industry. Any board member appointed |
8318
|
by the Chief Financial OfficerInsurance Commissionermay be |
8319
|
removed and replaced by her or him at any time without cause. |
8320
|
Six members of the board must be appointed by the participating |
8321
|
insurers, two of whom must be from the insurance agents' |
8322
|
associations. All board members, including the chair, must be |
8323
|
appointed to serve for 2-year terms beginning annually on a date |
8324
|
designated by the plan. |
8325
|
(f) Must provide that an agent appointed to a servicing |
8326
|
carrier must be a licensed general lines agent of an insurer |
8327
|
which is authorized to write automobile liability and physical |
8328
|
damage insurance in the state and which is actively writing such |
8329
|
coverage in the county in which the agent is located, or the |
8330
|
immediately adjoining counties, or an agent who places a volume |
8331
|
of other property and casualty insurance in an amount equal to |
8332
|
the premium volume placed with the Florida Joint Underwriting |
8333
|
Association. The officedepartmentmay, however, determine that |
8334
|
an agent may be appointed to a servicing carrier if, after |
8335
|
public hearing, the officedepartmentfinds that consumers in |
8336
|
the agent's operating area would not have adequate and |
8337
|
reasonable access to the purchase of automobile insurance if the |
8338
|
agent were not appointed to a servicing carrier. |
8339
|
(g) Must make available noncancelable coverage as provided |
8340
|
in s. 627.7275(2). |
8341
|
(h) Must provide for the furnishing of a list of insureds |
8342
|
and their mailing addresses upon the request of a member of the |
8343
|
association or an insurance agent licensed to place business |
8344
|
with an association member. The list must indicate whether the |
8345
|
insured is currently receiving a good driver discount from the |
8346
|
association. The plan may charge a reasonable fee to cover the |
8347
|
cost incurred in providing the list. |
8348
|
(i) Must not provide a renewal credit or discount or any |
8349
|
other inducement designed to retain a risk. |
8350
|
(j) Must not provide any other good driver credit or |
8351
|
discount that is not actuarially sound. In addition to other |
8352
|
criteria that the plan may specify, to be eligible for a good |
8353
|
driver credit, an insured must not have any criminal traffic |
8354
|
violations within the most recent 36-month period preceding the |
8355
|
date the discount is received. |
8356
|
(k) Shall have no liability, and no cause of action of any |
8357
|
nature shall arise against, any member insurer or its agents or |
8358
|
employees, agents or employees of the association, members of |
8359
|
the board of governors of the association, the Chief Financial |
8360
|
Officer, or the officedepartmentor its representatives, for |
8361
|
any action taken by them in the performance of their duties or |
8362
|
responsibilities under this subsection. Such immunity does not |
8363
|
apply to actions for or arising out of breach of any contract or |
8364
|
agreement pertaining to insurance, or any willful tort. |
8365
|
(l)1. Shall be subject to the public records requirements |
8366
|
of chapter 119 and the public meeting requirements of s. |
8367
|
286.011. However, the following records of the Florida |
8368
|
Automobile Joint Underwriting Association are confidential and |
8369
|
exempt from s. 119.07(1) and s. 24(a), Art. I of the State |
8370
|
Constitution: |
8371
|
a. Underwriting files, except that a policyholder or an |
8372
|
applicant shall have access to his or her own underwriting |
8373
|
files. |
8374
|
b. Claims files, until termination of all litigation and |
8375
|
settlement of all claims arising out of the same incident, |
8376
|
although portions of the claims files may remain exempt, as |
8377
|
otherwise provided by law. Confidential and exempt claims file |
8378
|
records may be released to other governmental agencies upon |
8379
|
written request and demonstration of need; such records held by |
8380
|
the receiving agency remain confidential and exempt as provided |
8381
|
by this paragraph. |
8382
|
c. Records obtained or generated by an internal auditor |
8383
|
pursuant to a routine audit, until the audit is completed or, if |
8384
|
the audit is conducted as part of an investigation, until the |
8385
|
investigation is closed or ceases to be active. An |
8386
|
investigation is considered "active" while the investigation is |
8387
|
being conducted with a reasonable, good faith belief that it |
8388
|
could lead to the filing of administrative, civil, or criminal |
8389
|
proceedings. |
8390
|
d. Matters reasonably encompassed in privileged attorney- |
8391
|
client communications. |
8392
|
e. Proprietary information licensed to the association |
8393
|
under contract when the contract provides for the |
8394
|
confidentiality of such proprietary information. |
8395
|
f. All information relating to the medical condition or |
8396
|
medical status of an association employee which is not relevant |
8397
|
to the employee's capacity to perform his or her duties, except |
8398
|
as otherwise provided in this paragraph. Information which is |
8399
|
exempt shall include, but is not limited to, information |
8400
|
relating to workers' compensation, insurance benefits, and |
8401
|
retirement or disability benefits. |
8402
|
g. All records relative to an employee's participation in |
8403
|
an employee assistance program designed to assist any employee |
8404
|
who has a behavioral or medical disorder, substance abuse |
8405
|
problem, or emotional difficulty which affects the employee's |
8406
|
job performance, except as otherwise provided in s. |
8407
|
112.0455(11). |
8408
|
h. Information relating to negotiations for financing, |
8409
|
reinsurance, depopulation, or contractual services, until the |
8410
|
conclusion of the negotiations. |
8411
|
i. Minutes of closed meetings regarding underwriting |
8412
|
files, and minutes of closed meetings regarding an open claims |
8413
|
file until termination of all litigation and settlement of all |
8414
|
claims with regard to that claim, except that information |
8415
|
otherwise confidential or exempt by law must be redacted. |
8416
|
|
8417
|
|
8418
|
When an authorized insurer is considering underwriting a risk |
8419
|
insured by the association, relevant underwriting files and |
8420
|
confidential claims files may be released to the insurer |
8421
|
provided the insurer agrees in writing, notarized and under |
8422
|
oath, to maintain the confidentiality of such files. When a |
8423
|
file is transferred to an insurer, that file is no longer a |
8424
|
public record because it is not held by an agency subject to the |
8425
|
provisions of the public records law. The association may make |
8426
|
the following information obtained from underwriting files and |
8427
|
confidential claims files available to licensed general lines |
8428
|
insurance agents: name, address, and telephone number of the |
8429
|
automobile owner or insured; location of the risk; rating |
8430
|
information; loss history; and policy type. The receiving |
8431
|
licensed general lines insurance agent must retain the |
8432
|
confidentiality of the information received. |
8433
|
2. Portions of meetings of the Florida Automobile Joint |
8434
|
Underwriting Association during which confidential underwriting |
8435
|
files or confidential open claims files are discussed are exempt |
8436
|
from the provisions of s. 286.011 and s. 24(b), Art. I of the |
8437
|
State Constitution. All portions of association meetings which |
8438
|
are closed to the public shall be recorded by a court reporter. |
8439
|
The court reporter shall record the times of commencement and |
8440
|
termination of the meeting, all discussion and proceedings, the |
8441
|
names of all persons present at any time, and the names of all |
8442
|
persons speaking. No portion of any closed meeting shall be off |
8443
|
the record. Subject to the provisions of this paragraph and s. |
8444
|
119.07(2)(a), the court reporter's notes of any closed meeting |
8445
|
shall be retained by the association for a minimum of 5 years. |
8446
|
A copy of the transcript, less any exempt matters, of any closed |
8447
|
meeting during which claims are discussed shall become public as |
8448
|
to individual claims after settlement of the claim. |
8449
|
|
8450
|
|
8451
|
This paragraph is subject to the Open Government Sunset Review |
8452
|
Act of 1995 in accordance with s. 119.15, and shall stand |
8453
|
repealed on October 2, 2003, unless reviewed and saved from |
8454
|
repeal through reenactment by the Legislature. |
8455
|
(4)(a) Effective upon this act becoming a law, The office |
8456
|
departmentshall, after consultation with insurers, approve a |
8457
|
joint underwriting plan of insurers which shall operate as a |
8458
|
nonprofit entity. For the purposes of this subsection, the term |
8459
|
"insurer" includes group self-insurance funds authorized by s. |
8460
|
624.4621, commercial self-insurance funds authorized by s. |
8461
|
624.462, assessable mutual insurers authorized under s. |
8462
|
628.6011, and insurers licensed to write workers' compensation |
8463
|
and employer's liability insurance in this state. The purpose of |
8464
|
the plan is to provide workers' compensation and employer's |
8465
|
liability insurance to applicants who are required by law to |
8466
|
maintain workers' compensation and employer's liability |
8467
|
insurance and who are in good faith entitled to but who are |
8468
|
unable to purchase such insurance through the voluntary market. |
8469
|
The joint underwriting plan shall issue policies beginning |
8470
|
January 1, 1994.The plan must have actuarially sound rates that |
8471
|
assure that the plan is self-supporting. |
8472
|
(b) The operation of the plan is subject to the |
8473
|
supervision of a 13-member board of governors. The board of |
8474
|
governors shall be comprised of: |
8475
|
1. Five of the 20 domestic insurers, as defined in s. |
8476
|
624.06(1), having the largest voluntary direct premiums written |
8477
|
in this state for workers' compensation and employer's liability |
8478
|
insurance, which shall be elected by those 20 domestic insurers; |
8479
|
2. Five of the 20 foreign insurers as defined in s. |
8480
|
624.06(2) having the largest voluntary direct premiums written |
8481
|
in this state for workers' compensation and employer's liability |
8482
|
insurance, which shall be elected by those 20 foreign insurers; |
8483
|
3. One person, who shall serve as the chair, appointed by |
8484
|
the Chief Financial OfficerInsurance Commissioner; |
8485
|
4. One person appointed by the largest property and |
8486
|
casualty insurance agents' association in this state; and |
8487
|
5. The consumer advocate appointed under s. 627.0613 or |
8488
|
the consumer advocate's designee. |
8489
|
|
8490
|
|
8491
|
Each board member shall serve a 4-year term and may serve |
8492
|
consecutive terms. No board member shall be an insurer which |
8493
|
provides service to the plan or which has an affiliate which |
8494
|
provides services to the plan or which is serviced by a service |
8495
|
company or third-party administrator which provides services to |
8496
|
the plan or which has an affiliate which provides services to |
8497
|
the plan. The minutes, audits, and procedures of the board of |
8498
|
governors are subject to chapter 119. |
8499
|
(c) The operation of the plan shall be governed by a plan |
8500
|
of operation that is prepared at the direction of the board of |
8501
|
governors. The plan of operation may be changed at any time by |
8502
|
the board of governors or upon request of the officedepartment. |
8503
|
The plan of operation and all changes thereto are subject to the |
8504
|
approval of the officedepartment. The plan of operation shall: |
8505
|
1. Authorize the board to engage in the activities |
8506
|
necessary to implement this subsection, including, but not |
8507
|
limited to, borrowing money. |
8508
|
2. Develop criteria for eligibility for coverage by the |
8509
|
plan, including, but not limited to, documented rejection by at |
8510
|
least two insurers which reasonably assures that insureds |
8511
|
covered under the plan are unable to acquire coverage in the |
8512
|
voluntary market. Any insured may voluntarily elect to accept |
8513
|
coverage from an insurer for a premium equal to or greater than |
8514
|
the plan premium if the insurer writing the coverage adheres to |
8515
|
the provisions of s. 627.171. |
8516
|
3. Require notice from the agent to the insured at the |
8517
|
time of the application for coverage that the application is for |
8518
|
coverage with the plan and that coverage may be available |
8519
|
through an insurer, group self-insurers' fund, commercial self- |
8520
|
insurance fund, or assessable mutual insurer through another |
8521
|
agent at a lower cost. |
8522
|
4. Establish programs to encourage insurers to provide |
8523
|
coverage to applicants of the plan in the voluntary market and |
8524
|
to insureds of the plan, including, but not limited to: |
8525
|
a. Establishing procedures for an insurer to use in |
8526
|
notifying the plan of the insurer's desire to provide coverage |
8527
|
to applicants to the plan or existing insureds of the plan and |
8528
|
in describing the types of risks in which the insurer is |
8529
|
interested. The description of the desired risks must be on a |
8530
|
form developed by the plan. |
8531
|
b. Developing forms and procedures that provide an insurer |
8532
|
with the information necessary to determine whether the insurer |
8533
|
wants to write particular applicants to the plan or insureds of |
8534
|
the plan. |
8535
|
c. Developing procedures for notice to the plan and the |
8536
|
applicant to the plan or insured of the plan that an insurer |
8537
|
will insure the applicant or the insured of the plan, and notice |
8538
|
of the cost of the coverage offered; and developing procedures |
8539
|
for the selection of an insuring entity by the applicant or |
8540
|
insured of the plan. |
8541
|
d. Provide for a market-assistance plan to assist in the |
8542
|
placement of employers. All applications for coverage in the |
8543
|
plan received 45 days before the effective date for coverage |
8544
|
shall be processed through the market-assistance plan. A market- |
8545
|
assistance plan specifically designed to serve the needs of |
8546
|
small good policyholders as defined by the board must be |
8547
|
finalized by January 1, 1994. |
8548
|
5. Provide for policy and claims services to the insureds |
8549
|
of the plan of the nature and quality provided for insureds in |
8550
|
the voluntary market. |
8551
|
6. Provide for the review of applications for coverage |
8552
|
with the plan for reasonableness and accuracy, using any |
8553
|
available historic information regarding the insured. |
8554
|
7. Provide for procedures for auditing insureds of the |
8555
|
plan which are based on reasonable business judgment and are |
8556
|
designed to maximize the likelihood that the plan will collect |
8557
|
the appropriate premiums. |
8558
|
8. Authorize the plan to terminate the coverage of and |
8559
|
refuse future coverage for any insured that submits a fraudulent |
8560
|
application to the plan or provides fraudulent or grossly |
8561
|
erroneous records to the plan or to any service provider of the |
8562
|
plan in conjunction with the activities of the plan. |
8563
|
9. Establish service standards for agents who submit |
8564
|
business to the plan. |
8565
|
10. Establish criteria and procedures to prohibit any |
8566
|
agent who does not adhere to the established service standards |
8567
|
from placing business with the plan or receiving, directly or |
8568
|
indirectly, any commissions for business placed with the plan. |
8569
|
11. Provide for the establishment of reasonable safety |
8570
|
programs for all insureds in the plan. |
8571
|
12. Authorize the plan to terminate the coverage of and |
8572
|
refuse future coverage to any insured who fails to pay premiums |
8573
|
or surcharges when due; who, at the time of application, is |
8574
|
delinquent in payments of workers' compensation or employer's |
8575
|
liability insurance premiums or surcharges owed to an insurer, |
8576
|
group self-insurers' fund, commercial self-insurance fund, or |
8577
|
assessable mutual insurer licensed to write such coverage in |
8578
|
this state; or who refuses to substantially comply with any |
8579
|
safety programs recommended by the plan. |
8580
|
13. Authorize the board of governors to provide the |
8581
|
services required by the plan through staff employed by the |
8582
|
plan, through reasonably compensated service providers who |
8583
|
contract with the plan to provide services as specified by the |
8584
|
board of governors, or through a combination of employees and |
8585
|
service providers. |
8586
|
14. Provide for service standards for service providers, |
8587
|
methods of determining adherence to those service standards, |
8588
|
incentives and disincentives for service, and procedures for |
8589
|
terminating contracts for service providers that fail to adhere |
8590
|
to service standards. |
8591
|
15. Provide procedures for selecting service providers and |
8592
|
standards for qualification as a service provider that |
8593
|
reasonably assure that any service provider selected will |
8594
|
continue to operate as an ongoing concern and is capable of |
8595
|
providing the specified services in the manner required. |
8596
|
16. Provide for reasonable accounting and data-reporting |
8597
|
practices. |
8598
|
17. Provide for annual review of costs associated with the |
8599
|
administration and servicing of the policies issued by the plan |
8600
|
to determine alternatives by which costs can be reduced. |
8601
|
18. Authorize the acquisition of such excess insurance or |
8602
|
reinsurance as is consistent with the purposes of the plan. |
8603
|
19. Provide for an annual report to the officedepartment |
8604
|
on a date specified by the officedepartmentand containing such |
8605
|
information as the officedepartmentreasonably requires. |
8606
|
20. Establish multiple rating plans for various |
8607
|
classifications of risk which reflect risk of loss, hazard |
8608
|
grade, actual losses, size of premium, and compliance with loss |
8609
|
control. At least one of such plans must be a preferred-rating |
8610
|
plan to accommodate small-premium policyholders with good |
8611
|
experience as defined in sub-subparagraph 22.a. |
8612
|
21. Establish agent commission schedules. |
8613
|
22. Establish three subplans as follows: |
8614
|
a. Subplan "A" must include those insureds whose annual |
8615
|
premium does not exceed $2,500 and who have neither incurred any |
8616
|
lost-time claims nor incurred medical-only claims exceeding 50 |
8617
|
percent of their premium for the immediate 2 years. |
8618
|
b. Subplan "B" must include insureds that are employers |
8619
|
identified by the board of governors as high-risk employers due |
8620
|
solely to the nature of the operations being performed by those |
8621
|
insureds and for whom no market exists in the voluntary market, |
8622
|
and whose experience modifications are less than 1.00. |
8623
|
c. Subplan "C" must include all other insureds within the |
8624
|
plan. |
8625
|
(e) The plan shall establish and use its rates and rating |
8626
|
plans, and the plan may establish and use changes in rating |
8627
|
plans at any time, but no more frequently than two times per any |
8628
|
rating class for any calendar year. By December 1, 1993, and |
8629
|
December 1 of each year thereafter, the board shall establish |
8630
|
and use actuarially sound rates for use by the plan to assure |
8631
|
that the plan is self-funding while those rates are in effect. |
8632
|
Such rates and rating plans must be filed with the office |
8633
|
departmentwithin 30 calendar days after their effective dates, |
8634
|
and shall be considered a "use and file" filing. Any disapproval |
8635
|
by the officedepartmentmust have an effective date that is at |
8636
|
least 60 days from the date of disapproval of the rates and |
8637
|
rating plan and must have prospective effect only. The plan may |
8638
|
not be subject to any order by the officedepartmentto return |
8639
|
to policyholders any portion of the rates disapproved by the |
8640
|
officedepartment. The officedepartmentmay not disapprove any |
8641
|
rates or rating plans unless it demonstrates that such rates and |
8642
|
rating plans are excessive, inadequate, or unfairly |
8643
|
discriminatory. |
8644
|
(f) No later than June 1 of each year, the plan shall |
8645
|
obtain an independent actuarial certification of the results of |
8646
|
the operations of the plan for prior years, and shall furnish a |
8647
|
copy of the certification to the officedepartment. If, after |
8648
|
the effective date of the plan, the projected ultimate incurred |
8649
|
losses and expenses and dividends for prior years exceed |
8650
|
collected premiums, accrued net investment income, and prior |
8651
|
assessments for prior years, the certification is subject to |
8652
|
review and approval by the officedepartmentbefore it becomes |
8653
|
final. |
8654
|
(g) Whenever a deficit exists, the plan shall, within 90 |
8655
|
days, provide the officedepartmentwith a program to eliminate |
8656
|
the deficit within a reasonable time. The deficit may be funded |
8657
|
through increased premiums charged to insureds of the plan for |
8658
|
subsequent years, through the use of policyholder surplus |
8659
|
attributable to any year, and through assessments on insureds in |
8660
|
the plan if the plan uses assessable policies. |
8661
|
Section 198. Section 627.3111, Florida Statutes, is |
8662
|
amended to read: |
8663
|
627.3111 Public records exemption.--All bank account |
8664
|
numbers and debit, charge, and credit card numbers, and all |
8665
|
other personal financial and health information of a consumer |
8666
|
held by the department or officeof Insurance or theirits |
8667
|
service providers or agents, relating to a consumer's complaint |
8668
|
or inquiry regarding a matter or activity regulated under the |
8669
|
Florida Insurance Code, are confidential and exempt from s. |
8670
|
119.07(1) and s. 24(a), Art. I of the State Constitution. For |
8671
|
the purpose of this section, the term "consumer" includes but is |
8672
|
not limited to a prospective purchaser, purchaser, or |
8673
|
beneficiary of, or applicant for, any product or service |
8674
|
regulated under the Florida Insurance Code, and a family member |
8675
|
or dependent of a consumer, a subscriber under a group policy, |
8676
|
or a policyholder. This information shall be redacted from |
8677
|
records that contain nonexempt information prior to disclosure. |
8678
|
This exemption applies to information made confidential and |
8679
|
exempt by this section held by the department or officeof |
8680
|
Insurance or theiritsservice providers or agents before, on, |
8681
|
or after the effective date of this exemption. Such confidential |
8682
|
and exempt information may be disclosed to another governmental |
8683
|
entity, if disclosure is necessary for the receiving entity to |
8684
|
perform its duties and responsibilities, and may be disclosed to |
8685
|
the National Association of Insurance Commissioners. The |
8686
|
receiving governmental entity and the association must maintain |
8687
|
the confidential and exempt status of such information. The |
8688
|
information made confidential and exempt by this section may be |
8689
|
used in a criminal, civil, or administrative proceeding so long |
8690
|
as the confidential and exempt status of such information is |
8691
|
maintained. This exemption does not include the name and address |
8692
|
of an inquirer or complainant to the department or officeor the |
8693
|
name of an insurer or other regulated entity which is the |
8694
|
subject of the inquiry or complaint. This section is subject to |
8695
|
the Open Government Sunset Review Act of 1995 in accordance with |
8696
|
s. 119.15 and shall stand repealed on October 2, 2007, unless |
8697
|
reviewed and saved from repeal through reenactment by the |
8698
|
Legislature. |
8699
|
Section 199. Subsection (1), paragraphs (a) and (c) of |
8700
|
subsection (3), paragraphs (a), (c), and (d) of subsection (4), |
8701
|
and subsections (5) and (6) of section 627.351, Florida |
8702
|
Statutes, are amended, and paragraph (f) is added to subsection |
8703
|
(2) of that section to read: |
8704
|
627.351 Insurance risk apportionment plans.-- |
8705
|
(1) MOTOR VEHICLE INSURANCE RISK |
8706
|
APPORTIONMENT.--Agreements may be made among casualty and surety |
8707
|
insurers with respect to the equitable apportionment among them |
8708
|
of insurance which may be afforded applicants who are in good |
8709
|
faith entitled to, but are unable to, procure such insurance |
8710
|
through ordinary methods, and such insurers may agree among |
8711
|
themselves on the use of reasonable rate modifications for such |
8712
|
insurance. Such agreements and rate modifications shall be |
8713
|
subject to the approval of the officedepartment. The office |
8714
|
departmentshall, after consultation with the insurers licensed |
8715
|
to write automobile liability insurance in this state, adopt a |
8716
|
reasonable plan or plans for the equitable apportionment among |
8717
|
such insurers of applicants for such insurance who are in good |
8718
|
faith entitled to, but are unable to, procure such insurance |
8719
|
through ordinary methods, and, when such plan has been adopted, |
8720
|
all such insurers shall subscribe thereto and shall participate |
8721
|
therein. Such plan or plans shall include rules for |
8722
|
classification of risks and rates therefor. The plan or plans |
8723
|
shall make available noncancelable coverage as provided in s. |
8724
|
627.7275(2). Any insured placed with the plan shall be notified |
8725
|
of the fact that insurance coverage is being afforded through |
8726
|
the plan and not through the private market, and such |
8727
|
notification shall be given in writing within 10 days of such |
8728
|
placement. To assure that plan rates are made adequate to pay |
8729
|
claims and expenses, insurers shall develop a means of obtaining |
8730
|
loss and expense experience at least annually, and the plan |
8731
|
shall file such experience, when available, with the office |
8732
|
departmentin sufficient detail to make a determination of rate |
8733
|
adequacy. Prior to the filing of such experience with the office |
8734
|
department, the plan shall poll each member insurer as to the |
8735
|
need for an actuary who is a member of the Casualty Actuarial |
8736
|
Society and who is not affiliated with the plan's statistical |
8737
|
agent to certify the plan's rate adequacy. If a majority of |
8738
|
those insurers responding indicate a need for such |
8739
|
certification, the plan shall include the certification as part |
8740
|
of its experience filing. Such experience shall be filed with |
8741
|
the officedepartmentnot more than 9 months following the end |
8742
|
of the annual statistical period under review, together with a |
8743
|
rate filing based on said experience. The officedepartment |
8744
|
shall initiate proceedings to disapprove the rate and so notify |
8745
|
the plan or shall finalize its review within 60 days of receipt |
8746
|
of the filing. Notification to the plan by the officedepartment |
8747
|
of its preliminary findings, which include a point of entry to |
8748
|
the plan pursuant to chapter 120, shall toll the 60-day period |
8749
|
during any such proceedings and subsequent judicial review. The |
8750
|
rate shall be deemed approved if the officedepartmentdoes not |
8751
|
issue notice to the plan of its preliminary findings within 60 |
8752
|
days of the filing. In addition to provisions for claims and |
8753
|
expenses, the ratemaking formula shall include a factor for |
8754
|
projected claims trending and 5 percent for contingencies. In no |
8755
|
instance shall the formula include a renewal discount for plan |
8756
|
insureds. However, the plan shall reunderwrite each insured on |
8757
|
an annual basis, based upon all applicable rating factors |
8758
|
approved by the officedepartment. Trend factors shall not be |
8759
|
found to be inappropriate if not in excess of trend factors |
8760
|
normally used in the development of residual market rates by the |
8761
|
appropriate licensed rating organization. Each application for |
8762
|
coverage in the plan shall include, in boldfaced 12-point type |
8763
|
immediately preceding the applicant's signature, the following |
8764
|
statement: |
8765
|
|
8766
|
"THIS INSURANCE IS BEING AFFORDED THROUGH THE FLORIDA JOINT |
8767
|
UNDERWRITING ASSOCIATION AND NOT THROUGH THE PRIVATE MARKET. |
8768
|
PLEASE BE ADVISED THAT COVERAGE WITH A PRIVATE INSURER MAY BE |
8769
|
AVAILABLE FROM ANOTHER AGENT AT A LOWER COST. AGENT AND COMPANY |
8770
|
LISTINGS ARE AVAILABLE IN THE LOCAL YELLOW PAGES." |
8771
|
|
8772
|
The plan shall annually report to the officedepartmentthe |
8773
|
number and percentage of plan insureds who are not surcharged |
8774
|
due to their driving record. |
8775
|
(2) WINDSTORM INSURANCE RISK APPORTIONMENT.-- |
8776
|
(f) As used in this subsection, the term "department" |
8777
|
means the former Department of Insurance. |
8778
|
(3) POLITICAL SUBDIVISION; CASUALTY INSURANCE RISK |
8779
|
APPORTIONMENT.-- |
8780
|
(a) The officedepartmentshall, after consultation with |
8781
|
the casualty insurers licensed in this state, adopt a plan or |
8782
|
plans for the equitable apportionment among them of casualty |
8783
|
insurance coverage which may be afforded political subdivisions |
8784
|
which are in good faith entitled to, but are unable to, procure |
8785
|
such coverage through the voluntary market at standard rates or |
8786
|
through a statutorily approved plan authorized by the office |
8787
|
department. The officedepartmentmay adopt a joint underwriting |
8788
|
plan which shall provide for one or more designated insurers |
8789
|
able and willing to provide policyholder and claims service, |
8790
|
including the issuance of insurance policies, to act on behalf |
8791
|
of all other insurers required to participate in the joint |
8792
|
underwriting plan. Any joint underwriting plan adopted shall |
8793
|
provide for the equitable apportionment of any profits realized, |
8794
|
or of losses and expenses incurred, among participating |
8795
|
insurers. The plan shall include, but shall not be limited to: |
8796
|
1. Rules for the classification of risks and rates which |
8797
|
reflect the past loss experience and prospective loss experience |
8798
|
in different geographic areas. |
8799
|
2. A rating plan which reasonably reflects the prior |
8800
|
claims experience of the insureds. |
8801
|
3. Excess coverage by insurers if the officeInsurance |
8802
|
Commissioner, in itshis or herdiscretion, requires such |
8803
|
coverage by insurers participating in the joint underwriting |
8804
|
plan. |
8805
|
(c) Any deficit sustained under the plan shall first be |
8806
|
recovered through a premium contingency assessment. |
8807
|
Concurrently, the rates for insureds shall be adjusted for the |
8808
|
next year so as to be actuarially sound in conformance with |
8809
|
rules adopted byof the commissiondepartment. |
8810
|
(4) MEDICAL MALPRACTICE RISK APPORTIONMENT.-- |
8811
|
(a) The officedepartmentshall, after consultation with |
8812
|
insurers as set forth in paragraph (b), adopt a joint |
8813
|
underwriting plan as set forth in paragraph (d). |
8814
|
(c) The Joint Underwriting Association shall operate |
8815
|
subject to the supervision and approval of a board of governors |
8816
|
consisting of representatives of five of the insurers |
8817
|
participating in the Joint Underwriting Association, an attorney |
8818
|
to be named by The Florida Bar, a physician to be named by the |
8819
|
Florida Medical Association, a dentist to be named by the |
8820
|
Florida Dental Association, and a hospital representative to be |
8821
|
named by the Florida Hospital Association. The board of |
8822
|
governors shall choose, during the first meeting of the board |
8823
|
after June 30 of each year, one of its members to serve as chair |
8824
|
of the board and another member to serve as vice chair of the |
8825
|
board. There shall be no liability on the part of, and no cause |
8826
|
of action of any nature shall arise against, any member insurer, |
8827
|
self-insurer, or its agents or employees, the Joint Underwriting |
8828
|
Association or its agents or employees, members of the board of |
8829
|
governors, or the officedepartmentor its representatives for |
8830
|
any action taken by them in the performance of their powers and |
8831
|
duties under this subsection. |
8832
|
(d) The plan shall provide coverage for claims arising out |
8833
|
of the rendering of, or failure to render, medical care or |
8834
|
services and, in the case of health care facilities, coverage |
8835
|
for bodily injury or property damage to the person or property |
8836
|
of any patient arising out of the insured's activities, in |
8837
|
appropriate policy forms for all health care providers as |
8838
|
defined in paragraph (h). The plan shall include, but shall not |
8839
|
be limited to: |
8840
|
1. Classifications of risks and rates which reflect past |
8841
|
and prospective loss and expense experience in different areas |
8842
|
of practice and in different geographical areas. To assure that |
8843
|
plan rates are adequate to pay claims and expenses, the Joint |
8844
|
Underwriting Association shall develop a means of obtaining loss |
8845
|
and expense experience; and the plan shall file such experience, |
8846
|
when available, with the officedepartmentin sufficient detail |
8847
|
to make a determination of rate adequacy. Within 60 days after a |
8848
|
rate filing, the officedepartmentshall approve such rates or |
8849
|
rate revisions as are fully supported by the filing. In addition |
8850
|
to provisions for claims and expenses, the ratemaking formula |
8851
|
may include a factor for projected claims trending and a margin |
8852
|
for contingencies. The use of trend factors shall not be found |
8853
|
to be inappropriate. |
8854
|
2. A rating plan which reasonably recognizes the prior |
8855
|
claims experience of insureds. |
8856
|
3. Provisions as to rates for: |
8857
|
a. Insureds who are retired or semiretired. |
8858
|
b. The estates of deceased insureds. |
8859
|
c. Part-time professionals. |
8860
|
4. Protection in an amount not to exceed $250,000 per |
8861
|
claim, $750,000 annual aggregate for health care providers other |
8862
|
than hospitals and in an amount not to exceed $1.5 million per |
8863
|
claim, $5 million annual aggregate for hospitals. Such coverage |
8864
|
for health care providers other than hospitals shall be |
8865
|
available as primary coverage and as excess coverage for the |
8866
|
layer of coverage between the primary coverage and the total |
8867
|
limits of $250,000 per claim, $750,000 annual aggregate. The |
8868
|
plan shall also provide tail coverage in these amounts to |
8869
|
insureds whose claims-made coverage with another insurer or |
8870
|
trust has or will be terminated. Such tail coverage shall |
8871
|
provide coverage for incidents that occurred during the claims- |
8872
|
made policy period for which a claim is made after the policy |
8873
|
period. |
8874
|
5. A risk management program for insureds of the |
8875
|
association. This program shall include, but not be limited to: |
8876
|
investigation and analysis of frequency, severity, and causes of |
8877
|
adverse or untoward medical injuries; development of measures to |
8878
|
control these injuries; systematic reporting of medical |
8879
|
incidents; investigation and analysis of patient complaints; and |
8880
|
auditing of association members to assure implementation of this |
8881
|
program. The plan may refuse to insure any insured who refuses |
8882
|
or fails to comply with the risk management program implemented |
8883
|
by the association. Prior to cancellation or refusal to renew |
8884
|
an insured, the association shall provide the insured 60 days' |
8885
|
notice of intent to cancel or nonrenew and shall further notify |
8886
|
the insured of any action which must be taken to be in |
8887
|
compliance with the risk management program. |
8888
|
(5) PROPERTY AND CASUALTY INSURANCE RISK |
8889
|
APPORTIONMENT.--The commissiondepartmentshall adopt by rule a |
8890
|
joint underwriting plan to equitably apportion among insurers |
8891
|
authorized in this state to write property insurance as defined |
8892
|
in s. 624.604 or casualty insurance as defined in s. 624.605, |
8893
|
the underwriting of one or more classes of property insurance or |
8894
|
casualty insurance, except for the types of insurance that are |
8895
|
included within property insurance or casualty insurance for |
8896
|
which an equitable apportionment plan, assigned risk plan, or |
8897
|
joint underwriting plan is authorized under s. 627.311 or |
8898
|
subsection (1), subsection (2), subsection(3), subsection (4), |
8899
|
or subsection (5) and except for risks eligible for flood |
8900
|
insurance written through the federal flood insurance program to |
8901
|
persons with risks eligible under subparagraph (a)1. and who are |
8902
|
in good faith entitled to, but are unable to, obtain such |
8903
|
property or casualty insurance coverage, including excess |
8904
|
coverage, through the voluntary market. For purposes of this |
8905
|
subsection, an adequate level of coverage means that coverage |
8906
|
which is required by state law or by responsible or prudent |
8907
|
business practices. The Joint Underwriting Association shall not |
8908
|
be required to provide coverage for any type of risk for which |
8909
|
there are no insurers providing similar coverage in this state. |
8910
|
The officedepartmentmay designate one or more participating |
8911
|
insurers who agree to provide policyholder and claims service, |
8912
|
including the issuance of policies, on behalf of the |
8913
|
participating insurers. |
8914
|
(a) The plan shall provide: |
8915
|
1. A means of establishing eligibility of a risk for |
8916
|
obtaining insurance through the plan, which provides that: |
8917
|
a. A risk shall be eligible for such property insurance or |
8918
|
casualty insurance as is required by Florida law if the |
8919
|
insurance is unavailable in the voluntary market, including the |
8920
|
market assistance program and the surplus lines market. |
8921
|
b. A commercial risk not eligible under sub-subparagraph |
8922
|
a. shall be eligible for property or casualty insurance if: |
8923
|
(I) The insurance is unavailable in the voluntary market, |
8924
|
including the market assistance plan and the surplus lines |
8925
|
market; |
8926
|
(II) Failure to secure the insurance would substantially |
8927
|
impair the ability of the entity to conduct its affairs; and |
8928
|
(III) The risk is not determined by the Risk Underwriting |
8929
|
Committee to be uninsurable. |
8930
|
c. In the event the Federal Government terminates the |
8931
|
Federal Crime Insurance Program established under 44 C.F.R. ss. |
8932
|
80-83, Florida commercial and residential risks previously |
8933
|
insured under the federal program shall be eligible under the |
8934
|
plan. |
8935
|
d.(I) In the event a risk is eligible under this paragraph |
8936
|
and in the event the market assistance plan receives a minimum |
8937
|
of 100 applications for coverage within a 3-month period, or 200 |
8938
|
applications for coverage within a 1-year period or less, for a |
8939
|
given class of risk contained in the classification system |
8940
|
defined in the plan of operation of the Joint Underwriting |
8941
|
Association, and unless the market assistance plan provides a |
8942
|
quotation for at least 80 percent of such applicants, such |
8943
|
classification shall immediately be eligible for coverage in the |
8944
|
Joint Underwriting Association. |
8945
|
(II) Any market assistance plan application which is |
8946
|
rejected because an individual risk is so hazardous as to be |
8947
|
practically uninsurable, considering whether the likelihood of a |
8948
|
loss for such a risk is substantially higher than for other |
8949
|
risks of the same class due to individual risk characteristics, |
8950
|
prior loss experience, unwillingness to cooperate with a prior |
8951
|
insurer, physical characteristics and physical location shall |
8952
|
not be included in the minimum percentage calculation provided |
8953
|
above. In the event that there is any legal or administrative |
8954
|
challenge to a determination by the officedepartmentthat the |
8955
|
conditions of this subparagraph have been met for eligibility |
8956
|
for coverage in the Joint Underwriting Association for a given |
8957
|
classification, any eligible risk may obtain coverage during the |
8958
|
pendency of any such challenge. |
8959
|
e. In order to qualify as a quotation for the purpose of |
8960
|
meeting the minimum percentage calculation in this subparagraph, |
8961
|
the quoted premium must meet the following criteria: |
8962
|
(I) In the case of an admitted carrier, the quoted premium |
8963
|
must not exceed the premium available for a given classification |
8964
|
currently in use by the Joint Underwriting Association or the |
8965
|
premium developed by using the rates and rating plans on file |
8966
|
with the officedepartmentby the quoting insurer, whichever is |
8967
|
greater. |
8968
|
(II) In the case of an authorized surplus lines insurer, |
8969
|
the quoted premium must not exceed the premium available for a |
8970
|
given classification currently in use by the Joint Underwriting |
8971
|
Association by more than 25 percent, after consideration of any |
8972
|
individual risk surcharge or credit. |
8973
|
f. Any agent who falsely certifies the unavailability of |
8974
|
coverage as provided by sub-subparagraphs a. and b., is subject |
8975
|
to the penalties provided in s. 626.611. |
8976
|
2. A means for the equitable apportionment of profits or |
8977
|
losses and expenses among participating insurers. |
8978
|
3. Rules for the classification of risks and rates which |
8979
|
reflect the past and prospective loss experience. |
8980
|
4. A rating plan which reasonably reflects the prior |
8981
|
claims experience of the insureds. Such rating plan shall |
8982
|
include at least two levels of rates for risks that have |
8983
|
favorable loss experience and risks that have unfavorable loss |
8984
|
experience, as established by the plan. |
8985
|
5. Reasonable limits to available amounts of insurance. |
8986
|
Such limits may not be less than the amounts of insurance |
8987
|
required of eligible risks by Florida law. |
8988
|
6. Risk management requirements for insurance where such |
8989
|
requirements are reasonable and are expected to reduce losses. |
8990
|
7. Deductibles as may be necessary to meet the needs of |
8991
|
insureds. |
8992
|
8. Policy forms which are consistent with the forms in use |
8993
|
by the majority of the insurers providing coverage in the |
8994
|
voluntary market for the coverage requested by the applicant. |
8995
|
9. A means to remove risks from the plan once such risks |
8996
|
no longer meet the eligibility requirements of this paragraph. |
8997
|
For this purpose, the plan shall include the following |
8998
|
requirements: At each 6-month interval after the activation of |
8999
|
any class of insureds, the board of governors or its designated |
9000
|
committee shall review the number of applications to the market |
9001
|
assistance plan for that class. If, based on these latest |
9002
|
numbers, at least 90 percent of such applications have been |
9003
|
provided a quotation, the Joint Underwriting Association shall |
9004
|
cease underwriting new applications for such class within 30 |
9005
|
days, and notification of this decision shall be sent to the |
9006
|
officeInsurance Commissioner, the major agents' associations, |
9007
|
and the board of directors of the market assistance plan. A |
9008
|
quotation for the purpose of this subparagraph shall meet the |
9009
|
same criteria for a quotation as provided in sub-subparagraph |
9010
|
1.esub-subparagraph d. All policies which were previously |
9011
|
written for that class shall continue in force until their |
9012
|
normal expiration date, at which time, subject to the required |
9013
|
timely notification of nonrenewal by the Joint Underwriting |
9014
|
Association, the insured may then elect to reapply to the Joint |
9015
|
Underwriting Association according to the requirements of |
9016
|
eligibility. If, upon reapplication, those previously insured |
9017
|
Joint Underwriting Association risks meet the eligibility |
9018
|
requirements, the Joint Underwriting Association shall provide |
9019
|
the coverage requested. |
9020
|
10. A means for providing credits to insurers against any |
9021
|
deficit assessment levied pursuant to paragraph (c), for risks |
9022
|
voluntarily written through the market assistance plan by such |
9023
|
insurers. |
9024
|
11. That the Joint Underwriting Association shall operate |
9025
|
subject to the supervision and approval of a board of governors |
9026
|
consisting of 13 individuals appointed by the Chief Financial |
9027
|
OfficerInsurance Commissioner, and shall have an executive or |
9028
|
underwriting committee. At least four of the members shall be |
9029
|
representatives of insurance trade associations as follows: one |
9030
|
member from the American Insurance Association, one member from |
9031
|
the Alliance of American Insurers, one member from the National |
9032
|
Association of Independent Insurers, and one member from an |
9033
|
unaffiliated insurer writing coverage on a national basis. Two |
9034
|
representatives shall be from two of the statewide agents' |
9035
|
associations. Each board member shall be appointed to serve for |
9036
|
2-year terms beginning on a date designated by the plan and |
9037
|
shall serve at the pleasure of the Chief Financial Officer |
9038
|
commissioner. Members may be reappointed for subsequent terms. |
9039
|
(b) Rates used by the Joint Underwriting Association shall |
9040
|
be actuarially sound. To the extent applicable, the rate |
9041
|
standards set forth in s. 627.062 shall be considered by the |
9042
|
officedepartmentin establishing rates to be used by the joint |
9043
|
underwriting plan. The initial rate level shall be determined |
9044
|
using the rates, rules, rating plans, and classifications |
9045
|
contained in the most current Insurance Services Office (ISO) |
9046
|
filing with the officedepartmentor the filing of other |
9047
|
licensed rating organizations with an additional increment of 25 |
9048
|
percent of premium. For any type of coverage or classification |
9049
|
which lends itself to manual rating for which the Insurance |
9050
|
Services Office or another licensed rating organization does not |
9051
|
file or publish a rate, the Joint Underwriting Association shall |
9052
|
file and use an initial rate based on the average current market |
9053
|
rate. The initial rate level for the rate plan shall also be |
9054
|
subject to an experience and schedule rating plan which may |
9055
|
produce a maximum of 25 percent debits or credits. For any risk |
9056
|
which does not lend itself to manual rating and for which no |
9057
|
rate has been promulgated under the rate plan, the board shall |
9058
|
develop and file with the officecommissioner, subject to its |
9059
|
his or herapproval, appropriate criteria and factors for rating |
9060
|
the individual risk. Such criteria and factors shall include, |
9061
|
but not be limited to, loss rating plans, composite rating |
9062
|
plans, and unique and unusual risk rating plans. The initial |
9063
|
rates required under this paragraph shall be adjusted in |
9064
|
conformity with future filings by the Insurance Services Office |
9065
|
with the officedepartmentand shall remain in effect until such |
9066
|
time as the Joint Underwriting Association has sufficient data |
9067
|
as to independently justify an actuarially sound change in such |
9068
|
rates. |
9069
|
(c)1. In the event an underwriting deficit exists for any |
9070
|
policy year the plan is in effect, any surplus which has accrued |
9071
|
from previous years and is not projected within reasonable |
9072
|
actuarial certainty to be needed for payment for claims in the |
9073
|
year the surplus arose shall be used to offset the deficit to |
9074
|
the extent available. |
9075
|
2. As to any remaining deficit, the board of governors of |
9076
|
the Joint Underwriting Association shall levy and collect an |
9077
|
assessment in an amount sufficient to offset such deficit. Such |
9078
|
assessment shall be levied against the insurers participating in |
9079
|
the plan during the year giving rise to the assessment. Any |
9080
|
assessments against insurers for the lines of property and |
9081
|
casualty insurance issued to commercial risks shall be recovered |
9082
|
from the participating insurers in the proportion that the net |
9083
|
direct premium of each insurer for commercial risks written |
9084
|
during the preceding calendar year bears to the aggregate net |
9085
|
direct premium written for commercial risks by all members of |
9086
|
the plan for the lines of insurance included in the plan. Any |
9087
|
assessments against insurers for the lines of property and |
9088
|
casualty insurance issued to personal risks eligible under sub- |
9089
|
subparagraph (a)1.a. or sub-subparagraph (a)1.c. shall be |
9090
|
recovered from the participating insurers in the proportion that |
9091
|
the net direct premium of each insurer for personal risks |
9092
|
written during the preceding calendar year bears to the |
9093
|
aggregate net direct premium written for personal risks by all |
9094
|
members of the plan for the lines of insurance included in the |
9095
|
plan. |
9096
|
3. The board shall take all reasonable and prudent steps |
9097
|
necessary to collect the amount of assessment due from each |
9098
|
participating insurer and policyholder, including, if prudent, |
9099
|
filing suit to collect such assessment. If the board is unable |
9100
|
to collect an assessment from any insurer, the uncollected |
9101
|
assessments shall be levied as an additional assessment against |
9102
|
the participating insurers and any participating insurer |
9103
|
required to pay an additional assessment as a result of such |
9104
|
failure to pay shall have a cause of action against such |
9105
|
nonpaying insurer. |
9106
|
4. Any funds or entitlements that the state may be |
9107
|
eligible to receive by virtue of the Federal Government's |
9108
|
termination of the Federal Crime Insurance Program referenced in |
9109
|
sub-subparagraph (a)1.c. may be used under the plan to offset |
9110
|
any subsequent underwriting deficits that may occur from risks |
9111
|
previously insured with the Federal Crime Insurance Program. |
9112
|
5. Assessments shall be included as an appropriate factor |
9113
|
in the making of rates as provided in s. 627.3512. |
9114
|
6.a. The Legislature finds that the potential for |
9115
|
unlimited assessments under this paragraph may induce insurers |
9116
|
to attempt to reduce their writings in the voluntary market, and |
9117
|
that such actions would worsen the availability problems that |
9118
|
the association was created to remedy. It is the intent of the |
9119
|
Legislature that insurers remain fully responsible for covering |
9120
|
any deficits of the association; however, it is also the intent |
9121
|
of the Legislature to provide a means by which assessment |
9122
|
liabilities may be amortized over a period of years. |
9123
|
b. The total amount of deficit assessments under this |
9124
|
paragraph with respect to any year may not exceed 10 percent of |
9125
|
the statewide total gross written premium for all insurers for |
9126
|
the coverages referred to in the introductory language of this |
9127
|
subsection for the prior year, except that if the deficit with |
9128
|
respect to any plan year exceeds such amount and bonds are |
9129
|
issued under sub-subparagraph c. to defray the deficit, the |
9130
|
total amount of assessments with respect to such deficit may not |
9131
|
in any year exceed 10 percent of the deficit, or such lesser |
9132
|
percentage as is sufficient to retire the bonds as determined by |
9133
|
the board, and shall continue annually until the bonds are |
9134
|
retired. |
9135
|
c. The governing body of any unit of local government, any |
9136
|
residents or businesses of which are insured by the association, |
9137
|
may issue bonds as defined in s. 125.013 or s. 166.101 from time |
9138
|
to time to fund an assistance program, in conjunction with the |
9139
|
association, for the purpose of defraying deficits of the |
9140
|
association. Revenue bonds may not be issued until validated |
9141
|
pursuant to chapter 75, unless a state of emergency is declared |
9142
|
by executive order or proclamation of the Governor pursuant to |
9143
|
s. 252.36 making such findings as are necessary to determine |
9144
|
that it is in the best interests of, and necessary for, the |
9145
|
protection of the public health, safety, and general welfare of |
9146
|
residents of this state and the protection and preservation of |
9147
|
the economic stability of insurers operating in this state, and |
9148
|
declaring it an essential public purpose to permit certain |
9149
|
municipalities or counties to issue such bonds as will provide |
9150
|
relief to claimants and policyholders of the joint underwriting |
9151
|
association and insurers responsible for apportionment of |
9152
|
association losses. The unit of local government shall enter |
9153
|
into such contracts with the association as are necessary to |
9154
|
carry out this paragraph. Any bonds issued under this sub- |
9155
|
subparagraph shall be payable from and secured by moneys |
9156
|
received by the association from assessments under this |
9157
|
paragraph, and assigned and pledged to or on behalf of the unit |
9158
|
of local government for the benefit of the holders of such |
9159
|
bonds. The funds, credit, property, and taxing power of the |
9160
|
state or of the unit of local government shall not be pledged |
9161
|
for the payment of such bonds. If any of the bonds remain unsold |
9162
|
60 days after issuance, the officedepartmentshall require all |
9163
|
insurers subject to assessment to purchase the bonds, which |
9164
|
shall be treated as admitted assets; each insurer shall be |
9165
|
required to purchase that percentage of the unsold portion of |
9166
|
the bond issue that equals the insurer's relative share of |
9167
|
assessment liability under this subsection. An insurer shall not |
9168
|
be required to purchase the bonds to the extent that the office |
9169
|
departmentdetermines that the purchase would endanger or impair |
9170
|
the solvency of the insurer. |
9171
|
7. The plan shall provide for the deferment, in whole or |
9172
|
in part, of the assessment of an insurer if the office |
9173
|
departmentfinds that payment of the assessment would endanger |
9174
|
or impair the solvency of the insurer. In the event an |
9175
|
assessment against an insurer is deferred in whole or in part, |
9176
|
the amount by which such assessment is deferred may be assessed |
9177
|
against the other member insurers in a manner consistent with |
9178
|
the basis for assessments set forth in subparagraph 2. |
9179
|
(d) Upon adoption of the plan, all insurers authorized in |
9180
|
this state to underwrite property or casualty insurance shall |
9181
|
participate in the plan. |
9182
|
(e) A Risk Underwriting Committee of the Joint |
9183
|
Underwriting Association composed of three members experienced |
9184
|
in evaluating insurance risks is created to review risks |
9185
|
rejected by the voluntary market for which application is made |
9186
|
for insurance through the joint underwriting plan. The committee |
9187
|
shall consist of a representative of the market assistance plan |
9188
|
created under s. 627.3515, a member selected by the insurers |
9189
|
participating in the Joint Underwriting Association, and a |
9190
|
member named by the Chief Financial OfficerInsurance |
9191
|
Commissioner. The Risk Underwriting Committee shall appoint such |
9192
|
advisory committees as are provided for in the plan and are |
9193
|
necessary to conduct its functions. The salaries and expenses of |
9194
|
the members of the Risk Underwriting Committee and its advisory |
9195
|
committees shall be paid by the joint underwriting plan. The |
9196
|
plan approved by the officedepartmentshall establish criteria |
9197
|
and procedures for use by the Risk Underwriting Committee for |
9198
|
determining whether an individual risk is so hazardous as to be |
9199
|
uninsurable. In making this determination and in establishing |
9200
|
the criteria and procedures, the following shall be considered: |
9201
|
1. Whether the likelihood of a loss for the individual |
9202
|
risk is substantially higher than for other risks of the same |
9203
|
class; and |
9204
|
2. Whether the uncertainty associated with the individual |
9205
|
risk is such that an appropriate premium cannot be determined. |
9206
|
|
9207
|
|
9208
|
The acceptance or rejection of a risk by the underwriting |
9209
|
committee shall be construed as the private placement of |
9210
|
insurance, and the provisions of chapter 120 shall not apply. |
9211
|
(f) There shall be no liability on the part of, and no |
9212
|
cause of action of any nature shall arise against, any member |
9213
|
insurer or its agents or employees, the Florida Property and |
9214
|
Casualty Joint Underwriting Association or its agents or |
9215
|
employees, members of the board of governors, the Chief |
9216
|
Financial Officer, or the officedepartmentor its |
9217
|
representatives for any action taken by them in the performance |
9218
|
of their duties under this subsection. Such immunity does not |
9219
|
apply to actions for breach of any contract or agreement |
9220
|
pertaining to insurance, or any other willful tort. |
9221
|
(6) CITIZENS PROPERTY INSURANCE CORPORATION.-- |
9222
|
(a)1. The Legislature finds that actual and threatened |
9223
|
catastrophic losses to property in this state from hurricanes |
9224
|
have caused insurers to be unwilling or unable to provide |
9225
|
property insurance coverage to the extent sought and needed. It |
9226
|
is in the public interest and a public purpose to assist in |
9227
|
assuring that property in the state is insured so as to |
9228
|
facilitate the remediation, reconstruction, and replacement of |
9229
|
damaged or destroyed property in order to reduce or avoid the |
9230
|
negative effects otherwise resulting to the public health, |
9231
|
safety, and welfare; to the economy of the state; and to the |
9232
|
revenues of the state and local governments needed to provide |
9233
|
for the public welfare. It is necessary, therefore, to provide |
9234
|
property insurance to applicants who are in good faith entitled |
9235
|
to procure insurance through the voluntary market but are unable |
9236
|
to do so. The Legislature intends by this subsection that |
9237
|
property insurance be provided and that it continues, as long as |
9238
|
necessary, through an entity organized to achieve efficiencies |
9239
|
and economies, all toward the achievement of the foregoing |
9240
|
public purposes. Because it is essential for the corporation to |
9241
|
have the maximum financial resources to pay claims following a |
9242
|
catastrophic hurricane, it is the intent of the Legislature that |
9243
|
the income of the corporation be exempt from federal income |
9244
|
taxation and that interest on the debt obligations issued by the |
9245
|
corporation be exempt from federal income taxation. |
9246
|
2. The Residential Property and Casualty Joint |
9247
|
Underwriting Association originally created by this statute |
9248
|
shall be known, as of July 1, 2002, as the Citizens Property |
9249
|
Insurance Corporation. The corporation shall provide insurance |
9250
|
for residential and commercial property, for applicants who are |
9251
|
in good faith entitled, but are unable, to procure insurance |
9252
|
through the voluntary market. The corporation shall operate |
9253
|
pursuant to a plan of operation approved by order of the office |
9254
|
department. The plan is subject to continuous review by the |
9255
|
officedepartment. The officedepartmentmay, by order, withdraw |
9256
|
approval of all or part of a plan if the officedepartment |
9257
|
determines that conditions have changed since approval was |
9258
|
granted and that the purposes of the plan require changes in the |
9259
|
plan. For the purposes of this subsection, residential coverage |
9260
|
includes both personal lines residential coverage, which |
9261
|
consists of the type of coverage provided by homeowner's, mobile |
9262
|
home owner's, dwelling, tenant's, condominium unit owner's, and |
9263
|
similar policies, and commercial lines residential coverage, |
9264
|
which consists of the type of coverage provided by condominium |
9265
|
association, apartment building, and similar policies. |
9266
|
(b)1. All insurers authorized to write one or more subject |
9267
|
lines of business in this state are subject to assessment by the |
9268
|
corporation and, for the purposes of this subsection, are |
9269
|
referred to collectively as "assessable insurers." Insurers |
9270
|
writing one or more subject lines of business in this state |
9271
|
pursuant to part VIII of chapter 626 are not assessable |
9272
|
insurers, but insureds who procure one or more subject lines of |
9273
|
business in this state pursuant to part VIII of chapter 626 are |
9274
|
subject to assessment by the corporation and are referred to |
9275
|
collectively as "assessable insureds." An authorized insurer's |
9276
|
assessment liability shall begin on the first day of the |
9277
|
calendar year following the year in which the insurer was issued |
9278
|
a certificate of authority to transact insurance for subject |
9279
|
lines of business in this state and shall terminate 1 year after |
9280
|
the end of the first calendar year during which the insurer no |
9281
|
longer holds a certificate of authority to transact insurance |
9282
|
for subject lines of business in this state. |
9283
|
2.a. All revenues, assets, liabilities, losses, and |
9284
|
expenses of the corporation shall be divided into three separate |
9285
|
accounts as follows: |
9286
|
(I) A personal lines account for personal residential |
9287
|
policies issued by the corporation or issued by the Residential |
9288
|
Property and Casualty Joint Underwriting Association and renewed |
9289
|
by the corporation that provide comprehensive, multiperil |
9290
|
coverage on risks that are not located in areas eligible for |
9291
|
coverage in the Florida Windstorm Underwriting Association as |
9292
|
those areas were defined on January 1, 2002 and for such |
9293
|
policies that do not provide coverage for the peril of wind on |
9294
|
risks that are located in such areas; |
9295
|
(II) A commercial lines account for commercial residential |
9296
|
policies issued by the corporation or issued by the Residential |
9297
|
Property and Casualty Joint Underwriting Association and renewed |
9298
|
by the corporation that provide coverage for basic property |
9299
|
perils on risks that are not located in areas eligible for |
9300
|
coverage in the Florida Windstorm Underwriting Association as |
9301
|
those areas were defined on January 1, 2002, and for such |
9302
|
policies that do not provide coverage for the peril of wind on |
9303
|
risks that are located in such areas; and |
9304
|
(III) A high-risk account for personal residential |
9305
|
policies and commercial residential and commercial |
9306
|
nonresidential property policies issued by the corporation or |
9307
|
transferred to the corporation that provide coverage for the |
9308
|
peril of wind on risks that are located in areas eligible for |
9309
|
coverage in the Florida Windstorm Underwriting Association as |
9310
|
those areas were defined on January 1, 2002. The high-risk |
9311
|
account must also include quota share primary insurance under |
9312
|
subparagraph (c)2. The area eligible for coverage under the |
9313
|
high-risk account also includes the area within Port Canaveral, |
9314
|
which is bordered on the south by the City of Cape Canaveral, |
9315
|
bordered on the west by the Banana River, and bordered on the |
9316
|
north by Federal Government property. The officedepartmentmay |
9317
|
remove territory from the area eligible for wind-only and quota |
9318
|
share coverage if, after a public hearing, the officedepartment |
9319
|
finds that authorized insurers in the voluntary market are |
9320
|
willing and able to write sufficient amounts of personal and |
9321
|
commercial residential coverage for all perils in the territory, |
9322
|
including coverage for the peril of wind, such that risks |
9323
|
covered by wind-only policies in the removed territory could be |
9324
|
issued a policy by the corporation in either the personal lines |
9325
|
or commercial lines account without a significant increase in |
9326
|
the corporation's probable maximum loss in such account. Removal |
9327
|
of territory from the area eligible for wind-only or quota share |
9328
|
coverage does not alter the assignment of wind coverage written |
9329
|
in such areas to the high-risk account. |
9330
|
b. The three separate accounts must be maintained as long |
9331
|
as financing obligations entered into by the Florida Windstorm |
9332
|
Underwriting Association or Residential Property and Casualty |
9333
|
Joint Underwriting Association are outstanding, in accordance |
9334
|
with the terms of the corresponding financing documents. When |
9335
|
the financing obligations are no longer outstanding, in |
9336
|
accordance with the terms of the corresponding financing |
9337
|
documents, the corporation may use a single account for all |
9338
|
revenues, assets, liabilities, losses, and expenses of the |
9339
|
corporation. |
9340
|
c. Creditors of the Residential Property and Casualty |
9341
|
Joint Underwriting Association shall have a claim against, and |
9342
|
recourse to, the accounts referred to in sub-sub-subparagraphs |
9343
|
a.(I) and (II) and shall have no claim against, or recourse to, |
9344
|
the account referred to in sub-sub-subparagraph a.(III). |
9345
|
Creditors of the Florida Windstorm Underwriting Association |
9346
|
shall have a claim against, and recourse to, the account |
9347
|
referred to in sub-sub-subparagraph a.(III) and shall have no |
9348
|
claim against, or recourse to, the accounts referred to in sub- |
9349
|
sub-subparagraphs a.(I) and (II). |
9350
|
d. Revenues, assets, liabilities, losses, and expenses not |
9351
|
attributable to particular accounts shall be prorated among the |
9352
|
accounts. |
9353
|
e. The Legislature finds that the revenues of the |
9354
|
corporation are revenues that are necessary to meet the |
9355
|
requirements set forth in documents authorizing the issuance of |
9356
|
bonds under this subsection. |
9357
|
f. No part of the income of the corporation may inure to |
9358
|
the benefit of any private person. |
9359
|
3. With respect to a deficit in an account: |
9360
|
a. When the deficit incurred in a particular calendar year |
9361
|
is not greater than 10 percent of the aggregate statewide direct |
9362
|
written premium for the subject lines of business for the prior |
9363
|
calendar year, the entire deficit shall be recovered through |
9364
|
regular assessments of assessable insurers under paragraph (g) |
9365
|
and assessable insureds. |
9366
|
b. When the deficit incurred in a particular calendar year |
9367
|
exceeds 10 percent of the aggregate statewide direct written |
9368
|
premium for the subject lines of business for the prior calendar |
9369
|
year, the corporation shall levy regular assessments on |
9370
|
assessable insurers under paragraph (g) and on assessable |
9371
|
insureds in an amount equal to the greater of 10 percent of the |
9372
|
deficit or 10 percent of the aggregate statewide direct written |
9373
|
premium for the subject lines of business for the prior calendar |
9374
|
year. Any remaining deficit shall be recovered through emergency |
9375
|
assessments under sub-subparagraph d. |
9376
|
c. Each assessable insurer's share of the amount being |
9377
|
assessed under sub-subparagraph a. or sub-subparagraph b. shall |
9378
|
be in the proportion that the assessable insurer's direct |
9379
|
written premium for the subject lines of business for the year |
9380
|
preceding the assessment bears to the aggregate statewide direct |
9381
|
written premium for the subject lines of business for that year. |
9382
|
The assessment percentage applicable to each assessable insured |
9383
|
is the ratio of the amount being assessed under sub-subparagraph |
9384
|
a. or sub-subparagraph b. to the aggregate statewide direct |
9385
|
written premium for the subject lines of business for the prior |
9386
|
year. Assessments levied by the corporation on assessable |
9387
|
insurers under sub-subparagraphs a. and b. shall be paid as |
9388
|
required by the corporation's plan of operation and paragraph |
9389
|
(g). Assessments levied by the corporation on assessable |
9390
|
insureds under sub-subparagraphs a. and b. shall be collected by |
9391
|
the surplus lines agent at the time the surplus lines agent |
9392
|
collects the surplus lines tax required by s. 626.932 and shall |
9393
|
be paid to the Florida Surplus Lines Service Office at the time |
9394
|
the surplus lines agent pays the surplus lines tax to the |
9395
|
Florida Surplus Lines Service Office. Upon receipt of regular |
9396
|
assessments from surplus lines agents, the Florida Surplus Lines |
9397
|
Service Office shall transfer the assessments directly to the |
9398
|
corporation as determined by the corporation. |
9399
|
d. Upon a determination by the board of governors that a |
9400
|
deficit in an account exceeds the amount that will be recovered |
9401
|
through regular assessments under sub-subparagraph a. or sub- |
9402
|
subparagraph b., the board shall levy, after verification by the |
9403
|
officedepartment, emergency assessments, for as many years as |
9404
|
necessary to cover the deficits, to be collected by assessable |
9405
|
insurers and the corporation and collected from assessable |
9406
|
insureds upon issuance or renewal of policies for subject lines |
9407
|
of business, excluding National Flood Insurance policies. The |
9408
|
amount of the emergency assessment collected in a particular |
9409
|
year shall be a uniform percentage of that year's direct written |
9410
|
premium for subject lines of business and all accounts of the |
9411
|
corporation, excluding National Flood Insurance Program policy |
9412
|
premiums, as annually determined by the board and verified by |
9413
|
the officedepartment. The officedepartmentshall verify the |
9414
|
arithmetic calculations involved in the board's determination |
9415
|
within 30 days after receipt of the information on which the |
9416
|
determination was based. Notwithstanding any other provision of |
9417
|
law, the corporation and each assessable insurer that writes |
9418
|
subject lines of business shall collect emergency assessments |
9419
|
from its policyholders without such obligation being affected by |
9420
|
any credit, limitation, exemption, or deferment. Emergency |
9421
|
assessments levied by the corporation on assessable insureds |
9422
|
shall be collected by the surplus lines agent at the time the |
9423
|
surplus lines agent collects the surplus lines tax required by |
9424
|
s. 626.932 and shall be paid to the Florida Surplus Lines |
9425
|
Service Office at the time the surplus lines agent pays the |
9426
|
surplus lines tax to the Florida Surplus Lines Service Office. |
9427
|
The emergency assessments so collected shall be transferred |
9428
|
directly to the corporation on a periodic basis as determined by |
9429
|
the corporation and shall be held by the corporation solely in |
9430
|
the applicable account. The aggregate amount of emergency |
9431
|
assessments levied for an account under this sub-subparagraph in |
9432
|
any calendar year may not exceed the greater of 10 percent of |
9433
|
the amount needed to cover the original deficit, plus interest, |
9434
|
fees, commissions, required reserves, and other costs associated |
9435
|
with financing of the original deficit, or 10 percent of the |
9436
|
aggregate statewide direct written premium for subject lines of |
9437
|
business and for all accounts of the corporation for the prior |
9438
|
year, plus interest, fees, commissions, required reserves, and |
9439
|
other costs associated with financing the original deficit. |
9440
|
e. The corporation may pledge the proceeds of assessments, |
9441
|
projected recoveries from the Florida Hurricane Catastrophe |
9442
|
Fund, other insurance and reinsurance recoverables, market |
9443
|
equalization surcharges and other surcharges, and other funds |
9444
|
available to the corporation as the source of revenue for and to |
9445
|
secure bonds issued under paragraph (g), bonds or other |
9446
|
indebtedness issued under subparagraph (c)3., or lines of credit |
9447
|
or other financing mechanisms issued or created under this |
9448
|
subsection, or to retire any other debt incurred as a result of |
9449
|
deficits or events giving rise to deficits, or in any other way |
9450
|
that the board determines will efficiently recover such |
9451
|
deficits. The purpose of the lines of credit or other financing |
9452
|
mechanisms is to provide additional resources to assist the |
9453
|
corporation in covering claims and expenses attributable to a |
9454
|
catastrophe. As used in this subsection, the term "assessments" |
9455
|
includes regular assessments under sub-subparagraph a., sub- |
9456
|
subparagraph b., or subparagraph (g)1. and emergency assessments |
9457
|
under sub-subparagraph d. Emergency assessments collected under |
9458
|
sub-subparagraph d. are not part of an insurer's rates, are not |
9459
|
premium, and are not subject to premium tax, fees, or |
9460
|
commissions; however, failure to pay the emergency assessment |
9461
|
shall be treated as failure to pay premium. The emergency |
9462
|
assessments under sub-subparagraph d. shall continue as long as |
9463
|
any bonds issued or other indebtedness incurred with respect to |
9464
|
a deficit for which the assessment was imposed remain |
9465
|
outstanding, unless adequate provision has been made for the |
9466
|
payment of such bonds or other indebtedness pursuant to the |
9467
|
documents governing such bonds or other indebtedness. |
9468
|
f. As used in this subsection, the term "subject lines of |
9469
|
business" means insurance written by assessable insurers or |
9470
|
procured by assessable insureds on real or personal property, as |
9471
|
defined in s. 624.604, including insurance for fire, industrial |
9472
|
fire, allied lines, farmowners multiperil, homeowners |
9473
|
multiperil, commercial multiperil, and mobile homes, and |
9474
|
including liability coverage on all such insurance, but |
9475
|
excluding inland marine as defined in s. 624.607(3) and |
9476
|
excluding vehicle insurance as defined in s. 624.605(1) other |
9477
|
than insurance on mobile homes used as permanent dwellings. |
9478
|
g. The Florida Surplus Lines Service Office shall |
9479
|
determine annually the aggregate statewide written premium in |
9480
|
subject lines of business procured by assessable insureds and |
9481
|
shall report that information to the corporation in a form and |
9482
|
at a time the corporation specifies to ensure that the |
9483
|
corporation can meet the requirements of this subsection and the |
9484
|
corporation's financing obligations. |
9485
|
h. The Florida Surplus Lines Service Office shall verify |
9486
|
the proper application by surplus lines agents of assessment |
9487
|
percentages for regular assessments and emergency assessments |
9488
|
levied under this subparagraph on assessable insureds and shall |
9489
|
assist the corporation in ensuring the accurate, timely |
9490
|
collection and payment of assessments by surplus lines agents as |
9491
|
required by the corporation. |
9492
|
(c) The plan of operation of the corporation: |
9493
|
1. Must provide for adoption of residential property and |
9494
|
casualty insurance policy forms and commercial residential and |
9495
|
nonresidential property insurance forms, which forms must be |
9496
|
approved by the officedepartmentprior to use. The corporation |
9497
|
shall adopt the following policy forms: |
9498
|
a. Standard personal lines policy forms that are |
9499
|
comprehensive multiperil policies providing full coverage of a |
9500
|
residential property equivalent to the coverage provided in the |
9501
|
private insurance market under an HO-3, HO-4, or HO-6 policy. |
9502
|
b. Basic personal lines policy forms that are policies |
9503
|
similar to an HO-8 policy or a dwelling fire policy that provide |
9504
|
coverage meeting the requirements of the secondary mortgage |
9505
|
market, but which coverage is more limited than the coverage |
9506
|
under a standard policy. |
9507
|
c. Commercial lines residential policy forms that are |
9508
|
generally similar to the basic perils of full coverage |
9509
|
obtainable for commercial residential structures in the admitted |
9510
|
voluntary market. |
9511
|
d. Personal lines and commercial lines residential |
9512
|
property insurance forms that cover the peril of wind only. The |
9513
|
forms are applicable only to residential properties located in |
9514
|
areas eligible for coverage under the high-risk account referred |
9515
|
to in sub-subparagraph (b)2.a. |
9516
|
e. Commercial lines nonresidential property insurance |
9517
|
forms that cover the peril of wind only. The forms are |
9518
|
applicable only to nonresidential properties located in areas |
9519
|
eligible for coverage under the high-risk account referred to in |
9520
|
sub-subparagraph (b)2.a. |
9521
|
2.a. Must provide that the corporation adopt a program in |
9522
|
which the corporation and authorized insurers enter into quota |
9523
|
share primary insurance agreements for hurricane coverage, as |
9524
|
defined in s. 627.4025(2)(a), for eligible risks, and adopt |
9525
|
property insurance forms for eligible risks which cover the |
9526
|
peril of wind only. As used in this subsection, the term: |
9527
|
(I) "Quota share primary insurance" means an arrangement |
9528
|
in which the primary hurricane coverage of an eligible risk is |
9529
|
provided in specified percentages by the corporation and an |
9530
|
authorized insurer. The corporation and authorized insurer are |
9531
|
each solely responsible for a specified percentage of hurricane |
9532
|
coverage of an eligible risk as set forth in a quota share |
9533
|
primary insurance agreement between the corporation and an |
9534
|
authorized insurer and the insurance contract. The |
9535
|
responsibility of the corporation or authorized insurer to pay |
9536
|
its specified percentage of hurricane losses of an eligible |
9537
|
risk, as set forth in the quota share primary insurance |
9538
|
agreement, may not be altered by the inability of the other |
9539
|
party to the agreement to pay its specified percentage of |
9540
|
hurricane losses. Eligible risks that are provided hurricane |
9541
|
coverage through a quota share primary insurance arrangement |
9542
|
must be provided policy forms that set forth the obligations of |
9543
|
the corporation and authorized insurer under the arrangement, |
9544
|
clearly specify the percentages of quota share primary insurance |
9545
|
provided by the corporation and authorized insurer, and |
9546
|
conspicuously and clearly state that neither the authorized |
9547
|
insurer nor the corporation may be held responsible beyond its |
9548
|
specified percentage of coverage of hurricane losses. |
9549
|
(II) "Eligible risks" means personal lines residential and |
9550
|
commercial lines residential risks that meet the underwriting |
9551
|
criteria of the corporation and are located in areas that were |
9552
|
eligible for coverage by the Florida Windstorm Underwriting |
9553
|
Association on January 1, 2002. |
9554
|
b. The corporation may enter into quota share primary |
9555
|
insurance agreements with authorized insurers at corporation |
9556
|
coverage levels of 90 percent and 50 percent. |
9557
|
c. If the corporation determines that additional coverage |
9558
|
levels are necessary to maximize participation in quota share |
9559
|
primary insurance agreements by authorized insurers, the |
9560
|
corporation may establish additional coverage levels. However, |
9561
|
the corporation's quota share primary insurance coverage level |
9562
|
may not exceed 90 percent. |
9563
|
d. Any quota share primary insurance agreement entered |
9564
|
into between an authorized insurer and the corporation must |
9565
|
provide for a uniform specified percentage of coverage of |
9566
|
hurricane losses, by county or territory as set forth by the |
9567
|
corporation board, for all eligible risks of the authorized |
9568
|
insurer covered under the quota share primary insurance |
9569
|
agreement. |
9570
|
e. Any quota share primary insurance agreement entered |
9571
|
into between an authorized insurer and the corporation is |
9572
|
subject to review and approval by the officedepartment. |
9573
|
However, such agreement shall be authorized only as to insurance |
9574
|
contracts entered into between an authorized insurer and an |
9575
|
insured who is already insured by the corporation for wind |
9576
|
coverage. |
9577
|
f. For all eligible risks covered under quota share |
9578
|
primary insurance agreements, the exposure and coverage levels |
9579
|
for both the corporation and authorized insurers shall be |
9580
|
reported by the corporation to the Florida Hurricane Catastrophe |
9581
|
Fund. For all policies of eligible risks covered under quota |
9582
|
share primary insurance agreements, the corporation and the |
9583
|
authorized insurer shall maintain complete and accurate records |
9584
|
for the purpose of exposure and loss reimbursement audits as |
9585
|
required by Florida Hurricane Catastrophe Fund rules. The |
9586
|
corporation and the authorized insurer shall each maintain |
9587
|
duplicate copies of policy declaration pages and supporting |
9588
|
claims documents. |
9589
|
g. The corporation board shall establish in its plan of |
9590
|
operation standards for quota share agreements which ensure that |
9591
|
there is no discriminatory application among insurers as to the |
9592
|
terms of quota share agreements, pricing of quota share |
9593
|
agreements, incentive provisions if any, and consideration paid |
9594
|
for servicing policies or adjusting claims. |
9595
|
h. The quota share primary insurance agreement between the |
9596
|
corporation and an authorized insurer must set forth the |
9597
|
specific terms under which coverage is provided, including, but |
9598
|
not limited to, the sale and servicing of policies issued under |
9599
|
the agreement by the insurance agent of the authorized insurer |
9600
|
producing the business, the reporting of information concerning |
9601
|
eligible risks, the payment of premium to the corporation, and |
9602
|
arrangements for the adjustment and payment of hurricane claims |
9603
|
incurred on eligible risks by the claims adjuster and personnel |
9604
|
of the authorized insurer. Entering into a quota sharing |
9605
|
insurance agreement between the corporation and an authorized |
9606
|
insurer shall be voluntary and at the discretion of the |
9607
|
authorized insurer. |
9608
|
3. May provide that the corporation may employ or |
9609
|
otherwise contract with individuals or other entities to provide |
9610
|
administrative or professional services that may be appropriate |
9611
|
to effectuate the plan. The corporation shall have the power to |
9612
|
borrow funds, by issuing bonds or by incurring other |
9613
|
indebtedness, and shall have other powers reasonably necessary |
9614
|
to effectuate the requirements of this subsection. The |
9615
|
corporation may, but is not required to, seek judicial |
9616
|
validation of its bonds or other indebtedness under chapter 75. |
9617
|
The corporation may issue bonds or incur other indebtedness, or |
9618
|
have bonds issued on its behalf by a unit of local government |
9619
|
pursuant to subparagraph(g)2., in the absence of a hurricane or |
9620
|
other weather-related event, upon a determination by the |
9621
|
corporation, subject to approval by the officedepartment, that |
9622
|
such action would enable it to efficiently meet the financial |
9623
|
obligations of the corporation and that such financings are |
9624
|
reasonably necessary to effectuate the requirements of this |
9625
|
subsection. The corporation is authorized to take all actions |
9626
|
needed to facilitate tax-free status for any such bonds or |
9627
|
indebtedness, including formation of trusts or other affiliated |
9628
|
entities. The corporation shall have the authority to pledge |
9629
|
assessments, projected recoveries from the Florida Hurricane |
9630
|
Catastrophe Fund, other reinsurance recoverables, market |
9631
|
equalization and other surcharges, and other funds available to |
9632
|
the corporation as security for bonds or other indebtedness. In |
9633
|
recognition of s. 10, Art. I of the State Constitution, |
9634
|
prohibiting the impairment of obligations of contracts, it is |
9635
|
the intent of the Legislature that no action be taken whose |
9636
|
purpose is to impair any bond indenture or financing agreement |
9637
|
or any revenue source committed by contract to such bond or |
9638
|
other indebtedness. |
9639
|
4.a.Must require that the corporation operate subject to |
9640
|
the supervision and approval of a board of governors consisting |
9641
|
of 7 individuals who are residents of this state, from different |
9642
|
geographical areas of this state, appointed by the Chief |
9643
|
Financial OfficerTreasurer. The Chief Financial Officer |
9644
|
Treasurershall designate one of the appointees as chair. All |
9645
|
board members serve at the pleasure of the Chief Financial |
9646
|
OfficerTreasurer. All board members, including the chair, must |
9647
|
be appointed to serve for 3-year terms beginning annually on a |
9648
|
date designated by the plan. Any board vacancy shall be filled |
9649
|
for the unexpired term by the Chief Financial OfficerTreasurer. |
9650
|
The Chief Financial OfficerTreasurershall appoint a technical |
9651
|
advisory group to provide information and advice to the board of |
9652
|
governors in connection with the board's duties under this |
9653
|
subsection. The executive director and senior managers of the |
9654
|
corporation shall be engaged by the Chief Financial Officer |
9655
|
Treasurer and serve at the pleasure of the Chief Financial |
9656
|
OfficerTreasurer. The executive director is responsible for |
9657
|
employing other staff as the corporation may require, subject to |
9658
|
review and concurrence by the Office of the Chief Financial |
9659
|
OfficerTreasurer. |
9660
|
b. To ensure the effective and efficient implementation of |
9661
|
this subsection, the Treasurer shall appoint the board of |
9662
|
governors by July 1, 2002. The board of governors shall work in |
9663
|
conjunction with the Residential Property Insurance Market |
9664
|
Coordinating Council to address appropriate organizational, |
9665
|
operational, and financial matters relating to the corporation. |
9666
|
In addition, after consultation with the Residential Property |
9667
|
Insurance Market Coordinating Council, the bond trustees and |
9668
|
rating agencies, the Treasurer may postpone for a period not to |
9669
|
exceed 180 days after the effective date, the implementation of |
9670
|
the corporation or the implementation of one or more of the |
9671
|
provisions relating to transfer of Florida Windstorm |
9672
|
Underwriting Association policies, obligations, rights, assets, |
9673
|
and liabilities into the high-risk accounts and such other |
9674
|
provisions that may be affected thereby if the Treasurer |
9675
|
determines that postponement is necessary: |
9676
|
(I) Due to emergency conditions; |
9677
|
(II) To ensure the effective and efficient implementation |
9678
|
of the corporation's operations; or |
9679
|
(III) To maintain existing financing arrangements without |
9680
|
a material adverse effect on the creditors of the Residential |
9681
|
Property and Casualty Joint Underwriting Association or the |
9682
|
Florida Windstorm Underwriting Association. |
9683
|
5. Must provide a procedure for determining the |
9684
|
eligibility of a risk for coverage, as follows: |
9685
|
a. Subject to the provisions of s. 627.3517, with respect |
9686
|
to personal lines residential risks, if the risk is offered |
9687
|
coverage from an authorized insurer at the insurer's approved |
9688
|
rate under either a standard policy including wind coverage or, |
9689
|
if consistent with the insurer's underwriting rules as filed |
9690
|
with the officedepartment, a basic policy including wind |
9691
|
coverage, the risk is not eligible for any policy issued by the |
9692
|
corporationassociation. If the risk is not able to obtain any |
9693
|
such offer, the risk is eligible for either a standard policy |
9694
|
including wind coverage or a basic policy including wind |
9695
|
coverage issued by the corporationassociation; however, if the |
9696
|
risk could not be insured under a standard policy including wind |
9697
|
coverage regardless of market conditions, the risk shall be |
9698
|
eligible for a basic policy including wind coverage unless |
9699
|
rejected under subparagraph 8. The corporationassociationshall |
9700
|
determine the type of policy to be provided on the basis of |
9701
|
objective standards specified in the underwriting manual and |
9702
|
based on generally accepted underwriting practices. |
9703
|
(I) If the risk accepts an offer of coverage through the |
9704
|
market assistance plan or an offer of coverage through a |
9705
|
mechanism established by the corporationassociationbefore a |
9706
|
policy is issued to the risk by the corporationassociationor |
9707
|
during the first 30 days of coverage by the corporation |
9708
|
association, and the producing agent who submitted the |
9709
|
application to the plan or to the corporationassociationis not |
9710
|
currently appointed by the insurer, the insurer shall: |
9711
|
(A) Pay to the producing agent of record of the policy, |
9712
|
for the first year, an amount that is the greater of the |
9713
|
insurer's usual and customary commission for the type of policy |
9714
|
written or a fee equal to the usual and customary commission of |
9715
|
the corporationassociation; or |
9716
|
(B) Offer to allow the producing agent of record of the |
9717
|
policy to continue servicing the policy for a period of not less |
9718
|
than 1 year and offer to pay the agent the greater of the |
9719
|
insurer's or the corporation'sassociation'susual and customary |
9720
|
commission for the type of policy written. |
9721
|
|
9722
|
|
9723
|
If the producing agent is unwilling or unable to accept |
9724
|
appointment, the new insurer shall pay the agent in accordance |
9725
|
with sub-sub-sub-subparagraph (A). |
9726
|
(II) When the corporationassociationenters into a |
9727
|
contractual agreement for a take-out plan, the producing agent |
9728
|
of record of the corporationassociationpolicy is entitled to |
9729
|
retain any unearned commission on the policy, and the insurer |
9730
|
shall: |
9731
|
(A) Pay to the producing agent of record of the |
9732
|
corporationassociationpolicy, for the first year, an amount |
9733
|
that is the greater of the insurer's usual and customary |
9734
|
commission for the type of policy written or a fee equal to the |
9735
|
usual and customary commission of the corporationassociation; |
9736
|
or |
9737
|
(B) Offer to allow the producing agent of record of the |
9738
|
corporationassociationpolicy to continue servicing the policy |
9739
|
for a period of not less than 1 year and offer to pay the agent |
9740
|
the greater of the insurer's or the corporation'sassociation's |
9741
|
usual and customary commission for the type of policy written. |
9742
|
|
9743
|
|
9744
|
If the producing agent is unwilling or unable to accept |
9745
|
appointment, the new insurer shall pay the agent in accordance |
9746
|
with sub-sub-sub-subparagraph (A). |
9747
|
b. With respect to commercial lines residential risks, if |
9748
|
the risk is offered coverage under a policy including wind |
9749
|
coverage from an authorized insurer at its approved rate, the |
9750
|
risk is not eligible for any policy issued by the corporation |
9751
|
association. If the risk is not able to obtain any such offer, |
9752
|
the risk is eligible for a policy including wind coverage issued |
9753
|
by the corporationassociation. |
9754
|
(I) If the risk accepts an offer of coverage through the |
9755
|
market assistance plan or an offer of coverage through a |
9756
|
mechanism established by the corporationassociationbefore a |
9757
|
policy is issued to the risk by the corporationassociationor |
9758
|
during the first 30 days of coverage by the corporation |
9759
|
association, and the producing agent who submitted the |
9760
|
application to the plan or the corporationassociationis not |
9761
|
currently appointed by the insurer, the insurer shall: |
9762
|
(A) Pay to the producing agent of record of the policy, |
9763
|
for the first year, an amount that is the greater of the |
9764
|
insurer's usual and customary commission for the type of policy |
9765
|
written or a fee equal to the usual and customary commission of |
9766
|
the corporationassociation; or |
9767
|
(B) Offer to allow the producing agent of record of the |
9768
|
policy to continue servicing the policy for a period of not less |
9769
|
than 1 year and offer to pay the agent the greater of the |
9770
|
insurer's or the corporation'sassociation'susual and customary |
9771
|
commission for the type of policy written. |
9772
|
|
9773
|
|
9774
|
If the producing agent is unwilling or unable to accept |
9775
|
appointment, the new insurer shall pay the agent in accordance |
9776
|
with sub-sub-sub-subparagraph (A). |
9777
|
(II) When the corporationassociationenters into a |
9778
|
contractual agreement for a take-out plan, the producing agent |
9779
|
of record of the corporationassociationpolicy is entitled to |
9780
|
retain any unearned commission on the policy, and the insurer |
9781
|
shall: |
9782
|
(A) Pay to the producing agent of record of the |
9783
|
corporationassociationpolicy, for the first year, an amount |
9784
|
that is the greater of the insurer's usual and customary |
9785
|
commission for the type of policy written or a fee equal to the |
9786
|
usual and customary commission of the corporationassociation; |
9787
|
or |
9788
|
(B) Offer to allow the producing agent of record of the |
9789
|
corporationassociationpolicy to continue servicing the policy |
9790
|
for a period of not less than 1 year and offer to pay the agent |
9791
|
the greater of the insurer's or the corporation'sassociation's |
9792
|
usual and customary commission for the type of policy written. |
9793
|
|
9794
|
|
9795
|
If the producing agent is unwilling or unable to accept |
9796
|
appointment, the new insurer shall pay the agent in accordance |
9797
|
with sub-sub-sub-subparagraph (A). |
9798
|
c. This subparagraph does not require the association to |
9799
|
provide wind coverage or hurricane coverage in any area in which |
9800
|
such coverage is available through the Florida Windstorm |
9801
|
Underwriting Association. |
9802
|
6. Must include rules for classifications of risks and |
9803
|
rates therefor. |
9804
|
7. Must provide that if premium and investment income for |
9805
|
an account attributable to a particular calendar year are in |
9806
|
excess of projected losses and expenses for the account |
9807
|
attributable to that year, such excess shall be held in surplus |
9808
|
in the account. Such surplus shall be available to defray |
9809
|
deficits in that account as to future years and shall be used |
9810
|
for that purpose prior to assessing assessable insurers and |
9811
|
assessable insureds as to any calendar year. |
9812
|
8. Must provide objective criteria and procedures to be |
9813
|
uniformly applied for all applicants in determining whether an |
9814
|
individual risk is so hazardous as to be uninsurable. In making |
9815
|
this determination and in establishing the criteria and |
9816
|
procedures, the following shall be considered: |
9817
|
a. Whether the likelihood of a loss for the individual |
9818
|
risk is substantially higher than for other risks of the same |
9819
|
class; and |
9820
|
b. Whether the uncertainty associated with the individual |
9821
|
risk is such that an appropriate premium cannot be determined. |
9822
|
|
9823
|
|
9824
|
The acceptance or rejection of a risk by the corporation shall |
9825
|
be construed as the private placement of insurance, and the |
9826
|
provisions of chapter 120 shall not apply. |
9827
|
9. Must provide that the corporation shall make its best |
9828
|
efforts to procure catastrophe reinsurance at reasonable rates, |
9829
|
as determined by the board of governors. |
9830
|
10. Must provide that in the event of regular deficit |
9831
|
assessments under sub-subparagraph (b)3.a. or sub-subparagraph |
9832
|
(b)3.b., in the personal lines account, the commercial lines |
9833
|
residential account, or the high-risk account, the corporation |
9834
|
shall levy upon corporation policyholders in its next rate |
9835
|
filing, or by a separate rate filing solely for this purpose, a |
9836
|
market equalization surcharge arising from a regular assessment |
9837
|
in such account in a percentage equal to the total amount of |
9838
|
such regular assessments divided by the aggregate statewide |
9839
|
direct written premium for subject lines of business for the |
9840
|
prior calendar year. Market equalization surcharges under this |
9841
|
subparagraph are not considered premium and are not subject to |
9842
|
commissions, fees, or premium taxes; however, failure to pay a |
9843
|
market equalization surcharge shall be treated as failure to pay |
9844
|
premium. |
9845
|
11. The policies issued by the corporation must provide |
9846
|
that, if the corporation or the market assistance plan obtains |
9847
|
an offer from an authorized insurer to cover the risk at its |
9848
|
approved rates, the risk is no longer eligible for renewal |
9849
|
through the corporation. |
9850
|
12. Corporation policies and applications must include a |
9851
|
notice that the corporation policy could, under this section, be |
9852
|
replaced with a policy issued by an authorized insurer that does |
9853
|
not provide coverage identical to the coverage provided by the |
9854
|
corporation. The notice shall also specify that acceptance of |
9855
|
corporation coverage creates a conclusive presumption that the |
9856
|
applicant or policyholder is aware of this potential. |
9857
|
13. May establish, subject to approval by the office |
9858
|
department, different eligibility requirements and operational |
9859
|
procedures for any line or type of coverage for any specified |
9860
|
county or area if the board determines that such changes to the |
9861
|
eligibility requirements and operational procedures are |
9862
|
justified due to the voluntary market being sufficiently stable |
9863
|
and competitive in such area or for such line or type of |
9864
|
coverage and that consumers who, in good faith, are unable to |
9865
|
obtain insurance through the voluntary market through ordinary |
9866
|
methods would continue to have access to coverage from the |
9867
|
corporation. When coverage is sought in connection with a real |
9868
|
property transfer, such requirements and procedures shall not |
9869
|
provide for an effective date of coverage later than the date of |
9870
|
the closing of the transfer as established by the transferor, |
9871
|
the transferee, and, if applicable, the lender. |
9872
|
14. Must provide that, with respect to the high-risk |
9873
|
account, any assessable insurer with a surplus as to |
9874
|
policyholders of $25 million or less writing 25 percent or more |
9875
|
of its total countrywide property insurance premiums in this |
9876
|
state may petition the officedepartment, within the first 90 |
9877
|
days of each calendar year, to qualify as a limited |
9878
|
apportionment company. In no event shall a limited apportionment |
9879
|
company be required to participate in the portion of any |
9880
|
assessment, within the high-risk account, pursuant to sub- |
9881
|
subparagraph (b)3.a. or sub-subparagraph (b)3.b. in the |
9882
|
aggregate which exceeds $50 million after payment of available |
9883
|
high-risk account funds in any calendar year. However, a limited |
9884
|
apportionment company shall collect from its policyholders any |
9885
|
emergency assessment imposed under sub-subparagraph (b)3.d. The |
9886
|
plan shall provide that, if the officedepartmentdetermines |
9887
|
that any regular assessment will result in an impairment of the |
9888
|
surplus of a limited apportionment company, the office |
9889
|
departmentmay direct that all or part of such assessment be |
9890
|
deferred as provided in subparagraph (g)4. However, there shall |
9891
|
be no limitation or deferment of an emergency assessment to be |
9892
|
collected from policyholders under sub-subparagraph(b)3.d. |
9893
|
15. Must provide that the corporation appoint as its |
9894
|
licensed agents only those agents who also hold an appointment |
9895
|
as defined in s. 626.104 with an insurer who at the time of the |
9896
|
agent's initial appointment by the corporation is authorized to |
9897
|
write and is actually writing personal lines residential |
9898
|
property coverage, commercial residential property coverage, or |
9899
|
commercial nonresidential property coverage within the state. |
9900
|
(d)1. It is the intent of the Legislature that the rates |
9901
|
for coverage provided by the corporation be actuarially sound |
9902
|
and not competitive with approved rates charged in the admitted |
9903
|
voluntary market, so that the corporation functions as a |
9904
|
residual market mechanism to provide insurance only when the |
9905
|
insurance cannot be procured in the voluntary market. Rates |
9906
|
shall include an appropriate catastrophe loading factor that |
9907
|
reflects the actual catastrophic exposure of the corporation. |
9908
|
2. For each county, the average rates of the corporation |
9909
|
for each line of business for personal lines residential |
9910
|
policies excluding rates for wind-only policies shall be no |
9911
|
lower than the average rates charged by the insurer that had the |
9912
|
highest average rate in that county among the 20 insurers with |
9913
|
the greatest total direct written premium in the state for that |
9914
|
line of business in the preceding year, except that with respect |
9915
|
to mobile home coverages, the average rates of the corporation |
9916
|
shall be no lower than the average rates charged by the insurer |
9917
|
that had the highest average rate in that county among the 5 |
9918
|
insurers with the greatest total written premium for mobile home |
9919
|
owner's policies in the state in the preceding year. |
9920
|
3. Rates for personal lines residential wind-only policies |
9921
|
must be actuarially sound and not competitive with approved |
9922
|
rates charged by authorized insurers. However, for personal |
9923
|
lines residential wind-only policies issued or renewed between |
9924
|
July 1, 2002, and June 30, 2003, the maximum premium increase |
9925
|
must be no greater than 10 percent of the Florida Windstorm |
9926
|
Underwriting Association premium for that policy in effect on |
9927
|
June 30, 2002, as adjusted for coverage changes and seasonal |
9928
|
occupancy surcharges. The personal lines residential wind-only |
9929
|
rates for the corporation effective July 1, 2003, must be based |
9930
|
on a rate filing by the corporation which establishes rates |
9931
|
which are actuarially sound and not competitive with approved |
9932
|
rates charged by authorized insurers. Corporation rate manuals |
9933
|
shall include a rate surcharge for seasonal occupancy. To |
9934
|
ensure that personal lines residential wind-only rates effective |
9935
|
on or after July 1, 2003, are not competitive with approved |
9936
|
rates charged by authorized insurers, the officedepartment, by |
9937
|
March 1 of each year, shall provide the corporation, for each |
9938
|
county in which there are geographical areas in which personal |
9939
|
lines residential wind-only policies may be issued, the average |
9940
|
rates charged by the insurer that had the highest average rate |
9941
|
in that county for wind coverage in that insurer's rating |
9942
|
territories which most closely approximate the geographical area |
9943
|
in that county in which personal lines residential wind-only |
9944
|
policies may be written by the corporation. The average rates |
9945
|
provided must be from an insurer among the 20 insurers with the |
9946
|
greatest total direct written premium in the state for personal |
9947
|
lines residential property insurance for the preceding year. |
9948
|
With respect to mobile homes, the five insurers with the |
9949
|
greatest total written premium for that line of business in the |
9950
|
preceding year shall be used. The corporation shall certify to |
9951
|
the officedepartmentthat its average personal lines |
9952
|
residential wind-only rates are no lower in each county than the |
9953
|
average rates provided by the officedepartment. The commission |
9954
|
maydepartment is authorized toadopt rules to establish |
9955
|
reporting requirements to obtain the necessary wind-only rate |
9956
|
information from insurers to implement this provision. |
9957
|
4. Rates for commercial lines coverage shall not be |
9958
|
subject to the requirements of subparagraph 2., but shall be |
9959
|
subject to all other requirements of this paragraph and s. |
9960
|
627.062. |
9961
|
5. Nothing in this paragraph shall require or allow the |
9962
|
corporation to adopt a rate that is inadequate under s. 627.062. |
9963
|
6. The corporation shall make a rate filing at least once |
9964
|
a year, but no more often than quarterly. |
9965
|
7. In addition to the rates otherwise determined pursuant |
9966
|
to this paragraph, the corporation shall impose and collect an |
9967
|
amount equal to the premium tax provided for in s. 624.509 to |
9968
|
augment the financial resources of the corporation. |
9969
|
(e) If coverage in an account is deactivated pursuant to |
9970
|
paragraph (f), coverage through the corporation shall be |
9971
|
reactivated by order of the officedepartmentonly under one of |
9972
|
the following circumstances: |
9973
|
1. If the market assistance plan receives a minimum of 100 |
9974
|
applications for coverage within a 3-month period, or 200 |
9975
|
applications for coverage within a 1-year period or less for |
9976
|
residential coverage, unless the market assistance plan provides |
9977
|
a quotation from admitted carriers at their filed rates for at |
9978
|
least 90 percent of such applicants. Any market assistance plan |
9979
|
application that is rejected because an individual risk is so |
9980
|
hazardous as to be uninsurable using the criteria specified in |
9981
|
subparagraph (c)8. shall not be included in the minimum |
9982
|
percentage calculation provided herein. In the event that there |
9983
|
is a legal or administrative challenge to a determination by the |
9984
|
officedepartmentthat the conditions of this subparagraph have |
9985
|
been met for eligibility for coverage in the corporation, any |
9986
|
eligible risk may obtain coverage during the pendency of such |
9987
|
challenge. |
9988
|
2. In response to a state of emergency declared by the |
9989
|
Governor under s. 252.36, the officedepartmentmay activate |
9990
|
coverage by order for the period of the emergency upon a finding |
9991
|
by the officedepartmentthat the emergency significantly |
9992
|
affects the availability of residential property insurance. |
9993
|
(f)1. The corporation shall file with the office |
9994
|
departmentquarterly statements of financial condition, an |
9995
|
annual statement of financial condition, and audited financial |
9996
|
statements in the manner prescribed by law. In addition, the |
9997
|
corporation shall report to the officedepartmentmonthly on the |
9998
|
types, premium, exposure, and distribution by county of its |
9999
|
policies in force, and shall submit other reports as the office |
10000
|
departmentrequires to carry out its oversight of the |
10001
|
corporation. |
10002
|
2. The activities of the corporation shall be reviewed at |
10003
|
least annually by the officedepartmentto determine whether |
10004
|
coverage shall be deactivated in an account on the basis that |
10005
|
the conditions giving rise to its activation no longer exist. |
10006
|
(g)1. The corporation shall certify to the office |
10007
|
departmentits needs for annual assessments as to a particular |
10008
|
calendar year, and for any interim assessments that it deems to |
10009
|
be necessary to sustain operations as to a particular year |
10010
|
pending the receipt of annual assessments. Upon verification, |
10011
|
the officedepartmentshall approve such certification, and the |
10012
|
corporation shall levy such annual or interim assessments. Such |
10013
|
assessments shall be prorated as provided in paragraph (b). The |
10014
|
corporation shall take all reasonable and prudent steps |
10015
|
necessary to collect the amount of assessment due from each |
10016
|
assessable insurer, including, if prudent, filing suit to |
10017
|
collect such assessment. If the corporation is unable to collect |
10018
|
an assessment from any assessable insurer, the uncollected |
10019
|
assessments shall be levied as an additional assessment against |
10020
|
the assessable insurers and any assessable insurer required to |
10021
|
pay an additional assessment as a result of such failure to pay |
10022
|
shall have a cause of action against such nonpaying assessable |
10023
|
insurer. Assessments shall be included as an appropriate factor |
10024
|
in the making of rates. The failure of a surplus lines agent to |
10025
|
collect and remit any regular or emergency assessment levied by |
10026
|
the corporation is considered to be a violation of s. 626.936 |
10027
|
and subjects the surplus lines agent to the penalties provided |
10028
|
in that section. |
10029
|
2. The governing body of any unit of local government, any |
10030
|
residents of which are insured by the corporation, may issue |
10031
|
bonds as defined in s. 125.013 or s. 166.101 from time to time |
10032
|
to fund an assistance program, in conjunction with the |
10033
|
corporation, for the purpose of defraying deficits of the |
10034
|
corporation. In order to avoid needless and indiscriminate |
10035
|
proliferation, duplication, and fragmentation of such assistance |
10036
|
programs, any unit of local government, any residents of which |
10037
|
are insured by the corporation, may provide for the payment of |
10038
|
losses, regardless of whether or not the losses occurred within |
10039
|
or outside of the territorial jurisdiction of the local |
10040
|
government. Revenue bonds under this subparagraph may not be |
10041
|
issued until validated pursuant to chapter 75, unless a state of |
10042
|
emergency is declared by executive order or proclamation of the |
10043
|
Governor pursuant to s. 252.36 making such findings as are |
10044
|
necessary to determine that it is in the best interests of, and |
10045
|
necessary for, the protection of the public health, safety, and |
10046
|
general welfare of residents of this state and declaring it an |
10047
|
essential public purpose to permit certain municipalities or |
10048
|
counties to issue such bonds as will permit relief to claimants |
10049
|
and policyholders of the corporation. Any such unit of local |
10050
|
government may enter into such contracts with the corporation |
10051
|
and with any other entity created pursuant to this subsection as |
10052
|
are necessary to carry out this paragraph. Any bonds issued |
10053
|
under this subparagraph shall be payable from and secured by |
10054
|
moneys received by the corporation from emergency assessments |
10055
|
under sub-subparagraph (b)3.d., and assigned and pledged to or |
10056
|
on behalf of the unit of local government for the benefit of the |
10057
|
holders of such bonds. The funds, credit, property, and taxing |
10058
|
power of the state or of the unit of local government shall not |
10059
|
be pledged for the payment of such bonds. If any of the bonds |
10060
|
remain unsold 60 days after issuance, the officedepartment |
10061
|
shall require all insurers subject to assessment to purchase the |
10062
|
bonds, which shall be treated as admitted assets; each insurer |
10063
|
shall be required to purchase that percentage of the unsold |
10064
|
portion of the bond issue that equals the insurer's relative |
10065
|
share of assessment liability under this subsection. An insurer |
10066
|
shall not be required to purchase the bonds to the extent that |
10067
|
the officedepartmentdetermines that the purchase would |
10068
|
endanger or impair the solvency of the insurer. |
10069
|
3.a. The corporation shall adopt one or more programs |
10070
|
subject to approval by the officedepartmentfor the reduction |
10071
|
of both new and renewal writings in the corporation. The |
10072
|
corporation may consider any prudent and not unfairly |
10073
|
discriminatory approach to reducing corporation writings, and |
10074
|
may adopt a credit against assessment liability or other |
10075
|
liability that provides an incentive for insurers to take risks |
10076
|
out of the corporation and to keep risks out of the corporation |
10077
|
by maintaining or increasing voluntary writings in counties or |
10078
|
areas in which corporation risks are highly concentrated and a |
10079
|
program to provide a formula under which an insurer voluntarily |
10080
|
taking risks out of the corporation by maintaining or increasing |
10081
|
voluntary writings will be relieved wholly or partially from |
10082
|
assessments under sub-subparagraphs (b)3.a. and b. When the |
10083
|
corporation enters into a contractual agreement for a take-out |
10084
|
plan, the producing agent of record of the corporation policy is |
10085
|
entitled to retain any unearned commission on such policy, and |
10086
|
the insurer shall either: |
10087
|
(I) Pay to the producing agent of record of the policy, |
10088
|
for the first year, an amount which is the greater of the |
10089
|
insurer's usual and customary commission for the type of policy |
10090
|
written or a policy fee equal to the usual and customary |
10091
|
commission of the corporation; or |
10092
|
(II) Offer to allow the producing agent of record of the |
10093
|
policy to continue servicing the policy for a period of not less |
10094
|
than 1 year and offer to pay the agent the insurer's usual and |
10095
|
customary commission for the type of policy written. If the |
10096
|
producing agent is unwilling or unable to accept appointment by |
10097
|
the new insurer, the new insurer shall pay the agent in |
10098
|
accordance with sub-sub-subparagraph (I). |
10099
|
b. Any credit or exemption from regular assessments |
10100
|
adopted under this subparagraph shall last no longer than the 3 |
10101
|
years following the cancellation or expiration of the policy by |
10102
|
the corporation. With the approval of the officedepartment, the |
10103
|
board may extend such credits for an additional year if the |
10104
|
insurer guarantees an additional year of renewability for all |
10105
|
policies removed from the corporation, or for 2 additional years |
10106
|
if the insurer guarantees 2 additional years of renewability for |
10107
|
all policies so removed. |
10108
|
c. There shall be no credit, limitation, exemption, or |
10109
|
deferment from emergency assessments to be collected from |
10110
|
policyholders pursuant to sub-subparagraph (b)3.d. |
10111
|
4. The plan shall provide for the deferment, in whole or |
10112
|
in part, of the assessment of an assessable insurer, other than |
10113
|
an emergency assessment collected from policyholders pursuant to |
10114
|
sub-subparagraph (b)3.d., if the officedepartmentfinds that |
10115
|
payment of the assessment would endanger or impair the solvency |
10116
|
of the insurer. In the event an assessment against an assessable |
10117
|
insurer is deferred in whole or in part, the amount by which |
10118
|
such assessment is deferred may be assessed against the other |
10119
|
assessable insurers in a manner consistent with the basis for |
10120
|
assessments set forth in paragraph (b). |
10121
|
(h) Nothing in this subsection shall be construed to |
10122
|
preclude the issuance of residential property insurance coverage |
10123
|
pursuant to part VIII of chapter 626. |
10124
|
(i) There shall be no liability on the part of, and no |
10125
|
cause of action of any nature shall arise against, any |
10126
|
assessable insurer or its agents or employees, the corporation |
10127
|
or its agents or employees, members of the board of governors or |
10128
|
their respective designees at a board meeting, corporation |
10129
|
committee members, or the officedepartmentor its |
10130
|
representatives, for any action taken by them in the performance |
10131
|
of their duties or responsibilities under this subsection. Such |
10132
|
immunity does not apply to: |
10133
|
1. Any of the foregoing persons or entities for any |
10134
|
willful tort; |
10135
|
2. The corporation or its producing agents for breach of |
10136
|
any contract or agreement pertaining to insurance coverage; |
10137
|
3. The corporation with respect to issuance or payment of |
10138
|
debt; or |
10139
|
4. Any assessable insurer with respect to any action to |
10140
|
enforce an assessable insurer's obligations to the corporation |
10141
|
under this subsection. |
10142
|
(j) For the purposes of s. 199.183(1), the corporation |
10143
|
shall be considered a political subdivision of the state and |
10144
|
shall be exempt from the corporate income tax. The premiums, |
10145
|
assessments, investment income, and other revenue of the |
10146
|
corporation are funds received for providing property insurance |
10147
|
coverage as required by this subsection, paying claims for |
10148
|
Florida citizens insured by the corporation, securing and |
10149
|
repaying debt obligations issued by the corporation, and |
10150
|
conducting all other activities of the corporation, and shall |
10151
|
not be considered taxes, fees, licenses, or charges for services |
10152
|
imposed by the Legislature on individuals, businesses, or |
10153
|
agencies outside state government. Bonds and other debt |
10154
|
obligations issued by or on behalf of the corporation are not to |
10155
|
be considered "state bonds" within the meaning of s. |
10156
|
215.58(8)(10). The corporation is not subject to the procurement |
10157
|
provisions of chapter 287, and policies and decisions of the |
10158
|
corporation relating to incurring debt, levying of assessments |
10159
|
and the sale, issuance, continuation, terms and claims under |
10160
|
corporation policies, and all services relating thereto, are not |
10161
|
subject to the provisions of chapter 120. The corporation is not |
10162
|
required to obtain or to hold a certificate of authority issued |
10163
|
by the officedepartment, nor is it required to participate as a |
10164
|
member insurer of the Florida Insurance Guaranty Association. |
10165
|
However, the corporation is required to pay, in the same manner |
10166
|
as an authorized insurer, assessments pledged by the Florida |
10167
|
Insurance Guaranty Association to secure bonds issued or other |
10168
|
indebtedness incurred to pay covered claims arising from insurer |
10169
|
insolvencies caused by, or proximately related to, hurricane |
10170
|
losses. It is the intent of the Legislature that the tax |
10171
|
exemptions provided in this paragraph will augment the financial |
10172
|
resources of the corporation to better enable the corporation to |
10173
|
fulfill its public purposes. Any bonds issued by the |
10174
|
corporation, their transfer, and the income therefrom, including |
10175
|
any profit made on the sale thereof, shall at all times be free |
10176
|
from taxation of every kind by the state and any political |
10177
|
subdivision or local unit or other instrumentality thereof; |
10178
|
however, this exemption does not apply to any tax imposed by |
10179
|
chapter 220chapter 200on interest, income, or profits on debt |
10180
|
obligations owned by corporations other than the corporation. |
10181
|
(k) Upon a determination by the officedepartmentthat the |
10182
|
conditions giving rise to the establishment and activation of |
10183
|
the corporation no longer exist, the corporation is dissolved. |
10184
|
Upon dissolution, the assets of the corporationassociation |
10185
|
shall be applied first to pay all debts, liabilities, and |
10186
|
obligations of the corporation, including the establishment of |
10187
|
reasonable reserves for any contingent liabilities or |
10188
|
obligations, and all remaining assets of the corporation shall |
10189
|
become property of the state and be deposited in the Florida |
10190
|
Hurricane Catastrophe Fund. However, no dissolution shall take |
10191
|
effect as long as the corporation has bonds or other financial |
10192
|
obligations outstanding unless adequate provision has been made |
10193
|
for the payment of the bonds or other financial obligations |
10194
|
pursuant to the documents authorizing the issuance of the bonds |
10195
|
or other financial obligations. |
10196
|
(l)1. Effective July 1, 2002, policies of the Residential |
10197
|
Property and Casualty Joint Underwriting Association shall |
10198
|
become policies of the corporation. All obligations, rights, |
10199
|
assets and liabilities of the Residential Property and Casualty |
10200
|
Joint Underwriting Association, including bonds, note and debt |
10201
|
obligations, and the financing documents pertaining to them |
10202
|
become those of the corporation as of July 1, 2002. The |
10203
|
corporation is not required to issue endorsements or |
10204
|
certificates of assumption to insureds during the remaining term |
10205
|
of in-force transferred policies. |
10206
|
2. Effective July 1, 2002, policies of the Florida |
10207
|
Windstorm Underwriting Association are transferred to the |
10208
|
corporation and shall become policies of the corporation. All |
10209
|
obligations, rights, assets, and liabilities of the Florida |
10210
|
Windstorm Underwriting Association, including bonds, note, and |
10211
|
debt obligations, and the financing documents pertaining to them |
10212
|
are transferred to and assumed by the corporation on July 1, |
10213
|
2002. The corporation is not required to issue endorsement or |
10214
|
certificates of assumption to insureds during the remaining term |
10215
|
of in-force transferred policies. |
10216
|
3. The Florida Windstorm Underwriting Association and the |
10217
|
Residential Property and Casualty Joint Underwriting Association |
10218
|
shall take all actions as may be proper to further evidence the |
10219
|
transfers and shall provide the documents and instruments of |
10220
|
further assurance as may reasonably be requested by the |
10221
|
corporation for that purpose. The corporation shall execute |
10222
|
assumptions and instruments as the trustees or other parties to |
10223
|
the financing documents of the Florida Windstorm Underwriting |
10224
|
Association or the Residential Property and Casualty Joint |
10225
|
Underwriting Association may reasonably request to further |
10226
|
evidence the transfers and assumptions, which transfers and |
10227
|
assumptions, however, are effective on the date provided under |
10228
|
this paragraph whether or not, and regardless of the date on |
10229
|
which, the assumptions or instruments are executed by the |
10230
|
corporation. Subject to the relevant financing documents |
10231
|
pertaining to their outstanding bonds, notes, indebtedness, or |
10232
|
other financing obligations, the moneys, investments, |
10233
|
receivables, choses in action, and other intangibles of the |
10234
|
Florida Windstorm Underwriting Association shall be credited to |
10235
|
the high-risk account of the corporation, and those of the |
10236
|
personal lines residential coverage account and the commercial |
10237
|
lines residential coverage account of the Residential Property |
10238
|
and Casualty Joint Underwriting Association shall be credited to |
10239
|
the personal lines account and the commercial lines account, |
10240
|
respectively, of the corporation. |
10241
|
4. Effective July 1, 2002, a new applicant for property |
10242
|
insurance coverage who would otherwise have been eligible for |
10243
|
coverage in the Florida Windstorm Underwriting Association is |
10244
|
eligible for coverage from the corporation as provided in this |
10245
|
subsection. |
10246
|
5. The transfer of all policies, obligations, rights, |
10247
|
assets, and liabilities from the Florida Windstorm Underwriting |
10248
|
Association to the corporation and the renaming of the |
10249
|
Residential Property and Casualty Joint Underwriting Association |
10250
|
as the corporation shall in no way affect the coverage with |
10251
|
respect to covered policies as defined in s. 215.555(2)(c) |
10252
|
provided to these entities by the Florida Hurricane Catastrophe |
10253
|
Fund. The coverage provided by the Florida Hurricane Catastrophe |
10254
|
Fund to the Florida Windstorm Underwriting Association based on |
10255
|
its exposures as of June 30, 2002, and each June 30 thereafter |
10256
|
shall be redesignated as coverage for the high-risk account of |
10257
|
the corporation. Notwithstanding any other provision of law, the |
10258
|
coverage provided by the Florida Hurricane Catastrophe Fund to |
10259
|
the Residential Property and Casualty Joint Underwriting |
10260
|
Association based on its exposures as of June 30, 2002, and each |
10261
|
June 30 thereafter shall be transferred to the personal lines |
10262
|
account and the commercial lines account of the corporation. |
10263
|
Notwithstanding any other provision of law, the high-risk |
10264
|
account shall be treated, for all Florida Hurricane Catastrophe |
10265
|
Fund purposes, as if it were a separate participating insurer |
10266
|
with its own exposures, reimbursement premium, and loss |
10267
|
reimbursement. Likewise, the personal lines and commercial lines |
10268
|
accounts shall be viewed together, for all Florida Hurricane |
10269
|
Catastrophe Fund purposes, as if the two accounts were one and |
10270
|
represent a single, separate participating insurer with its own |
10271
|
exposures, reimbursement premium, and loss reimbursement. The |
10272
|
coverage provided by the Florida Hurricane Catastrophe Fund to |
10273
|
the corporation shall constitute and operate as a full transfer |
10274
|
of coverage from the Florida Windstorm Underwriting Association |
10275
|
and Residential Property and Casualty Joint Underwriting to the |
10276
|
corporation. |
10277
|
(m) Notwithstanding any other provision of law: |
10278
|
1. The pledge or sale of, the lien upon, and the security |
10279
|
interest in any rights, revenues, or other assets of the |
10280
|
corporation created or purported to be created pursuant to any |
10281
|
financing documents to secure any bonds or other indebtedness of |
10282
|
the corporation shall be and remain valid and enforceable, |
10283
|
notwithstanding the commencement of and during the continuation |
10284
|
of, and after, any rehabilitation, insolvency, liquidation, |
10285
|
bankruptcy, receivership, conservatorship, reorganization, or |
10286
|
similar proceeding against the corporation under the laws of |
10287
|
this state. |
10288
|
2. No such proceeding shall relieve the corporation of its |
10289
|
obligation, or otherwise affect its ability to perform its |
10290
|
obligation, to continue to collect, or levy and collect, |
10291
|
assessments, market equalization or other surcharges under |
10292
|
subparagraph (c)10., or any other rights, revenues, or other |
10293
|
assets of the corporation pledged pursuant to any financing |
10294
|
documents. |
10295
|
3. Each such pledge or sale of, lien upon, and security |
10296
|
interest in, including the priority of such pledge, lien, or |
10297
|
security interest, any such assessments, market equalization or |
10298
|
other surcharges, or other rights, revenues, or other assets |
10299
|
which are collected, or levied and collected, after the |
10300
|
commencement of and during the pendency of, or after, any such |
10301
|
proceeding shall continue unaffected by such proceeding. As |
10302
|
used in this subsection, the term "financing documents" means |
10303
|
any agreement or agreements, instrument or instruments, or other |
10304
|
document or documents now existing or hereafter created |
10305
|
evidencing any bonds or other indebtedness of the corporation or |
10306
|
pursuant to which any such bonds or other indebtedness has been |
10307
|
or may be issued and pursuant to which any rights, revenues, or |
10308
|
other assets of the corporation are pledged or sold to secure |
10309
|
the repayment of such bonds or indebtedness, together with the |
10310
|
payment of interest on such bonds or such indebtedness, or the |
10311
|
payment of any other obligation or financial product, as defined |
10312
|
in the plan of operation of the corporation related to such |
10313
|
bonds or indebtedness. |
10314
|
4. Any such pledge or sale of assessments, revenues, |
10315
|
contract rights, or other rights or assets of the corporation |
10316
|
shall constitute a lien and security interest, or sale, as the |
10317
|
case may be, that is immediately effective and attaches to such |
10318
|
assessments, revenues, or contract rights or other rights or |
10319
|
assets, whether or not imposed or collected at the time the |
10320
|
pledge or sale is made. Any such pledge or sale is effective, |
10321
|
valid, binding, and enforceable against the corporation or other |
10322
|
entity making such pledge or sale, and valid and binding against |
10323
|
and superior to any competing claims or obligations owed to any |
10324
|
other person or entity, including policyholders in this state, |
10325
|
asserting rights in any such assessments, revenues, or contract |
10326
|
rights or other rights or assets to the extent set forth in and |
10327
|
in accordance with the terms of the pledge or sale contained in |
10328
|
the applicable financing documents, whether or not any such |
10329
|
person or entity has notice of such pledge or sale and without |
10330
|
the need for any physical delivery, recordation, filing, or |
10331
|
other action. |
10332
|
(n)1. The following records of the corporation are |
10333
|
confidential and exempt from the provisions of s. 119.07(1) and |
10334
|
s. 24(a), Art. I of the State Constitution: |
10335
|
a. Underwriting files, except that a policyholder or an |
10336
|
applicant shall have access to his or her own underwriting |
10337
|
files. |
10338
|
b. Claims files, until termination of all litigation and |
10339
|
settlement of all claims arising out of the same incident, |
10340
|
although portions of the claims files may remain exempt, as |
10341
|
otherwise provided by law. Confidential and exempt claims file |
10342
|
records may be released to other governmental agencies upon |
10343
|
written request and demonstration of need; such records held by |
10344
|
the receiving agency remain confidential and exempt as provided |
10345
|
for herein. |
10346
|
c. Records obtained or generated by an internal auditor |
10347
|
pursuant to a routine audit, until the audit is completed, or if |
10348
|
the audit is conducted as part of an investigation, until the |
10349
|
investigation is closed or ceases to be active. An |
10350
|
investigation is considered "active" while the investigation is |
10351
|
being conducted with a reasonable, good faith belief that it |
10352
|
could lead to the filing of administrative, civil, or criminal |
10353
|
proceedings. |
10354
|
d. Matters reasonably encompassed in privileged attorney- |
10355
|
client communications. |
10356
|
e. Proprietary information licensed to the corporation |
10357
|
under contract and the contract provides for the confidentiality |
10358
|
of such proprietary information. |
10359
|
f. All information relating to the medical condition or |
10360
|
medical status of a corporation employee which is not relevant |
10361
|
to the employee's capacity to perform his or her duties, except |
10362
|
as otherwise provided in this paragraph. Information which is |
10363
|
exempt shall include, but is not limited to, information |
10364
|
relating to workers' compensation, insurance benefits, and |
10365
|
retirement or disability benefits. |
10366
|
g. Upon an employee's entrance into the employee |
10367
|
assistance program, a program to assist any employee who has a |
10368
|
behavioral or medical disorder, substance abuse problem, or |
10369
|
emotional difficulty which affects the employee's job |
10370
|
performance, all records relative to that participation shall be |
10371
|
confidential and exempt from the provisions of s. 119.07(1) and |
10372
|
s. 24(a), Art. I of the State Constitution, except as otherwise |
10373
|
provided in s. 112.0455(11). |
10374
|
h. Information relating to negotiations for financing, |
10375
|
reinsurance, depopulation, or contractual services, until the |
10376
|
conclusion of the negotiations. |
10377
|
i. Minutes of closed meetings regarding underwriting |
10378
|
files, and minutes of closed meetings regarding an open claims |
10379
|
file until termination of all litigation and settlement of all |
10380
|
claims with regard to that claim, except that information |
10381
|
otherwise confidential or exempt by law will be redacted. |
10382
|
|
10383
|
|
10384
|
When an authorized insurer is considering underwriting a risk |
10385
|
insured by the corporation, relevant underwriting files and |
10386
|
confidential claims files may be released to the insurer |
10387
|
provided the insurer agrees in writing, notarized and under |
10388
|
oath, to maintain the confidentiality of such files. When a |
10389
|
file is transferred to an insurer that file is no longer a |
10390
|
public record because it is not held by an agency subject to the |
10391
|
provisions of the public records law. Underwriting files and |
10392
|
confidential claims files may also be released to staff of and |
10393
|
the board of governors of the market assistance plan established |
10394
|
pursuant to s. 627.3515, who must retain the confidentiality of |
10395
|
such files, except such files may be released to authorized |
10396
|
insurers that are considering assuming the risks to which the |
10397
|
files apply, provided the insurer agrees in writing, notarized |
10398
|
and under oath, to maintain the confidentiality of such files. |
10399
|
Finally, the corporation or the board or staff of the market |
10400
|
assistance plan may make the following information obtained from |
10401
|
underwriting files and confidential claims files available to |
10402
|
licensed general lines insurance agents: name, address, and |
10403
|
telephone number of the residential property owner or insured; |
10404
|
location of the risk; rating information; loss history; and |
10405
|
policy type. The receiving licensed general lines insurance |
10406
|
agent must retain the confidentiality of the information |
10407
|
received. |
10408
|
2. Portions of meetings of the corporation are exempt from |
10409
|
the provisions of s. 286.011 and s. 24(b), Art. I of the State |
10410
|
Constitution wherein confidential underwriting files or |
10411
|
confidential open claims files are discussed. All portions of |
10412
|
corporation meetings which are closed to the public shall be |
10413
|
recorded by a court reporter. The court reporter shall record |
10414
|
the times of commencement and termination of the meeting, all |
10415
|
discussion and proceedings, the names of all persons present at |
10416
|
any time, and the names of all persons speaking. No portion of |
10417
|
any closed meeting shall be off the record. Subject to the |
10418
|
provisions hereof and s. 119.07(2)(a), the court reporter's |
10419
|
notes of any closed meeting shall be retained by the corporation |
10420
|
for a minimum of 5 years. A copy of the transcript, less any |
10421
|
exempt matters, of any closed meeting wherein claims are |
10422
|
discussed shall become public as to individual claims after |
10423
|
settlement of the claim. |
10424
|
(o) It is the intent of the Legislature that the |
10425
|
amendments to this subsection enacted in 2002 should, over time, |
10426
|
reduce the probable maximum windstorm losses in the residual |
10427
|
markets and should reduce the potential assessments to be levied |
10428
|
on property insurers and policyholders statewide. In |
10429
|
furtherance of this intent: |
10430
|
1. The board shall, on or before February 1 of each year, |
10431
|
provide a report to the President of the Senate and the Speaker |
10432
|
of the House of Representatives showing the reduction or |
10433
|
increase in the 100-year probable maximum loss attributable to |
10434
|
wind-only coverages and the quota share program under this |
10435
|
subsection combined, as compared to the benchmark 100-year |
10436
|
probable maximum loss of the Florida Windstorm Underwriting |
10437
|
Association. For purposes of this paragraph, the benchmark 100- |
10438
|
year probable maximum loss of the Florida Windstorm Underwriting |
10439
|
Association shall be the calculation dated February 2001 and |
10440
|
based on November 30, 2000, exposures. In order to ensure |
10441
|
comparability of data, the board shall use the same methods for |
10442
|
calculating its probable maximum loss as were used to calculate |
10443
|
the benchmark probable maximum loss. |
10444
|
2. Beginning February 1, 2007, if the report under |
10445
|
subparagraph 1. for any year indicates that the 100-year |
10446
|
probable maximum loss attributable to wind-only coverages and |
10447
|
the quota share program combined does not reflect a reduction of |
10448
|
at least 25 percent from the benchmark, the board shall reduce |
10449
|
the boundaries of the high-risk area eligible for wind-only |
10450
|
coverages under this subsection in a manner calculated to reduce |
10451
|
such probable maximum loss to an amount at least 25 percent |
10452
|
below the benchmark. |
10453
|
3. Beginning February 1, 2012, if the report under |
10454
|
subparagraph 1. for any year indicates that the 100-year |
10455
|
probable maximum loss attributable to wind-only coverages and |
10456
|
the quota share program combined does not reflect a reduction of |
10457
|
at least 50 percent from the benchmark, the boundaries of the |
10458
|
high-risk area eligible for wind-only coverages under this |
10459
|
subsection shall be reduced by the elimination of any area that |
10460
|
is not seaward of a line 1,000 feet inland from the Intracoastal |
10461
|
Waterway. |
10462
|
(p) In enacting the provisions of this section, the |
10463
|
Legislature recognizes that both the Florida Windstorm |
10464
|
Underwriting Association and the Residential Property and |
10465
|
Casualty Joint Underwriting Association have entered into |
10466
|
financing arrangements that obligate each entity to service its |
10467
|
debts and maintain the capacity to repay funds secured under |
10468
|
these financing arrangements. It is the intent of the |
10469
|
Legislature that nothing in this section be construed to |
10470
|
compromise, diminish, or interfere with the rights of creditors |
10471
|
under such financing arrangements. It is further the intent of |
10472
|
the Legislature to preserve the obligations of the Florida |
10473
|
Windstorm Underwriting Association and Residential Property and |
10474
|
Casualty Joint Underwriting Association with regard to |
10475
|
outstanding financing arrangements, with such obligations |
10476
|
passing entirely and unchanged to the corporation and, |
10477
|
specifically, to the applicable account of the corporation. So |
10478
|
long as any bonds, notes, indebtedness, or other financing |
10479
|
obligations of the Florida Windstorm Underwriting Association or |
10480
|
the Residential Property and Casualty Joint Underwriting |
10481
|
Association are outstanding, under the terms of the financing |
10482
|
documents pertaining to them, the governing board of the |
10483
|
corporation shall have and shall exercise the authority to levy, |
10484
|
charge, collect, and receive all premiums, assessments, |
10485
|
surcharges, charges, revenues, and receipts that the |
10486
|
associations had authority to levy, charge, collect, or receive |
10487
|
under the provisions of subsection (2) and this subsection, |
10488
|
respectively, as they existed on January 1, 2002, to provide |
10489
|
moneys, without exercise of the authority provided by this |
10490
|
subsection, in at least the amounts, and by the times, as would |
10491
|
be provided under those former provisions of subsection (2) or |
10492
|
this subsection, respectively, so that the value, amount, and |
10493
|
collectability of any assets, revenues, or revenue source |
10494
|
pledged or committed to, or any lien thereon securing such |
10495
|
outstanding bonds, notes, indebtedness, or other financing |
10496
|
obligations will not be diminished, impaired, or adversely |
10497
|
affected by the amendments made by this act and to permit |
10498
|
compliance with all provisions of financing documents pertaining |
10499
|
to such bonds, notes, indebtedness, or other financing |
10500
|
obligations, or the security or credit enhancement for them, and |
10501
|
any reference in this subsection to bonds, notes, indebtedness, |
10502
|
financing obligations, or similar obligations, of the |
10503
|
corporation shall include like instruments or contracts of the |
10504
|
Florida Windstorm Underwriting Association and the Residential |
10505
|
Property and Casualty Joint Underwriting Association to the |
10506
|
extent not inconsistent with the provisions of the financing |
10507
|
documents pertaining to them. |
10508
|
(q) Effective January 7, 2003, any reference in this |
10509
|
subsection to the Treasurer shall be deemed to be a reference to |
10510
|
the Chief Financial Officer and any reference to the Department |
10511
|
of Insurance shall be deemed to be a reference to the Department |
10512
|
of Insurance and Financial Services or other successor to the |
10513
|
Department of Insurance specified by law. |
10514
|
(q)(r)The corporation shall not require the securing of |
10515
|
flood insurance as a condition of coverage if the insured or |
10516
|
applicant executes a form approved by the officedepartment |
10517
|
affirming that flood insurance is not provided by the |
10518
|
corporation and that if flood insurance is not secured by the |
10519
|
applicant or insured in addition to coverage by the corporation, |
10520
|
the risk will not be covered for flood damage. A corporation |
10521
|
policyholder electing not to secure flood insurance and |
10522
|
executing a form as provided herein making a claim for water |
10523
|
damage against the corporation shall have the burden of proving |
10524
|
the damage was not caused by flooding. Notwithstanding other |
10525
|
provisions of this subsection, the corporation may deny coverage |
10526
|
to an applicant or insured who refuses to execute the form |
10527
|
described herein. |
10528
|
Section 200. Section 627.3511, Florida Statutes, is |
10529
|
amended to read: |
10530
|
627.3511 Depopulation of Citizens Property Insurance |
10531
|
CorporationResidential Property and Casualty Joint Underwriting |
10532
|
Association.-- |
10533
|
(1) LEGISLATIVE INTENT.--The Legislature finds that the |
10534
|
public policy of this state requires the maintenance of a |
10535
|
residual market for residential property insurance. It is the |
10536
|
intent of the Legislature to provide a variety of financial |
10537
|
incentives to encourage the replacement of the highest possible |
10538
|
number of Citizens Property Insurance CorporationResidential |
10539
|
Property and Casualty Joint Underwriting Associationpolicies |
10540
|
with policies written by admitted insurers at approved rates. |
10541
|
(2) TAKE-OUT BONUS.--The Citizens Property Insurance |
10542
|
CorporationResidential Property and Casualty Joint Underwriting |
10543
|
Associationshall pay the sum of up to $100 to an insurer for |
10544
|
each risk that the insurer removes from the corporation |
10545
|
association, either by issuance of a policy upon expiration or |
10546
|
cancellation of the corporationassociationpolicy or by |
10547
|
assumption of the corporation'sassociation'sobligations with |
10548
|
respect to an in-force policy. Such payment is subject to |
10549
|
approval of the corporationassociationboard. In order to |
10550
|
qualify for the bonus under this subsection, the take-out plan |
10551
|
must include a minimum of 25,000 policies. Within 30 days after |
10552
|
approval by the board, the officedepartmentmay reject the |
10553
|
insurer's take-out plan and disqualify the insurer from the |
10554
|
bonus, based on the following criteria: |
10555
|
(a) The capacity of the insurer to absorb the policies |
10556
|
proposed to be taken out of the corporationassociationand the |
10557
|
concentration of risks of those policies. |
10558
|
(b) Whether the geographic and risk characteristics of |
10559
|
policies in the proposed take-out plan serve to reduce the |
10560
|
exposure of the corporationassociationsufficiently to justify |
10561
|
the bonus. |
10562
|
(c) Whether coverage for risks to be taken out otherwise |
10563
|
exists in the admitted voluntary market. |
10564
|
(d) The degree to which the take-out bonus is promoting |
10565
|
new capital being allocated by the insurer to Florida |
10566
|
residential property coverage. |
10567
|
(3) EXEMPTION FROM DEFICIT ASSESSMENTS.-- |
10568
|
(a) The calculation of an insurer's assessment liability |
10569
|
under s. 627.351(6)(b)3.a. or b. shall, for an insurer that in |
10570
|
any calendar year removes 50,000 or more risks from the Citizens |
10571
|
Property Insurance CorporationResidential Property and Casualty |
10572
|
Joint Underwriting Association, either by issuance of a policy |
10573
|
upon expiration or cancellation of the corporationassociation |
10574
|
policy or by assumption of the corporation'sassociation's |
10575
|
obligations with respect to in-force policies, exclude such |
10576
|
removed policies for the succeeding 3 years, as follows: |
10577
|
1. In the first year following removal of the risks, the |
10578
|
risks are excluded from the calculation to the extent of 100 |
10579
|
percent. |
10580
|
2. In the second year following removal of the risks, the |
10581
|
risks are excluded from the calculation to the extent of 75 |
10582
|
percent. |
10583
|
3. In the third year following removal of the risks, the |
10584
|
risks are excluded from the calculation to the extent of 50 |
10585
|
percent. |
10586
|
|
10587
|
|
10588
|
If the removal of risks is accomplished through assumption of |
10589
|
obligations with respect to in-force policies, the corporation |
10590
|
associationshall pay to the assuming insurer all unearned |
10591
|
premium with respect to such policies less any policy |
10592
|
acquisition costs agreed to by the corporationassociationand |
10593
|
assuming insurer. The term "policy acquisition costs" is defined |
10594
|
as costs of issuance of the policy by the corporation |
10595
|
associationwhich includes agent commissions, servicing company |
10596
|
fees, and premium tax. This paragraph does not apply to an |
10597
|
insurer that, at any time within 5 years before removing the |
10598
|
risks, had a market share in excess of 0.1 percent of the |
10599
|
statewide aggregate gross direct written premium for any line of |
10600
|
property insurance, or to an affiliate of such an insurer. This |
10601
|
paragraph does not apply unless either at least 40 percent of |
10602
|
the risks removed from the corporationassociationare located |
10603
|
in Dade, Broward, and Palm Beach Counties, or at least 30 |
10604
|
percent of the risks removed from the corporationassociation |
10605
|
are located in such counties and an additional 50 percent of the |
10606
|
risks removed from the corporationassociationare located in |
10607
|
other coastal counties. |
10608
|
(b) An insurer that first wrote personal lines residential |
10609
|
property coverage in this state on or after July 1, 1994, is |
10610
|
exempt from regular deficit assessments imposed pursuant to s. |
10611
|
627.351(6)(b)3.a. and b., but not emergency assessments |
10612
|
collected from policyholders pursuant to s. 627.351(6)(b)3.d., |
10613
|
of the Citizens Property Insurance CorporationResidential |
10614
|
Property and Casualty Joint Underwriting Associationuntil the |
10615
|
earlier of the following: |
10616
|
1. The end of the calendar year in which it first wrote |
10617
|
0.5 percent or more of the statewide aggregate direct written |
10618
|
premium for any line of residential property coverage; or |
10619
|
2. December 31, 1997, or December 31 of the third year in |
10620
|
which it wrote such coverage in this state, whichever is later. |
10621
|
(c) Other than an insurer that is exempt under paragraph |
10622
|
(b), an insurer that in any calendar year increases its total |
10623
|
structure exposure subject to wind coverage by 25 percent or |
10624
|
more over its exposure for the preceding calendar year is, with |
10625
|
respect to that year, exempt from deficit assessments imposed |
10626
|
pursuant to s. 627.351(6)(b)3.a. and b., but not emergency |
10627
|
assessments collected from policyholders pursuant to s. |
10628
|
627.351(6)(b)3.d., of the Citizens Property Insurance |
10629
|
CorporationResidential Property and Casualty Joint Underwriting |
10630
|
Associationattributable to such increase in exposure. |
10631
|
(d) Any exemption or credit from regular assessments |
10632
|
authorized by this section shall last no longer than 3 years |
10633
|
following the cancellation or expiration of the policy by the |
10634
|
corporationassociation. With the approval of the office |
10635
|
department, the board may extend such credits for an additional |
10636
|
year if the insurer guarantees an additional year of |
10637
|
renewability for all policies removed from the corporation |
10638
|
association, or for 2 additional years if the insurer guarantees |
10639
|
2 additional years of renewability for all policies so removed. |
10640
|
(4) AGENT BONUS.--When the corporationResidential |
10641
|
Property and Casualty Joint Underwriting Associationenters into |
10642
|
a contractual agreement for a take-out plan that provides a |
10643
|
bonus to the insurer, the producing agent of record of the |
10644
|
corporationassociationpolicy is entitled to retain any |
10645
|
unearned commission on such policy, and the insurer shall |
10646
|
either: |
10647
|
(a) Pay to the producing agent of record of the |
10648
|
association policy, for the first year, an amount that is the |
10649
|
greater of the insurer's usual and customary commission for the |
10650
|
type of policy written or a fee equal to the usual and customary |
10651
|
commission of the corporationassociation; or |
10652
|
(b) Offer to allow the producing agent of record of the |
10653
|
corporationassociationpolicy to continue servicing the policy |
10654
|
for a period of not less than 1 year and offer to pay the agent |
10655
|
the greater of the insurer's or the corporation'sassociation's |
10656
|
usual and customary commission for the type of policy written. |
10657
|
|
10658
|
|
10659
|
If the producing agent is unwilling or unable to accept |
10660
|
appointment, the new insurer shall pay the agent in accordance |
10661
|
with paragraph (a). The requirement of this subsection that the |
10662
|
producing agent of record is entitled to retain the unearned |
10663
|
commission on an association policy does not apply to a policy |
10664
|
for which coverage has been provided in the association for 30 |
10665
|
days or less or for which a cancellation notice has been issued |
10666
|
pursuant to s. 627.351(6)(c)11. during the first 30 days of |
10667
|
coverage. |
10668
|
(5) APPLICABILITY.-- |
10669
|
(a) The take-out bonus provided by subsection (2) and the |
10670
|
exemption from assessment provided by paragraph (3)(a) apply |
10671
|
only if the corporationassociationpolicy is replaced by either |
10672
|
a standard policy including wind coverage or, if consistent with |
10673
|
the insurer's underwriting rules as filed with the office |
10674
|
department, a basic policy including wind coverage; however, |
10675
|
with respect to risks located in areas where coverage through |
10676
|
the high-risk account of the corporationFlorida Windstorm |
10677
|
Underwriting Associationis available, the replacement policy |
10678
|
need not provide wind coverage. The insurer must renew the |
10679
|
replacement policy at approved rates on substantially similar |
10680
|
terms for two additional 1-year terms, unless canceled by the |
10681
|
insurer for a lawful reason other than reduction of hurricane |
10682
|
exposure. If an insurer assumes the corporation'sassociation's |
10683
|
obligations for a policy, it must issue a replacement policy for |
10684
|
a 1-year term upon expiration of the corporationassociation |
10685
|
policy and must renew the replacement policy at approved rates |
10686
|
on substantially similar terms for two additional 1-year terms, |
10687
|
unless canceled by the insurer for a lawful reason other than |
10688
|
reduction of hurricane exposure. For each replacement policy |
10689
|
canceled or nonrenewed by the insurer for any reason during the |
10690
|
3-year coverage period required by this paragraph, the insurer |
10691
|
must remove from the corporationassociationone additional |
10692
|
policy covering a risk similar to the risk covered by the |
10693
|
canceled or nonrenewed policy. In addition to these |
10694
|
requirements, the corporationassociationmust place the bonus |
10695
|
moneys in escrow for a period of 3 years; such moneys may be |
10696
|
released from escrow only to pay claims. A take-out bonus |
10697
|
provided by subsection (2) or subsection (6) shall not be |
10698
|
considered premium income for purposes of taxes and assessments |
10699
|
under the Florida Insurance Code and shall remain the property |
10700
|
of the corporationResidential Property and Casualty Joint |
10701
|
Underwriting Association, subject to the prior security interest |
10702
|
of the insurer under the escrow agreement until it is released |
10703
|
from escrow, and after it is released from escrow it shall be |
10704
|
considered an asset of the insurer and credited to the insurer's |
10705
|
capital and surplus. |
10706
|
(b) It is the intent of the Legislature that an insurer |
10707
|
eligible for the exemption under paragraph (3)(a) establish a |
10708
|
preference in appointment of agents for those agents who lose a |
10709
|
substantial amount of business as a result of risks being |
10710
|
removed from the corporationassociation. |
10711
|
(6) COMMERCIAL RESIDENTIAL TAKE-OUT PLANS.-- |
10712
|
(a) The corporationResidential Property and Casualty |
10713
|
Joint Underwriting Associationshall pay a bonus to an insurer |
10714
|
for each commercial residential policy that the insurer removes |
10715
|
from the corporationassociationpursuant to an approved take- |
10716
|
out plan, either by issuance of a new policy upon expiration of |
10717
|
the corporationassociation policy or by assumption of the |
10718
|
corporation'sassociation'sobligations with respect to an in- |
10719
|
force policy. The corporationassociationboard shall determine |
10720
|
the amount of the bonus based on such factors as the coverage |
10721
|
provided, relative hurricane risk, the length of time that the |
10722
|
property has been covered by the corporationassociation, and |
10723
|
the criteria specified in paragraphs (b) and (c). The amount of |
10724
|
the bonus with respect to a particular policy may not exceed 25 |
10725
|
percent of the corporation'sassociation's1-year premium for |
10726
|
the policy. Such payment is subject to approval of the |
10727
|
corporationassociationboard. In order to qualify for the bonus |
10728
|
under this subsection, the take-out plan must include policies |
10729
|
reflecting at least $100 million in structure exposure. |
10730
|
(b) In order for a plan to qualify for approval: |
10731
|
1. At least 40 percent of the policies removed from the |
10732
|
corporationassociationunder the plan must be located in Dade, |
10733
|
Broward, and Palm Beach Counties, or at least 30 percent of the |
10734
|
policies removed from the corporationassociationunder the plan |
10735
|
must be located in such counties and an additional 50 percent of |
10736
|
the policies removed from the corporationassociationmust be |
10737
|
located in other coastal counties. |
10738
|
2. The insurer must renew the replacement policy at |
10739
|
approved rates on substantially similar terms for two additional |
10740
|
1-year terms, unless canceled or nonrenewed by the insurer for a |
10741
|
lawful reason other than reduction of hurricane exposure. If an |
10742
|
insurer assumes the corporation'sassociation'sobligations for |
10743
|
a policy, it must issue a replacement policy for a 1-year term |
10744
|
upon expiration of the corporationassociationpolicy and must |
10745
|
renew the replacement policy at approved rates on substantially |
10746
|
similar terms for two additional 1-year terms, unless canceled |
10747
|
by the insurer for a lawful reason other than reduction of |
10748
|
hurricane exposure. For each replacement policy canceled or |
10749
|
nonrenewed by the insurer for any reason during the 3-year |
10750
|
coverage period required by this subparagraph, the insurer must |
10751
|
remove from the corporationassociationone additional policy |
10752
|
covering a risk similar to the risk covered by the canceled or |
10753
|
nonrenewed policy. |
10754
|
(c) A take-out plan is deemed approved unless the office |
10755
|
department, within 120 days after the board votes to recommend |
10756
|
the plan, disapproves the plan based on: |
10757
|
1. The capacity of the insurer to absorb the policies |
10758
|
proposed to be taken out of the corporationassociationand the |
10759
|
concentration of risks of those policies. |
10760
|
2. Whether the geographic and risk characteristics of |
10761
|
policies in the proposed take-out plan serve to reduce the |
10762
|
exposure of the corporationassociationsufficiently to justify |
10763
|
the bonus. |
10764
|
3. Whether coverage for risks to be taken out otherwise |
10765
|
exists in the admitted voluntary market. |
10766
|
4. The degree to which the take-out bonus is promoting new |
10767
|
capital being allocated by the insurer to residential property |
10768
|
coverage in this state. |
10769
|
(d) The calculation of an insurer's regular assessment |
10770
|
liability under s. 627.351(b)3.a. and b., but not emergency |
10771
|
assessments collected from policyholders pursuant to s. |
10772
|
627.351(6)(b)3.d., shall, with respect to commercial residential |
10773
|
policies removed from the corporationassociationunder an |
10774
|
approved take-out plan, exclude such removed policies for the |
10775
|
succeeding 3 years, as follows: |
10776
|
1. In the first year following removal of the policies, |
10777
|
the policies are excluded from the calculation to the extent of |
10778
|
100 percent. |
10779
|
2. In the second year following removal of the policies, |
10780
|
the policies are excluded from the calculation to the extent of |
10781
|
75 percent. |
10782
|
3. In the third year following removal of the policies, |
10783
|
the policies are excluded from the calculation to the extent of |
10784
|
50 percent. |
10785
|
(e) An insurer that first wrote commercial residential |
10786
|
property coverage in this state on or after June 1, 1996, is |
10787
|
exempt from regular assessments under s. 627.351(6)(b)3.a. and |
10788
|
b., but not emergency assessments collected from policyholders |
10789
|
pursuant to s. 627.351(6)(b)3.d., with respect to commercial |
10790
|
residential policies until the earlier of: |
10791
|
1. The end of the calendar year in which such insurer |
10792
|
first wrote 0.5 percent or more of the statewide aggregate |
10793
|
direct written premium for commercial residential property |
10794
|
coverage; or |
10795
|
2. December 31 of the third year in which such insurer |
10796
|
wrote commercial residential property coverage in this state. |
10797
|
(f) An insurer that is not otherwise exempt from regular |
10798
|
assessments under s. 627.351(6)(b)3.a. and b. with respect to |
10799
|
commercial residential policies is, for any calendar year in |
10800
|
which such insurer increased its total commercial residential |
10801
|
hurricane exposure by 25 percent or more over its exposure for |
10802
|
the preceding calendar year, exempt from regular assessments |
10803
|
under s. 627.351(6)(b)3.a. and b., but not emergency assessments |
10804
|
collected from policyholders pursuant to s. 627.351(6)(b)3.d., |
10805
|
attributable to such increased exposure. |
10806
|
(7) A minority business, which is at least 51 percent |
10807
|
owned by minority persons as described in s. 288.703(3), |
10808
|
desiring to operate or become licensed as a property and |
10809
|
casualty insurer may exempt up to $50 of the escrow requirements |
10810
|
of the take-out bonus, as described in this section. Such |
10811
|
minority business, which has applied for a certificate of |
10812
|
authority to engage in business as a property and casualty |
10813
|
insurer, may simultaneously file the business' proposed take-out |
10814
|
plan, as described in this section, with the corporationto the |
10815
|
Residential Property and Casualty Joint Underwriting |
10816
|
Association. |
10817
|
Section 201. Section 627.3513, Florida Statutes, is |
10818
|
amended to read: |
10819
|
627.3513 Standards for sale of bonds by Citizens Property |
10820
|
Insurance Corporationunderwriting associations.-- |
10821
|
(1)(a) The purpose of this section is to provide standards |
10822
|
for the sale of bonds pursuant to s. 627.351(2) and (6). |
10823
|
(b) The term "corporation," as used in this section, means |
10824
|
the Citizens Property Insurance Corporation."Association" or |
10825
|
"associations," for purposes of this section, means the Florida |
10826
|
Windstorm Underwriting Association and the Residential Property |
10827
|
and Casualty Joint Underwriting Association as established |
10828
|
pursuant to s. 627.351(2) and (6), and any corporation or other |
10829
|
entity established pursuant to those subsections. |
10830
|
(2) The plan of operation of the corporationeach |
10831
|
associationshall provide for the selection of financial |
10832
|
services providers and underwriters. Such provisions shall |
10833
|
include the method for publicizing or otherwise providing |
10834
|
reasonable notice to potential financial services providers, |
10835
|
underwriters, and other interested parties, which may include |
10836
|
expedited procedures and methods for emergency situations. The |
10837
|
corporationassociationsshall not engage the services of any |
10838
|
person or firm as a securities broker or bond underwriter that |
10839
|
is not eligible to be engaged by the state under the provisions |
10840
|
of s. 215.684. The corporationassociationsshall make all |
10841
|
selections of financial service providers and managing |
10842
|
underwriters at a noticed public meeting. |
10843
|
(3) The plan of operation of the corporationeach |
10844
|
associationshall provide for any managing underwriter or |
10845
|
financial adviser to provide to the corporationassociationa |
10846
|
disclosure statement containing at least the following |
10847
|
information: |
10848
|
(a) An itemized list setting forth the nature and |
10849
|
estimated amounts of expenses to be incurred by the managing |
10850
|
underwriter in connection with the issuance of such bonds. |
10851
|
Notwithstanding the foregoing, any such list may include an item |
10852
|
for miscellaneous expenses, provided such item includes only |
10853
|
minor items of expense which cannot be easily categorized |
10854
|
elsewhere in the statement. |
10855
|
(b) The names, addresses, and estimated amounts of |
10856
|
compensation of any finders connected with the issuance of the |
10857
|
bonds. |
10858
|
(c) The amount of underwriting spread expected to be |
10859
|
realized and the amount of fees and expenses expected to be paid |
10860
|
to the financial adviser. |
10861
|
(d) Any management fee charged by the managing |
10862
|
underwriter. |
10863
|
(e) Any other fee, bonus, or compensation estimated to be |
10864
|
paid by the managing underwriter in connection with the bond |
10865
|
issue to any person not regularly employed or retained by it. |
10866
|
(f) The name and address of each financial adviser or |
10867
|
managing underwriter, if any, connected with the bond issue. |
10868
|
(g) Any other disclosure which the corporationassociation |
10869
|
may require. |
10870
|
(4)(a) No underwriter, commercial bank, investment banker, |
10871
|
or financial consultant or adviser shall pay any finder any |
10872
|
bonus, fee, or gratuity in connection with the sale of bonds |
10873
|
issued by the corporationassociationunless full disclosure is |
10874
|
made in writing to the corporationassociationprior to or |
10875
|
concurrently with the submission of a purchase proposal for |
10876
|
bonds by the underwriter, commercial bank, investment banker, or |
10877
|
financial consultant or adviser, providing the name and address |
10878
|
of any finder and the amount of bonus, fee, or gratuity paid to |
10879
|
such finder. A violation of this subsection shall not affect the |
10880
|
validity of the bond issue. |
10881
|
(b) As used in this subsection, the term "finder" means a |
10882
|
person who is neither regularly employed by, nor a partner or |
10883
|
officer of, an underwriter, bank, banker, or financial |
10884
|
consultant or adviser and who enters into an understanding with |
10885
|
either the issuer or the managing underwriter, or both, for any |
10886
|
paid or promised compensation or valuable consideration, |
10887
|
directly or indirectly, expressed or implied, to act solely as |
10888
|
an intermediary between such issuer and managing underwriter for |
10889
|
the purpose of influencing any transaction in the purpose of |
10890
|
such bonds. |
10891
|
(5) This section is not intended to restrict or prohibit |
10892
|
the employment of professional services relating to bonds issued |
10893
|
under s. 627.351(6)s. 627.351(2) or (6)or the issuance of |
10894
|
bonds by the corporationassociations. |
10895
|
(6) The failure of the corporationassociationto comply |
10896
|
with one or more provisions of this section shall not affect the |
10897
|
validity of the bond issue; however, the failure of the |
10898
|
corporationeither associationto comply in good faith both with |
10899
|
this section and with the plan as amended shall be a violation |
10900
|
of its plan of operation and a violation of the insurance code. |
10901
|
Section 202. Section 627.3515, Florida Statutes, is |
10902
|
amended to read: |
10903
|
627.3515 Market assistance plan; property and casualty |
10904
|
risks.-- |
10905
|
(1) The officedepartmentshall adopt a market assistance |
10906
|
plan to assist in the placement of risks of applicants who are |
10907
|
unable to procure property insurance as defined in s. 624.604 or |
10908
|
casualty insurance as defined in s. 624.605(1)(b), (e), (f), |
10909
|
(g), or (h) from authorized insurers when such insurance is |
10910
|
otherwise generally available from insurers authorized to |
10911
|
transact and actually writing that kind and class of insurance |
10912
|
in this state. Through such measures as are found appropriate by |
10913
|
the board of governors, the market assistance plan shall take |
10914
|
affirmative steps to assist in the removal from the Citizens |
10915
|
Property Insurance CorporationResidential Property and Casualty |
10916
|
Joint Underwriting Associationany risk that can be placed in |
10917
|
the voluntary market. All property and casualty insurers |
10918
|
licensed in this state shall participate in the plan. |
10919
|
(2)(a) Each person serving as a member of the board of |
10920
|
governors of the Citizens Property Insurance Corporation |
10921
|
Residential Property and Casualty Joint Underwriting Association |
10922
|
shall also serve as a member of the board of governors of the |
10923
|
market assistance plan. |
10924
|
(b) The plan shall be funded through payments from the |
10925
|
Citizens Property Insurance CorporationResidential Property and |
10926
|
Casualty Joint Underwriting Associationand annual assessments |
10927
|
of residential property insurers in the amount of $450. |
10928
|
(c) The plan is not required to assist in the placement of |
10929
|
any workers' compensation, employer's liability, malpractice, or |
10930
|
motor vehicle insurance coverage. |
10931
|
Section 203. Subsections (2), (4), and (6), paragraphs (c) |
10932
|
and (h) of subsection (7), and subsection (8) of section |
10933
|
627.357, Florida Statutes, are amended to read: |
10934
|
627.357 Medical malpractice self-insurance.-- |
10935
|
(2) A group or association of health care providers |
10936
|
composed of any number of members, is authorized to self-insure |
10937
|
against claims arising out of the rendering of, or failure to |
10938
|
render, medical care or services, or against claims for injury |
10939
|
or death to the insured's patients arising out of the insured's |
10940
|
activities, upon obtaining approval from the officedepartment |
10941
|
and upon complying with the following conditions: |
10942
|
(a) Establishment of a Medical Malpractice Risk Management |
10943
|
Trust Fund to provide coverage against professional medical |
10944
|
malpractice liability. |
10945
|
(b) Employment of professional consultants for loss |
10946
|
prevention and claims management coordination under a risk |
10947
|
management program. |
10948
|
(4) The fund is subject to regulation and investigation by |
10949
|
the officedepartment. The fund is subject to rules of the |
10950
|
commissiondepartmentand to part IX of chapter 626, relating to |
10951
|
trade practices and frauds. |
10952
|
(6) The commissiondepartmentshall adopt rules to |
10953
|
implement this section, including rules that ensure that a trust |
10954
|
fund maintains a sufficient reserve to cover contingent |
10955
|
liabilities under subsection (7) in the event of its |
10956
|
dissolution. |
10957
|
(7) |
10958
|
(c) The trust fund may from time to time assess members of |
10959
|
the fund liable therefor under the terms of their policies and |
10960
|
pursuant to this section. The officedepartmentmay assess the |
10961
|
members in the event of liquidation of the fund. |
10962
|
(h) If the trust fund fails to make an assessment as |
10963
|
required by paragraph(g), the officedepartmentshall order the |
10964
|
fund to do so. If the deficiency is not sufficiently made up |
10965
|
within 60 days after the date of the order, the fund is deemed |
10966
|
insolvent and grounds exist to proceed against the fund as |
10967
|
provided for in part I of chapter 631. |
10968
|
(8) The expense factors associated with rates used by a |
10969
|
fund shall be filed with the officedepartmentat least 30 days |
10970
|
prior to use and may not be used until approved by the office |
10971
|
department. The officedepartmentshall disapprove the rates |
10972
|
unless the filed expense factors associated therewith are |
10973
|
justified and reasonable for the benefits and services provided. |
10974
|
Section 204. Paragraph (a) of subsection (3) of section |
10975
|
627.4236, Florida Statutes, is amended to read: |
10976
|
627.4236 Coverage for bone marrow transplant procedures.-- |
10977
|
(3)(a) The Agency for Health Care Administration shall |
10978
|
adopt rules specifying the bone marrow transplant procedures |
10979
|
that are accepted within the appropriate oncological specialty |
10980
|
and are not experimental for purposes of this section. The rules |
10981
|
must be based upon recommendations of an advisory panel |
10982
|
appointed by the secretary of the agency, composed of: |
10983
|
1. One adult oncologist, selected from a list of three |
10984
|
names recommended by the Florida Medical Association; |
10985
|
2. One pediatric oncologist, selected from a list of three |
10986
|
names recommended by the Florida Pediatric Society; |
10987
|
3. One representative of the J. Hillis Miller Health |
10988
|
Center at the University of Florida; |
10989
|
4. One representative of the H. Lee Moffitt Cancer Center |
10990
|
and Research Institute, Inc.; |
10991
|
5. One consumer representative, selected from a list of |
10992
|
three names recommended by the Chief Financial OfficerInsurance |
10993
|
Commissioner; |
10994
|
6. One representative of the Health Insurance Association |
10995
|
of America; |
10996
|
7. Two representatives of health insurers, one of whom |
10997
|
represents the insurer with the largest Florida health insurance |
10998
|
premium volume and one of whom represents the insurer with the |
10999
|
second largest Florida health insurance premium volume; and |
11000
|
8. One representative of the insurer with the largest |
11001
|
Florida small group health insurance premium volume. |
11002
|
Section 205. Paragraphs (a) and (e) of subsection (2), |
11003
|
subsection (3), paragraphs (e), (j), and (k) of subsection (4), |
11004
|
and subsection (6) of section 627.6488, Florida Statutes, are |
11005
|
amended to read: |
11006
|
627.6488 Florida Comprehensive Health Association.-- |
11007
|
(2)(a) The association shall operate subject to the |
11008
|
supervision and approval of a three-member board of directors. |
11009
|
The board of directors shall be appointed by the Chief Financial |
11010
|
OfficerInsurance Commissioneras follows: |
11011
|
1. The chair of the board shall be the Chief Financial |
11012
|
OfficerInsurance Commissioneror his or her designee. |
11013
|
2. One representative of policyholders who is not |
11014
|
associated with the medical profession, a hospital, or an |
11015
|
insurer. |
11016
|
3. One representative of insurers. |
11017
|
|
11018
|
|
11019
|
The administrator or his or her affiliate shall not be a member |
11020
|
of the board. Any board member appointed by the Chief Financial |
11021
|
Officercommissionermay be removed and replaced by him or her |
11022
|
at any time without cause. |
11023
|
(e) There shall be no liability on the part of, and no |
11024
|
cause of action of any nature shall arise against, any member |
11025
|
insurer, or its agents or employees, agents or employees of the |
11026
|
association, members of the board of directors of the |
11027
|
association, or the Chief Financial Officer'sdepartmental |
11028
|
representatives for any act or omission taken by them in the |
11029
|
performance of their powers and duties under this act, unless |
11030
|
such act or omission by such person is in intentional disregard |
11031
|
of the rights of the claimant. |
11032
|
(3) The association shall adopt a plan pursuant to this |
11033
|
act and submit its articles, bylaws, and operating rules to the |
11034
|
officedepartmentfor approval. If the association fails to |
11035
|
adopt such plan and suitable articles, bylaws, and operating |
11036
|
rules within 180 days after the appointment of the board, the |
11037
|
commissiondepartmentshall adopt rules to effectuate the |
11038
|
provisions of this act; and such rules shall remain in effect |
11039
|
until superseded by a plan and articles, bylaws, and operating |
11040
|
rules submitted by the association and approved by the office |
11041
|
department. |
11042
|
(4) The association shall: |
11043
|
(e) Require that all policy forms issued by the |
11044
|
association conform to standard forms developed by the |
11045
|
association. The forms shall be approved by the office |
11046
|
department. |
11047
|
(j) Make a report to the Governor, the officeInsurance |
11048
|
Commissioner, the President of the Senate, the Speaker of the |
11049
|
House of Representatives, and the Minority Leaders of the Senate |
11050
|
and House of Representatives, not later than 45 days after the |
11051
|
close of each calendar quarter, which includes, for the prior |
11052
|
quarter, current data and estimates of net written and earned |
11053
|
premiums, the expenses of administration, and the paid and |
11054
|
incurred losses. The report shall identify any statutorily |
11055
|
mandated program that has not been fully implemented by the |
11056
|
board. |
11057
|
(k) To facilitate preparation of assessments and for other |
11058
|
purposes, the board shall direct preparation of annual audited |
11059
|
financial statements for each calendar year as soon as feasible |
11060
|
following the conclusion of that calendar year, and shall, |
11061
|
within 30 days after rendition of such statements, file with the |
11062
|
officedepartmentthe annual report containing such information |
11063
|
as required by the officedepartmentto be filed on March 1 of |
11064
|
each year. |
11065
|
(6) The officedepartmentshall examine and investigate |
11066
|
the association in the manner provided in part II of chapter |
11067
|
624. |
11068
|
Section 206. Paragraph (a) of subsection (3), paragraphs |
11069
|
(c), (d), (e), and (i) of subsection (5), paragraphs (a) and (b) |
11070
|
of subsection (6), paragraphs (b), (c), and (d) of subsection |
11071
|
(8), paragraphs (a) and (b) of subsection (9), subsection (10), |
11072
|
paragraphs (b), (c), (d), (e), (g), (h), (j), and (m) of |
11073
|
subsection (11), subsection (12), paragraph (i) of subsection |
11074
|
(13), paragraph(a) of subsection (15), and subsection (16) of |
11075
|
section 627.6699, Florida Statutes, are amended to read: |
11076
|
627.6699 Employee Health Care Access Act.-- |
11077
|
(3) DEFINITIONS.--As used in this section, the term: |
11078
|
(a) "Actuarial certification" means a written statement, |
11079
|
by a member of the American Academy of Actuaries or another |
11080
|
person acceptable to the officedepartment, that a small |
11081
|
employer carrier is in compliance with subsection (6), based |
11082
|
upon the person's examination, including a review of the |
11083
|
appropriate records and of the actuarial assumptions and methods |
11084
|
used by the carrier in establishing premium rates for applicable |
11085
|
health benefit plans. |
11086
|
(5) AVAILABILITY OF COVERAGE.-- |
11087
|
(c) Every small employer carrier must, as a condition of |
11088
|
transacting business in this state: |
11089
|
1. Beginning July 1, 2000,Offer and issue all small |
11090
|
employer health benefit plans on a guaranteed-issue basis to |
11091
|
every eligible small employer, with 2 to 50 eligible employees, |
11092
|
that elects to be covered under such plan, agrees to make the |
11093
|
required premium payments, and satisfies the other provisions of |
11094
|
the plan. A rider for additional or increased benefits may be |
11095
|
medically underwritten and may only be added to the standard |
11096
|
health benefit plan. The increased rate charged for the |
11097
|
additional or increased benefit must be rated in accordance with |
11098
|
this section. |
11099
|
2. Beginning July 1, 2000, and until July 31, 2001, offer |
11100
|
and issue basic and standard small employer health benefit plans |
11101
|
on a guaranteed-issue basis to every eligible small employer |
11102
|
which is eligible for guaranteed renewal, has less than two |
11103
|
eligible employees, is not formed primarily for the purpose of |
11104
|
buying health insurance, elects to be covered under such plan, |
11105
|
agrees to make the required premium payments, and satisfies the |
11106
|
other provisions of the plan. A rider for additional or |
11107
|
increased benefits may be medically underwritten and may be |
11108
|
added only to the standard benefit plan. The increased rate |
11109
|
charged for the additional or increased benefit must be rated in |
11110
|
accordance with this section. For purposes of this subparagraph, |
11111
|
a person, his or her spouse, and his or her dependent children |
11112
|
shall constitute a single eligible employee if that person and |
11113
|
spouse are employed by the same small employer and either one |
11114
|
has a normal work week of less than 25 hours. |
11115
|
2.3. Beginning August 1, 2001,Offer and issue basic and |
11116
|
standard small employer health benefit plans on a guaranteed- |
11117
|
issue basis, during a 31-day open enrollment period of August 1 |
11118
|
through August 31 of each year, to every eligible small |
11119
|
employer, with fewer than two eligible employees, which small |
11120
|
employer is not formed primarily for the purpose of buying |
11121
|
health insurance and which elects to be covered under such plan, |
11122
|
agrees to make the required premium payments, and satisfies the |
11123
|
other provisions of the plan. Coverage provided under this |
11124
|
subparagraph shall begin on October 1 of the same year as the |
11125
|
date of enrollment, unless the small employer carrier and the |
11126
|
small employer agree to a different date. A rider for additional |
11127
|
or increased benefits may be medically underwritten and may only |
11128
|
be added to the standard health benefit plan. The increased |
11129
|
rate charged for the additional or increased benefit must be |
11130
|
rated in accordance with this section. For purposes of this |
11131
|
subparagraph, a person, his or her spouse, and his or her |
11132
|
dependent children constitute a single eligible employee if that |
11133
|
person and spouse are employed by the same small employer and |
11134
|
either that person or his or her spouse has a normal work week |
11135
|
of less than 25 hours. |
11136
|
3.4.This paragraph does not limit a carrier's ability to |
11137
|
offer other health benefit plans to small employers if the |
11138
|
standard and basic health benefit plans are offered and |
11139
|
rejected. |
11140
|
(d) A small employer carrier must file with the office |
11141
|
department, in a format and manner prescribed by the committee, |
11142
|
a standard health care plan and a basic health care plan to be |
11143
|
used by the carrier. |
11144
|
(e) The officedepartmentat any time may, after providing |
11145
|
notice and an opportunity for a hearing, disapprove the |
11146
|
continued use by the small employer carrier of the standard or |
11147
|
basic health benefit plan on the grounds that such plan does not |
11148
|
meet the requirements of this section. |
11149
|
(i)1. A small employer carrier need not offer coverage or |
11150
|
accept applications pursuant to paragraph (a): |
11151
|
a. To a small employer if the small employer is not |
11152
|
physically located in an established geographic service area of |
11153
|
the small employer carrier, provided such geographic service |
11154
|
area shall not be less than a county; |
11155
|
b. To an employee if the employee does not work or reside |
11156
|
within an established geographic service area of the small |
11157
|
employer carrier; or |
11158
|
c. To a small employer group within an area in which the |
11159
|
small employer carrier reasonably anticipates, and demonstrates |
11160
|
to the satisfaction of the officedepartment, that it cannot, |
11161
|
within its network of providers, deliver service adequately to |
11162
|
the members of such groups because of obligations to existing |
11163
|
group contract holders and enrollees. |
11164
|
2. A small employer carrier that cannot offer coverage |
11165
|
pursuant to sub-subparagraph 1.c. may not offer coverage in the |
11166
|
applicable area to new cases of employer groups having more than |
11167
|
50 eligible employees or small employer groups until the later |
11168
|
of 180 days following each such refusal or the date on which the |
11169
|
carrier notifies the officedepartmentthat it has regained its |
11170
|
ability to deliver services to small employer groups. |
11171
|
3.a. A small employer carrier may deny health insurance |
11172
|
coverage in the small-group market if the carrier has |
11173
|
demonstrated to the officedepartmentthat: |
11174
|
(I) It does not have the financial reserves necessary to |
11175
|
underwrite additional coverage; and |
11176
|
(II) It is applying this sub-subparagraph uniformly to all |
11177
|
employers in the small-group market in this state consistent |
11178
|
with this section and without regard to the claims experience of |
11179
|
those employers and their employees and their dependents or any |
11180
|
health-status-related factor that relates to such employees and |
11181
|
dependents. |
11182
|
b. A small employer carrier, upon denying health insurance |
11183
|
coverage in connection with health benefit plans in accordance |
11184
|
with sub-subparagraph a., may not offer coverage in connection |
11185
|
with group health benefit plans in the small-group market in |
11186
|
this state for a period of 180 days after the date such coverage |
11187
|
is denied or until the insurer has demonstrated to the office |
11188
|
departmentthat the insurer has sufficient financial reserves to |
11189
|
underwrite additional coverage, whichever is later. The office |
11190
|
departmentmay provide for the application of this sub- |
11191
|
subparagraph on a service-area-specific basis. |
11192
|
4. Beginning in 1994, The commissiondepartmentshall, by |
11193
|
rule, require each small employer carrier to report, on or |
11194
|
before March 1 of each year, its gross annual premiums for all |
11195
|
health benefit plans issued to small employers during the |
11196
|
previous calendar year, and also to report its gross annual |
11197
|
premiums for new, but not renewal, standard and basic health |
11198
|
benefit plans subject to this section issued during the previous |
11199
|
calendar year. No later than May 1 of each year, the office |
11200
|
departmentshall calculate each carrier's percentage of all |
11201
|
small employer group health premiums for the previous calendar |
11202
|
year and shall calculate the aggregate gross annual premiums for |
11203
|
new, but not renewal, standard and basic health benefit plans |
11204
|
for the previous calendar year. |
11205
|
(6) RESTRICTIONS RELATING TO PREMIUM RATES.-- |
11206
|
(a) The commissiondepartmentmay, by rule, establish |
11207
|
regulations to administer this section and to assure that rating |
11208
|
practices used by small employer carriers are consistent with |
11209
|
the purpose of this section, including assuring that differences |
11210
|
in rates charged for health benefit plans by small employer |
11211
|
carriers are reasonable and reflect objective differences in |
11212
|
plan design, not including differences due to the nature of the |
11213
|
groups assumed to select particular health benefit plans. |
11214
|
(b) For all small employer health benefit plans that are |
11215
|
subject to this section and are issued by small employer |
11216
|
carriers on or after January 1, 1994, premium rates for health |
11217
|
benefit plans subject to this section are subject to the |
11218
|
following: |
11219
|
1. Small employer carriers must use a modified community |
11220
|
rating methodology in which the premium for each small employer |
11221
|
must be determined solely on the basis of the eligible |
11222
|
employee's and eligible dependent's gender, age, family |
11223
|
composition, tobacco use, or geographic area as determined under |
11224
|
paragraph (5)(j) and in which the premium may be adjusted as |
11225
|
permitted by this paragraph. |
11226
|
2. Rating factors related to age, gender, family |
11227
|
composition, tobacco use, or geographic location may be |
11228
|
developed by each carrier to reflect the carrier's experience. |
11229
|
The factors used by carriers are subject to officedepartment |
11230
|
review and approval. |
11231
|
3. Small employer carriers may not modify the rate for a |
11232
|
small employer for 12 months from the initial issue date or |
11233
|
renewal date, unless the composition of the group changes or |
11234
|
benefits are changed. However, a small employer carrier may |
11235
|
modify the rate one time prior to 12 months after the initial |
11236
|
issue date for a small employer who enrolls under a previously |
11237
|
issued group policy that has a common anniversary date for all |
11238
|
employers covered under the policy if: |
11239
|
a. The carrier discloses to the employer in a clear and |
11240
|
conspicuous manner the date of the first renewal and the fact |
11241
|
that the premium may increase on or after that date. |
11242
|
b. The insurer demonstrates to the officedepartmentthat |
11243
|
efficiencies in administration are achieved and reflected in the |
11244
|
rates charged to small employers covered under the policy. |
11245
|
4. A carrier may issue a group health insurance policy to |
11246
|
a small employer health alliance or other group association with |
11247
|
rates that reflect a premium credit for expense savings |
11248
|
attributable to administrative activities being performed by the |
11249
|
alliance or group association if such expense savings are |
11250
|
specifically documented in the insurer's rate filing and are |
11251
|
approved by the officedepartment. Any such credit may not be |
11252
|
based on different morbidity assumptions or on any other factor |
11253
|
related to the health status or claims experience of any person |
11254
|
covered under the policy. Nothing in this subparagraph exempts |
11255
|
an alliance or group association from licensure for any |
11256
|
activities that require licensure under the insurance code. A |
11257
|
carrier issuing a group health insurance policy to a small |
11258
|
employer health alliance or other group association shall allow |
11259
|
any properly licensed and appointed agent of that carrier to |
11260
|
market and sell the small employer health alliance or other |
11261
|
group association policy. Such agent shall be paid the usual and |
11262
|
customary commission paid to any agent selling the policy. |
11263
|
5. Any adjustments in rates for claims experience, health |
11264
|
status, or duration of coverage may not be charged to individual |
11265
|
employees or dependents. For a small employer's policy, such |
11266
|
adjustments may not result in a rate for the small employer |
11267
|
which deviates more than 15 percent from the carrier's approved |
11268
|
rate. Any such adjustment must be applied uniformly to the rates |
11269
|
charged for all employees and dependents of the small employer. |
11270
|
A small employer carrier may make an adjustment to a small |
11271
|
employer's renewal premium, not to exceed 10 percent annually, |
11272
|
due to the claims experience, health status, or duration of |
11273
|
coverage of the employees or dependents of the small employer. |
11274
|
Semiannually, small group carriers shall report information on |
11275
|
forms adopted by rule by the commissiondepartment, to enable |
11276
|
the officedepartmentto monitor the relationship of aggregate |
11277
|
adjusted premiums actually charged policyholders by each carrier |
11278
|
to the premiums that would have been charged by application of |
11279
|
the carrier's approved modified community rates. If the |
11280
|
aggregate resulting from the application of such adjustment |
11281
|
exceeds the premium that would have been charged by application |
11282
|
of the approved modified community rate by 5 percent for the |
11283
|
current reporting period, the carrier shall limit the |
11284
|
application of such adjustments only to minus adjustments |
11285
|
beginning not more than 60 days after the report is sent to the |
11286
|
officedepartment. For any subsequent reporting period, if the |
11287
|
total aggregate adjusted premium actually charged does not |
11288
|
exceed the premium that would have been charged by application |
11289
|
of the approved modified community rate by 5 percent, the |
11290
|
carrier may apply both plus and minus adjustments. A small |
11291
|
employer carrier may provide a credit to a small employer's |
11292
|
premium based on administrative and acquisition expense |
11293
|
differences resulting from the size of the group. Group size |
11294
|
administrative and acquisition expense factors may be developed |
11295
|
by each carrier to reflect the carrier's experience and are |
11296
|
subject to officedepartmentreview and approval. |
11297
|
6. A small employer carrier rating methodology may include |
11298
|
separate rating categories for one dependent child, for two |
11299
|
dependent children, and for three or more dependent children for |
11300
|
family coverage of employees having a spouse and dependent |
11301
|
children or employees having dependent children only. A small |
11302
|
employer carrier may have fewer, but not greater, numbers of |
11303
|
categories for dependent children than those specified in this |
11304
|
subparagraph. |
11305
|
7. Small employer carriers may not use a composite rating |
11306
|
methodology to rate a small employer with fewer than 10 |
11307
|
employees. For the purposes of this subparagraph, a "composite |
11308
|
rating methodology" means a rating methodology that averages the |
11309
|
impact of the rating factors for age and gender in the premiums |
11310
|
charged to all of the employees of a small employer. |
11311
|
8.a. A carrier may separate the experience of small |
11312
|
employer groups with less than 2 eligible employees from the |
11313
|
experience of small employer groups with 2-50 eligible employees |
11314
|
for purposes of determining an alternative modified community |
11315
|
rating. |
11316
|
b. If a carrier separates the experience of small employer |
11317
|
groups as provided in sub-subparagraph a., the rate to be |
11318
|
charged to small employer groups of less than 2 eligible |
11319
|
employees may not exceed 150 percent of the rate determined for |
11320
|
small employer groups of 2-50 eligible employees. However, the |
11321
|
carrier may charge excess losses of the experience pool |
11322
|
consisting of small employer groups with less than 2 eligible |
11323
|
employees to the experience pool consisting of small employer |
11324
|
groups with 2-50 eligible employees so that all losses are |
11325
|
allocated and the 150-percent rate limit on the experience pool |
11326
|
consisting of small employer groups with less than 2 eligible |
11327
|
employees is maintained. Notwithstanding s. 627.411(1), the rate |
11328
|
to be charged to a small employer group of fewer than 2 eligible |
11329
|
employees, insured as of July 1, 2002, may be up to 125 percent |
11330
|
of the rate determined for small employer groups of 2-50 |
11331
|
eligible employees for the first annual renewal and 150 percent |
11332
|
for subsequent annual renewals. |
11333
|
(8) MAINTENANCE OF RECORDS.-- |
11334
|
(b) Each small employer carrier must file with the office |
11335
|
departmenton or before March 15 of each year an actuarial |
11336
|
certification that the carrier is in compliance with this |
11337
|
section and that the rating methods of the carrier are |
11338
|
actuarially sound. The certification must be in a form and |
11339
|
manner and contain the information prescribed by the commission |
11340
|
department. The carrier must retain a copy of the certification |
11341
|
at its principal place of business. |
11342
|
(c) A small employer carrier must make the information and |
11343
|
documentation described in paragraph (a) available to the office |
11344
|
departmentupon request. The information constitutes |
11345
|
proprietary and trade secret information and may not be |
11346
|
disclosed by the officedepartment to persons outside the office |
11347
|
department, except as agreed to by the carrier or as ordered by |
11348
|
a court of competent jurisdiction. |
11349
|
(d) Each small employer carrier must file with the office |
11350
|
department quarterly an enrollment report as directed by the |
11351
|
officedepartment. Such report shall not constitute proprietary |
11352
|
or trade secret information. |
11353
|
(9) SMALL EMPLOYER CARRIER'S ELECTION TO BECOME A RISK- |
11354
|
ASSUMING CARRIER OR A REINSURING CARRIER.-- |
11355
|
(a) A small employer carrier must elect to become either a |
11356
|
risk-assuming carrier or a reinsuring carrier. Each small |
11357
|
employer carrier must make an initial election, binding through |
11358
|
January 1, 1994. The carrier's initial election must be made no |
11359
|
later than October 31, 1992. By October 31, 1993, all small |
11360
|
employer carriers must file a final election, which is binding |
11361
|
for 2 years, from January 1, 1994, through December 31, 1995, |
11362
|
after which an election shall be binding for a period of 5 |
11363
|
years. Any carrier that is not a small employer carrier on |
11364
|
October 31, 1992, and intends to become a small employer carrier |
11365
|
after October 31, 1992, must file its designation when it files |
11366
|
the forms and rates it intends to use for small employer group |
11367
|
health insurance; such designation shall be binding for 2 years |
11368
|
after the date of approval of the forms and rates, and any |
11369
|
subsequent designation is binding for 5 years. The office |
11370
|
departmentmay permit a carrier to modify its election at any |
11371
|
time for good cause shown, after a hearing. |
11372
|
(b) The commissiondepartmentshall establish an |
11373
|
application process for small employer carriers seeking to |
11374
|
change their status under this subsection. |
11375
|
(10) ELECTION PROCESS TO BECOME A RISK-ASSUMING CARRIER.-- |
11376
|
(a)1. A small employer carrier may become a risk-assuming |
11377
|
carrier by filing with the officedepartmenta designation of |
11378
|
election under subsection (9) in a format and manner prescribed |
11379
|
by the commissiondepartment. The officedepartmentshall |
11380
|
approve the election of a small employer carrier to become a |
11381
|
risk-assuming carrier if the officedepartmentfinds that the |
11382
|
carrier is capable of assuming that status pursuant to the |
11383
|
criteria set forth in paragraph (b). |
11384
|
2. The officedepartmentmust approve or disapprove any |
11385
|
designation as a risk-assuming carrier within 60 days after |
11386
|
filing. |
11387
|
(b) In determining whether to approve an application by a |
11388
|
small employer carrier to become a risk-assuming carrier, the |
11389
|
officedepartmentshall consider: |
11390
|
1. The carrier's financial ability to support the |
11391
|
assumption of the risk of small employer groups. |
11392
|
2. The carrier's history of rating and underwriting small |
11393
|
employer groups. |
11394
|
3. The carrier's commitment to market fairly to all small |
11395
|
employers in the state or its service area, as applicable. |
11396
|
4. The carrier's ability to assume and manage the risk of |
11397
|
enrolling small employer groups without the protection of the |
11398
|
reinsurance program provided in subsection (11). |
11399
|
(c) A small employer carrier that becomes a risk-assuming |
11400
|
carrier pursuant to this subsection is not subject to the |
11401
|
assessment provisions of subsection(11). |
11402
|
(d) The officedepartmentshall provide public notice of a |
11403
|
small employer carrier's designation of election under |
11404
|
subsection(9) to become a risk-assuming carrier and shall |
11405
|
provide at least a 21-day period for public comment prior to |
11406
|
making a decision on the election. The officedepartmentshall |
11407
|
hold a hearing on the election at the request of the carrier. |
11408
|
(e) The officedepartmentmay rescind the approval granted |
11409
|
to a risk-assuming carrier under this subsection if the office |
11410
|
departmentfinds that the carrier no longer meets the criteria |
11411
|
of paragraph (b). |
11412
|
(11) SMALL EMPLOYER HEALTH REINSURANCE PROGRAM.-- |
11413
|
(b)1. The program shall operate subject to the supervision |
11414
|
and control of the board. |
11415
|
2. Effective upon this act becoming a law, the board shall |
11416
|
consist of the Chief Financial Officercommissioneror his or |
11417
|
her designee, who shall serve as the chairperson, and 13 |
11418
|
additional members who are representatives of carriers and |
11419
|
insurance agents and are appointed by the Chief Financial |
11420
|
Officercommissionerand serve as follows: |
11421
|
a. The Chief Financial Officercommissionershall include |
11422
|
representatives of small employer carriers subject to assessment |
11423
|
under this subsection. If two or more carriers elect to be |
11424
|
risk-assuming carriers, the membership must include at least two |
11425
|
representatives of risk-assuming carriers; if one carrier is |
11426
|
risk-assuming, one member must be a representative of such |
11427
|
carrier. At least one member must be a carrier who is subject |
11428
|
to the assessments, but is not a small employer carrier. |
11429
|
Subject to such restrictions, at least five members shall be |
11430
|
selected from individuals recommended by small employer carriers |
11431
|
pursuant to procedures provided by rule of the commission |
11432
|
department. Three members shall be selected from a list of |
11433
|
health insurance carriers that issue individual health insurance |
11434
|
policies. At least two of the three members selected must be |
11435
|
reinsuring carriers. Two members shall be selected from a list |
11436
|
of insurance agents who are actively engaged in the sale of |
11437
|
health insurance. |
11438
|
b. A member appointed under this subparagraph shall serve |
11439
|
a term of 4 years and shall continue in office until the |
11440
|
member's successor takes office, except that, in order to |
11441
|
provide for staggered terms, the Chief Financial Officer |
11442
|
commissionershall designate two of the initial appointees under |
11443
|
this subparagraph to serve terms of 2 years and shall designate |
11444
|
three of the initial appointees under this subparagraph to serve |
11445
|
terms of 3 years. |
11446
|
3. The Chief Financial Officercommissionermay remove a |
11447
|
member for cause. |
11448
|
4. Vacancies on the board shall be filled in the same |
11449
|
manner as the original appointment for the unexpired portion of |
11450
|
the term. |
11451
|
5. The Chief Financial Officercommissionermay require an |
11452
|
entity that recommends persons for appointment to submit |
11453
|
additional lists of recommended appointees. |
11454
|
(c)1. No later than August 15, 1992,The board shall |
11455
|
submit to the officedepartmenta plan of operation to assure |
11456
|
the fair, reasonable, and equitable administration of the |
11457
|
program. The board may at any time submit to the office |
11458
|
departmentany amendments to the plan that the board finds to be |
11459
|
necessary or suitable. |
11460
|
2. No later than September 15, 1992, The officedepartment |
11461
|
shall, after notice and hearing, approve the plan of operation |
11462
|
if it determines that the plan submitted by the board is |
11463
|
suitable to assure the fair, reasonable, and equitable |
11464
|
administration of the program and provides for the sharing of |
11465
|
program gains and losses equitably and proportionately in |
11466
|
accordance with paragraph (j). |
11467
|
3. The plan of operation, or any amendment thereto, |
11468
|
becomes effective upon written approval of the office |
11469
|
department. |
11470
|
(d) The plan of operation must, among other things: |
11471
|
1. Establish procedures for handling and accounting for |
11472
|
program assets and moneys and for an annual fiscal reporting to |
11473
|
the officedepartment. |
11474
|
2. Establish procedures for selecting an administering |
11475
|
carrier and set forth the powers and duties of the administering |
11476
|
carrier. |
11477
|
3. Establish procedures for reinsuring risks. |
11478
|
4. Establish procedures for collecting assessments from |
11479
|
participating carriers to provide for claims reinsured by the |
11480
|
program and for administrative expenses, other than amounts |
11481
|
payable to the administrative carrier, incurred or estimated to |
11482
|
be incurred during the period for which the assessment is made. |
11483
|
5. Provide for any additional matters at the discretion of |
11484
|
the board. |
11485
|
(e) The board shall recommend to the officedepartment |
11486
|
market conduct requirements and other requirements for carriers |
11487
|
and agents, including requirements relating to: |
11488
|
1. Registration by each carrier with the officedepartment |
11489
|
of its intention to be a small employer carrier under this |
11490
|
section; |
11491
|
2. Publication by the officedepartmentof a list of all |
11492
|
small employer carriers, including a requirement applicable to |
11493
|
agents and carriers that a health benefit plan may not be sold |
11494
|
by a carrier that is not identified as a small employer carrier; |
11495
|
3. The availability of a broadly publicized, toll-free |
11496
|
telephone number for access by small employers to information |
11497
|
concerning this section; |
11498
|
4. Periodic reports by carriers and agents concerning |
11499
|
health benefit plans issued; and |
11500
|
5. Methods concerning periodic demonstration by small |
11501
|
employer carriers and agents that they are marketing or issuing |
11502
|
health benefit plans to small employers. |
11503
|
(g) A reinsuring carrier may reinsure with the program |
11504
|
coverage of an eligible employee of a small employer, or any |
11505
|
dependent of such an employee, subject to each of the following |
11506
|
provisions: |
11507
|
1. With respect to a standard and basic health care plan, |
11508
|
the program must reinsure the level of coverage provided; and, |
11509
|
with respect to any other plan, the program must reinsure the |
11510
|
coverage up to, but not exceeding, the level of coverage |
11511
|
provided under the standard and basic health care plan. |
11512
|
2. Except in the case of a late enrollee, a reinsuring |
11513
|
carrier may reinsure an eligible employee or dependent within 60 |
11514
|
days after the commencement of the coverage of the small |
11515
|
employer. A newly employed eligible employee or dependent of a |
11516
|
small employer may be reinsured within 60 days after the |
11517
|
commencement of his or her coverage. |
11518
|
3. A small employer carrier may reinsure an entire |
11519
|
employer group within 60 days after the commencement of the |
11520
|
group's coverage under the plan. The carrier may choose to |
11521
|
reinsure newly eligible employees and dependents of the |
11522
|
reinsured group pursuant to subparagraph 1. |
11523
|
4. The program may not reimburse a participating carrier |
11524
|
with respect to the claims of a reinsured employee or dependent |
11525
|
until the carrier has paid incurred claims of at least $5,000 in |
11526
|
a calendar year for benefits covered by the program. In |
11527
|
addition, the reinsuring carrier shall be responsible for 10 |
11528
|
percent of the next $50,000 and 5 percent of the next $100,000 |
11529
|
of incurred claims during a calendar year and the program shall |
11530
|
reinsure the remainder. |
11531
|
5. The board annually shall adjust the initial level of |
11532
|
claims and the maximum limit to be retained by the carrier to |
11533
|
reflect increases in costs and utilization within the standard |
11534
|
market for health benefit plans within the state. The adjustment |
11535
|
shall not be less than the annual change in the medical |
11536
|
component of the "Consumer Price Index for All Urban Consumers" |
11537
|
of the Bureau of Labor Statistics of the Department of Labor, |
11538
|
unless the board proposes and the officedepartmentapproves a |
11539
|
lower adjustment factor. |
11540
|
6. A small employer carrier may terminate reinsurance for |
11541
|
all reinsured employees or dependents on any plan anniversary. |
11542
|
7. The premium rate charged for reinsurance by the program |
11543
|
to a health maintenance organization that is approved by the |
11544
|
Secretary of Health and Human Services as a federally qualified |
11545
|
health maintenance organization pursuant to 42 U.S.C. s. |
11546
|
300e(c)(2)(A) and that, as such, is subject to requirements that |
11547
|
limit the amount of risk that may be ceded to the program, which |
11548
|
requirements are more restrictive than subparagraph 4., shall be |
11549
|
reduced by an amount equal to that portion of the risk, if any, |
11550
|
which exceeds the amount set forth in subparagraph 4. which may |
11551
|
not be ceded to the program. |
11552
|
8. The board may consider adjustments to the premium rates |
11553
|
charged for reinsurance by the program for carriers that use |
11554
|
effective cost containment measures, including high-cost case |
11555
|
management, as defined by the board. |
11556
|
9. A reinsuring carrier shall apply its case-management |
11557
|
and claims-handling techniques, including, but not limited to, |
11558
|
utilization review, individual case management, preferred |
11559
|
provider provisions, other managed care provisions or methods of |
11560
|
operation, consistently with both reinsured business and |
11561
|
nonreinsured business. |
11562
|
(h)1. The board, as part of the plan of operation, shall |
11563
|
establish a methodology for determining premium rates to be |
11564
|
charged by the program for reinsuring small employers and |
11565
|
individuals pursuant to this section. The methodology shall |
11566
|
include a system for classification of small employers that |
11567
|
reflects the types of case characteristics commonly used by |
11568
|
small employer carriers in the state. The methodology shall |
11569
|
provide for the development of basic reinsurance premium rates, |
11570
|
which shall be multiplied by the factors set for them in this |
11571
|
paragraph to determine the premium rates for the program. The |
11572
|
basic reinsurance premium rates shall be established by the |
11573
|
board, subject to the approval of the officedepartment, and |
11574
|
shall be set at levels which reasonably approximate gross |
11575
|
premiums charged to small employers by small employer carriers |
11576
|
for health benefit plans with benefits similar to the standard |
11577
|
and basic health benefit plan. The premium rates set by the |
11578
|
board may vary by geographical area, as determined under this |
11579
|
section, to reflect differences in cost. The multiplying |
11580
|
factors must be established as follows: |
11581
|
a. The entire group may be reinsured for a rate that is |
11582
|
1.5 times the rate established by the board. |
11583
|
b. An eligible employee or dependent may be reinsured for |
11584
|
a rate that is 5 times the rate established by the board. |
11585
|
2. The board periodically shall review the methodology |
11586
|
established, including the system of classification and any |
11587
|
rating factors, to assure that it reasonably reflects the claims |
11588
|
experience of the program. The board may propose changes to the |
11589
|
rates which shall be subject to the approval of the office |
11590
|
department. |
11591
|
(j)1. Before March 1 of each calendar year, the board |
11592
|
shall determine and report to the officedepartmentthe program |
11593
|
net loss for the previous year, including administrative |
11594
|
expenses for that year, and the incurred losses for the year, |
11595
|
taking into account investment income and other appropriate |
11596
|
gains and losses. |
11597
|
2. Any net loss for the year shall be recouped by |
11598
|
assessment of the carriers, as follows: |
11599
|
a. The operating losses of the program shall be assessed |
11600
|
in the following order subject to the specified limitations. |
11601
|
The first tier of assessments shall be made against reinsuring |
11602
|
carriers in an amount which shall not exceed 5 percent of each |
11603
|
reinsuring carrier's premiums from health benefit plans covering |
11604
|
small employers. If such assessments have been collected and |
11605
|
additional moneys are needed, the board shall make a second tier |
11606
|
of assessments in an amount which shall not exceed 0.5 percent |
11607
|
of each carrier's health benefit plan premiums. Except as |
11608
|
provided in paragraph (n), risk-assuming carriers are exempt |
11609
|
from all assessments authorized pursuant to this section. The |
11610
|
amount paid by a reinsuring carrier for the first tier of |
11611
|
assessments shall be credited against any additional assessments |
11612
|
made. |
11613
|
b. The board shall equitably assess carriers for operating |
11614
|
losses of the plan based on market share. The board shall |
11615
|
annually assess each carrier a portion of the operating losses |
11616
|
of the plan. The first tier of assessments shall be determined |
11617
|
by multiplying the operating losses by a fraction, the numerator |
11618
|
of which equals the reinsuring carrier's earned premium |
11619
|
pertaining to direct writings of small employer health benefit |
11620
|
plans in the state during the calendar year for which the |
11621
|
assessment is levied, and the denominator of which equals the |
11622
|
total of all such premiums earned by reinsuring carriers in the |
11623
|
state during that calendar year. The second tier of assessments |
11624
|
shall be based on the premiums that all carriers, except risk- |
11625
|
assuming carriers, earned on all health benefit plans written in |
11626
|
this state. The board may levy interim assessments against |
11627
|
carriers to ensure the financial ability of the plan to cover |
11628
|
claims expenses and administrative expenses paid or estimated to |
11629
|
be paid in the operation of the plan for the calendar year prior |
11630
|
to the association's anticipated receipt of annual assessments |
11631
|
for that calendar year. Any interim assessment is due and |
11632
|
payable within 30 days after receipt by a carrier of the interim |
11633
|
assessment notice. Interim assessment payments shall be credited |
11634
|
against the carrier's annual assessment. Health benefit plan |
11635
|
premiums and benefits paid by a carrier that are less than an |
11636
|
amount determined by the board to justify the cost of collection |
11637
|
may not be considered for purposes of determining assessments. |
11638
|
c. Subject to the approval of the officedepartment, the |
11639
|
board shall make an adjustment to the assessment formula for |
11640
|
reinsuring carriers that are approved as federally qualified |
11641
|
health maintenance organizations by the Secretary of Health and |
11642
|
Human Services pursuant to 42 U.S.C. s. 300e(c)(2)(A) to the |
11643
|
extent, if any, that restrictions are placed on them that are |
11644
|
not imposed on other small employer carriers. |
11645
|
3. Before March 1 of each year, the board shall determine |
11646
|
and file with the officedepartmentan estimate of the |
11647
|
assessments needed to fund the losses incurred by the program in |
11648
|
the previous calendar year. |
11649
|
4. If the board determines that the assessments needed to |
11650
|
fund the losses incurred by the program in the previous calendar |
11651
|
year will exceed the amount specified in subparagraph 2., the |
11652
|
board shall evaluate the operation of the program and report its |
11653
|
findings, including any recommendations for changes to the plan |
11654
|
of operation, to the officedepartmentwithin 90 days following |
11655
|
the end of the calendar year in which the losses were incurred. |
11656
|
The evaluation shall include an estimate of future assessments, |
11657
|
the administrative costs of the program, the appropriateness of |
11658
|
the premiums charged and the level of carrier retention under |
11659
|
the program, and the costs of coverage for small employers. If |
11660
|
the board fails to file a report with the officedepartment |
11661
|
within 90 days following the end of the applicable calendar |
11662
|
year, the officedepartmentmay evaluate the operations of the |
11663
|
program and implement such amendments to the plan of operation |
11664
|
the officedepartmentdeems necessary to reduce future losses |
11665
|
and assessments. |
11666
|
5. If assessments exceed the amount of the actual losses |
11667
|
and administrative expenses of the program, the excess shall be |
11668
|
held as interest and used by the board to offset future losses |
11669
|
or to reduce program premiums. As used in this paragraph, the |
11670
|
term "future losses" includes reserves for incurred but not |
11671
|
reported claims. |
11672
|
6. Each carrier's proportion of the assessment shall be |
11673
|
determined annually by the board, based on annual statements and |
11674
|
other reports considered necessary by the board and filed by the |
11675
|
carriers with the board. |
11676
|
7. Provision shall be made in the plan of operation for |
11677
|
the imposition of an interest penalty for late payment of an |
11678
|
assessment. |
11679
|
8. A carrier may seek, from the officecommissioner, a |
11680
|
deferment, in whole or in part, from any assessment made by the |
11681
|
board. The officedepartmentmay defer, in whole or in part, |
11682
|
the assessment of a carrier if, in the opinion of the office |
11683
|
department, the payment of the assessment would place the |
11684
|
carrier in a financially impaired condition. If an assessment |
11685
|
against a carrier is deferred, in whole or in part, the amount |
11686
|
by which the assessment is deferred may be assessed against the |
11687
|
other carriers in a manner consistent with the basis for |
11688
|
assessment set forth in this section. The carrier receiving such |
11689
|
deferment remains liable to the program for the amount deferred |
11690
|
and is prohibited from reinsuring any individuals or groups in |
11691
|
the program if it fails to pay assessments. |
11692
|
(m) The board shall monitor compliance with this section, |
11693
|
including the market conduct of small employer carriers, and |
11694
|
shall report to the officedepartmentany unfair trade practices |
11695
|
and misleading or unfair conduct by a small employer carrier |
11696
|
that has been reported to the board by agents, consumers, or any |
11697
|
other person. The officedepartmentshall investigate all |
11698
|
reports and, upon a finding of noncompliance with this section |
11699
|
or of unfair or misleading practices, shall take action against |
11700
|
the small employer carrier as permitted under the insurance code |
11701
|
or chapter 641. The board is not given investigatory or |
11702
|
regulatory powers, but must forward all reports of cases or |
11703
|
abuse or misrepresentation to the officedepartment. |
11704
|
(12) STANDARD, BASIC, AND LIMITED HEALTH BENEFIT PLANS.-- |
11705
|
(a)1. By May 15, 1993, The Chief Financial Officer |
11706
|
commissionershall appoint a health benefit plan committee |
11707
|
composed of four representatives of carriers which shall include |
11708
|
at least two representatives of HMOs, at least one of which is a |
11709
|
staff model HMO, two representatives of agents, four |
11710
|
representatives of small employers, and one employee of a small |
11711
|
employer. The carrier members shall be selected from a list of |
11712
|
individuals recommended by the board. The Chief Financial |
11713
|
Officercommissionermay require the board to submit additional |
11714
|
recommendations of individuals for appointment. |
11715
|
2. The plans shall comply with all of the requirements of |
11716
|
this subsection. |
11717
|
3. The plans must be filed with and approved by the office |
11718
|
departmentprior to issuance or delivery by any small employer |
11719
|
carrier. |
11720
|
4. After approval of the revised health benefit plans, if |
11721
|
the officedepartmentdetermines that modifications to a plan |
11722
|
might be appropriate, the Chief Financial Officercommissioner |
11723
|
shall appoint a new health benefit plan committee in the manner |
11724
|
provided in subparagraph 1. to submit recommended modifications |
11725
|
to the officedepartmentfor approval. |
11726
|
(b)1. Each small employer carrier issuing new health |
11727
|
benefit plans shall offer to any small employer, upon request, a |
11728
|
standard health benefit plan and a basic health benefit plan |
11729
|
that meets the criteria set forth in this section. |
11730
|
2. For purposes of this subsection, the terms "standard |
11731
|
health benefit plan" and "basic health benefit plan" mean |
11732
|
policies or contracts that a small employer carrier offers to |
11733
|
eligible small employers that contain: |
11734
|
a. An exclusion for services that are not medically |
11735
|
necessary or that are not covered preventive health services; |
11736
|
and |
11737
|
b. A procedure for preauthorization by the small employer |
11738
|
carrier, or its designees. |
11739
|
3. A small employer carrier may include the following |
11740
|
managed care provisions in the policy or contract to control |
11741
|
costs: |
11742
|
a. A preferred provider arrangement or exclusive provider |
11743
|
organization or any combination thereof, in which a small |
11744
|
employer carrier enters into a written agreement with the |
11745
|
provider to provide services at specified levels of |
11746
|
reimbursement or to provide reimbursement to specified |
11747
|
providers. Any such written agreement between a provider and a |
11748
|
small employer carrier must contain a provision under which the |
11749
|
parties agree that the insured individual or covered member has |
11750
|
no obligation to make payment for any medical service rendered |
11751
|
by the provider which is determined not to be medically |
11752
|
necessary. A carrier may use preferred provider arrangements or |
11753
|
exclusive provider arrangements to the same extent as allowed in |
11754
|
group products that are not issued to small employers. |
11755
|
b. A procedure for utilization review by the small |
11756
|
employer carrier or its designees. |
11757
|
|
11758
|
|
11759
|
This subparagraph does not prohibit a small employer carrier |
11760
|
from including in its policy or contract additional managed care |
11761
|
and cost containment provisions, subject to the approval of the |
11762
|
officedepartment, which have potential for controlling costs in |
11763
|
a manner that does not result in inequitable treatment of |
11764
|
insureds or subscribers. The carrier may use such provisions to |
11765
|
the same extent as authorized for group products that are not |
11766
|
issued to small employers. |
11767
|
4. The standard health benefit plan shall include: |
11768
|
a. Coverage for inpatient hospitalization; |
11769
|
b. Coverage for outpatient services; |
11770
|
c. Coverage for newborn children pursuant to s. 627.6575; |
11771
|
d. Coverage for child care supervision services pursuant |
11772
|
to s. 627.6579; |
11773
|
e. Coverage for adopted children upon placement in the |
11774
|
residence pursuant to s. 627.6578; |
11775
|
f. Coverage for mammograms pursuant to s. 627.6613; |
11776
|
g. Coverage for handicapped children pursuant to s. |
11777
|
627.6615; |
11778
|
h. Emergency or urgent care out of the geographic service |
11779
|
area; and |
11780
|
i. Coverage for services provided by a hospice licensed |
11781
|
under s. 400.602 in cases where such coverage would be the most |
11782
|
appropriate and the most cost-effective method for treating a |
11783
|
covered illness. |
11784
|
5. The standard health benefit plan and the basic health |
11785
|
benefit plan may include a schedule of benefit limitations for |
11786
|
specified services and procedures. If the committee develops |
11787
|
such a schedule of benefits limitation for the standard health |
11788
|
benefit plan or the basic health benefit plan, a small employer |
11789
|
carrier offering the plan must offer the employer an option for |
11790
|
increasing the benefit schedule amounts by 4 percent annually. |
11791
|
6. The basic health benefit plan shall include all of the |
11792
|
benefits specified in subparagraph 4.; however, the basic health |
11793
|
benefit plan shall place additional restrictions on the benefits |
11794
|
and utilization and may also impose additional cost containment |
11795
|
measures. |
11796
|
7. Sections 627.419(2), (3), and (4), 627.6574, 627.6612, |
11797
|
627.66121, 627.66122, 627.6616, 627.6618, 627.668, and 627.66911 |
11798
|
apply to the standard health benefit plan and to the basic |
11799
|
health benefit plan. However, notwithstanding said provisions, |
11800
|
the plans may specify limits on the number of authorized |
11801
|
treatments, if such limits are reasonable and do not |
11802
|
discriminate against any type of provider. |
11803
|
8. Each small employer carrier that provides for inpatient |
11804
|
and outpatient services by allopathic hospitals may provide as |
11805
|
an option of the insured similar inpatient and outpatient |
11806
|
services by hospitals accredited by the American Osteopathic |
11807
|
Association when such services are available and the osteopathic |
11808
|
hospital agrees to provide the service. |
11809
|
(c) If a small employer rejects, in writing, the standard |
11810
|
health benefit plan and the basic health benefit plan, the small |
11811
|
employer carrier may offer the small employer a limited benefit |
11812
|
policy or contract. |
11813
|
(d)1. Upon offering coverage under a standard health |
11814
|
benefit plan, a basic health benefit plan, or a limited benefit |
11815
|
policy or contract for any small employer, the small employer |
11816
|
carrier shall provide such employer group with a written |
11817
|
statement that contains, at a minimum: |
11818
|
a. An explanation of those mandated benefits and providers |
11819
|
that are not covered by the policy or contract; |
11820
|
b. An explanation of the managed care and cost control |
11821
|
features of the policy or contract, along with all appropriate |
11822
|
mailing addresses and telephone numbers to be used by insureds |
11823
|
in seeking information or authorization; and |
11824
|
c. An explanation of the primary and preventive care |
11825
|
features of the policy or contract. |
11826
|
|
11827
|
|
11828
|
Such disclosure statement must be presented in a clear and |
11829
|
understandable form and format and must be separate from the |
11830
|
policy or certificate or evidence of coverage provided to the |
11831
|
employer group. |
11832
|
2. Before a small employer carrier issues a standard |
11833
|
health benefit plan, a basic health benefit plan, or a limited |
11834
|
benefit policy or contract, it must obtain from the prospective |
11835
|
policyholder a signed written statement in which the prospective |
11836
|
policyholder: |
11837
|
a. Certifies as to eligibility for coverage under the |
11838
|
standard health benefit plan, basic health benefit plan, or |
11839
|
limited benefit policy or contract; |
11840
|
b. Acknowledges the limited nature of the coverage and an |
11841
|
understanding of the managed care and cost control features of |
11842
|
the policy or contract; |
11843
|
c. Acknowledges that if misrepresentations are made |
11844
|
regarding eligibility for coverage under a standard health |
11845
|
benefit plan, a basic health benefit plan, or a limited benefit |
11846
|
policy or contract, the person making such misrepresentations |
11847
|
forfeits coverage provided by the policy or contract; and |
11848
|
d. If a limited plan is requested, acknowledges that the |
11849
|
prospective policyholder had been offered, at the time of |
11850
|
application for the insurance policy or contract, the |
11851
|
opportunity to purchase any health benefit plan offered by the |
11852
|
carrier and that the prospective policyholder had rejected that |
11853
|
coverage. |
11854
|
|
11855
|
|
11856
|
A copy of such written statement shall be provided to the |
11857
|
prospective policyholder no later than at the time of delivery |
11858
|
of the policy or contract, and the original of such written |
11859
|
statement shall be retained in the files of the small employer |
11860
|
carrier for the period of time that the policy or contract |
11861
|
remains in effect or for 5 years, whichever period is longer. |
11862
|
3. Any material statement made by an applicant for |
11863
|
coverage under a health benefit plan which falsely certifies as |
11864
|
to the applicant's eligibility for coverage serves as the basis |
11865
|
for terminating coverage under the policy or contract. |
11866
|
4. Each marketing communication that is intended to be |
11867
|
used in the marketing of a health benefit plan in this state |
11868
|
must be submitted for review by the officedepartmentprior to |
11869
|
use and must contain the disclosures stated in this subsection. |
11870
|
(e) A small employer carrier may not use any policy, |
11871
|
contract, form, or rate under this section, including |
11872
|
applications, enrollment forms, policies, contracts, |
11873
|
certificates, evidences of coverage, riders, amendments, |
11874
|
endorsements, and disclosure forms, until the insurer has filed |
11875
|
it with the officedepartment and the officedepartmenthas |
11876
|
approved it under ss. 627.410 and 627.411 and this section. |
11877
|
(13) STANDARDS TO ASSURE FAIR MARKETING.-- |
11878
|
(i) The commissiondepartmentmay establish regulations |
11879
|
setting forth additional standards to provide for the fair |
11880
|
marketing and broad availability of health benefit plans to |
11881
|
small employers in this state. |
11882
|
(15) APPLICABILITY OF OTHER STATE LAWS.-- |
11883
|
(a) Except as expressly provided in this section, a law |
11884
|
requiring coverage for a specific health care service or |
11885
|
benefit, or a law requiring reimbursement, utilization, or |
11886
|
consideration of a specific category of licensed health care |
11887
|
practitioner, does not apply to a standard or basic health |
11888
|
benefit plan policy or contract or a limited benefit policy or |
11889
|
contract offered or delivered to a small employer unless that |
11890
|
law is made expressly applicable to such policies or contracts. |
11891
|
A law restricting or limiting deductibles, coinsurance, |
11892
|
copayments, or annual or lifetime maximum payments does not |
11893
|
apply to any health plan policy, including a standard or basic |
11894
|
health benefit plan policy or contract, offered or delivered to |
11895
|
a small employer unless such law is made expressly applicable to |
11896
|
such policy or contract. However, every small employer carrier |
11897
|
must offer to eligible small employers the standard benefit plan |
11898
|
and the basic benefit plan, as required by subsection (5), as |
11899
|
such plans have been approved by the officedepartmentpursuant |
11900
|
to subsection (12). |
11901
|
(16) RULEMAKING AUTHORITY.--The commissiondepartmentmay |
11902
|
adopt rules to administer this section, including rules |
11903
|
governing compliance by small employer carriers and small |
11904
|
employers. |
11905
|
Section 207. Section 627.7015, Florida Statutes, is |
11906
|
amended to read: |
11907
|
627.7015 Alternative procedure for resolution of disputed |
11908
|
property insurance claims.-- |
11909
|
(1) PURPOSE AND SCOPE.--This section sets forth a |
11910
|
nonadversarial alternative dispute resolution procedure for a |
11911
|
mediated claim resolution conference prompted by the need for |
11912
|
effective, fair, and timely handling of property insurance |
11913
|
claims. There is a particular need for an informal, |
11914
|
nonthreatening forum for helping parties who elect this |
11915
|
procedure to resolve their claims disputes because most |
11916
|
homeowner's insurance policies obligate insureds to participate |
11917
|
in a potentially expensive and time-consuming adversarial |
11918
|
appraisal process prior to litigation. The procedure set forth |
11919
|
in this section is designed to bring the parties together for a |
11920
|
mediated claims settlement conference without any of the |
11921
|
trappings or drawbacks of an adversarial process. Before |
11922
|
resorting to these procedures, insureds and insurers are |
11923
|
encouraged to resolve claims as quickly and fairly as possible. |
11924
|
This section is available with respect to claims under personal |
11925
|
lines policies for all claimants and insurers prior to |
11926
|
commencing the appraisal process, or commencing litigation. If |
11927
|
requested by the insured, participation by legal counsel shall |
11928
|
be permitted. Mediation under this section is also available to |
11929
|
litigants referred to the department by a county court or |
11930
|
circuit court. This section does not apply to commercial |
11931
|
coverages, to private passenger motor vehicle insurance |
11932
|
coverages, or to disputes relating to liability coverages in |
11933
|
policies of property insurance. |
11934
|
(2) At the time a first-party claim within the scope of |
11935
|
this section is filed, the insurer shall notify all first-party |
11936
|
claimants of their right to participate in the mediation program |
11937
|
under this section. The department shall prepare a consumer |
11938
|
information pamphlet for distribution to persons participating |
11939
|
in mediation under this section. |
11940
|
(3) The costs of mediation shall be reasonable, and the |
11941
|
insurer shall bear all of the cost of conducting mediation |
11942
|
conferences, except as otherwise provided in this section. If an |
11943
|
insured fails to appear at the conference, the conference shall |
11944
|
be rescheduled upon the insured's payment of the costs of a |
11945
|
rescheduled conference. If the insurer fails to appear at the |
11946
|
conference, the insurer shall pay the insured's actual cash |
11947
|
expenses incurred in attending the conference if the insurer's |
11948
|
failure to attend was not due to a good cause acceptable to the |
11949
|
department. An insurer will be deemed to have failed to appear |
11950
|
if the insurer's representative lacks authority to settle the |
11951
|
full value of the claim. The insurer shall incur an additional |
11952
|
fee for a rescheduled conference necessitated by the insurer's |
11953
|
failure to appear at a scheduled conference. The fees assessed |
11954
|
by the administrator shall include a charge necessary to defray |
11955
|
the expenses of the department related to its duties under this |
11956
|
section and shall be deposited in the Insurance Commissioner's |
11957
|
Regulatory Trust Fund. |
11958
|
(4) The department shall adopt by rule a property |
11959
|
insurance mediation program to be administered by the department |
11960
|
or its designee. The department may also adopt special rules |
11961
|
which are applicable in cases of an emergency within the state. |
11962
|
The rules shall be modeled after practices and procedures set |
11963
|
forth in mediation rules of procedure adopted by the Supreme |
11964
|
Court. The rules shall provide for: |
11965
|
(a) Reasonable requirement for processing and scheduling |
11966
|
of requests for mediation. |
11967
|
(b) Qualifications of mediators as provided in s. 627.745 |
11968
|
and in the Florida Rules of Certified and Court Appointed |
11969
|
Mediators, and for such other individuals as are qualified by |
11970
|
education, training, or experience as the department determines |
11971
|
to be appropriate. |
11972
|
(c) Provisions governing who may attend mediation |
11973
|
conferences. |
11974
|
(d) Selection of mediators. |
11975
|
(e) Criteria for the conduct of mediation conferences. |
11976
|
(f) Right to legal counsel. |
11977
|
(5) All statements made and documents produced at a |
11978
|
mediation conference shall be deemed to be settlement |
11979
|
negotiations in anticipation of litigation within the scope of |
11980
|
s. 90.408. All parties to the mediation must negotiate in good |
11981
|
faith and must have the authority to immediately settle the |
11982
|
claim. Mediators are deemed to be agents of the department and |
11983
|
shall have the immunity from suit provided in s. 44.107. |
11984
|
(6) Mediation is nonbinding; however, if a written |
11985
|
settlement is reached, the insured has 3 business days within |
11986
|
which the insured may rescind the settlement unless the insured |
11987
|
has cashed or deposited any check or draft disbursed to the |
11988
|
insured for the disputed matters as a result of the conference. |
11989
|
If a settlement agreement is reached and is not rescinded, it |
11990
|
shall be binding and act as a release of all specific claims |
11991
|
that were presented in that mediation conference. |
11992
|
(7) If the insurer requests the mediation, and the |
11993
|
mediation results are rejected by either party, the insured |
11994
|
shall not be required to submit to or participate in any |
11995
|
contractual loss appraisal process of the property loss damage |
11996
|
as a precondition to legal action for breach of contract against |
11997
|
the insurer for its failure to pay the policyholder's claims |
11998
|
covered by the policy. |
11999
|
(8) The department may designate an entity or person to |
12000
|
serve as administrator to carry out any of the provisions of |
12001
|
this section and may take this action by means of a written |
12002
|
contract or agreement. |
12003
|
Section 208. Section 627.745, Florida Statutes, is amended |
12004
|
to read: |
12005
|
627.745 Mediation of claims.-- |
12006
|
(1)(a) In any claim filed with an insurer for personal |
12007
|
injury in an amount of $10,000 or less or any claim for property |
12008
|
damage in any amount, arising out of the ownership, operation, |
12009
|
use, or maintenance of a motor vehicle, either party may demand |
12010
|
mediation of the claim prior to the institution of litigation. |
12011
|
(b) A request for mediation shall be filed with the office |
12012
|
department on a form approved by the officedepartment. The |
12013
|
request for mediation shall state the reason for the request for |
12014
|
mediation and the issues in dispute which are to be mediated. |
12015
|
The filing of a request for mediation tolls the applicable time |
12016
|
requirements for filing suit for a period of 60 days following |
12017
|
the conclusion of the mediation process or the time prescribed |
12018
|
in s. 95.11, whichever is later. |
12019
|
(c) The insurance policy must specify in detail the terms |
12020
|
and conditions for mediation of a first-party claim. |
12021
|
(d) The mediation shall be conducted as an informal |
12022
|
process in which formal rules of evidence and procedure need not |
12023
|
be observed. Any party participating in a mediation must have |
12024
|
the authority to make a binding decision. All parties must |
12025
|
mediate in good faith. |
12026
|
(e) The officedepartmentshall randomly select mediators. |
12027
|
Each party may once reject the mediator selected, either |
12028
|
originally or after the opposing side has exercised its option |
12029
|
to reject a mediator. |
12030
|
(f) Costs of mediation shall be borne equally by both |
12031
|
parties unless the mediator determines that one party has not |
12032
|
mediated in good faith. |
12033
|
(g) Only one mediation may be requested for each claim, |
12034
|
unless all parties agree to further mediation. |
12035
|
(2) Upon receipt of a request for mediation, the office |
12036
|
departmentshall refer the request to a mediator. The mediator |
12037
|
shall notify the applicant and all interested parties, as |
12038
|
identified by the applicant, and any other parties the mediator |
12039
|
believes may have an interest in the mediation, of the date, |
12040
|
time, and place of the mediation conference. The conference may |
12041
|
be held by telephone, if feasible. The mediation conference |
12042
|
shall be held within 45 days after the request for mediation. |
12043
|
(3)(a) The officedepartmentshall approve mediators to |
12044
|
conduct mediations pursuant to this section. All mediators must |
12045
|
file an application under oath for approval as a mediator. |
12046
|
(b) To qualify for approval as a mediator, a person must |
12047
|
meet the following qualifications: |
12048
|
1. Possess a masters or doctorate degree in psychology, |
12049
|
counseling, business, accounting, or economics, be a member of |
12050
|
The Florida Bar, be licensed as a certified public accountant, |
12051
|
or demonstrate that the applicant for approval has been actively |
12052
|
engaged as a qualified mediator for at least 4 years prior to |
12053
|
July 1, 1990. |
12054
|
2. Within 4 years immediately preceding the date the |
12055
|
application for approval is filed with the officedepartment, |
12056
|
have completed a minimum of a 40-hour training program approved |
12057
|
by the officedepartmentand successfully passed a final |
12058
|
examination included in the training program and approved by the |
12059
|
officedepartment. The training program shall include and |
12060
|
address all of the following: |
12061
|
a. Mediation theory. |
12062
|
b. Mediation process and techniques. |
12063
|
c. Standards of conduct for mediators. |
12064
|
d. Conflict management and intervention skills. |
12065
|
e. Insurance nomenclature. |
12066
|
(4) The commissiondepartmentmust adopt rules of |
12067
|
procedure for claims mediation, taking into consideration a |
12068
|
system which: |
12069
|
(a) Is fair. |
12070
|
(b) Promotes settlement. |
12071
|
(c) Avoids delay. |
12072
|
(d) Is nonadversarial. |
12073
|
(e) Uses a framework for modern mediating technique. |
12074
|
(f) Controls costs and expenses of mediation. |
12075
|
(5) Disclosures and information divulged in the mediation |
12076
|
process are not admissible in any subsequent action or |
12077
|
proceeding relating to the claim or to the cause of action |
12078
|
giving rise to the claim. A person demanding mediation under |
12079
|
this section may not demand or request mediation after a suit is |
12080
|
filed relating to the same facts already mediated. |
12081
|
Section 209. Section 628.4615, Florida Statutes, is |
12082
|
amended to read: |
12083
|
628.4615 Specialty insurers; acquisition of controlling |
12084
|
stock, ownership interest, assets, or control; merger or |
12085
|
consolidation.-- |
12086
|
(1) For the purposes of this section, the term "specialty |
12087
|
insurer" means any person holding a license or certificate of |
12088
|
authority as: |
12089
|
(a) A motor vehicle service agreement company authorized |
12090
|
to issue motor vehicle service agreements as those terms are |
12091
|
defined in s. 634.011(7)(8) and(8)(9); |
12092
|
(b) A home warranty association authorized to issue "home |
12093
|
warranties" as those terms are defined in s. 634.301(3)(4) and |
12094
|
(4)(5); |
12095
|
(c) A service warranty association authorized to issue |
12096
|
"service warranties" as those terms are defined in s. |
12097
|
634.401(13)(14) and (14)(15); |
12098
|
(d) A prepaid limited health service organization |
12099
|
authorized to issue prepaid limited health service contracts, as |
12100
|
those terms are defined in chapter 636An optometric service |
12101
|
plan corporation authorized to issue optometric service plan |
12102
|
contracts as those terms are defined in s. 637.001(2) and (3); |
12103
|
(e) A pharmaceutical service plan corporation authorized |
12104
|
to issue pharmaceutical service plan contracts as those terms |
12105
|
are defined in s. 637.1701(2) and (3); |
12106
|
(f) A dental service plan corporation licensed to issue |
12107
|
contracts for dental services pursuant to a dental service plan |
12108
|
as that term is defined in s. 637.401(1); |
12109
|
(g) An ambulance service association authorized to issue |
12110
|
ambulance service contracts as those terms are defined in s. |
12111
|
638.021(1) and (2); |
12112
|
(e)(h)An authorized health maintenance organization |
12113
|
operating pursuant to s. 641.21; |
12114
|
(f)(i)An authorized prepaid health clinic operating |
12115
|
pursuant to s. 641.405; |
12116
|
(g)(j)A legal expense insurance corporation authorized to |
12117
|
engage in a legal expense insurance business pursuant to s. |
12118
|
642.021; |
12119
|
(h)(k)A provider which is licensed to operate a facility |
12120
|
which undertakes to provide continuing care as those terms are |
12121
|
defined in s. 651.011(2), (4), (5), and (6), and (7); |
12122
|
(i)(l)A multiple-employer welfare arrangement operating |
12123
|
pursuant to ss. 624.436-624.446; |
12124
|
(j)(m)A premium finance company authorized to finance |
12125
|
insurance premiums pursuant to s. 627.828; or |
12126
|
(k)(n)A corporation authorized to accept donor annuity |
12127
|
agreements pursuant to s. 627.481. |
12128
|
(2) No person shall, individually or in conjunction with |
12129
|
any affiliated person of such person, directly or indirectly, |
12130
|
conclude a tender offer or exchange offer for, enter into any |
12131
|
agreement to exchange securities for, or otherwise finally |
12132
|
acquire, 10 percent or more of the outstanding voting securities |
12133
|
of a specialty insurer which is a stock corporation or of a |
12134
|
controlling company of a specialty insurer which is a stock |
12135
|
corporation; or conclude an acquisition of, or otherwise finally |
12136
|
acquire, 10 percent or more of the ownership interest of a |
12137
|
specialty insurer which is not a stock corporation or of a |
12138
|
controlling company of a specialty insurer which is not a stock |
12139
|
corporation, unless: |
12140
|
(a) The person or affiliated person has filed with the |
12141
|
officedepartmentand sent by registered mail to the principal |
12142
|
office of the specialty insurer and controlling company an |
12143
|
application, signed under oath and prepared on forms prescribed |
12144
|
by the commissiondepartment, that contains the information |
12145
|
specified in subsection(4) no later than 5 days after any form |
12146
|
of tender offer or exchange offer is proposed, or no later than |
12147
|
5 days after the acquisition of the securities or ownership |
12148
|
interest if no tender offer or exchange offer is involved. |
12149
|
(b) The officedepartmenthas approved the tender offer or |
12150
|
exchange offer, or acquisition if no tender offer or exchange |
12151
|
offer is involved. |
12152
|
(3) This section does not apply to any acquisition of |
12153
|
voting securities or ownership interest of a specialty insurer |
12154
|
or of a controlling company by any person who, on July 9, 1986, |
12155
|
is the owner of a majority of such voting securities or |
12156
|
ownership interest or who, on or after July 9, 1986, becomes the |
12157
|
owner of a majority of such voting securities or ownership |
12158
|
interest with the approval of the officedepartmentpursuant to |
12159
|
this section. |
12160
|
(4) The application to be filed with the officedepartment |
12161
|
and furnished to the specialty insurer and controlling company |
12162
|
shall contain the following information and any additional |
12163
|
information as the office deemsdepartment may deemnecessary to |
12164
|
determine the character, experience, ability, and other |
12165
|
qualifications of the person or affiliated person of such person |
12166
|
for the protection of the insureds of the insurer and of the |
12167
|
public: |
12168
|
(a)1. The identity of, and the background information |
12169
|
specified in subsection (5) on, each natural person by whom, or |
12170
|
on whose behalf, the acquisition is to be made; and, |
12171
|
2. If the acquisition is to be made by, or on behalf of, a |
12172
|
person other than a natural person and as to any person who |
12173
|
controls, either directly or indirectly, such other person, the |
12174
|
identity of, and the background information specified in |
12175
|
subsection (5) on: |
12176
|
a. Each director, officer, or trustee, if a corporation, |
12177
|
or |
12178
|
b. Each partner, owner, manager, or joint venturer, or |
12179
|
other person performing duties similar to those of persons in |
12180
|
the aforementioned positions, if not a corporation, |
12181
|
|
12182
|
|
12183
|
for the person. |
12184
|
(b) The source and amount of the funds or other |
12185
|
consideration used, or to be used, in making the acquisition. |
12186
|
(c) Any plans or proposals which such persons may have |
12187
|
made to liquidate the specialty insurer, to sell any of its |
12188
|
assets or merge or consolidate it with any person, or to make |
12189
|
any other major change in its business or corporate structure or |
12190
|
management; and any plans or proposals which such persons may |
12191
|
have made to liquidate any controlling company of the specialty |
12192
|
insurer, to sell any of its assets or merge or consolidate it |
12193
|
with any person, or to make any other major change in its |
12194
|
business or corporate structure or management. |
12195
|
(d) The nature and the extent of the controlling interest |
12196
|
which the person or affiliated person of such person proposes to |
12197
|
acquire, the terms of the proposed acquisition, and the manner |
12198
|
in which the controlling interest is to be acquired of a |
12199
|
specialty insurer or controlling company which is not a stock |
12200
|
corporation. |
12201
|
(e) The number of shares or other securities which the |
12202
|
person or affiliated person of such person proposes to acquire, |
12203
|
the terms of the proposed acquisition, and the manner in which |
12204
|
the securities are to be acquired. |
12205
|
(f) Information as to any contract, arrangement, or |
12206
|
understanding with any party with respect to any of the |
12207
|
securities of the specialty insurer or controlling company, |
12208
|
including, but not limited to, information relating to the |
12209
|
transfer of any of the securities, option arrangements, puts or |
12210
|
calls, or the giving or withholding of proxies, which |
12211
|
information names the party with whom the contract, arrangement, |
12212
|
or understanding has been entered into and gives the details |
12213
|
thereof. |
12214
|
(5)(a) The information as to the background and identity |
12215
|
of each natural person, which information is required to be |
12216
|
furnished pursuant to paragraph(4)(a), shall include: |
12217
|
1. The natural person's occupations, positions of |
12218
|
employment, and offices held during the past 10 years. |
12219
|
2. The principal business and address of any business, |
12220
|
corporation, or organization in which each such office of the |
12221
|
natural person was held, or in which each such occupation or |
12222
|
position of employment was carried on. |
12223
|
3. Whether the natural person was, at any time during such |
12224
|
10-year period, convicted of any crime other than a traffic |
12225
|
violation. |
12226
|
4. Whether the natural person has been, during such 10- |
12227
|
year period, the subject of any proceeding for the revocation of |
12228
|
any license and, if so, the nature of the proceeding and the |
12229
|
disposition of the proceeding. |
12230
|
5. Whether, during the 10-year period, the natural person |
12231
|
has been the subject of any proceeding under the federal |
12232
|
Bankruptcy Act; or whether, during the 10-year period, any |
12233
|
person or other business or organization in which the natural |
12234
|
person was a director, officer, trustee, partner, owner, |
12235
|
manager, or other official has been subject to any such |
12236
|
proceeding, either during the time in which the natural person |
12237
|
was a director, officer, or trustee, if a corporation, or a |
12238
|
partner, owner, manager, joint venturer, or other official, if |
12239
|
not a corporation, or within 12 months thereafter. |
12240
|
6. Whether, during the 10-year period, the natural person |
12241
|
has been enjoined, either temporarily or permanently, by a court |
12242
|
of competent jurisdiction from violating any federal or state |
12243
|
law regulating the business of insurance, securities, or |
12244
|
banking, or from carrying out any particular practice or |
12245
|
practices in the course of the business of insurance, |
12246
|
securities, or banking, together with details as to any such |
12247
|
event. |
12248
|
7. Fingerprints of each person referred to in subsection |
12249
|
(4). |
12250
|
(b) Any person filing the statement required by this |
12251
|
section shall give all required information that is within the |
12252
|
knowledge of: |
12253
|
1. The directors, officers, or trustees, if a corporation, |
12254
|
or |
12255
|
2. The partners, owners, managers, or joint venturers, or |
12256
|
others performing functions similar to those of a director, |
12257
|
officer, or trustee, if not a corporation, |
12258
|
|
12259
|
|
12260
|
of the person making the filing and of any person controlling |
12261
|
either directly or indirectly such person. If any material |
12262
|
change occurs in the facts set forth in the application filed |
12263
|
with the officedepartmentpursuant to this section, an |
12264
|
amendment setting forth such changes shall be filed immediately |
12265
|
with the officedepartment, and a copy of the amendment shall be |
12266
|
sent by registered mail to the principal office of the specialty |
12267
|
insurer and to the principal office of the controlling company. |
12268
|
(6)(a) The acquisition application shall be reviewed in |
12269
|
accordance with chapter 120. The officedepartmentmay on its |
12270
|
own initiate, or, if requested to do so in writing by a |
12271
|
substantially affected person, shall conduct, a proceeding to |
12272
|
consider the appropriateness of the proposed filing. Time |
12273
|
periods for purposes of chapter 120 shall be tolled during the |
12274
|
pendency of the proceeding. Any written request for a proceeding |
12275
|
must be filed with the officedepartmentwithin 10 days of the |
12276
|
date notice of the filing is given. During the pendency of the |
12277
|
proceeding or review period by the officedepartment, any person |
12278
|
or affiliated person complying with the filing requirements of |
12279
|
this section may proceed and take all steps necessary to |
12280
|
conclude the acquisition so long as the acquisition becoming |
12281
|
final is conditioned upon obtaining officedepartmental |
12282
|
approval. The officedepartmentshall, however, at any time it |
12283
|
finds an immediate danger to the public health, safety, and |
12284
|
welfare of the insureds exists, immediately order, pursuant to |
12285
|
s. 120.569(2)(n), the proposed acquisition disapproved and any |
12286
|
further steps to conclude the acquisition ceased. |
12287
|
(b) During the pendency of the office'sdepartment's |
12288
|
review of any acquisition subject to the provisions of this |
12289
|
section, the acquiring person shall not make any material change |
12290
|
in the operation of the specialty insurer or controlling company |
12291
|
unless the officedepartmenthas specifically approved the |
12292
|
change nor shall the acquiring person make any material change |
12293
|
in the management of the specialty insurer unless advance |
12294
|
written notice of the change in management is furnished to the |
12295
|
officedepartment. A material change in the operation of the |
12296
|
specialty insurer is a transaction which disposes of or |
12297
|
obligates 5 percent or more of the capital and surplus of the |
12298
|
specialty insurer. A material change in the management of the |
12299
|
specialty insurer is any change in management involving officers |
12300
|
or directors of the specialty insurer or any person of the |
12301
|
specialty insurer or controlling company having authority to |
12302
|
dispose of or obligate 5 percent or more of the specialty |
12303
|
insurer's capital or surplus. The officedepartmentshall |
12304
|
approve a material change in operations if it finds the |
12305
|
applicable provisions of subsection (8) have been met. The |
12306
|
officedepartmentmay disapprove a material change in management |
12307
|
if it finds that the applicable provisions of subsection (8) |
12308
|
have not been met and in such case the specialty insurer shall |
12309
|
promptly change management as acceptable to the office |
12310
|
department. |
12311
|
(c) If a request for a proceeding is filed, the proceeding |
12312
|
shall be conducted within 60 days after the date the written |
12313
|
request for a proceeding is received by the officedepartment. A |
12314
|
recommended order shall be issued within 20 days of the date of |
12315
|
the close of the proceedings. A final order shall be issued |
12316
|
within 20 days of the date of the recommended order or, if |
12317
|
exceptions to the recommended order are filed, within 20 days of |
12318
|
the date the exceptions are filed. |
12319
|
(7) The officedepartmentmay disapprove any acquisition |
12320
|
subject to the provisions of this section by any person or any |
12321
|
affiliated person of such person who: |
12322
|
(a) Willfully violates this section; |
12323
|
(b) In violation of an order of the officedepartment |
12324
|
issued pursuant to subsection (11), fails to divest himself or |
12325
|
herself of any stock or ownership interest obtained in violation |
12326
|
of this section or fails to divest himself or herself of any |
12327
|
direct or indirect control of such stock or ownership interest, |
12328
|
within 25 days after such order; or |
12329
|
(c) In violation of an order issued by the office |
12330
|
departmentpursuant to subsection (11), acquires an additional |
12331
|
stock or ownership interest in a specialty insurer or |
12332
|
controlling company or direct or indirect control of such stock |
12333
|
or ownership interest, without complying with this section. |
12334
|
(8) The person or persons filing the application required |
12335
|
by subsection(2) shall have the burden of proof. The office |
12336
|
departmentshall approve any such acquisition if it finds, on |
12337
|
the basis of the record made during any proceeding or on the |
12338
|
basis of the filed application if no proceeding is conducted, |
12339
|
that: |
12340
|
(a) Upon completion of the acquisition, the specialty |
12341
|
insurer will be able to satisfy the requirements for the |
12342
|
issuance of a license or certificate to write the line of |
12343
|
insurance for which it is presently licensed or certificated. |
12344
|
(b) The financial condition of the acquiring person or |
12345
|
persons will not jeopardize the financial stability of the |
12346
|
specialty insurer or prejudice the interests of its insureds or |
12347
|
the public. |
12348
|
(c) Any plan or proposal which the acquiring person has, |
12349
|
or acquiring persons have, made: |
12350
|
1. To liquidate the specialty insurer, sell its assets, or |
12351
|
merge or consolidate it with any person, or to make any other |
12352
|
major change in its business or corporate structure or |
12353
|
management, or |
12354
|
2. To liquidate any controlling company, sell its assets, |
12355
|
or merge or consolidate it with any person, or to make any major |
12356
|
change in its business or corporate structure or management |
12357
|
which would have an effect upon the specialty insurer, |
12358
|
|
12359
|
|
12360
|
is fair and free of prejudice to the insureds of the specialty |
12361
|
insurer or to the public. |
12362
|
(d) The competence, experience, and integrity of those |
12363
|
persons who will control directly or indirectly the operation of |
12364
|
the specialty insurer indicate that the acquisition is in the |
12365
|
best interest of the insureds of the insurer and in the public |
12366
|
interest. |
12367
|
(e) The natural persons for whom background information is |
12368
|
required to be furnished pursuant to this section have such |
12369
|
backgrounds as to indicate that it is in the best interests of |
12370
|
the insureds of the specialty insurer and in the public interest |
12371
|
to permit such persons to exercise control over the specialty |
12372
|
insurer. |
12373
|
(f) The directors and officers, if such specialty insurer |
12374
|
or controlling company is a stock corporation, or the trustees, |
12375
|
partners, owners, managers, or joint venturers or other persons |
12376
|
performing duties similar to those of persons in the |
12377
|
aforementioned positions, if such specialty insurer or |
12378
|
controlling company is not a stock corporation, to be employed |
12379
|
after the acquisition have sufficient insurance experience and |
12380
|
ability to assure reasonable promise of successful operation. |
12381
|
(g) The management of the specialty insurer after the |
12382
|
acquisition will be competent and trustworthy, and will possess |
12383
|
sufficient managerial experience so as to make the proposed |
12384
|
operation of the specialty insurer not hazardous to the |
12385
|
insurance-buying public. |
12386
|
(h) The management of the specialty insurer after the |
12387
|
acquisition shall not include any person who has directly or |
12388
|
indirectly through ownership, control, reinsurance transactions, |
12389
|
or other insurance or business relations unlawfully manipulated |
12390
|
the assets, accounts, finances, or books of any insurer or |
12391
|
otherwise acted in bad faith with respect thereto. |
12392
|
(i) The acquisition is not likely to be hazardous or |
12393
|
prejudicial to the insureds of the insurer or to the public. |
12394
|
(j) The effect of the acquisition would not substantially |
12395
|
lessen competition in the line of insurance for which the |
12396
|
specialty insurer is licensed or certified in this state or |
12397
|
would not tend to create a monopoly therein. |
12398
|
(9) No vote by the stockholder of record, or by any other |
12399
|
person, of any security acquired in contravention of the |
12400
|
provisions of this section is valid. Any acquisition contrary |
12401
|
to the provisions of this section is void. Upon the petition of |
12402
|
the specialty insurer or the controlling company, the circuit |
12403
|
court for the county in which the principal office of the |
12404
|
specialty insurer is located may, without limiting the |
12405
|
generality of its authority, order the issuance or entry of an |
12406
|
injunction or other order to enforce the provisions of this |
12407
|
section. There shall be a private right of action in favor of |
12408
|
the specialty insurer or controlling company to enforce the |
12409
|
provisions of this section. No demand upon the office |
12410
|
departmentthat it perform its functions shall be required as a |
12411
|
prerequisite to any suit by the specialty insurer or controlling |
12412
|
company against any other person, and in no case shall the |
12413
|
officedepartmentbe deemed a necessary party to any action by |
12414
|
the specialty insurer or controlling company to enforce the |
12415
|
provisions of this section. Any person who makes or proposes an |
12416
|
acquisition requiring the filing of an application pursuant to |
12417
|
this section, or who files such an application, shall be deemed |
12418
|
to have thereby designated the Chief Financial OfficerInsurance |
12419
|
Commissioner and Treasurer, or his or her assistant or deputy or |
12420
|
another person in charge of his or her office, as such person's |
12421
|
agent for service of process under this section and shall |
12422
|
thereby be deemed to have submitted himself or herself to the |
12423
|
administrative jurisdiction of the officedepartmentand to the |
12424
|
jurisdiction of the circuit court. |
12425
|
(10) Any approval by the officedepartmentunder this |
12426
|
section does not constitute a recommendation by the office |
12427
|
departmentof the tender offer or exchange offer, or |
12428
|
acquisition, if no tender offer or exchange offer is involved. |
12429
|
It is unlawful for a person to represent that the office's |
12430
|
department'sapproval constitutes a recommendation. A person who |
12431
|
violates the provisions of this subsection commits a felony of |
12432
|
the third degree, punishable as provided in s. 775.082, s. |
12433
|
775.083, or s. 775.084. The statute-of-limitations period for |
12434
|
the prosecution of an offense committed under this subsection is |
12435
|
5 years. |
12436
|
(11) If the officedepartmentdetermines that any person |
12437
|
or any affiliated person of such person has acquired 10 percent |
12438
|
or more of the outstanding voting securities of a specialty |
12439
|
insurer or controlling company which is a stock corporation, or |
12440
|
10 percent or more of the ownership interest of a specialty |
12441
|
insurer or controlling company which is not a stock corporation, |
12442
|
without complying with the provisions of this section, the |
12443
|
officedepartmentmay order that the person and any affiliated |
12444
|
person of such person cease acquisition of the specialty insurer |
12445
|
or controlling company and, if appropriate, divest itself of any |
12446
|
stock or ownership interest acquired in violation of this |
12447
|
section. |
12448
|
(12)(a) The officedepartmentshall, if necessary to |
12449
|
protect the public interest, suspend or revoke the certificate |
12450
|
of authority of any specialty insurer or controlling company |
12451
|
acquired in violation of this section. |
12452
|
(b) If any specialty insurer is subject to suspension or |
12453
|
revocation pursuant to paragraph (a), the specialty insurer |
12454
|
shall be deemed to be in such condition, or to be using or to |
12455
|
have been subject to such methods or practices in the conduct of |
12456
|
its business, as to render its further transaction of insurance |
12457
|
presently or prospectively hazardous to its insureds, creditors, |
12458
|
or stockholders or to the public. |
12459
|
(13)(a) For the purpose of this section, the term |
12460
|
"acquisition" includes: |
12461
|
1. A tender offer or exchange offer for securities, |
12462
|
assets, or other ownership interest; |
12463
|
2. An agreement to exchange securities for other |
12464
|
securities, assets, or other ownership interest; |
12465
|
3. A merger of a person or affiliated person into a |
12466
|
specialty insurer or a merger of any person with a specialty |
12467
|
insurer; |
12468
|
4. A consolidation; or |
12469
|
5. Any other form of change of control |
12470
|
|
12471
|
|
12472
|
whereby any person or affiliated person acquires or attempts to |
12473
|
acquire, directly or indirectly, 10 percent or more of the |
12474
|
ownership interest or assets of a specialty insurer or of a |
12475
|
controlling company. However, in the case of a health |
12476
|
maintenance organization organized as a for-profit corporation, |
12477
|
the provisions of s. 628.451 shall govern with respect to any |
12478
|
merger or consolidation, and, in the case of a health |
12479
|
maintenance organization organized as a not-for-profit |
12480
|
corporation, the provisions of s. 628.471 shall govern with |
12481
|
respect to any merger or consolidation. |
12482
|
(b) For the purpose of this section, the term "affiliated |
12483
|
person" of another person includes: |
12484
|
1. The spouse of such other natural person; |
12485
|
2. The parents of such other natural person and their |
12486
|
lineal descendants and the parents of such other natural |
12487
|
person's spouse and their lineal descendants; |
12488
|
3. Any person who directly or indirectly owns or controls, |
12489
|
or holds with power to vote, 10 percent or more of the |
12490
|
outstanding voting securities of such other person; |
12491
|
4. Any person who directly or indirectly owns 10 percent |
12492
|
or more of the outstanding voting securities which are directly |
12493
|
or indirectly owned or controlled, or held with power to vote, |
12494
|
by such other person; |
12495
|
5. Any person or group of persons who directly or |
12496
|
indirectly control, are controlled by, or are under common |
12497
|
control with such other person; |
12498
|
6. Any director, officer, trustee, partner, owner, |
12499
|
manager, joint venturer, or employee, or other person performing |
12500
|
duties similar to those of persons in the aforementioned |
12501
|
positions, of such other person; |
12502
|
7. If such other person is an investment company, any |
12503
|
investment adviser of such company or any member of an advisory |
12504
|
board of such company; |
12505
|
8. If such other person is an unincorporated investment |
12506
|
company not having a board of directors, the depositor of such |
12507
|
company; or |
12508
|
9. Any person who has entered into an agreement, written |
12509
|
or unwritten, to act in concert with such other person in |
12510
|
acquiring, or limiting the disposition of, securities of a |
12511
|
specialty insurer or controlling company which is a stock |
12512
|
corporation or in acquiring, or limiting the disposition of, an |
12513
|
ownership interest of a specialty insurer or controlling company |
12514
|
which is not a stock corporation. |
12515
|
(c) For the purposes of this section, the term |
12516
|
"controlling company" means any corporation, trust, or |
12517
|
association owning, directly or indirectly, 25 percent or more |
12518
|
of the voting securities of one or more specialty insurance |
12519
|
companies which are stock corporations, or 25 percent or more of |
12520
|
the ownership interest of one or more specialty insurance |
12521
|
companies which are not stock corporations. |
12522
|
(d) For the purpose of this section, the term "natural |
12523
|
person" means an individual. |
12524
|
(e) For the purpose of this section, the term "person" |
12525
|
includes a natural person, corporation, association, trust, |
12526
|
general partnership, limited partnership, joint venture, firm, |
12527
|
proprietorship, or any other entity which may hold a license or |
12528
|
certificate as a specialty insurer. |
12529
|
(14) The commission maydepartment is authorized toadopt, |
12530
|
amend, or repeal rules that are necessary to implement the |
12531
|
provisions of this section, pursuant to chapter 120. |
12532
|
Section 210. Section 628.917, Florida Statutes, is amended |
12533
|
to read: |
12534
|
628.917 Insolvency and liquidation.--In the event that a |
12535
|
captive insurer is insolvent as defined in chapter 631, the |
12536
|
officedepartmentshall liquidate the captive insurer pursuant |
12537
|
to the provisions of part I of chapter 631; except that the |
12538
|
officedepartmentshall make no attempt to rehabilitate such |
12539
|
insurer. |
12540
|
Section 211. Subsection (3) of section 631.021, Florida |
12541
|
Statutes, is amended to |
12542
|
631.021 Jurisdiction of delinquency proceeding; venue; |
12543
|
change of venue; exclusiveness of remedy; appeal.-- |
12544
|
(3) A delinquency proceeding pursuant to this chapter |
12545
|
constitutes the sole and exclusive method of liquidating, |
12546
|
rehabilitating, reorganizing, or conserving an insurer. No court |
12547
|
shall entertain a petition for the commencement of such a |
12548
|
proceeding unless the petition has been filed in the name of the |
12549
|
state on the relation of the officedepartment. The Florida |
12550
|
Insurance Guaranty Association, Incorporated, the Florida |
12551
|
Workers' Compensation Insurance Guaranty Association, |
12552
|
Incorporated, and the Florida Life and Health Guaranty |
12553
|
Association, Incorporated, shall be given reasonable written |
12554
|
notice by the officedepartmentof all hearings which pertain to |
12555
|
an adjudication of insolvency of a member insurer. |
12556
|
Section 212. Section 631.025, Florida Statutes, is amended |
12557
|
to read: |
12558
|
631.025 Persons subject to this part.--Delinquency |
12559
|
proceedings authorized by this part may be initiated against any |
12560
|
insurer, as defined in s. 631.011(15), if the statutory grounds |
12561
|
are present as to that insurer, and the court may exercise |
12562
|
jurisdiction over any person required to cooperate with the |
12563
|
department and officepursuant to s. 631.391 and over all |
12564
|
persons made subject to the court's jurisdiction by other |
12565
|
provisions of law. Such persons include, but are not limited to: |
12566
|
(1) A person transacting, or that has transacted, |
12567
|
insurance business in or from this state and against whom claims |
12568
|
arising from that business may exist now or in the future. |
12569
|
(2) A person purporting to transact an insurance business |
12570
|
in this state and any person who acts as an insurer, transacts |
12571
|
insurance, or otherwise engages in insurance activities in or |
12572
|
from this state, with or without a certificate of authority or |
12573
|
proper authority from the officedepartment, against whom claims |
12574
|
arising from that business may exist now or in the future. |
12575
|
(3) An insurer with policyholders resident in this state. |
12576
|
(4) All other persons organized or in the process of |
12577
|
organizing with the intent to transact an insurance business in |
12578
|
this state. |
12579
|
Section 213. Section 631.031, Florida Statutes, is amended |
12580
|
to read: |
12581
|
631.031 Commencement of delinquency proceeding.--The |
12582
|
officedepartmentmay commence any such proceeding by |
12583
|
application to the court for an order directing the insurer to |
12584
|
show cause why the officedepartmentshould not have the relief |
12585
|
prayed for. On the return of such order to show cause, and after |
12586
|
a full hearing, the court shall either deny the application or |
12587
|
grant the application, together with such other relief as the |
12588
|
nature of the case and the interests of the policyholders, |
12589
|
creditors, stockholders, members, subscribers, or public may |
12590
|
require. The officedepartmentmay also commence any such |
12591
|
proceeding by application to the court by petition for the entry |
12592
|
of a consent order of conservation, rehabilitation, or |
12593
|
liquidation. |
12594
|
Section 214. Subsections (2), (3), (4), and (5) of section |
12595
|
631.041, Florida Statutes, are amended to read: |
12596
|
631.041 Automatic stay; relief from stay; injunctions.-- |
12597
|
(2) Upon written request of a person or entity subject to |
12598
|
the stay against obtaining or enforcing a judgment against an |
12599
|
insurer or affiliate provided in paragraph (1)(b) the court, |
12600
|
with notice to the office anddepartment and upon hearing, may |
12601
|
grant relief from the stay provided the movant, who has the |
12602
|
burden of proof, establishes by clear and convincing evidence |
12603
|
that the judgment is not voidable or void by a receiver and that |
12604
|
property from which the judgment would be satisfied does not |
12605
|
constitute premium funds or another asset which belongs to the |
12606
|
insurer. |
12607
|
(3) Upon application by the office ordepartment pursuant |
12608
|
to this part for an order to show cause or upon petition, or at |
12609
|
any time thereafter, the court may without notice issue an |
12610
|
injunction restraining the insurer and its officers, directors, |
12611
|
stockholders, members, subscribers, and agents and all other |
12612
|
persons from the transaction of its business or the waste or |
12613
|
disposition of its property until the further order of the |
12614
|
court. |
12615
|
(4) The court may without notice at any time during a |
12616
|
proceeding under this chapter issue such other injunctions or |
12617
|
orders as may be deemed necessary to prevent interference with |
12618
|
the office ordepartment or the proceeding; waste of the assets |
12619
|
of the insurer; the commencement or prosecution of any actions; |
12620
|
the obtaining of preferences, judgments, attachments, or other |
12621
|
liens; or the making of any levy against the insurer or against |
12622
|
its assets or any part thereof. |
12623
|
(5) Notwithstanding any other provision of law, no bond |
12624
|
shall be required of the office ordepartment as a prerequisite |
12625
|
for the issuance of any injunction or restraining order pursuant |
12626
|
to this section. |
12627
|
Section 215. Subsections (1) and (4) of section 631.042, |
12628
|
Florida Statutes, are amended to read: |
12629
|
631.042 Extension of time.-- |
12630
|
(1) With respect to any action by or against an insurer, |
12631
|
no statute of limitations or defense of laches shall run between |
12632
|
the date the officedepartmentfiles a petition for a |
12633
|
delinquency proceeding against an insurer and the date the court |
12634
|
enters an order granting or denying that petition. If the |
12635
|
petition is denied, any action against the insurer that might |
12636
|
have been commenced when the petition was filed may be commenced |
12637
|
no later than 60 days after the order denying such relief or the |
12638
|
remaining unexpired time under the applicable statute of |
12639
|
limitations or defense of laches that was available on the day |
12640
|
the petition was filed, whichever is longer. |
12641
|
(4) For actions not covered by subsection (2), if any |
12642
|
unexpired time period is fixed by any agreement or in any |
12643
|
proceeding for doing any act for the benefit of the estate, the |
12644
|
receiver shall have 180 days, or for good cause shown more than |
12645
|
180 days as allowed by the court, from the date the court enters |
12646
|
the order granting the office'sdepartment'spetition for a |
12647
|
delinquency proceeding. |
12648
|
Section 216. Section 631.051, Florida Statutes, is amended |
12649
|
to read: |
12650
|
631.051 Grounds for rehabilitation; domestic |
12651
|
insurers.--The officedepartmentmay petition for an order |
12652
|
directing it to rehabilitate a domestic insurer or an alien |
12653
|
insurer domiciled in this state on any one or more of the |
12654
|
following grounds, that the insurer: |
12655
|
(1) Is impaired or insolvent; |
12656
|
(2) Has failed to comply with an order of the office |
12657
|
departmentto make good an impairment of capital or surplus or |
12658
|
both; |
12659
|
(3) Is found by the officedepartmentto be in such |
12660
|
condition or is using or has been subject to such methods or |
12661
|
practices in the conduct of its business, as to render its |
12662
|
further transaction of insurance presently or prospectively |
12663
|
hazardous to its policyholders, creditors, stockholders, or the |
12664
|
public; |
12665
|
(4) Has failed, or its parent corporation, subsidiary, or |
12666
|
affiliated person controlled by either the insurer or the parent |
12667
|
corporation has failed, to submit its books, documents, |
12668
|
accounts, records, and affairs pertaining to the insurer to the |
12669
|
reasonable inspection or examination of the officedepartmentor |
12670
|
its authorized representative; or any individual exercising any |
12671
|
executive authority in the affairs of the insurer, or parent |
12672
|
corporation, or subsidiary, or affiliated person has refused to |
12673
|
be examined under oath by the officedepartmentor its |
12674
|
authorized representative, whether within this state or |
12675
|
otherwise, concerning the pertinent affairs of the insurer, or |
12676
|
parent corporation or subsidiary or affiliated person; or if |
12677
|
examined under oath refuses to divulge pertinent information |
12678
|
reasonably known to her or him; or officers, directors, agents, |
12679
|
employees, or other representatives of the insurer or parent |
12680
|
corporation, subsidiary, or affiliated person have failed to |
12681
|
comply promptly with the reasonable requests of the office |
12682
|
departmentor its authorized representative for the purposes of, |
12683
|
and during the conduct of, any such examination; |
12684
|
(5) Has concealed or removed records or assets or |
12685
|
otherwise violated s. 628.271 or s. 628.281; |
12686
|
(6) Through its board of directors or governing body is |
12687
|
deadlocked in the management of the insurer's affairs and that |
12688
|
the members of a mutual, reciprocal, or any other type of |
12689
|
organization or stockholders are unable to break the deadlock |
12690
|
and that irreparable injury to the insurer, its creditors, its |
12691
|
policyholders, its members or subscribers, or the public is |
12692
|
threatened by reason thereof; |
12693
|
(7) Has transferred or attempted to transfer substantially |
12694
|
its entire property or business, or has entered into any |
12695
|
transaction the effect of which is to merge substantially its |
12696
|
entire property or business into that of any other insurer or |
12697
|
entity without having first obtained the written approval of the |
12698
|
officedepartmentunder the provisions of s. 628.451, s. |
12699
|
628.461, or s. 628.4615, as the case may be; |
12700
|
(8) Has willfully violated its charter or certificate of |
12701
|
incorporation or any law of this state; |
12702
|
(9) Is in such a position that control of it, whether by |
12703
|
stock ownership or otherwise, and whether direct or indirect, is |
12704
|
in one or more persons found by the officedepartmentafter |
12705
|
notice and hearing to be dishonest or untrustworthy; or that the |
12706
|
insurer has failed, upon order of the officedepartmentand |
12707
|
expiration of such reasonable time for such removal as the |
12708
|
officedepartmentshall specify in the order, to remove any |
12709
|
person who in fact has executive authority, directly or |
12710
|
indirectly, in the insurer, whether as an officer, director, |
12711
|
manager, agent, employee, or otherwise, and if such person has |
12712
|
been found by the officedepartmentafter notice and hearing, to |
12713
|
be incompetent, dishonest, untrustworthy, or so lacking in |
12714
|
insurance company managerial experience as to be hazardous to |
12715
|
the insurance-buying public; |
12716
|
(10) Has been or is the subject of an application for the |
12717
|
appointment of a receiver, trustee, custodian, or sequestrator |
12718
|
of the insurer or its property otherwise than pursuant to the |
12719
|
provisions of this code, but only if such an appointment has |
12720
|
been made or is imminent; |
12721
|
(11) Has consented to such an order through a majority of |
12722
|
its directors, stockholders, members, or subscribers; |
12723
|
(12) Has failed to pay a final judgment rendered against |
12724
|
it in this state upon any insurance contract issued or assumed |
12725
|
by it, within 60 days after the judgment became final, within 60 |
12726
|
days after the time for taking an appeal has expired, or within |
12727
|
30 days after dismissal of an appeal before final determination, |
12728
|
whichever date is the later; |
12729
|
(13) Has been the victim of embezzlement, wrongful |
12730
|
sequestration, conversion, diversion, or encumbering of its |
12731
|
assets; forgery or fraud affecting it; or other illegal conduct |
12732
|
in, by, or with respect to it, which if established would |
12733
|
threaten its solvency; or that the officedepartmenthas |
12734
|
reasonable cause to so believe any of the foregoing has occurred |
12735
|
or may occur; |
12736
|
(14) Is engaging in a systematic practice of reaching |
12737
|
settlements with and obtaining releases from policyholders or |
12738
|
third-party claimants and then unreasonably delaying payment of, |
12739
|
or failing to pay, the agreed-upon settlements; or |
12740
|
(15) Within the previous 12 months has systematically |
12741
|
attempted to compromise with creditors on the ground that it is |
12742
|
financially unable to pay its claims in full. |
12743
|
Section 217. Section 631.0515, Florida Statutes, is |
12744
|
amended to read: |
12745
|
631.0515 Appointment of receiver; insurance holding |
12746
|
company.--A delinquency proceeding pursuant to this chapter |
12747
|
constitutes the sole and exclusive method of dissolving, |
12748
|
liquidating, rehabilitating, reorganizing, conserving, or |
12749
|
appointing a receiver of a Florida corporation which is not |
12750
|
insolvent as defined by s. 607.01401(16); which through its |
12751
|
shareholders, board of directors, or governing body is |
12752
|
deadlocked in the management of its affairs; and which directly |
12753
|
or indirectly owns all of the stock of a Florida domestic |
12754
|
insurer. The officedepartmentmay petition for an order |
12755
|
directing the departmentitto rehabilitate such corporation if |
12756
|
the interests of policyholders or the public will be harmed as a |
12757
|
result of the deadlock. The department shall use due diligence |
12758
|
to resolve the deadlock. Whether or not the officedepartment |
12759
|
petitions for an order, the circuit court shall not have |
12760
|
jurisdiction pursuant to s. 607.271, s. 607.274, or s. 607.277 |
12761
|
to dissolve, liquidate, or appoint receivers with respect to, a |
12762
|
Florida corporation which directly or indirectly owns all of the |
12763
|
stock of a Florida domestic insurer and which is not insolvent |
12764
|
as defined by s. 607.01401(16). |
12765
|
Section 218. Section 631.061, Florida Statutes, is amended |
12766
|
to read: |
12767
|
631.061 Grounds for liquidation.--The officedepartment |
12768
|
may apply to the court for an order appointing the departmentit |
12769
|
as receiver (if its appointment as receiver is not then in |
12770
|
effect) and directing the departmentitto liquidate the |
12771
|
business of a domestic insurer or of the United States branch of |
12772
|
an alien insurer having trusteed assets in this state, |
12773
|
regardless of whether or not there has been a prior order |
12774
|
directing it to rehabilitate such insurer, upon any of the |
12775
|
grounds specified in s. 631.051, or if such insurer: |
12776
|
(1) Is or is about to become insolvent. |
12777
|
(2) Is an insolvent insurer and has commenced or is |
12778
|
attempting to commence voluntary liquidation or dissolution |
12779
|
except under this code. |
12780
|
(3) Has not completed its organization and obtained a |
12781
|
certificate of authority as an insurer within the time allowed |
12782
|
therefor under any applicable law. |
12783
|
Section 219. Section 631.071, Florida Statutes, is amended |
12784
|
to read: |
12785
|
631.071 Grounds for conservation; foreign insurers.--The |
12786
|
officedepartment may apply to the court for an order appointing |
12787
|
the departmentitas receiver or ancillary receiver, and |
12788
|
directing it to conserve the assets within this state, of a |
12789
|
foreign insurer upon any of the following grounds: |
12790
|
(1) Upon any of the grounds specified in s. 631.051 or s. |
12791
|
631.061, or |
12792
|
(2) Upon the ground that its property has been |
12793
|
sequestrated in its domiciliary sovereignty or in any other |
12794
|
sovereignty. |
12795
|
Section 220. Section 631.081, Florida Statutes, is amended |
12796
|
to read: |
12797
|
631.081 Grounds for conservation; alien insurers.--The |
12798
|
officedepartment may apply to the court for an order appointing |
12799
|
the departmentitas receiver or ancillary receiver, and |
12800
|
directing it to conserve the assets within this state, of any |
12801
|
alien insurer upon any of the following grounds: |
12802
|
(1) Upon any of the grounds specified in s. 631.051 or s. |
12803
|
631.061; |
12804
|
(2) Upon the ground that the insurer has failed to comply, |
12805
|
within the time designated by the officedepartment, with an |
12806
|
order made by it to make good an impairment of its trusteed |
12807
|
funds; or |
12808
|
(3) Upon the ground that the property of the insurer has |
12809
|
been sequestrated in its domiciliary sovereignty or elsewhere. |
12810
|
Section 221. Section 631.091, Florida Statutes, is amended |
12811
|
to read: |
12812
|
631.091 Grounds for ancillary liquidation; foreign |
12813
|
insurers.--The officedepartmentmay apply to the circuit court |
12814
|
for an order appointing the departmentitas ancillary receiver |
12815
|
of, and directing it to liquidate the business and assets of, a |
12816
|
foreign insurer which has assets, business, or claims in this |
12817
|
state upon the appointment in the domiciliary state of such |
12818
|
insurer of a receiver, liquidator, conservator, rehabilitator, |
12819
|
or other officer by whatever name called for the purpose of |
12820
|
liquidating the business of such insurer. |
12821
|
Section 222. Subsection (3) of section 631.111, Florida |
12822
|
Statutes, is amended to read: |
12823
|
631.111 Order of liquidation; domestic insurers.-- |
12824
|
(3) The department or officemay apply for and secure an |
12825
|
order dissolving the corporate existence of a domestic insurer |
12826
|
upon theitsapplication for an order of liquidation of such |
12827
|
insurer or at any time after such order has been granted. |
12828
|
Section 223. Subsection (1) of section 631.152, Florida |
12829
|
Statutes, is amended to read: |
12830
|
631.152 Conduct of delinquency proceeding; foreign |
12831
|
insurers.-- |
12832
|
(1) Whenever under this chapter an ancillary receiver is |
12833
|
to be appointed in a delinquency proceeding for an insurer not |
12834
|
domiciled in this state, the court shall appoint the department |
12835
|
as ancillary receiver. The officedepartmentshall file a |
12836
|
petition requesting the appointment on the grounds set forth in |
12837
|
s. 631.091: |
12838
|
(a) If it finds that there are sufficient assets of the |
12839
|
insurer located in this state to justify the appointment of an |
12840
|
ancillary receiver, or |
12841
|
(b) If 10 or more persons resident in this state having |
12842
|
claims against such insurer file a petition with the office |
12843
|
departmentrequesting the appointment of such ancillary |
12844
|
receiver. |
12845
|
Section 224. Paragraph (d) of subsection (6) of section |
12846
|
631.154, Florida Statutes, is amended to read: |
12847
|
631.154 Funds, assets, or other property in the possession |
12848
|
of third person.-- |
12849
|
(6) Should the receiver be successful in establishing its |
12850
|
claim or any part thereof, the receiver shall be entitled to |
12851
|
recover judgment for the following: |
12852
|
(d) All costs, investigative and other expenses, |
12853
|
including, but not limited to, those for department and office |
12854
|
staff, incurred in the recovery of the property, assets, or |
12855
|
funds, and reasonable attorney's fees. Department and office |
12856
|
staff costs and expenses include staff salaries. |
12857
|
|
12858
|
|
12859
|
It is the intent of this section that a person found to be |
12860
|
holding receivership assets fully reimburse the receiver for any |
12861
|
and all efforts made to recover those assets. |
12862
|
Section 225. Section 631.221, Florida Statutes, is amended |
12863
|
to read: |
12864
|
631.221 Deposit of moneys collected.--The moneys collected |
12865
|
by the department in a proceeding under this chapter shall be |
12866
|
deposited in a qualified public depository as defined in s. |
12867
|
280.02, which depository with regards to such funds shall |
12868
|
conform to and be bound by all the provisions of chapter 280, or |
12869
|
invested with the Chief Financial OfficerState Treasurer |
12870
|
pursuant to chapter 18. For the purpose of accounting for the |
12871
|
assets and transactions of the estate, the receiver shall use |
12872
|
such accounting books, records, and systems as the court directs |
12873
|
after it hears and considers the recommendations of the |
12874
|
receiver. |
12875
|
Section 226 Section 631.231, Florida Statutes, is amended |
12876
|
to read: |
12877
|
631.231 Exemption from fees.--The department or office |
12878
|
shall not be required to pay any fee to any public officer in |
12879
|
this state for filing, recording, issuing a transcript or |
12880
|
certificate, or authenticating any paper or instrument |
12881
|
pertaining to the exercise by the department or officeof any of |
12882
|
the powers or duties conferred upon it under this chapter, |
12883
|
whether or not such paper or instrument be executed by the |
12884
|
department or office or theiritsemployees or attorneys of |
12885
|
record and whether or not it is connected with the commencement |
12886
|
of any action or proceeding by or against the department or |
12887
|
office, or with the subsequent conduct of such action or |
12888
|
proceeding. |
12889
|
Section 227 Section 631.361, Florida Statutes, is amended |
12890
|
to read: |
12891
|
631.361 Seizure under court order.-- |
12892
|
(1) Upon filing by the officedepartmentin the circuit |
12893
|
court in and for Leon County of its verified petition alleging |
12894
|
any ground for a formal delinquency proceeding against an |
12895
|
insurer under this chapter, alleging that the interests of the |
12896
|
insurer's policyholders, claimants, or creditors or the public |
12897
|
will be endangered or jeopardized by delay, and setting forth |
12898
|
the order deemed necessary by the officedepartment, the court |
12899
|
may, ex parte and without notice or hearing, issue forthwith the |
12900
|
requested order. The requested order may: |
12901
|
(a) Direct the department to take possession and control |
12902
|
of all or part of the property, books, documents, accounts, and |
12903
|
other records of the insurer and the premises occupied by it for |
12904
|
transaction of its business and premium funds and other property |
12905
|
of the insurer held by an affiliate; and |
12906
|
(b) Until further order of court, enjoin the insurer and |
12907
|
any affiliate and their officers, directors, managers, agents, |
12908
|
and employees from removal, concealment, or other disposition of |
12909
|
the insurer's property, books, records, or accounts and from |
12910
|
transaction of the insurer's business except with the |
12911
|
department's written consent. |
12912
|
(2) The court's order shall be for such duration specified |
12913
|
in the order as the court deems necessary to enable the office |
12914
|
anddepartment to ascertain the insurer's condition. Upon motion |
12915
|
of any party or affected person, or upon its own motion, the |
12916
|
court may hold such hearings as it deems desirable, after such |
12917
|
notice as it deems appropriate, and may extend, shorten, or |
12918
|
modify the terms of the order. The court shall vacate the |
12919
|
seizure order if the officedepartmentfails to commence a |
12920
|
formal proceeding under this chapter after having had a |
12921
|
reasonable opportunity to do so, and a seizure order is |
12922
|
automatically vacated by issuance of the court's order pursuant |
12923
|
to a formal delinquency proceeding under this chapter. |
12924
|
(3) Entry of a seizure order under this section shall not |
12925
|
constitute an anticipatory breach of any contract of the |
12926
|
insurer. |
12927
|
Section 228 Section 631.371, Florida Statutes, is amended |
12928
|
to read: |
12929
|
631.371 Seizure under order of the officedepartment.-- |
12930
|
(1) Upon the office'sdepartmentfiling a verified |
12931
|
petition with any circuit judge of the proper judicial circuit |
12932
|
as required by s. 631.021(2), which states that it believes that |
12933
|
the interest of policyholders, the insurer, claimants, |
12934
|
creditors, or the public will be endangered or jeopardized and |
12935
|
that prima facie grounds exist for rehabilitation, liquidation, |
12936
|
or conservation of an insurer under s. 631.051, s. 631.061, or |
12937
|
s. 631.131, the officedepartmentmay request a seizure order |
12938
|
and shall be entitled to an ex parte hearing forthwith and an |
12939
|
appropriate seizure order from the judge or court in the |
12940
|
interest of protecting the public and such insurer and its |
12941
|
policyholders, claimants, or creditors. After a diligent effort |
12942
|
is made to be heard by the judges of the circuit and such judges |
12943
|
or the court fails or refuses to hear such petition for any |
12944
|
reason, the officedepartmentshall then file a duplicate |
12945
|
original of said petition and exhibits, if any, in the Circuit |
12946
|
Court of Leon County along with an affidavit which shall state |
12947
|
that a diligent effort was made to obtain such initial hearing |
12948
|
in the judicial circuit where such hearing was sought and that |
12949
|
the request to be heard was refused or that a hearing was not |
12950
|
granted and the reasons therefor, if known. Upon compliance with |
12951
|
the above and if said affidavit further states that the office |
12952
|
departmentbelieves that irreparable harm will result to the |
12953
|
public and the insurer and its policyholders, creditors, or |
12954
|
claimants as a result of further delay, it may thereafter issue |
12955
|
a seizure order on any ground that would justify court seizure |
12956
|
under s. 631.361. Such seizure order may contain any or all the |
12957
|
provisions of s. 631.361(1). The officedepartmentshall retain |
12958
|
possession and control until the order is vacated or is replaced |
12959
|
by an order of court pursuant to subsection (2) or subsection |
12960
|
(3) or pursuant to a formal delinquency proceeding under this |
12961
|
chapter. |
12962
|
(2) The officedepartmentmay, at any time after seizure |
12963
|
under its order, report its actions to the proper court; and, in |
12964
|
the event that the insurer, for any reason, fails to avail |
12965
|
itself of the judicial review provided for by law, then the |
12966
|
officedepartmentshall forthwith report its actions to the |
12967
|
proper court. The officedepartmentmay request the court to |
12968
|
substitute its order for the office'sdepartment'sor it may |
12969
|
seek any other order which it deems appropriate. |
12970
|
(3) Every law enforcement officer of this state authorized |
12971
|
by law shall assist the officedepartmentin making and |
12972
|
enforcing any such seizure, and every such officer shall furnish |
12973
|
it with such deputies, patrolmen, patrolwomen, or officers as |
12974
|
are necessary to assist it in execution of its order. |
12975
|
(4) Entry of a seizure order under this section shall not |
12976
|
constitute an anticipatory breach of any contract of the |
12977
|
insurer. |
12978
|
Section 229 Section 631.391, Florida Statutes, is amended |
12979
|
to read: |
12980
|
631.391 Cooperation of officers and employees.-- |
12981
|
(1) Any officer, director, manager, trustee, agent, |
12982
|
adjuster, employee, or independent contractor of any insurer or |
12983
|
affiliate and any other person who possesses any executive |
12984
|
authority over, or who exercises any control over, any segment |
12985
|
of the affairs of the insurer or affiliate shall fully cooperate |
12986
|
with the department and officein any proceeding under this |
12987
|
chapter or any investigation preliminary or incidental to the |
12988
|
proceeding. An order of rehabilitation or liquidation which |
12989
|
results in the discharge or suspension of any of the persons |
12990
|
listed above does not operate to release such person from the |
12991
|
duty to cooperate with the department and officeas set out |
12992
|
herein. To "cooperate" includes, but is not limited to, the |
12993
|
following: |
12994
|
(a) To reply promptly in writing to any inquiry from the |
12995
|
department or officerequesting such a reply; |
12996
|
(b) Promptly to make available and deliver to the |
12997
|
department or officeany books, accounts, documents, other |
12998
|
records, information, data processing software, or property of |
12999
|
or pertaining to the insurer and in her or his possession, |
13000
|
custody, or control; or |
13001
|
(c) Promptly to provide access to all data processing |
13002
|
records in hard copy and in electronic form and to data |
13003
|
processing facilities and services. |
13004
|
(2) No person shall obstruct or interfere with the |
13005
|
department or officein the conduct of any delinquency |
13006
|
proceeding or any investigation preliminary or incidental |
13007
|
thereto. |
13008
|
(3) This section does not prohibit any person from seeking |
13009
|
legal relief from a court when aggrieved by the petition for |
13010
|
liquidation or other delinquency proceeding or by other orders. |
13011
|
(4) Any person referred to in subsection (1) who fails to |
13012
|
cooperate with the department or office, or any other person who |
13013
|
obstructs or interferes with the department or office, in the |
13014
|
conduct of any delinquency proceeding or any investigation |
13015
|
preliminary or incidental thereto, is guilty of a misdemeanor of |
13016
|
the first degree, punishable as provided in s. 775.082 or by |
13017
|
fine of not more than $10,000. |
13018
|
(5) Refusal by any person referred to in subsection (1) to |
13019
|
provide records upon the request of the department or officeis |
13020
|
grounds for revocation of any insurance-related license, |
13021
|
including, but not limited to, agent and third-party |
13022
|
administrator licenses. |
13023
|
Section 230. Section 631.392, Florida Statutes, is amended |
13024
|
to read: |
13025
|
631.392 Immunity.--There shall be no liability on the part |
13026
|
of, and no cause of action of any nature shall arise against, |
13027
|
the Chief Financial Officer,Insurance Commissioner orthe |
13028
|
department, the office, or any of theiritsemployees or agents |
13029
|
for any action taken by them in the performance of their powers |
13030
|
and duties under this chapter. |
13031
|
Section 231. Section 631.398, Florida Statutes, is amended |
13032
|
to read: |
13033
|
631.398 Prevention of insolvencies.--To aid in the |
13034
|
detection and prevention of insurer insolvencies or impairments: |
13035
|
(1) Any member insurer; agent, employee, or member of the |
13036
|
board of directors; or representative of any insurance guaranty |
13037
|
association may make reports and recommendations to the |
13038
|
department or officeupon any matter germane to the solvency, |
13039
|
liquidation, rehabilitation, or conservation of any member |
13040
|
insurer or germane to the solvency of any company seeking to do |
13041
|
an insurance business in this state. Such reports and |
13042
|
recommendations are confidential and exempt from the provisions |
13043
|
of s. 119.07(1) until the termination of a delinquency |
13044
|
proceeding. |
13045
|
(2) The officedepartmentshall: |
13046
|
(a) Report to the board of directors of the appropriate |
13047
|
insurance guaranty association when it has reasonable cause to |
13048
|
believe from any examination, whether completed or in process, |
13049
|
of any member insurer that such insurer may be an impaired or |
13050
|
insolvent insurer. |
13051
|
(b) Seek the advice and recommendations of the board of |
13052
|
directors of the appropriate insurance guaranty association |
13053
|
concerning any matter affecting the duties and responsibilities |
13054
|
of the officedepartmentin relation to the financial condition |
13055
|
of member companies and companies seeking admission to transact |
13056
|
insurance business in this state. |
13057
|
(3) The office and department jointlyshall, no later than |
13058
|
the conclusion of any domestic insurer insolvency proceeding, |
13059
|
prepare a summary report containing such information as is in |
13060
|
theiritspossession relating to the history and causes of such |
13061
|
insolvency, including a statement of the business practices of |
13062
|
such insurer which led to such insolvency. |
13063
|
Section 232. Section 631.54, Florida Statutes, is amended |
13064
|
to read: |
13065
|
631.54 Definitions.--As used in this part: |
13066
|
(1) "Account" means any one of the three accounts created |
13067
|
by s. 631.55. |
13068
|
(2) "Association" means the Florida Insurance Guaranty |
13069
|
Association, Incorporated. |
13070
|
(3) "Covered claim" means an unpaid claim, including one |
13071
|
of unearned premiums, which arises out of, and is within the |
13072
|
coverage, and not in excess of, the applicable limits of an |
13073
|
insurance policy to which this part applies, issued by an |
13074
|
insurer, if such insurer becomes an insolvent insurer after |
13075
|
October 1, 1970, and the claimant or insured is a resident of |
13076
|
this state at the time of the insured event or the property from |
13077
|
which the claim arises is permanently located in this state. |
13078
|
"Covered claim" shall not include any amount due any reinsurer, |
13079
|
insurer, insurance pool, or underwriting association, as |
13080
|
subrogation, contribution, indemnification, or otherwise. Member |
13081
|
insurers shall have no right of subrogation against the insured |
13082
|
of any insolvent member. |
13083
|
(4) "Department" means the Department of Insurance. |
13084
|
(4)(5)"Expenses in handling claims" means allocated and |
13085
|
unallocated expenses, including, but not limited to, general |
13086
|
administrative expenses and those expenses which relate to the |
13087
|
investigation, adjustment, defense, or settlement of specific |
13088
|
claims under, or arising out of, a specific policy. |
13089
|
(5)(6)"Insolvent insurer" means a member insurer |
13090
|
authorized to transact insurance in this state, either at the |
13091
|
time the policy was issued or when the insured event occurred, |
13092
|
and against which an order of liquidation with a finding of |
13093
|
insolvency has been entered by a court of competent jurisdiction |
13094
|
if such order has become final by the exhaustion of appellate |
13095
|
review. |
13096
|
(6)(7)"Member insurer" means any person who writes any |
13097
|
kind of insurance to which this part applies under s. 631.52, |
13098
|
including the exchange of reciprocal or interinsurance |
13099
|
contracts, and is licensed to transact insurance in this state. |
13100
|
(7)(8)"Net direct written premiums" means direct gross |
13101
|
premiums written in this state on insurance policies to which |
13102
|
this part applies, less return premiums thereon and dividends |
13103
|
paid or credited to policyholders on such direct business. "Net |
13104
|
direct written premiums" does not include premiums on contracts |
13105
|
between insurers or reinsurers. |
13106
|
(8)(9)"Person" means individuals, children, firms, |
13107
|
associations, joint ventures, partnerships, estates, trusts, |
13108
|
business trusts, syndicates, fiduciaries, corporations, and all |
13109
|
other groups or combinations. |
13110
|
Section 233. Subsection (1) of section 631.55, Florida |
13111
|
Statutes, is amended to read: |
13112
|
631.55 Creation of the association.-- |
13113
|
(1) There is created a nonprofit corporation to be known |
13114
|
as the "Florida Insurance Guaranty Association, Incorporated." |
13115
|
All insurers defined as member insurers in s. 631.54(6)(7)shall |
13116
|
be members of the association as a condition of their authority |
13117
|
to transact insurance in this state, and, further, as a |
13118
|
condition of such authority, an insurer shall agree to reimburse |
13119
|
the association for all claim payments the association makes on |
13120
|
said insurer's behalf if such insurer is subsequently |
13121
|
rehabilitated. The association shall perform its functions under |
13122
|
a plan of operation established and approved under s. 631.58 and |
13123
|
shall exercise its powers through a board of directors |
13124
|
established under s. 631.56. The corporation shall have all |
13125
|
those powers granted or permitted nonprofit corporations, as |
13126
|
provided in chapter 617. |
13127
|
Section 234. Subsection (1) of section 631.56, Florida |
13128
|
Statutes, is amended to read: |
13129
|
631.56 Board of directors.-- |
13130
|
(1) The board of directors of the association shall |
13131
|
consist of not less than five or more than nine persons serving |
13132
|
terms as established in the plan of operation. The department |
13133
|
shall approve and appoint to the board persons recommended by |
13134
|
the member insurers. In the event the department finds that any |
13135
|
recommended person does not meet the qualifications for service |
13136
|
on the board, the department shall request the member insurers |
13137
|
to recommend another person. Each member shall serve for a 4- |
13138
|
year term and may be reappointed. Vacancies on the board shall |
13139
|
be filled for the remaining period of the term in the same |
13140
|
manner as initial appointments. If no members are selected by |
13141
|
November 30, 1970, the department may appoint the initial |
13142
|
members of the board of directors. |
13143
|
Section 235. Paragraph (a) of subsection (1) and |
13144
|
subsection (3) of section 631.57, Florida Statutes, are amended |
13145
|
to read: |
13146
|
631.57 Powers and duties of the association.-- |
13147
|
(1) The association shall: |
13148
|
(a)1. Be obligated to the extent of the covered claims |
13149
|
existing: |
13150
|
a. Prior to adjudication of insolvency and arising within |
13151
|
30 days after the determination of insolvency; |
13152
|
b. Before the policy expiration date if less than 30 days |
13153
|
after the determination; or |
13154
|
c. Before the insured replaces the policy or causes its |
13155
|
cancellation, if she or he does so within 30 days of the |
13156
|
determination. |
13157
|
2. The obligation under subparagraph 1. shall include only |
13158
|
that amount of each covered claim which is in excess of $100 and |
13159
|
is less than $300,000, except with respect to policies covering |
13160
|
condominium associations or homeowners' associations, which |
13161
|
associations have a responsibility to provide insurance coverage |
13162
|
on residential units within the association, the obligation |
13163
|
shall include that amount of each covered property insurance |
13164
|
claim which is less than $100,000 multiplied by the number of |
13165
|
condominium units or other residential units; however, as to |
13166
|
homeowners' associations, this subparagraph applies only to |
13167
|
claims for damage or loss to residential units and structures |
13168
|
attached to residential units. |
13169
|
3. In no event shall the association be obligated to a |
13170
|
policyholder or claimant in an amount in excess of the |
13171
|
obligation of the insolvent insurer under the policy from which |
13172
|
the claim arises. |
13173
|
|
13174
|
The foregoing notwithstanding, the association shall have no |
13175
|
obligation to pay covered claims to be paid from the proceeds of |
13176
|
bonds issued under s. 166.111(2). However, the association shall |
13177
|
cause assessments to be made under paragraph (3)(e) for such |
13178
|
covered claims, and such assessments shall be assigned and |
13179
|
pledged under paragraph (3)(e) to or on behalf of the issuer of |
13180
|
such bonds for the benefit of the holders of such bonds. The |
13181
|
association shall administer any such covered claims and present |
13182
|
valid covered claims for payment in accordance with the |
13183
|
provisions of the assistance program in connection with which |
13184
|
such bonds have been issued.
|
13185
|
(3)(a) To the extent necessary to secure the funds for the |
13186
|
respective accounts for the payment of covered claims and also |
13187
|
to pay the reasonable costs to administer the same, the office |
13188
|
department, upon certification of the board of directors, shall |
13189
|
levy assessments in the proportion that each insurer's net |
13190
|
direct written premiums in this state in the classes protected |
13191
|
by the account bears to the total of said net direct written |
13192
|
premiums received in this state by all such insurers for the |
13193
|
preceding calendar year for the kinds of insurance included |
13194
|
within such account. Assessments shall be remitted to and |
13195
|
administered by the board of directors in the manner specified |
13196
|
by the approved plan. Each insurer so assessed shall have at |
13197
|
least 30 days' written notice as to the date the assessment is |
13198
|
due and payable. Every assessment shall be made as a uniform |
13199
|
percentage applicable to the net direct written premiums of each |
13200
|
insurer in the kinds of insurance included within the account in |
13201
|
which the assessment is made. The assessments levied against |
13202
|
any insurer shall not exceed in any one year more than 2 percent |
13203
|
of that insurer's net direct written premiums in this state for |
13204
|
the kinds of insurance included within such account during the |
13205
|
calendar year next preceding the date of such assessments. |
13206
|
(b) If sufficient funds from such assessments, together |
13207
|
with funds previously raised, are not available in any one year |
13208
|
in the respective account to make all the payments or |
13209
|
reimbursements then owing to insurers, the funds available shall |
13210
|
be prorated and the unpaid portion shall be paid as soon |
13211
|
thereafter as funds become available. |
13212
|
(c) Assessments shall be included as an appropriate factor |
13213
|
in the making of rates. |
13214
|
(d) No state funds of any kind shall be allocated or paid |
13215
|
to said association or any of its accounts. |
13216
|
(e)1.a. In addition to assessments otherwise authorized in |
13217
|
paragraph (a), as a temporary measure related to insolvencies |
13218
|
caused by Hurricane Andrew, and to the extent necessary to |
13219
|
secure the funds for the account specified in s. 631.55(2)(c), |
13220
|
or to retire indebtedness, including, without limitation, the |
13221
|
principal, redemption premium, if any, and interest on, and |
13222
|
related costs of issuance of, bonds issued under s. 166.111(2), |
13223
|
and the funding of any reserves and other payments required |
13224
|
under the bond resolution or trust indenture pursuant to which |
13225
|
such bonds have been issued, the department, upon certification |
13226
|
of the board of directors, shall levy assessments upon insurers |
13227
|
holding a certificate of authority as follows: |
13228
|
(I) Except as provided in sub-sub-subparagraph (II), the |
13229
|
assessments payable under this paragraph by any insurer shall |
13230
|
not exceed in any 1 year more than 2 percent of that insurer's |
13231
|
direct written premiums, net of refunds, in this state during |
13232
|
the preceding calendar year for the kinds of insurance within |
13233
|
the account specified in s. 631.55(2)(c). |
13234
|
(II) If the amount levied under sub-sub-subparagraph (I) |
13235
|
is less than 2 percent of the insurer's direct written premiums, |
13236
|
net of refunds, in this state during calendar year 1991 for the |
13237
|
kinds of insurance within the account specified in s. |
13238
|
631.55(2)(c), in addition to and separate from such assessment, |
13239
|
the assessment shall also include the difference between the |
13240
|
amount calculated based on calendar year 1991 and the amount |
13241
|
determined under sub-sub-subparagraph (I). If this sub-sub- |
13242
|
subparagraph is held invalid, the invalidity shall not affect |
13243
|
other provisions of this section, and to this end the provisions |
13244
|
of this section are declared severable. |
13245
|
(III) In addition to any other insurers subject to this |
13246
|
subparagraph, this subparagraph also applies to any insurer that |
13247
|
held a certificate of authority on August 24, 1992. If this |
13248
|
sub-sub-subparagraph is held invalid, the invalidity shall not |
13249
|
affect other provisions of this section, and to this end the |
13250
|
provisions of this section are declared severable. |
13251
|
b. Any assessments authorized under this paragraph shall |
13252
|
be levied by the department upon insurers referred to in sub- |
13253
|
subparagraph a., upon certification as to the need therefor by |
13254
|
the board of directors, in 1992 and in each year that bonds |
13255
|
issued under s. 166.111(2) are outstanding, in such amounts up |
13256
|
to such 2 percent limit as required in order to provide for the |
13257
|
full and timely payment of the principal of, redemption premium, |
13258
|
if any, and interest on, and related costs of, issuance of bonds |
13259
|
issued under s. 166.111(2). The assessments provided for in |
13260
|
this paragraph are hereby assigned and pledged to a municipality |
13261
|
issuing bonds under s. 166.111(2)(b), for the benefit of the |
13262
|
holders of such bonds, in order to enable such municipality to |
13263
|
provide for the payment of the principal of, redemption premium, |
13264
|
if any, and interest on such bonds, the cost of issuance of such |
13265
|
bonds, and the funding of any reserves and other payments |
13266
|
required under the bond resolution or trust indenture pursuant |
13267
|
to which such bonds have been issued, without the necessity of |
13268
|
any further action by the association, the department, or any |
13269
|
other party. To the extent that bonds are issued under s. |
13270
|
166.111(2), the proceeds of assessments levied under this |
13271
|
paragraph shall be remitted directly to and administered by the |
13272
|
trustee appointed for such bonds. |
13273
|
c. Assessments under this paragraph shall be payable in 12 |
13274
|
monthly installments with the first installment being due and |
13275
|
payable at the end of the month after an assessment is levied, |
13276
|
and subsequent installments being due not later than the end of |
13277
|
each succeeding month. |
13278
|
d. The association shall issue a monthly report on the |
13279
|
status of the use of the bond proceeds as related to |
13280
|
insolvencies caused by Hurricane Andrew. The report must contain |
13281
|
the number of claims paid and the amount of claims paid. The |
13282
|
association shall also include an analysis of the revenue |
13283
|
generated from the additional assessment levied under this |
13284
|
subsection. The report must be sent to the Legislature and the |
13285
|
Insurance Commissioner monthly. |
13286
|
2. In order to assure that insurers paying assessments |
13287
|
levied under this paragraph continue to charge rates that are |
13288
|
neither inadequate nor excessive, within 90 days after being |
13289
|
notified of such assessments, each insurer that is to be |
13290
|
assessed pursuant to this paragraph shall make a rate filing for |
13291
|
coverage included within the account specified in s. |
13292
|
631.55(2)(c) and for which rates are required to be filed under |
13293
|
s. 627.062. If the filing reflects a rate change that, as a |
13294
|
percentage, is equal to the difference between the rate of such |
13295
|
assessment and the rate of the previous year's assessment under |
13296
|
this paragraph, the filing shall consist of a certification so |
13297
|
stating and shall be deemed approved when made, subject to the |
13298
|
department's continuing authority to require actuarial |
13299
|
justification as to the adequacy of any rate at any time. Any |
13300
|
rate change of a different percentage shall be subject to the |
13301
|
standards and procedures of s. 627.062. |
13302
|
|
13303
|
Section 236. Section 631.59, Florida Statutes, is amended |
13304
|
to read: |
13305
|
631.59 Duties and powers of department and officeof |
13306
|
Insurance.-- |
13307
|
(1) The department shall: |
13308
|
(a) Notify the association of the existence of an |
13309
|
insolvent insurer not later than 3 days after it receives notice |
13310
|
of the determination of the insolvency; and |
13311
|
(b) Upon request of the board of directors, provide the |
13312
|
association with a statement of the net direct written premiums |
13313
|
of each member insurer. |
13314
|
(2) The department may: |
13315
|
(a)require that the association notify the insureds of |
13316
|
the insolvent insurer and any other interested parties of the |
13317
|
determination of insolvency and of their rights under this part. |
13318
|
Such notification shall be by mail at their last known |
13319
|
addresses, when available, but if sufficient information for |
13320
|
notification by mail is not available, notice by publication in |
13321
|
a newspaper of general circulation shall be sufficient. |
13322
|
(3)(b)The office may: |
13323
|
(a)Suspend or revoke the certificate of authority to |
13324
|
transact insurance in this state of any member insurer which |
13325
|
fails to pay an assessment when due or fails to comply with the |
13326
|
plan of operation. As an alternative, the officedepartmentmay |
13327
|
levy a fine on any member insurer which fails to pay an |
13328
|
assessment when due. Such fine may not exceed 5 percent of the |
13329
|
unpaid assessment per month, except that no fine shall be less |
13330
|
than $100 per month. |
13331
|
(b)(c)Revoke the designation of any servicing facility if |
13332
|
it finds claims are being handled unsatisfactorily. |
13333
|
Section 237. Section 631.62, Florida Statutes, is amended |
13334
|
to read: |
13335
|
631.62 Prevention of insolvencies.--To aid in the |
13336
|
detection and prevention of insurer insolvencies: |
13337
|
(1) It shall be the duty of the board of directors, upon |
13338
|
majority vote, to notify the officedepartmentof any |
13339
|
information indicating any member insurer may be insolvent or in |
13340
|
a financial condition hazardous to the policyholders or the |
13341
|
public. |
13342
|
(2) The board of directors may, upon majority vote, |
13343
|
request that the officedepartmentorder an examination of any |
13344
|
member insurer which the board in good faith believes may be in |
13345
|
a financial condition hazardous to the policyholders or the |
13346
|
public. Within 30 days of the receipt of such request, the |
13347
|
officedepartmentshall begin such examination. The examination |
13348
|
may be conducted as a National Association of Insurance |
13349
|
Commissioners examination or may be conducted by such persons as |
13350
|
the officedepartmentdesignates. The cost of such examination |
13351
|
shall be paid by the association and the examination report |
13352
|
shall be treated as are other examination reports pursuant to s. |
13353
|
624.319. In no event shall such examination report be released |
13354
|
to the board of directors prior to its release to the public. |
13355
|
The officedepartmentshall notify the board of directors when |
13356
|
the examination is completed. The request for an examination |
13357
|
shall be kept on file by the officedepartment; such request is |
13358
|
confidential and exempt from the provisions of s. 119.07(1) |
13359
|
until the examination report is released to the public. |
13360
|
(3) The board of directors may, upon majority vote, make |
13361
|
reports and recommendations to the department or officeupon any |
13362
|
matter germane to the solvency, liquidation, rehabilitation, or |
13363
|
conservation of any member insurer. Such reports and |
13364
|
recommendations are confidential and exempt from the provisions |
13365
|
of s. 119.07(1) until the termination of a delinquency |
13366
|
proceeding. |
13367
|
(4) The board of directors may, upon majority vote, make |
13368
|
recommendations to the officedepartmentfor the detection and |
13369
|
prevention of insurer insolvencies. |
13370
|
Section 238. Section 631.66, Florida Statutes, is amended |
13371
|
to read: |
13372
|
631.66 Immunity.--There shall be no liability on the part |
13373
|
of, and no cause of action of any nature shall arise against, |
13374
|
any member insurer, the association or its agents or employees, |
13375
|
the board of directors, or the department or office or theirits |
13376
|
representatives for any action taken by them in the performance |
13377
|
of their powers and duties under this part. Such immunity shall |
13378
|
extend to the participation in any organization of one or more |
13379
|
other state associations of similar purposes and to any such |
13380
|
organization and its agents or employees. |
13381
|
Section 239. Section 631.714, Florida Statutes, is amended |
13382
|
to read: |
13383
|
631.714 Definitions.--As used in this part, the term: |
13384
|
(1) "Account" means any of the three accounts created in |
13385
|
s. 631.715. |
13386
|
(2) "Association" means the Florida Life and Health |
13387
|
Insurance Guaranty Association created in s. 631.715. |
13388
|
(3) "Contractual obligation" means any obligation under |
13389
|
covered policies. |
13390
|
(4) "Covered policy" means any policy or contract set out |
13391
|
in s. 631.713 and reduced to written, printed, or other tangible |
13392
|
form. |
13393
|
(5) "Department" means the Department of Insurance. |
13394
|
(5)(6)"Impaired insurer" means a member insurer deemed by |
13395
|
the department to be potentially unable to fulfill its |
13396
|
contractual obligations and not an insolvent insurer. |
13397
|
(6)(7)"Insolvent insurer" means a member insurer |
13398
|
authorized to transact insurance in this state, either at the |
13399
|
time the policy was issued or when the insured event occurred, |
13400
|
and against which an order of liquidation with a finding of |
13401
|
insolvency has been entered by a court of competent |
13402
|
jurisdiction, if such order has become final by the exhaustion |
13403
|
of appellate review. |
13404
|
(7)(8)"Member insurer" means any person licensed to |
13405
|
transact in this state any kind of insurance as set out in s. |
13406
|
631.713. |
13407
|
(8)(9)"Premium" means any direct gross insurance premium |
13408
|
and any annuity consideration written on covered policies, less |
13409
|
return premium and consideration thereon and dividends paid or |
13410
|
credited to policyholders on such direct business. "Premium" |
13411
|
does not include premium and consideration on contracts between |
13412
|
insurers and reinsurers. |
13413
|
(9)(10)"Person" means any individual, corporation, |
13414
|
partnership, association, or voluntary organization. |
13415
|
(10)(11)"Resident" means any person who resides in this |
13416
|
state at the time a member insurer is determined to be an |
13417
|
impaired or insolvent insurer and to whom contractual |
13418
|
obligations are owed by such impaired or insolvent member |
13419
|
insurer. |
13420
|
Section 240. Subsections (2) and (3) of section 631.72, |
13421
|
Florida Statutes, are amended to read: |
13422
|
631.72 Premium or income tax credits for assessments |
13423
|
paid.-- |
13424
|
(2) If a member insurer ceases doing business in this |
13425
|
state and surrenders to the officedepartmentits certificate of |
13426
|
authority to transact insurance in this state, all uncredited |
13427
|
assessments may be credited as provided in this section against |
13428
|
either its premium or corporate income tax liabilities imposed |
13429
|
pursuant to ss. 624.509 and 220.11 for the year it ceases doing |
13430
|
business. |
13431
|
(3) Any sums acquired by refund pursuant to s. 631.718(6) |
13432
|
from the association which have theretofore been written off by |
13433
|
contributing insurers and offset against premium or corporate |
13434
|
income taxes as provided in subsection(1) and which are not |
13435
|
needed for purposes of this part shall be paid by the insurer to |
13436
|
the Department of Revenue for deposit with the Chief Financial |
13437
|
OfficerTreasurerto the credit of the General Revenue Fund. |
13438
|
Section 241. Section 631.722, Florida Statutes, is amended |
13439
|
to read: |
13440
|
631.722 Powers and duties of department and office.-- |
13441
|
(1) The officedepartmentshall: |
13442
|
(a) Upon request of the board of directors, provide the |
13443
|
association with a statement of the premiums in each of the |
13444
|
appropriate states for each member insurer. |
13445
|
(b) When an impairment is declared and the amount of the |
13446
|
impairment is determined, serve a demand upon the impaired |
13447
|
insurer to make good the impairment within a reasonable time. |
13448
|
Notice to the impaired insurer shall constitute notice to its |
13449
|
shareholders, if any. The failure of the insurer to promptly |
13450
|
comply with such demand shall not excuse the association from |
13451
|
the performance of its powers and duties under this part. |
13452
|
(2)(c)The department shall,in any liquidation or |
13453
|
rehabilitation proceeding involving a domestic insurer, be |
13454
|
appointed as the liquidator or rehabilitator. If a foreign or |
13455
|
alien member insurer is subject to a liquidation proceeding in |
13456
|
its domiciliary jurisdiction or state of entry, the department |
13457
|
shall be appointed conservator. |
13458
|
(3)(2) The officedepartmentmay suspend or revoke, after |
13459
|
notice and hearing, the certificate of authority to transact |
13460
|
insurance in this state of any member insurer that fails to pay |
13461
|
an assessment when due or fails to comply with the approved plan |
13462
|
of operation of the association. As an alternative, the office |
13463
|
departmentmay levy a forfeiture on any member insurer that |
13464
|
fails to pay an assessment when due. Such forfeiture shall not |
13465
|
exceed 5 percent of the unpaid assessment per month, but no |
13466
|
forfeiture shall be less than $100 per month. |
13467
|
(4)(3)Any action of the board of directors or of the |
13468
|
association may be appealed to the officedepartmentby any |
13469
|
member insurer if such appeal is taken within 30 days of the |
13470
|
action being appealed. If a member company is appealing an |
13471
|
assessment, the amount assessed shall be paid to the association |
13472
|
and available to meet association obligations during the |
13473
|
pendency of the appeal. If the appeal on the assessment is |
13474
|
upheld, the amount paid in error or excess shall be returned to |
13475
|
the member company. Any final action or order of the office |
13476
|
departmentshall be subject to judicial review in a court of |
13477
|
competent jurisdiction. |
13478
|
(5)(4)The liquidator, rehabilitator, or conservator of |
13479
|
any impaired insurer may notify all interested persons of the |
13480
|
effect of this part. |
13481
|
Section 242. Section 631.723, Florida Statutes, is amended |
13482
|
to read: |
13483
|
631.723 Prevention of insolvencies.--To aid in the |
13484
|
detection and prevention of insurer insolvencies or impairments: |
13485
|
(1) The board of directors may, upon majority vote, make |
13486
|
reports and recommendations to the department or officeupon any |
13487
|
matter germane to the solvency, liquidation, rehabilitation, or |
13488
|
conservation of any member insurer or germane to the solvency of |
13489
|
any company seeking to do an insurance business in this state. |
13490
|
Such reports and recommendations are confidential and exempt |
13491
|
from the provisions of s. 119.07(1) until the termination of a |
13492
|
delinquency proceeding. |
13493
|
(2) It is the duty of the board of directors, upon a |
13494
|
majority vote, to notify the officedepartmentof any |
13495
|
information indicating that any member insurer may be an |
13496
|
impaired or insolvent insurer. |
13497
|
(3) The board of directors may, upon majority vote, |
13498
|
request that the officedepartmentorder an examination of any |
13499
|
member insurer which the board in good faith believes may be an |
13500
|
impaired or insolvent insurer. Within 30 days of the receipt of |
13501
|
such a request, the officedepartmentshall begin such an |
13502
|
examination. The examination may be conducted as a National |
13503
|
Association of Insurance Commissioners examination or may be |
13504
|
conducted by such persons as the officeInsurance Commissioner |
13505
|
designates. The cost of such examination shall be paid by the |
13506
|
association, and the examination report shall be treated in a |
13507
|
manner similar to other examination reports pursuant to s. |
13508
|
624.319. In no event may such examination report be released to |
13509
|
the board of directors before its release to the public, but |
13510
|
this does not preclude the officedepartmentfrom complying with |
13511
|
s. 631.398(2). The officedepartmentshall notify the board of |
13512
|
directors when the examination is completed. The request for an |
13513
|
examination shall be kept on file by the officedepartment; such |
13514
|
request is confidential and exempt from the provisions of s. |
13515
|
119.07(1) until the examination report is released to the |
13516
|
public. |
13517
|
(4) The board of directors may, upon majority vote, make |
13518
|
recommendations to the officedepartmentfor the detection and |
13519
|
prevention of insurer insolvencies. |
13520
|
Section 243. Section 631.727, Florida Statutes, is amended |
13521
|
to read: |
13522
|
631.727 Immunity.--There shall be no liability on the part |
13523
|
of, and no cause of action of any nature shall arise against, |
13524
|
any member insurer or its agents or employees, the association |
13525
|
or its agents or employees, members of the board of directors, |
13526
|
or the department or office or theiritsrepresentatives for any |
13527
|
action taken by them in the performance of their powers and |
13528
|
duties under this part. Such immunity shall extend to the |
13529
|
participation in any organization of one or more other state |
13530
|
associations of similar purposes and to any such organization |
13531
|
and its agents or employees. |
13532
|
Section 244. Section 631.813, Florida Statutes, is amended |
13533
|
to read: |
13534
|
631.813 Application of part.--This part shall apply to HMO |
13535
|
contractual obligations to residents of Florida by HMOs |
13536
|
possessing a valid certificate of authority issued by the |
13537
|
Florida Department of Insuranceas provided by part I of chapter |
13538
|
641. The provisions of this part shall not apply to persons |
13539
|
participating in medical assistance programs under the Medicaid |
13540
|
program. |
13541
|
Section 245. Section 631.814, Florida Statutes, is amended |
13542
|
to read: |
13543
|
631.814 Definitions.--As used in this part, the term: |
13544
|
(1) "Plan" means the Florida Health Maintenance |
13545
|
Organization Consumer Assistance Plan created by this part. |
13546
|
(2) "Board" means the board of directors of the plan. |
13547
|
(3) "Contractual obligations" means any obligation under |
13548
|
covered health care policies. |
13549
|
(4) "Covered policy" means any policy or contract issued |
13550
|
by an HMO for health care services. |
13551
|
(5) "Date of insolvency" means the effective date of an |
13552
|
order of liquidation entered by a court of competent |
13553
|
jurisdiction. |
13554
|
(6) "Department" means the Florida Department of |
13555
|
Insurance. |
13556
|
(6)(7)"Health care services" means comprehensive health |
13557
|
care services as defined in s. 641.19. |
13558
|
(7)(8)"HMO" means a health maintenance organization |
13559
|
possessing a valid certificate of authority issued by the |
13560
|
department pursuant to part I of chapter 641. |
13561
|
(8)(9)"Insolvent HMO" means an HMO against which an order |
13562
|
of rehabilitation or liquidation has been entered by a court of |
13563
|
competent jurisdiction, with the department appointed as |
13564
|
receiver, even if such order has not become final by the |
13565
|
exhaustion of appellate reviews. |
13566
|
(9)(10)"Person" means any individual, corporation, |
13567
|
partnership, association, or voluntary organization. |
13568
|
(10)(11)"Subscriber" means any resident of this state who |
13569
|
is enrolled for benefits provided by an HMO and who makes |
13570
|
premium payments or for whom premium payments are made. |
13571
|
Section 246. Section 631.821, Florida Statutes, is amended |
13572
|
to read: |
13573
|
631.821 Powers and duties of the department and office.-- |
13574
|
(1) The officedepartmentmay suspend or revoke, after |
13575
|
notice and hearing, the certificate of authority of a member HMO |
13576
|
that fails to pay an assessment when due, fails to comply with |
13577
|
the approved plan of operation of the plan, or fails either to |
13578
|
timely comply with or to timely appeal pursuant to subsection |
13579
|
(2) its appointment under s. 631.818(2). |
13580
|
(2) Any action of the board of directors of the plan may |
13581
|
be appealed to the department by any member HMO if such appeal |
13582
|
is taken within 21 days of the action being appealed; however, |
13583
|
the HMO must comply with such action pending exhaustion of |
13584
|
appeal under s. 631.818(2). Any appeal shall be promptly |
13585
|
determined by the department, and final action or order of the |
13586
|
department shall be subject to judicial review in a court of |
13587
|
competent jurisdiction. |
13588
|
(3) The department may: |
13589
|
(a)require that the plan notify the subscriber of the |
13590
|
insolvent HMO and any other interested parties of the |
13591
|
determination of insolvency and of their rights under this part. |
13592
|
Such notification shall be by mail at their last known |
13593
|
addresses, when available, but if sufficient information for |
13594
|
notification by mail is not available, notice by publication in |
13595
|
a newspaper of general circulation shall be sufficient. |
13596
|
(4)(b)The office mayrevoke the designation of any |
13597
|
servicing facility or administrator if it finds claims are being |
13598
|
handled unsatisfactorily. |
13599
|
Section 247. Section 631.825, Florida Statutes, is amended |
13600
|
to read: |
13601
|
631.825 Immunity.--There shall be no liability on the part |
13602
|
of, and no cause of action of any nature shall arise against, |
13603
|
any member HMO or its agents or employees, the plan or its |
13604
|
agents or employees, members of the board of directors, or the |
13605
|
department or office or theiritsrepresentatives for any action |
13606
|
taken by them in the performance of their powers and duties |
13607
|
under this part. |
13608
|
Section 248. Section 631.904, Florida Statutes, is amended |
13609
|
to read: |
13610
|
631.904 Definitions.--As used in this part, the term: |
13611
|
(1) "Corporation" means the Florida Workers' Compensation |
13612
|
Insurance Guaranty Association, Incorporated. |
13613
|
(2) "Covered claim" means an unpaid claim, including a |
13614
|
claim for return of unearned premiums, which arises out of, is |
13615
|
within the coverage of, and is not in excess of the applicable |
13616
|
limits of, an insurance policy to which this part applies, which |
13617
|
policy was issued by an insurer and which claim is made on |
13618
|
behalf of a claimant or insured who was a resident of this state |
13619
|
at the time of the injury. The term "covered claim" does not |
13620
|
include any amount sought as a return of premium under any |
13621
|
retrospective rating plan; any amount due any reinsurer, |
13622
|
insurer, insurance pool, or underwriting association, as |
13623
|
subrogation recoveries or otherwise; or any return of premium |
13624
|
resulting from a policy that was not in force on the date of the |
13625
|
final order of liquidation. Member insurers have no right of |
13626
|
subrogation against the insured of any insolvent insurer. This |
13627
|
provision shall be applied retroactively to cover claims of an |
13628
|
insolvent self-insurance fund resulting from accidents or losses |
13629
|
incurred prior to January 1, 1994, regardless of the date the |
13630
|
Department of Insurance filed a petition in circuit court was |
13631
|
filedalleging insolvency and the date the court entered an |
13632
|
order appointing a receiver. |
13633
|
(3) "Department" means the Department of Insurance. |
13634
|
(3)(4)"Insolvency" means that condition in which all of |
13635
|
the assets of the insurer, if made immediately available, would |
13636
|
not be sufficient to discharge all of its liabilities or that |
13637
|
condition in which the insurer is unable to pay its debts as |
13638
|
they become due in the usual course of business. When the |
13639
|
context of any provision of this part so indicates, insolvency |
13640
|
also includes impairment of surplus or impairment of capital. |
13641
|
(4)(5)"Insolvent insurer" means an insurer that was |
13642
|
authorized to transact insurance in this state, either at the |
13643
|
time the policy was issued or when the insured event occurred, |
13644
|
and against which an order of liquidation with a finding of |
13645
|
insolvency has been entered by a court of competent jurisdiction |
13646
|
if such order has become final by the exhaustion of appellate |
13647
|
review. |
13648
|
(5)(6)"Insurer" means an insurance carrier or self- |
13649
|
insurance fund authorized to insure under chapter 440. For |
13650
|
purposes of this act, "insurer" does not include a qualified |
13651
|
local government self-insurance fund, as defined in s. 624.4622, |
13652
|
or an individual self-insurer as defined in s. 440.385. |
13653
|
(6)(7)"Self-insurance fund" means a group self-insurance |
13654
|
fund authorized under s. 624.4621, a commercial self-insurance |
13655
|
fund writing workers' compensation insurance authorized under s. |
13656
|
624.462, or an assessable mutual insurer authorized under s. |
13657
|
628.6011. For purposes of this act, "self-insurance fund" does |
13658
|
not include a qualified local government self-insurance fund, as |
13659
|
defined in s. 624.4622, or an individual self-insurer as defined |
13660
|
in s. 440.385. |
13661
|
Section 249. Subsection (1) of section 631.911, Florida |
13662
|
Statutes, is amended to read: |
13663
|
631.911 Creation of the Florida Workers' Compensation |
13664
|
Insurance Guaranty Association, Incorporated; merger; effect of |
13665
|
merger.-- |
13666
|
(1)(a) The Florida Self-Insurance Fund Guaranty |
13667
|
Association established in former part V of chapter 631 and the |
13668
|
workers' compensation insurance account, which includes excess |
13669
|
workers' compensation insurance, established in former s. |
13670
|
631.55(2)(a) shall be merged, effective October 1, 1997, or as |
13671
|
provided in paragraph (b),in accordance with the plan of |
13672
|
operation adopted by the interim board of directors. The |
13673
|
successor nonprofit corporation shall be known as the "Florida |
13674
|
Workers' Compensation Insurance Guaranty Association, |
13675
|
Incorporated." |
13676
|
(b) The merger may be effected prior to October 1, 1997, |
13677
|
if: |
13678
|
1. The interim board of directors of the Workers' |
13679
|
Compensation Insurance Guaranty Association provides the |
13680
|
Department of Insurance with written notice of its intent to |
13681
|
effectuate the merger as of a date certain and its functional |
13682
|
readiness to initiate operations, such notice setting forth the |
13683
|
plan or summary thereof for effecting the merger; and, |
13684
|
2. The department, upon review of the plan or summary |
13685
|
thereof, determines the Workers' Compensation Insurance Guaranty |
13686
|
Association is functionally ready to initiate operations and so |
13687
|
certifies to the interim board of directors. |
13688
|
(c) Prior to the effective date of the merger, the Florida |
13689
|
Self-Insurance Fund Guaranty Association shall be the entity |
13690
|
responsible for the claims of insolvent self-insurance funds |
13691
|
resulting from accidents or losses incurred prior to January 1, |
13692
|
1994, regardless of the date the Department of Insurance filed a |
13693
|
petition in circuit court alleging insolvency and the date the |
13694
|
court entered an order appointing a receiver. |
13695
|
(b)(d)Upon the effective date of the merger: |
13696
|
1. The Florida Self-Insurance Fund Guaranty Association |
13697
|
and the workers' compensation insurance account within the |
13698
|
Florida Insurance Guaranty Association cease to exist and are |
13699
|
succeeded by the Florida Workers' Compensation Insurance |
13700
|
Guaranty Association. |
13701
|
2. Title to all assets of any description, all real estate |
13702
|
and other property, or any interest therein, owned by each party |
13703
|
to the merger is vested in the successor corporation without |
13704
|
reversion or impairment. |
13705
|
3. The successor corporation shall be responsible and |
13706
|
liable for all the liabilities and obligations of each party to |
13707
|
the merger. |
13708
|
4. Any claim existing or action or proceeding pending by |
13709
|
or against any party to the merger may be continued as if the |
13710
|
merger did not occur or the successor corporation may be |
13711
|
substituted in the proceeding for the corporation or account |
13712
|
which ceased existence. |
13713
|
5. Neither the rights of creditors nor any liens upon the |
13714
|
property of any party to the merger shall be impaired by such |
13715
|
merger. |
13716
|
6. Outstanding assessments levied by the Florida Self- |
13717
|
Insurance Guaranty Association or the Florida Insurance Guaranty |
13718
|
Association on behalf of the workers' compensation insurance |
13719
|
account remain in full force and effect and shall be paid when |
13720
|
due. |
13721
|
Section 250. Subsections (1) and (3) of section 631.912, |
13722
|
Florida Statutes, are amended to read: |
13723
|
631.912 Board of directors.-- |
13724
|
(1) The board of directors of the corporation shall |
13725
|
consist of 11 persons, 1 of whom is the insurance consumer |
13726
|
advocate appointed under s. 627.0613 or designee and 1 of whom |
13727
|
is designated by the Chief Financial OfficerInsurance |
13728
|
Commissioner. The department shall appoint to the board 6 |
13729
|
persons selected by private carriers from among the 20 workers' |
13730
|
compensation insurers with the largest amount of net direct |
13731
|
written premium as determined by the department, and 3 persons |
13732
|
selected by the self-insurance funds. At least two of the |
13733
|
private carriers shall be foreign carriers authorized to do |
13734
|
business in this state. The board shall elect a chairperson from |
13735
|
among its members. The Chief Financial Officercommissionermay |
13736
|
remove any board member for cause. Each board member shall |
13737
|
serve for a 4-year term and may be reappointed, except that four |
13738
|
members of the initial board shall have 2-year terms so as to |
13739
|
stagger the periods of service. A vacancy on the board shall be |
13740
|
filled for the remaining period of the term in the same manner |
13741
|
by which the original appointment was made. |
13742
|
(3) Effective upon this act becoming a law, the persons on |
13743
|
the board of directors created pursuant to s. 627.311(4)(a) who |
13744
|
evidence a willingness to serve in writing, shall serve as an |
13745
|
interim board of directors of the corporation until the initial |
13746
|
board of directors has been appointed for the corporation in |
13747
|
accordance with the provisions of subsection (1). The interim |
13748
|
board of directors shall serve for a period not to exceed 6 |
13749
|
months. The initial meeting shall be called by the commissioner |
13750
|
within 30 days after this act becomes a law. The interim board |
13751
|
of directors shall establish a process for the selection of |
13752
|
persons to serve on the board of the Florida Workers' |
13753
|
Compensation Insurance Guaranty Association in accordance with |
13754
|
the terms of subsection (1). The board of directors shall adopt |
13755
|
an interim plan of operation to effect the merger in s. 631.911 |
13756
|
and avoid any interruption of benefit payments to injured |
13757
|
workers. When necessary and upon approval of the chairs of |
13758
|
their respective board of directors, the Florida Self-Insurance |
13759
|
Fund Guaranty Association and the Florida Insurance Guaranty |
13760
|
Association shall provide staff support to the interim board of |
13761
|
directors. The board shall submit the interim plan to the |
13762
|
commissioner, who shall approve or disapprove the plan within 30 |
13763
|
days after receipt. |
13764
|
Section 251. Section 631.917, Florida Statutes, is amended |
13765
|
to read: |
13766
|
631.917 Prevention of insolvencies.--To aid in the |
13767
|
detection and prevention of insolvencies or impairments: |
13768
|
(1)(a) The board may make reasonable and lawful |
13769
|
investigation into the practices of any third-party |
13770
|
administrator or service company for a self-insurance fund |
13771
|
declared insolvent by the court. |
13772
|
(b) If the results of an investigation reasonably lead to |
13773
|
a finding that certain actions taken or not taken by those |
13774
|
handling, processing, or preparing covered claims for payment or |
13775
|
other benefit pursuant to any workers' compensation insurance |
13776
|
policy contributed to the insolvency of an insurer, such |
13777
|
information may, in the discretion of the board, be provided to |
13778
|
the department or officein an expedited manner. |
13779
|
(2) The board of directors may make reports and |
13780
|
recommendations to the department or officeupon any matter |
13781
|
germane to the solvency, liquidation, rehabilitation, or |
13782
|
conservation of any member insurer or germane to the solvency of |
13783
|
any insurer seeking to do insurance business in this state. |
13784
|
(3) The board of directors, in its discretion, may notify |
13785
|
the officedepartmentof any information indicating that any |
13786
|
member insurer may be an impaired or insolvent insurer. |
13787
|
(4) The board of directors, in its discretion, may request |
13788
|
that the officedepartmentorder an examination of any member |
13789
|
insurer which the board in good faith believes may be an |
13790
|
impaired or insolvent insurer. Within 30 days after receipt of |
13791
|
such a request, the officedepartmentshall begin such an |
13792
|
examination. The examination may be conducted as a National |
13793
|
Association of Insurance Commissioners examination or may be |
13794
|
conducted by such persons as the officeInsurance Commissioner |
13795
|
designates. The cost of such examination shall be paid by the |
13796
|
corporation, and the examination report shall be treated in a |
13797
|
manner similar to other examination reports pursuant to s. |
13798
|
624.319. In no event may such examination report be released to |
13799
|
the board of directors before its release to the public, but |
13800
|
this requirement does not preclude the officedepartmentfrom |
13801
|
complying with s. 631.398(2). The officedepartmentshall |
13802
|
notify the board of directors when the examination is completed. |
13803
|
The request for an examination shall be kept on file by the |
13804
|
officedepartment. |
13805
|
(5) The board is authorized to assist and aid the |
13806
|
department or office, in any manner consistent with existing |
13807
|
laws and this chapter, in the department's or office's |
13808
|
investigation or referral for prosecution of those whose action |
13809
|
or inaction may have contributed to the impairment or insolvency |
13810
|
of the insurer. |
13811
|
(6) The board may make recommendations to the office |
13812
|
departmentfor the detection and prevention of insurer |
13813
|
insolvencies. |
13814
|
Section 252. Section 631.918, Florida Statutes, is amended |
13815
|
to read: |
13816
|
631.918 Immunity.--There is no liability on the part of, |
13817
|
and a cause of action may not arise against, the corporation, |
13818
|
its agents or employees, or members of its board of directors, |
13819
|
or the department or office or theiritsagents or employees, |
13820
|
for any action taken by them in the performance of their powers |
13821
|
and duties under this section, unless such action is found to be |
13822
|
a violation of antitrust laws, was in bad faith, or was |
13823
|
undertaken with malicious purpose or in a manner exhibiting |
13824
|
wanton and willful disregard of human rights, safety, or |
13825
|
property. |
13826
|
Section 253. Section 631.931, Florida Statutes, is amended |
13827
|
to read: |
13828
|
631.931 Reports and recommendations by board; public |
13829
|
records exemption.--Reports and recommendations made by the |
13830
|
Board of Directors of the Florida Workers' Compensation |
13831
|
Insurance Guaranty Association to the Department of Insurance |
13832
|
under s. 631.917 upon any matter germane to the solvency, |
13833
|
liquidation, rehabilitation, or conservation of any member |
13834
|
insurer are confidential and exempt from the provisions of s. |
13835
|
119.07(1) and s. 24(a), Art. I of the State Constitution until |
13836
|
the termination of a delinquency proceeding. |
13837
|
Section 254. Subsections (3) and (4) of section 634.3284, |
13838
|
Florida Statutes, are amended to read: |
13839
|
634.3284 Civil remedy.-- |
13840
|
(3) As a condition precedent to bringing an action under |
13841
|
this section, the officedepartmentand the insurer shall be |
13842
|
given written notice of the violation. The notice shall state |
13843
|
with specificity the facts which allegedly constitute the |
13844
|
violation and the law upon which the plaintiff is relying and |
13845
|
shall state that such notice is given in order to perfect the |
13846
|
right to pursue the civil remedy authorized by this section. No |
13847
|
action will lie if, within 30 days thereafter, the damages are |
13848
|
paid or the circumstances giving rise to the violation are |
13849
|
corrected. |
13850
|
(4) This section shall not be construed to authorize a |
13851
|
class action suit against a home warranty association or a civil |
13852
|
action against the department or office or their, its employees, |
13853
|
or the Chief Financial OfficerInsurance Commissioner. |
13854
|
Section 255. Subsection (2) of section 634.430, Florida |
13855
|
Statutes, is amended to read: |
13856
|
634.430 Dissolution or liquidation.-- |
13857
|
(2) The department and officeshall be notified of the |
13858
|
commencement of voluntary dissolution proceedings of a |
13859
|
manufacturer licensed under this part. As to the warranty |
13860
|
operations of a manufacturer in this state, the department shall |
13861
|
supervise the voluntary dissolution and shall require protection |
13862
|
of the interests of the department, office,and consumers who |
13863
|
have been issued service warranties by the manufacturer by the |
13864
|
continuation of deposits or bonds as required by this part until |
13865
|
that time as all warranties issued by the manufacturer are no |
13866
|
longer in effect or all outstanding warranties have been |
13867
|
assigned to another association approved by the department and |
13868
|
office. The notification as provided herein shall be made by the |
13869
|
manufacturer within 30 days of the commencement of any legal |
13870
|
action for dissolution. |
13871
|
Section 256. Subsections (3) and (4) of section 634.433, |
13872
|
Florida Statutes, are amended to read: |
13873
|
634.433 Civil remedy.-- |
13874
|
(3) As a condition precedent to bringing an action under |
13875
|
this section, the officedepartmentand the insurer shall be |
13876
|
given written notice of the violation. The notice shall state |
13877
|
with specificity the facts which allegedly constitute the |
13878
|
violation and the law upon which the plaintiff is relying and |
13879
|
shall state that such notice is given in order to perfect the |
13880
|
right to pursue the civil remedy authorized by this section. No |
13881
|
action will lie if, within 30 days thereafter, the damages are |
13882
|
paid or the circumstances giving rise to the violation are |
13883
|
corrected. |
13884
|
(4) This section shall not be construed to authorize a |
13885
|
class action suit against a service warranty association or a |
13886
|
civil action against the department, the office, theirits |
13887
|
employees, or the Chief Financial OfficerInsurance |
13888
|
Commissioner. |
13889
|
Section 257. Section 636.067, Florida Statutes, is amended |
13890
|
to read: |
13891
|
636.067 Rules.--The commission maydepartment has |
13892
|
authority toadopt rules pursuant to ss. 120.536(1) and 120.54 |
13893
|
to implement the provisions of this act. A violation of any |
13894
|
such rule subjects the violator to the provisions of s. 636.048. |
13895
|
Section 258. Section 641.183, Florida Statutes, is amended |
13896
|
to read: |
13897
|
641.183 Statutory accounting procedures; transition |
13898
|
provisions.--All health maintenance organizations, authorized to |
13899
|
do business under this chapter on January 1, 2001, shall elect a |
13900
|
transition method for compliance with statutory accounting |
13901
|
principles as follows: |
13902
|
(1) Report assets acquired prior to June 30, 2001, in |
13903
|
accordance with s. 641.35, Florida Statutes (2000), through |
13904
|
December 31, 2005. Assets acquired on or after June 30, 2001, |
13905
|
shall be accounted for in accordance with the National |
13906
|
Association of Insurance Commissioners Accounting Practices and |
13907
|
Procedures Manual as of 2002effective January 1, 2001. A health |
13908
|
maintenance organization electing to report assets pursuant to |
13909
|
this subsection shall maintain complete and detailed records |
13910
|
reflecting such accounting treatment; or |
13911
|
(2) Report all assets in accordance with the NAIC |
13912
|
Accounting Practices and Procedures Manual as of 2002effective |
13913
|
January 1, 2001. |
13914
|
Section 259. Section 641.185, Florida Statutes, is amended |
13915
|
to read: |
13916
|
641.185 Health maintenance organization subscriber |
13917
|
protections.-- |
13918
|
(1) With respect to the provisions of this part and part |
13919
|
III, the principles expressed in the following statements shall |
13920
|
serve as standards to be followed by the commission, the office, |
13921
|
the department,of Insuranceand the Agency for Health Care |
13922
|
Administration in exercising their powers and duties, in |
13923
|
exercising administrative discretion, in administrative |
13924
|
interpretations of the law, in enforcing its provisions, and in |
13925
|
adopting rules: |
13926
|
(a) A health maintenance organization shall ensure that |
13927
|
the health care services provided to its subscribers shall be |
13928
|
rendered under reasonable standards of quality of care which are |
13929
|
at a minimum consistent with the prevailing standards of medical |
13930
|
practice in the community pursuant to ss. 641.495(1) and 641.51. |
13931
|
(b) A health maintenance organization subscriber should |
13932
|
receive quality health care from a broad panel of providers, |
13933
|
including referrals, preventive care pursuant to s. 641.402(1), |
13934
|
emergency screening and services pursuant to ss. 641.31(12) and |
13935
|
641.513, and second opinions pursuant to s. 641.51. |
13936
|
(c) A health maintenance organization subscriber should |
13937
|
receive assurance that the health maintenance organization has |
13938
|
been independently accredited by a national review organization |
13939
|
pursuant to s. 641.512, and is financially secure as determined |
13940
|
by the state pursuant to ss. 641.221, 641.225, and 641.228. |
13941
|
(d) A health maintenance organization subscriber should |
13942
|
receive continuity of health care, even after the provider is no |
13943
|
longer with the health maintenance organization pursuant to s. |
13944
|
641.51(8). |
13945
|
(e) A health maintenance organization subscriber should |
13946
|
receive timely, concise information regarding the health |
13947
|
maintenance organization's reimbursement to providers and |
13948
|
services pursuant to ss. 641.31 and 641.31015 and should receive |
13949
|
prompt payment from the organization pursuant to s. 641.3155. |
13950
|
(f) A health maintenance organization subscriber should |
13951
|
receive the flexibility to transfer to another Florida health |
13952
|
maintenance organization, regardless of health status, pursuant |
13953
|
to ss. 641.228, 641.3104, 641.3107, 641.3111, 641.3921, and |
13954
|
641.3922. |
13955
|
(g) A health maintenance organization subscriber should be |
13956
|
eligible for coverage without discrimination against individual |
13957
|
participants and beneficiaries of group plans based on health |
13958
|
status pursuant to s. 641.31073. |
13959
|
(h) A health maintenance organization that issues a group |
13960
|
health contract must: provide coverage for preexisting |
13961
|
conditions pursuant to s. 641.31071; guarantee renewability of |
13962
|
coverage pursuant to s. 641.31074; provide notice of |
13963
|
cancellation pursuant to s. 641.3108; provide extension of |
13964
|
benefits pursuant to s. 641.3111; provide for conversion on |
13965
|
termination of eligibility pursuant to s. 641.3921; and provide |
13966
|
for conversion contracts and conditions pursuant to s. 641.3922. |
13967
|
(i) A health maintenance organization subscriber should |
13968
|
receive timely and, if necessary, urgent grievances and appeals |
13969
|
within the health maintenance organization pursuant to ss. |
13970
|
641.228, 641.31(5), 641.47, and 641.511. |
13971
|
(j) A health maintenance organization should receive |
13972
|
timely and, if necessary, urgent review by an independent state |
13973
|
external review organization for unresolved grievances and |
13974
|
appeals pursuant to s. 408.7056. |
13975
|
(k) A health maintenance organization subscriber shall be |
13976
|
given written notice at least 30 days in advance of a rate |
13977
|
change pursuant to s. 641.31(3)(b). In the case of a group |
13978
|
member, there may be a contractual agreement with the health |
13979
|
maintenance organization to have the employer provide the |
13980
|
required notice to the individual members of the group pursuant |
13981
|
to s. 641.31(3)(b). |
13982
|
(l) A health maintenance organization subscriber shall be |
13983
|
given a copy of the applicable health maintenance contract, |
13984
|
certificate, or member handbook specifying: all the provisions, |
13985
|
disclosure, and limitations required pursuant to s. 641.31(1) |
13986
|
and (4); the covered services, including those services, medical |
13987
|
conditions, and provider types specified in ss. 641.31, |
13988
|
641.31094, 641.31095, 641.31096, 641.51(11), and 641.513; and |
13989
|
where and in what manner services may be obtained pursuant to s. |
13990
|
641.31(4). |
13991
|
(2) This section shall not be construed as creating a |
13992
|
civil cause of action by any subscriber or provider against any |
13993
|
health maintenance organization. |
13994
|
Section 260. Section 641.19, Florida Statutes, is amended |
13995
|
to read: |
13996
|
641.19 Definitions.--As used in this part, the term: |
13997
|
(1) "Affiliate" means any entity thatwhichexercises |
13998
|
control over or is controlled by the health maintenance |
13999
|
organization, directly or indirectly, through: |
14000
|
(a) Equity ownership of voting securities; |
14001
|
(b) Common managerial control; or |
14002
|
(c) Collusive participation by the management of the |
14003
|
health maintenance organization and affiliate in the management |
14004
|
of the health maintenance organization or the affiliate. |
14005
|
(2) "Agency" means the Agency for Health Care |
14006
|
Administration. |
14007
|
(3) "Capitation" means the fixed amount paid by an HMO to |
14008
|
a health care provider under contract with the health |
14009
|
maintenance organization in exchange for the rendering of |
14010
|
covered medical services. |
14011
|
(4) "Comprehensive health care services" means services, |
14012
|
medical equipment, and supplies furnished by a provider, which |
14013
|
may include, but which are not limited to, medical, surgical, |
14014
|
and dental care; psychological, optometric, optic, chiropractic, |
14015
|
podiatric, nursing, physical therapy, and pharmaceutical |
14016
|
services; health education, preventive medical, rehabilitative, |
14017
|
and home health services; inpatient and outpatient hospital |
14018
|
services; extended care; nursing home care; convalescent |
14019
|
institutional care; technical and professional clinical |
14020
|
pathology laboratory services; laboratory and ambulance |
14021
|
services; appliances, drugs, medicines, and supplies; and any |
14022
|
other care, service, or treatment of disease, or correction of |
14023
|
defects for human beings. |
14024
|
(5) "Copayment" means a specific dollar amount, except as |
14025
|
otherwise provided for by statute, that the subscriber must pay |
14026
|
upon receipt of covered health care services. Copayments may |
14027
|
not be established in an amount that will prevent a person from |
14028
|
receiving a covered service or benefit as specified in the |
14029
|
subscriber contract approved by the officedepartment. |
14030
|
(6) "Department" means the Department of Insurance. |
14031
|
(6)(7)"Emergency medical condition" means: |
14032
|
(a) A medical condition manifesting itself by acute |
14033
|
symptoms of sufficient severity, which may include severe pain |
14034
|
or other acute symptoms, such that the absence of immediate |
14035
|
medical attention could reasonably be expected to result in any |
14036
|
of the following: |
14037
|
1. Serious jeopardy to the health of a patient, including |
14038
|
a pregnant woman or a fetus. |
14039
|
2. Serious impairment to bodily functions. |
14040
|
3. Serious dysfunction of any bodily organ or part. |
14041
|
(b) With respect to a pregnant woman: |
14042
|
1. That there is inadequate time to effect safe transfer |
14043
|
to another hospital prior to delivery; |
14044
|
2. That a transfer may pose a threat to the health and |
14045
|
safety of the patient or fetus; or |
14046
|
3. That there is evidence of the onset and persistence of |
14047
|
uterine contractions or rupture of the membranes. |
14048
|
(7)(8)"Emergency services and care" means medical |
14049
|
screening, examination, and evaluation by a physician, or, to |
14050
|
the extent permitted by applicable law, by other appropriate |
14051
|
personnel under the supervision of a physician, to determine if |
14052
|
an emergency medical condition exists and, if it does, the care, |
14053
|
treatment, or surgery for a covered service by a physician |
14054
|
necessary to relieve or eliminate the emergency medical |
14055
|
condition, within the service capability of a hospital. |
14056
|
(8)(9)"Entity" means any legal entity with continuing |
14057
|
existence, including, but not limited to, a corporation, |
14058
|
association, trust, or partnership. |
14059
|
(9)(10)"Geographic area" means the county or counties, or |
14060
|
any portion of a county or counties, within which the health |
14061
|
maintenance organization provides or arranges for comprehensive |
14062
|
health care services to be available to its subscribers. |
14063
|
(10)(11) "Guaranteeing organization" is an organization |
14064
|
thatwhich is domiciled in the United States; thatwhichhas |
14065
|
authorized service of process against it; and thatwhichhas |
14066
|
appointed the Chief Financial OfficerInsurance Commissioner and |
14067
|
Treasureras its agent for service of process issuing upon any |
14068
|
cause of action arising in this state, based upon any guarantee |
14069
|
entered into under this part. |
14070
|
(11)(12)"Health maintenance contract" means any contract |
14071
|
entered into by a health maintenance organization with a |
14072
|
subscriber or group of subscribers to provide comprehensive |
14073
|
health care services in exchange for a prepaid per capita or |
14074
|
prepaid aggregate fixed sum. |
14075
|
(12)(13)"Health maintenance organization" means any |
14076
|
organization authorized under this part which: |
14077
|
(a) Provides emergency care, inpatient hospital services, |
14078
|
physician care including care provided by physicians licensed |
14079
|
under chapters 458, 459, 460, and 461, ambulatory diagnostic |
14080
|
treatment, and preventive health care services; |
14081
|
(b) Provides, either directly or through arrangements with |
14082
|
other persons, health care services to persons enrolled with |
14083
|
such organization, on a prepaid per capita or prepaid aggregate |
14084
|
fixed-sum basis; |
14085
|
(c) Provides, either directly or through arrangements with |
14086
|
other persons, comprehensive health care services which |
14087
|
subscribers are entitled to receive pursuant to a contract; |
14088
|
(d) Provides physician services, by physicians licensed |
14089
|
under chapters 458, 459, 460, and 461, directly through |
14090
|
physicians who are either employees or partners of such |
14091
|
organization or under arrangements with a physician or any group |
14092
|
of physicians; and |
14093
|
(e) If offering services through a managed care system, |
14094
|
then the managed care system must be a system in which a primary |
14095
|
physician licensed under chapter 458 or chapter 459 and chapters |
14096
|
460 and 461 is designated for each subscriber upon request of a |
14097
|
subscriber requesting service by a physician licensed under any |
14098
|
of those chapters, and is responsible for coordinating the |
14099
|
health care of the subscriber of the respectively requested |
14100
|
service and for referring the subscriber to other providers of |
14101
|
the same discipline when necessary. Each female subscriber may |
14102
|
select as her primary physician an obstetrician/gynecologist who |
14103
|
has agreed to serve as a primary physician and is in the health |
14104
|
maintenance organization's provider network. |
14105
|
(13)(14)"Insolvent" or "insolvency" means that all the |
14106
|
statutory assets of the health maintenance organization, if made |
14107
|
immediately available, would not be sufficient to discharge all |
14108
|
of its liabilities or that the health maintenance organization |
14109
|
is unable to pay its debts as they become due in the usual |
14110
|
course of business. In the event that all the assets of the |
14111
|
health maintenance organization, if made immediately available, |
14112
|
would not be sufficient to discharge all of its liabilities, but |
14113
|
the organization has a written guarantee of the type and subject |
14114
|
to the same provisions as outlined in s. 641.225, the |
14115
|
organization shall not be considered insolvent unless it is |
14116
|
unable to pay its debts as they become due in the usual course |
14117
|
of business. |
14118
|
(14)(15)"Provider" means any physician, hospital, or |
14119
|
other institution, organization, or person that furnishes health |
14120
|
care services and is licensed or otherwise authorized to |
14121
|
practice in the state. |
14122
|
(15)(16)"Reporting period" means the annual calendar year |
14123
|
accounting period or any part thereof. |
14124
|
(16)(17)"Statutory accounting principles" means |
14125
|
accounting principles as defined in the National Association of |
14126
|
Insurance Commissioners Accounting Practices and Procedures |
14127
|
Manual as of 2002effective January 1, 2001. |
14128
|
(17((18)"Subscriber" means an entity or individual who |
14129
|
has contracted, or on whose behalf a contract has been entered |
14130
|
into, with a health maintenance organization for health care |
14131
|
services or other persons who also receive health care services |
14132
|
as a result of the contract. |
14133
|
(18)(19)"Surplus" means total statutory assets in excess |
14134
|
of total liabilities, except that assets pledged to secure debts |
14135
|
not reflected on the books of the health maintenance |
14136
|
organization shall not be included in surplus. Surplus includes |
14137
|
capital stock, capital in excess of par, other contributed |
14138
|
capital, retained earnings, and surplus notes. |
14139
|
(19)(20)"Uncovered expenditures" means the cost of health |
14140
|
care services that are covered by a health maintenance |
14141
|
organization, for which a subscriber would also be liable in the |
14142
|
event of the insolvency of the organization. |
14143
|
(20)(21)"Health care risk contract" means a contract |
14144
|
under which an individual or entity receives consideration or |
14145
|
other compensation in an amount greater than 1 percent of the |
14146
|
health maintenance organization's annual gross written premium |
14147
|
in exchange for providing to the health maintenance organization |
14148
|
a provider network or other services, which may include |
14149
|
administrative services. The 1-percent threshold shall be |
14150
|
calculated on a contract-by-contract basis for each such |
14151
|
individual or entity and not in the aggregate for all health |
14152
|
care risk contracts. |
14153
|
Section 261. Section 641.2017, Florida Statutes, is |
14154
|
amended to read: |
14155
|
641.2017 Insurance business not authorized.--Nothing in |
14156
|
the Florida Insurance Code or this part shall be deemed to |
14157
|
authorize any health maintenance organization to transact any |
14158
|
insurance business other than that of health maintenance |
14159
|
organization type insurance or otherwise to engage in any other |
14160
|
type of insurance unless it is authorized under a certificate of |
14161
|
authority issued by the officedepartmentunder the provisions |
14162
|
of the Florida Insurance Code. However, a health maintenance |
14163
|
organization may by contract: |
14164
|
(1) Enter into arrangements whereby the expected cost of |
14165
|
health care services provided directly or through arrangements |
14166
|
with other persons by the health maintenance organization is |
14167
|
self-funded by the person contracting with the health |
14168
|
maintenance organization, but the health maintenance |
14169
|
organization assumes the risks that costs will exceed that |
14170
|
amount on a prepaid per capita or prepaid aggregate fixed-sum |
14171
|
basis; or |
14172
|
(2) Enter into arrangements whereby the cost of health |
14173
|
care services provided directly or through arrangements with |
14174
|
other persons by the health maintenance organization is self- |
14175
|
funded by the person contracting with the health maintenance |
14176
|
organization. |
14177
|
Section 262. Subsections (1) and (2) of section 641.2018, |
14178
|
Florida Statutes, are amended to read: |
14179
|
641.2018 Limited coverage for home health care |
14180
|
authorized.-- |
14181
|
(1) Notwithstanding other provisions of this chapter, a |
14182
|
health maintenance organization may issue a contract that limits |
14183
|
coverage to home health care services only. The organization and |
14184
|
the contract shall be subject to all of the requirements of this |
14185
|
part that do not require or otherwise apply to specific benefits |
14186
|
other than home care services. To this extent, all of the |
14187
|
requirements of this part apply to any organization or contract |
14188
|
that limits coverage to home care services, except the |
14189
|
requirements for providing comprehensive health care services as |
14190
|
provided in ss. 641.19(4), (11), and (12), and (13),and |
14191
|
641.31(1), except ss. 641.31(9), (12), (17), (18), (19), (20), |
14192
|
(21), and (24) and 641.31095. |
14193
|
(2) Notwithstanding the other provisions of this chapter, |
14194
|
a health maintenance organization may apply for and obtain a |
14195
|
certificate of authority from the officedepartmentpursuant to |
14196
|
this part and a health care provider certificate pursuant to |
14197
|
part III, which certificate limits the authority of the |
14198
|
organization to the issuance of contracts that limit coverage to |
14199
|
home health care services pursuant to subsection (1). In |
14200
|
addition to all applicable requirements of this part, as |
14201
|
specified in subsection (1), all of the requirements of part III |
14202
|
apply to an organization applying for such a limited |
14203
|
certificate, except to the extent that such requirements |
14204
|
directly conflict with the limited nature of the coverage |
14205
|
provided. |
14206
|
Section 263. Subsections (1) and (2) of section 641.21, |
14207
|
Florida Statutes, are amended to read: |
14208
|
641.21 Application for certificate.-- |
14209
|
(1) Before any entity may operate a health maintenance |
14210
|
organization, it shall obtain a certificate of authority from |
14211
|
the officedepartment. The officedepartmentshall accept and |
14212
|
shall begin its review of an application for a certificate of |
14213
|
authority anytime after an organization has filed an application |
14214
|
for a health care provider certificate pursuant to part III of |
14215
|
this chapter. However, the office maydepartment shallnot |
14216
|
issue a certificate of authority to any applicant which does not |
14217
|
possess a valid health care provider certificate issued by the |
14218
|
agency. Each application for a certificate shall be on such form |
14219
|
as the commissiondepartmentshall prescribe, shall be verified |
14220
|
by the oath of two officers of the corporation and properly |
14221
|
notarized, and shall be accompanied by the following: |
14222
|
(a) A copy of the articles of incorporation and all |
14223
|
amendments thereto; |
14224
|
(b) A copy of the bylaws, rules and regulations, or |
14225
|
similar form of document, if any, regulating the conduct of the |
14226
|
affairs of the applicant; |
14227
|
(c) A list of the names, addresses, and official |
14228
|
capacities with the organization of the persons who are to be |
14229
|
responsible for the conduct of the affairs of the health |
14230
|
maintenance organization, including all officers, directors, and |
14231
|
owners of in excess of 5 percent of the common stock of the |
14232
|
corporation. Such persons shall fully disclose to the office |
14233
|
departmentand the directors of the health maintenance |
14234
|
organization the extent and nature of any contracts or |
14235
|
arrangements between them and the health maintenance |
14236
|
organization, including any possible conflicts of interest; |
14237
|
(d) A complete biographical statement on forms prescribed |
14238
|
by the commissiondepartment, and an independent investigation |
14239
|
report and fingerprints obtained pursuant to chapter 624, of all |
14240
|
of the individuals referred to in paragraph (c); |
14241
|
(e) A statement generally describing the health |
14242
|
maintenance organization, its operations, and its grievance |
14243
|
procedures; |
14244
|
(f) Forms of all health maintenance contracts, |
14245
|
certificates, and member handbooks the applicant proposes to |
14246
|
offer the subscribers, showing the benefits to which they are |
14247
|
entitled, together with a table of the rates charged, or |
14248
|
proposed to be charged, for each form of such contract. A |
14249
|
certified actuary shall: |
14250
|
1. Certify that the rates are neither inadequate nor |
14251
|
excessive nor unfairly discriminatory; |
14252
|
2. Certify that the rates are appropriate for the classes |
14253
|
of risks for which they have been computed; and |
14254
|
3. File an adequate description of the rating methodology |
14255
|
showing that such methodology follows consistent and equitable |
14256
|
actuarial principles; |
14257
|
(g) A statement describing with reasonable certainty the |
14258
|
geographic area or areas to be served by the health maintenance |
14259
|
organization; |
14260
|
(h) As to any applicant whose business plan indicates that |
14261
|
it will receive Medicaid funds, a list of all contracts and |
14262
|
agreements and any information relative to any payment or |
14263
|
agreement to pay, directly or indirectly, a consultant fee, a |
14264
|
broker fee, a commission, or other fee or charge related in any |
14265
|
way to the application for a certificate of authority or the |
14266
|
issuance of a certificate of authority, including, but not |
14267
|
limited to, the name of the person or entity paying the fee; the |
14268
|
name of the person or entity receiving the fee; the date of |
14269
|
payment; and a brief description of the work performed. The |
14270
|
contract, agreement, and related information shall, if |
14271
|
requested, be provided to the officedepartment. |
14272
|
(i) An audited financial statement prepared on the basis |
14273
|
of statutory accounting principles and certified by an |
14274
|
independent certified public accountant, except that surplus |
14275
|
notes acceptable to the officedepartmentand meeting the |
14276
|
requirements of this act shall be included in the calculation of |
14277
|
surplus; and |
14278
|
(j) Such additional reasonable data, financial statements, |
14279
|
and other pertinent information as the commissioner or office |
14280
|
requiresdepartment may requirewith respect to the |
14281
|
determination that the applicant can provide the services to be |
14282
|
offered. |
14283
|
(2) After submission of the application for a certificate |
14284
|
of authority, the entity may engage in initial group marketing |
14285
|
activities solely with respect to employers, representatives of |
14286
|
labor unions, professional associations, and trade associations, |
14287
|
so long as it does not enter into, issue, deliver, or otherwise |
14288
|
effectuate health maintenance contracts, effectuate or bind |
14289
|
coverage or benefits, provide health care services, or collect |
14290
|
premiums or charges until it has been issued a certificate of |
14291
|
authority by the officedepartment. Any such activities, oral |
14292
|
or written, shall include a statement that the entity does not |
14293
|
possess a valid certificate of authority and cannot enter into |
14294
|
health maintenance contracts until such time as it has been |
14295
|
issued a certificate of authority by the officedepartment. |
14296
|
Section 264. Section 641.215, Florida Statutes, is amended |
14297
|
to read: |
14298
|
641.215 Conditions precedent to issuance or maintenance of |
14299
|
certificate of authority; effect of bankruptcy proceedings.-- |
14300
|
(1) As a condition precedent to the issuance or |
14301
|
maintenance of a certificate of authority, a health maintenance |
14302
|
organization insurer must file or have on file with the office |
14303
|
department: |
14304
|
(a) An acknowledgment that a delinquency proceeding |
14305
|
pursuant to part I of chapter 631, or supervision by the office |
14306
|
department pursuant to ss. 624.80-624.87,constitutes the sole |
14307
|
and exclusive method for the liquidation, rehabilitation, |
14308
|
reorganization, or conservation of a health maintenance |
14309
|
organization. |
14310
|
(b) A waiver of any right to file or be subject to a |
14311
|
bankruptcy proceeding. |
14312
|
(2) The commencement of a bankruptcy proceeding either by |
14313
|
or against a health maintenance organization shall, by operation |
14314
|
of law: |
14315
|
(a) Terminate the health maintenance organization's |
14316
|
certificate of authority. |
14317
|
(b) Vest in the officedepartmentfor the use and benefit |
14318
|
of the subscribers of the health maintenance organization the |
14319
|
title to any deposits of the insurer held by the department. |
14320
|
|
14321
|
|
14322
|
If the proceeding is initiated by a party other than the health |
14323
|
maintenance organization, the operation of subsection (2) shall |
14324
|
be stayed for a period of 60 days following the date of |
14325
|
commencement of the proceeding. |
14326
|
Section 265. Section 641.22, Florida Statutes, is amended |
14327
|
to read: |
14328
|
641.22 Issuance of certificate of authority.--The office |
14329
|
departmentshall issue a certificate of authority to any entity |
14330
|
filing a completed application in conformity with s. 641.21, |
14331
|
upon payment of the prescribed fees and upon the office's |
14332
|
department'sbeing satisfied that: |
14333
|
(1) As a condition precedent to the issuance of any |
14334
|
certificate, the entity has obtained a health care provider |
14335
|
certificate from the Agency for Health Care Administration |
14336
|
pursuant to part III of this chapter. |
14337
|
(2) The health maintenance organization is actuarially |
14338
|
sound. |
14339
|
(3) The entity has met the applicable requirements |
14340
|
specified in s. 641.225. |
14341
|
(4) The procedures for offering comprehensive health care |
14342
|
services and offering and terminating contracts to subscribers |
14343
|
will not unfairly discriminate on the basis of age, sex, race, |
14344
|
health, or economic status. However, this section does not |
14345
|
prohibit reasonable underwriting classifications for the |
14346
|
purposes of establishing contract rates, nor does it prohibit |
14347
|
experience rating. |
14348
|
(5) The entity furnishes evidence of adequate insurance |
14349
|
coverage or an adequate plan for self-insurance to respond to |
14350
|
claims for injuries arising out of the furnishing of |
14351
|
comprehensive health care. |
14352
|
(6) The ownership, control, and management of the entity |
14353
|
is competent and trustworthy and possesses managerial experience |
14354
|
that would make the proposed health maintenance organization |
14355
|
operation beneficial to the subscribers. The officedepartment |
14356
|
shall not grant or continue authority to transact the business |
14357
|
of a health maintenance organization in this state at any time |
14358
|
during which the officedepartmenthas good reason to believe |
14359
|
that: |
14360
|
(a) The ownership, control, or management of the |
14361
|
organization includes any person: |
14362
|
1. Who is incompetent or untrustworthy; |
14363
|
2. Who is so lacking in health maintenance organization |
14364
|
expertise as to make the operation of the health maintenance |
14365
|
organization hazardous to potential and existing subscribers; |
14366
|
3. Who is so lacking in health maintenance organization |
14367
|
experience, ability, and standing as to jeopardize the |
14368
|
reasonable promise of successful operation; |
14369
|
4. Who is affiliated, directly or indirectly, through |
14370
|
ownership, control, reinsurance transactions, or other business |
14371
|
relations, with any person whose business operations are or have |
14372
|
been marked by business practices or conduct that is to the |
14373
|
detriment of the public, stockholders, investors, or creditors; |
14374
|
or |
14375
|
5. Whose business operations are or have been marked by |
14376
|
business practices or conduct that is to the detriment of the |
14377
|
public, stockholders, investors, or creditors; |
14378
|
(b) Any person, including any stock subscriber, |
14379
|
stockholder, or incorporator, who exercises or has the ability |
14380
|
to exercise effective control of the organization, or who |
14381
|
influences or has the ability to influence the transaction of |
14382
|
the business of the health maintenance organization, does not |
14383
|
possess the financial standing and business experience for the |
14384
|
successful operation of the health maintenance organization; |
14385
|
(c) Any person, including any stock subscriber, |
14386
|
stockholder, or incorporator, who exercises or has the ability |
14387
|
to exercise effective control of the organization, or who |
14388
|
influences or has the ability to influence the transaction of |
14389
|
the business of the health maintenance organization, has been |
14390
|
found guilty of, or has pled guilty or no contest to, any felony |
14391
|
or crime punishable by imprisonment of 1 year or more under the |
14392
|
laws of the United States or any state thereof or under the laws |
14393
|
of any other country, which involves moral turpitude, without |
14394
|
regard to whether a judgment or conviction has been entered by |
14395
|
the court having jurisdiction in such case. However, in the case |
14396
|
of a health maintenance organization operating under a |
14397
|
subsisting certificate of authority, the health maintenance |
14398
|
organization shall remove any such person immediately upon |
14399
|
discovery of the conditions set forth in this paragraph when |
14400
|
applicable to such person or under the order of the office |
14401
|
department, and the failure to so act by the organization is |
14402
|
grounds for revocation or suspension of the health maintenance |
14403
|
organization's certificate of authority; or |
14404
|
(d) Any person, including any stock subscriber, |
14405
|
stockholder, or incorporator, who exercises or has the ability |
14406
|
to exercise effective control of the organization, or who |
14407
|
influences or has the ability to influence the transaction of |
14408
|
the business of the health maintenance organization, is now or |
14409
|
was in the past affiliated, directly or indirectly, through |
14410
|
ownership interest of 10 percent or more, control, or |
14411
|
reinsurance transactions, with any business, corporation, or |
14412
|
other entity that has been found guilty of or has pleaded guilty |
14413
|
or nolo contendere to any felony or crime punishable by |
14414
|
imprisonment for 1 year or more under the laws of the United |
14415
|
States, any state, or any other country, regardless of |
14416
|
adjudication. In the case of a health maintenance organization |
14417
|
operating under a subsisting certificate of authority, the |
14418
|
health maintenance organization shall immediately remove such |
14419
|
person or immediately notify the officedepartmentof such |
14420
|
person upon discovery of the conditions set forth in this |
14421
|
paragraph, either when applicable to such person or upon order |
14422
|
of the officedepartment. The failure to remove such person, |
14423
|
provide such notice, or comply with such order constitutes |
14424
|
grounds for suspension or revocation of the health maintenance |
14425
|
organization's certificate of authority. |
14426
|
(7) The entity has a blanket fidelity bond in the amount |
14427
|
of $100,000, issued by a licensed insurance carrier in this |
14428
|
state, that will reimburse the entity in the event that anyone |
14429
|
handling the funds of the entity either misappropriates or |
14430
|
absconds with the funds. All employees handling the funds shall |
14431
|
be covered by the blanket fidelity bond. An agent licensed |
14432
|
under the provisions of the Florida Insurance Code may either |
14433
|
directly or indirectly represent the health maintenance |
14434
|
organization in the solicitation, negotiation, effectuation, |
14435
|
procurement, receipt, delivery, or forwarding of any health |
14436
|
maintenance organization subscriber's contract or collect or |
14437
|
forward any consideration paid by the subscriber to the health |
14438
|
maintenance organization; and the licensed agent shall not be |
14439
|
required to post the bond required by this subsection. |
14440
|
(8) The entity has filed with the officedepartment, and |
14441
|
obtained approval from the officedepartmentof, all reinsurance |
14442
|
contracts as provided in s. 641.285. |
14443
|
(9) The health maintenance organization has a grievance |
14444
|
procedure that will facilitate the resolution of subscriber |
14445
|
grievances and that includes both formal and informal steps |
14446
|
available within the organization. |
14447
|
Section 266. Subsections (2) and (4), and paragraphs (b) |
14448
|
and (d) of subsection (6) of section 641.225, Florida Statutes, |
14449
|
are amended to read: |
14450
|
641.225 Surplus requirements.-- |
14451
|
(2) The officedepartmentshall not issue a certificate of |
14452
|
authority, except as provided in subsection (3), unless the |
14453
|
health maintenance organization has a minimum surplus in an |
14454
|
amount which is the greater of: |
14455
|
(a) Ten percent of their total liabilities based on their |
14456
|
startup projection as set forth in this part; |
14457
|
(b) Two percent of their total projected premiums based on |
14458
|
their startup projection as set forth in this part; or |
14459
|
(c) $1,500,000, plus all startup losses, excluding |
14460
|
profits, projected to be incurred on their startup projection |
14461
|
until the projection reflects statutory net profits for 12 |
14462
|
consecutive months. |
14463
|
(4) The commissiondepartmentmay adopt rules to set |
14464
|
uniform standards and criteria for the early warning that the |
14465
|
continued operation of any health maintenance organization might |
14466
|
be hazardous to its subscribers, creditors, or the general |
14467
|
public, and to set standards for evaluating the financial |
14468
|
condition of any health maintenance organization. |
14469
|
(6) In lieu of having any minimum surplus, the health |
14470
|
maintenance organization may provide a written guarantee to |
14471
|
assure payment of covered subscriber claims and all other |
14472
|
liabilities of the health maintenance organization, provided |
14473
|
that the written guarantee is made by a guaranteeing |
14474
|
organization which: |
14475
|
(b) Submits a guarantee that is approved by the office |
14476
|
departmentas meeting the requirements of this part, provided |
14477
|
that the written guarantee contains a provision which requires |
14478
|
that the guarantee be irrevocable unless the guaranteeing |
14479
|
organization can demonstrate to the officedepartmentthat the |
14480
|
cancellation of the guarantee will not result in the insolvency |
14481
|
of the health maintenance organization and the officedepartment |
14482
|
approves cancellation of the guarantee. |
14483
|
(d) Submits annually, within 3 months after the end of its |
14484
|
fiscal year, an audited financial statement certified by an |
14485
|
independent certified public accountant, prepared in accordance |
14486
|
with generally accepted accounting principles. The office |
14487
|
departmentmay, as it deems necessary, require quarterly |
14488
|
financial statements from the guaranteeing organization. |
14489
|
Section 267. Subsection (1) of section 641.227, Florida |
14490
|
Statutes, is amended to read: |
14491
|
641.227 Rehabilitation Administrative Expense Fund.-- |
14492
|
(1) The officedepartmentshall not issue or permit to |
14493
|
exist a certificate of authority to operate a health maintenance |
14494
|
organization in this state unless the organization has deposited |
14495
|
with the department $10,000 in cash for use in the |
14496
|
Rehabilitation Administrative Expense Fund as established in |
14497
|
subsection (2). |
14498
|
Section 268. Subsections (1) and (3) of section 641.228, |
14499
|
Florida Statutes, are amended to read: |
14500
|
641.228 Florida Health Maintenance Organization Consumer |
14501
|
Assistance Plan.-- |
14502
|
(1) The officedepartmentshall not issue a certificate to |
14503
|
any health maintenance organization after July 1, 1989, until |
14504
|
the applicant health maintenance organization has paid in full |
14505
|
its special assessment as set forth in s. 631.819(2)(a). |
14506
|
(3) The officedepartmentmay suspend or revoke the |
14507
|
certificate of authority of any health maintenance organization |
14508
|
which does not timely pay its assessment to the Florida Health |
14509
|
Maintenance Organization Consumer Assistance Plan. |
14510
|
Section 269. Section 641.23, Florida Statutes, is amended |
14511
|
to read: |
14512
|
641.23 Revocation or cancellation of certificate of |
14513
|
authority; suspension of enrollment of new subscribers; terms of |
14514
|
suspension.-- |
14515
|
(1) The maintenance of a valid and current health care |
14516
|
provider certificate issued pursuant to part III of this chapter |
14517
|
is a condition of the maintenance of a valid and current |
14518
|
certificate of authority issued by the officedepartmentto |
14519
|
operate a health maintenance organization. Denial or revocation |
14520
|
of a health care provider certificate shall be deemed to be an |
14521
|
automatic and immediate cancellation of a health maintenance |
14522
|
organization's certificate of authority. At the discretion of |
14523
|
the officeDepartment of Insurance, nonrenewal of a health care |
14524
|
provider certificate may be deemed to be an automatic and |
14525
|
immediate cancellation of a health maintenance organization's |
14526
|
certificate of authority if the Agency for Health Care |
14527
|
Administration notifies the officeDepartment of Insurance, in |
14528
|
writing, that the health care provider certificate will not be |
14529
|
renewed. |
14530
|
(2) The officedepartmentmay suspend the authority of a |
14531
|
health maintenance organization to enroll new subscribers or |
14532
|
revoke any certificate issued to a health maintenance |
14533
|
organization, or order compliance within 30 days, if it finds |
14534
|
that any of the following conditions exists: |
14535
|
(a) The organization is not operating in compliance with |
14536
|
this part; |
14537
|
(b) The plan is no longer actuarially sound or the |
14538
|
organization does not have the minimum surplus as required by |
14539
|
this part; |
14540
|
(c) The existing contract rates are excessive, inadequate, |
14541
|
or unfairly discriminatory; |
14542
|
(d) The organization has advertised, merchandised, or |
14543
|
attempted to merchandise its services in such a manner as to |
14544
|
misrepresent its services or capacity for service or has engaged |
14545
|
in deceptive, misleading, or unfair practices with respect to |
14546
|
advertising or merchandising; or |
14547
|
(e) The organization is insolvent. |
14548
|
(3) Whenever the financial condition of the health |
14549
|
maintenance organization is such that, if not modified or |
14550
|
corrected, its continued operation would result in impairment or |
14551
|
insolvency, the officedepartmentmay order the health |
14552
|
maintenance organization to file with the officedepartmentand |
14553
|
implement a corrective action plan designed to do one or more of |
14554
|
the following: |
14555
|
(a) Reduce the total amount of present potential liability |
14556
|
for benefits by reinsurance or other means. |
14557
|
(b) Reduce the volume of new business being accepted. |
14558
|
(c) Reduce the expenses of the health maintenance |
14559
|
organization by specified methods. |
14560
|
(d) Suspend or limit the writing of new business for a |
14561
|
period of time. |
14562
|
(e) Require an increase in the health maintenance |
14563
|
organization's net worth. |
14564
|
|
14565
|
|
14566
|
If the health maintenance organization fails to submit a plan |
14567
|
within 30 days of the office'sdepartment'sorder or submits a |
14568
|
plan which is insufficient to correct the health maintenance |
14569
|
organization's financial condition, the officedepartmentmay |
14570
|
order the health maintenance organization to implement one or |
14571
|
more of the corrective actions listed in this subsection. |
14572
|
(4) The officedepartmentshall, in its order suspending |
14573
|
the authority of a health maintenance organization to enroll new |
14574
|
subscribers, specify the period during which the suspension is |
14575
|
to be in effect and the conditions, if any, which must be met by |
14576
|
the health maintenance organization prior to reinstatement of |
14577
|
its authority to enroll new subscribers. The order of |
14578
|
suspension is subject to rescission or modification by further |
14579
|
order of the officedepartmentprior to the expiration of the |
14580
|
suspension period. Reinstatement shall not be made unless |
14581
|
requested by the health maintenance organization; however, the |
14582
|
officedepartmentshall not grant reinstatement if it finds that |
14583
|
the circumstances for which the suspension occurred still exist |
14584
|
or are likely to recur. |
14585
|
(5) The commissiondepartment shall adoptpromulgaterules |
14586
|
establishing an actuarially sound medical loss ratio for |
14587
|
Medicaid. In determining the appropriate medical loss ratio, |
14588
|
the commissiondepartmentshall consider factors, including but |
14589
|
not limited to, plan age, plan structure, geographic service |
14590
|
area, product mix, provider network, medical inflation, provider |
14591
|
services, other professional services, out of network referrals |
14592
|
and expenditures, in and out of network emergency room |
14593
|
expenditures, inpatient expenditures, other medical |
14594
|
expenditures, incentive pool adjustments, copayments, |
14595
|
coordination of benefits, subrogation, and any other expenses |
14596
|
associated with the delivery of medical benefits. The |
14597
|
commissiondepartmentshall utilize assistance from the Agency |
14598
|
for Health Care Administration, the State University System, an |
14599
|
independent actuary, and representatives from health maintenance |
14600
|
organizations in developing the rule for appropriate medical |
14601
|
loss ratios. |
14602
|
(6) The officedepartmentshall calculate and publish at |
14603
|
least annually the medical loss ratios of all licensed health |
14604
|
maintenance organizations. The publication shall include an |
14605
|
explanation of what the medical loss ratio means and shall |
14606
|
disclose that the medical loss ratio is not a direct reflection |
14607
|
of quality, but must be looked at along with patient |
14608
|
satisfaction and other standards that define quality. |
14609
|
Section 270. Subsections (1), (2), and (3) of section |
14610
|
641.234, Florida Statutes, are amended to read: |
14611
|
641.234 Administrative, provider, and management |
14612
|
contracts.-- |
14613
|
(1) The officedepartmentmay require a health maintenance |
14614
|
organization to submit any contract for administrative services, |
14615
|
contract with a provider other than an individual physician, |
14616
|
contract for management services, and contract with an |
14617
|
affiliated entity to the officedepartment. |
14618
|
(2) After review of a contract the officedepartmentmay |
14619
|
order the health maintenance organization to cancel the contract |
14620
|
in accordance with the terms of the contract and applicable law |
14621
|
if it determines: |
14622
|
(a) That the fees to be paid by the health maintenance |
14623
|
organization under the contract are so unreasonably high as |
14624
|
compared with similar contracts entered into by the health |
14625
|
maintenance organization or as compared with similar contracts |
14626
|
entered into by other health maintenance organizations in |
14627
|
similar circumstances that the contract is detrimental to the |
14628
|
subscribers, stockholders, investors, or creditors of the health |
14629
|
maintenance organization; or |
14630
|
(b) That the contract is with an entity that is not |
14631
|
licensed under state statutes, if such license is required, or |
14632
|
is not in good standing with the applicable regulatory agency. |
14633
|
(3) All contracts for administrative services, management |
14634
|
services, provider services other than individual physician |
14635
|
contracts, and with affiliated entities entered into or renewed |
14636
|
by a health maintenance organization on or after October 1, |
14637
|
1988, shall contain a provision that the contract shall be |
14638
|
canceled upon issuance of an order by the officedepartment |
14639
|
pursuant to this section. |
14640
|
Section 271. Section 641.2342, Florida Statutes, is |
14641
|
amended to read: |
14642
|
641.2342 Contract providers.--Each health maintenance |
14643
|
organization shall file, upon the request of the office |
14644
|
department, financial statements for all contract providers of |
14645
|
comprehensive health care services who have assumed, through |
14646
|
capitation or other means, more than 10 percent of the health |
14647
|
care risks of the health maintenance organization. However, |
14648
|
this provision shall not apply to any individual physician. |
14649
|
Section 272. Section 641.25, Florida Statutes, is amended |
14650
|
to read: |
14651
|
641.25 Administrative penalty in lieu of suspension or |
14652
|
revocation.--If the officedepartmentfinds that one or more |
14653
|
grounds exist for the revocation or suspension of a certificate |
14654
|
issued under this part, the officedepartmentmay, in lieu of |
14655
|
revocation or suspension, impose a fine upon the health |
14656
|
maintenance organization. With respect to any nonwillful |
14657
|
violation, the fine must not exceed $2,500 per violation. Such |
14658
|
fines may not exceed an aggregate amount of $25,000 for all |
14659
|
nonwillful violations arising out of the same action. With |
14660
|
respect to any knowing and willful violation of a lawful order |
14661
|
or rule of the office or commissiondepartmentor a provision of |
14662
|
this part, the officedepartmentmay impose upon the |
14663
|
organization a fine in an amount not to exceed $20,000 for each |
14664
|
such violation. Such fines may not exceed an aggregate amount |
14665
|
of $250,000 for all knowing and willful violations arising out |
14666
|
of the same action. The commissiondepartmentmust adopt by |
14667
|
rule by January 1, 1997,penalty categories that specify varying |
14668
|
ranges of monetary fines for willful violations and for |
14669
|
nonwillful violations. |
14670
|
Section 273. Subsection (2) of section 641.255, Florida |
14671
|
Statutes, is amended to read: |
14672
|
641.255 Acquisition, merger, or consolidation.-- |
14673
|
(2) In addition to the requirements set forth in ss. |
14674
|
628.451, 628.4615, and 628.471, each party to any transaction |
14675
|
involving any licensee which, as indicated in its most recent |
14676
|
quarterly or annual statement, derives income from Medicaid |
14677
|
funds shall in the filing made with the officedepartment |
14678
|
identify: |
14679
|
(a) Any person who has received any payment from either |
14680
|
party or any person on that party's behalf; or |
14681
|
(b) The existence of any agreement entered into by either |
14682
|
party or by any person on that party's behalf to pay a |
14683
|
consultant fee, a broker fee, a commission, or other fee or |
14684
|
charge, |
14685
|
|
14686
|
|
14687
|
which in any way relates to the acquisition, merger, or |
14688
|
consolidation. The commissiondepartmentmay adopt a form to be |
14689
|
made part of the application which is to be sworn to by an |
14690
|
officer of the entity which made or will make the payment. The |
14691
|
form shall include the name of the person or entity paying the |
14692
|
fee; the name of the person or entity receiving the fee; the |
14693
|
date of payment; and a brief description of the work performed. |
14694
|
Section 274. Section 641.26, Florida Statutes, is amended |
14695
|
to read: |
14696
|
641.26 Annual and quarterly reports.-- |
14697
|
(1) Every health maintenance organization shall, annually |
14698
|
within 3 months after the end of its fiscal year, or within an |
14699
|
extension of time therefor as the officedepartment, for good |
14700
|
cause, may grant, in a form prescribed by the commission |
14701
|
department, file a report with the officedepartment, verified |
14702
|
by the oath of two officers of the organization or, if not a |
14703
|
corporation, of two persons who are principal managing directors |
14704
|
of the affairs of the organization, properly notarized, showing |
14705
|
its condition on the last day of the immediately preceding |
14706
|
reporting period. Such report shall include: |
14707
|
(a) A financial statement of the health maintenance |
14708
|
organization filed on a computer diskette using a format |
14709
|
acceptable to the officedepartment. |
14710
|
(b) A financial statement of the health maintenance |
14711
|
organization filed on forms acceptable to the officedepartment. |
14712
|
(c) An audited financial statement of the health |
14713
|
maintenance organization, including its balance sheet and a |
14714
|
statement of operations for the preceding year certified by an |
14715
|
independent certified public accountant, prepared in accordance |
14716
|
with statutory accounting principles. |
14717
|
(d) The number of health maintenance contracts issued and |
14718
|
outstanding and the number of health maintenance contracts |
14719
|
terminated. |
14720
|
(e) The number and amount of damage claims for medical |
14721
|
injury initiated against the health maintenance organization and |
14722
|
any of the providers engaged by it during the reporting year, |
14723
|
broken down into claims with and without formal legal process, |
14724
|
and the disposition, if any, of each such claim. |
14725
|
(f) An actuarial certification that: |
14726
|
1. The health maintenance organization is actuarially |
14727
|
sound, which certification shall consider the rates, benefits, |
14728
|
and expenses of, and any other funds available for the payment |
14729
|
of obligations of, the organization. |
14730
|
2. The rates being charged or to be charged are |
14731
|
actuarially adequate to the end of the period for which rates |
14732
|
have been guaranteed. |
14733
|
3. Incurred but not reported claims and claims reported |
14734
|
but not fully paid have been adequately provided for. |
14735
|
4. The health maintenance organization has adequately |
14736
|
provided for all obligations required by s. 641.35(3)(a). |
14737
|
(g) A report prepared by the certified public accountant |
14738
|
and filed with the officedepartmentdescribing material |
14739
|
weaknesses in the health maintenance organization's internal |
14740
|
control structure as noted by the certified public accountant |
14741
|
during the audit. The report must be filed with the annual |
14742
|
audited financial report as required in paragraph (c). The |
14743
|
health maintenance organization shall provide a description of |
14744
|
remedial actions taken or proposed to correct material |
14745
|
weaknesses, if the actions are not described in the independent |
14746
|
certified public accountant's report. |
14747
|
(h) Such other information relating to the performance of |
14748
|
health maintenance organizations as is required by the |
14749
|
commission or officedepartment. |
14750
|
(2) The officedepartmentmay require updates of the |
14751
|
actuarial certification as to a particular health maintenance |
14752
|
organization if the officedepartmenthas reasonable cause to |
14753
|
believe that such reserves are understated to the extent of |
14754
|
materially misstating the financial position of the health |
14755
|
maintenance organization. Workpapers in support of the |
14756
|
statement of the updated actuarial certification must be |
14757
|
provided to the officedepartmentupon request. |
14758
|
(3) Every health maintenance organization shall file |
14759
|
quarterly, for the first three calendar quarters of each year, |
14760
|
an unaudited financial statement of the organization as |
14761
|
described in paragraphs (1)(a) and (b). The statement for the |
14762
|
quarter ending March 31 shall be filed on or before May 15, the |
14763
|
statement for the quarter ending June 30 shall be filed on or |
14764
|
before August 15, and the statement for the quarter ending |
14765
|
September 30 shall be filed on or before November 15. The |
14766
|
quarterly report shall be verified by the oath of two officers |
14767
|
of the organization, properly notarized. |
14768
|
(4) Any health maintenance organization that neglects to |
14769
|
file an annual report or quarterly report in the form and within |
14770
|
the time required by this section shall forfeit up to $1,000 for |
14771
|
each day for the first 10 days during which the neglect |
14772
|
continues and shall forfeit up to $2,000 for each day after the |
14773
|
first 10 days during which the neglect continues; and, upon |
14774
|
notice by the officedepartmentto that effect, the |
14775
|
organization's authority to enroll new subscribers or to do |
14776
|
business in this state shall cease while such default continues. |
14777
|
The officedepartmentshall deposit all sums collected by it |
14778
|
under this section to the credit of the Insurance Commissioner's |
14779
|
Regulatory Trust Fund. The officedepartmentshall not collect |
14780
|
more than $100,000 for each report. |
14781
|
(5) Each authorized health maintenance organization shall |
14782
|
retain an independent certified public accountant, referred to |
14783
|
in this section as "CPA," who agrees by written contract with |
14784
|
the health maintenance organization to comply with the |
14785
|
provisions of this part. |
14786
|
(a) The CPA shall provide to the HMO audited financial |
14787
|
statements consistent with this part. |
14788
|
(b) Any determination by the CPA that the health |
14789
|
maintenance organization does not meet minimum surplus |
14790
|
requirements as set forth in this part shall be stated by the |
14791
|
CPA, in writing, in the audited financial statement. |
14792
|
(c) The completed work papers and any written |
14793
|
communications between the CPA firm and the health maintenance |
14794
|
organization relating to the audit of the health maintenance |
14795
|
organization shall be made available for review on a visual- |
14796
|
inspection-only basis by the officedepartmentat the offices of |
14797
|
the health maintenance organization, at the officedepartment, |
14798
|
or at any other reasonable place as mutually agreed between the |
14799
|
officedepartmentand the health maintenance organization. The |
14800
|
CPA must retain for review the work papers and written |
14801
|
communications for a period of not less than 6 years. |
14802
|
(d) The CPA shall provide to the officedepartmenta |
14803
|
written report describing material weaknesses in the health |
14804
|
maintenance organization's internal control structure as noted |
14805
|
during the audit. |
14806
|
(6) To facilitate uniformity in financial statements and |
14807
|
to facilitate officedepartment analysis, the commission |
14808
|
departmentmay by rule adopt the form for financial statements |
14809
|
of a health maintenance organization, including supplements as |
14810
|
approved by the National Association of Insurance Commissioners |
14811
|
in 1995, and may adopt subsequent amendments thereto if the |
14812
|
methodology remains substantially consistent, and may by rule |
14813
|
require each health maintenance organization to submit to the |
14814
|
officedepartmentall or part of the information contained in |
14815
|
the annual statement in a computer-readable form compatible with |
14816
|
the electronic data processing system specified by the office |
14817
|
department. |
14818
|
(7) In addition to information called for and furnished in |
14819
|
connection with its annual or quarterly statements, the health |
14820
|
maintenance organization shall furnish to the officedepartment |
14821
|
as soon as reasonably possible such information as to its |
14822
|
material transactions which, in the office'sdepartment's |
14823
|
opinion, may have a material adverse effect on the health |
14824
|
maintenance organization's financial condition, as the office |
14825
|
requestsdepartment may requestin writing. All such information |
14826
|
furnished pursuant to the office'sdepartment'srequest must be |
14827
|
verified by the oath of two executive officers of the health |
14828
|
maintenance organization. |
14829
|
(8) Each health maintenance organization shall file one |
14830
|
copy of its annual statement convention blank in electronic |
14831
|
form, along with such additional filings as prescribed by the |
14832
|
commissiondepartmentfor the preceding calendar year or |
14833
|
quarter, with the National Association of Insurance |
14834
|
Commissioners. Each health maintenance organization shall pay |
14835
|
fees assessed by the National Association of Insurance |
14836
|
Commissioners to cover costs associated with the filing and |
14837
|
analysis of the documents by the National Association of |
14838
|
Insurance Commissioners. |
14839
|
Section 275. Section 641.27, Florida Statutes, is amended |
14840
|
to read: |
14841
|
641.27 Examination by the department.-- |
14842
|
(1) The officedepartmentshall examine the affairs, |
14843
|
transactions, accounts, business records, and assets of any |
14844
|
health maintenance organization as often as it deems it |
14845
|
expedient for the protection of the people of this state, but |
14846
|
not less frequently than once every 3 years. In lieu of making |
14847
|
its own financial examination, the officedepartmentmay accept |
14848
|
an independent certified public accountant's audit report |
14849
|
prepared on a statutory accounting basis consistent with this |
14850
|
part. However, except when the medical records are requested |
14851
|
and copies furnished pursuant to s. 456.057, medical records of |
14852
|
individuals and records of physicians providing service under |
14853
|
contract to the health maintenance organization shall not be |
14854
|
subject to audit, although they may be subject to subpoena by |
14855
|
court order upon a showing of good cause. For the purpose of |
14856
|
examinations, the officedepartmentmay administer oaths to and |
14857
|
examine the officers and agents of a health maintenance |
14858
|
organization concerning its business and affairs. The |
14859
|
examination of each health maintenance organization by the |
14860
|
officedepartmentshall be subject to the same terms and |
14861
|
conditions as apply to insurers under chapter 624. In no event |
14862
|
shall expenses of all examinations exceed a maximum of $20,000 |
14863
|
for any 1-year period. Any rehabilitation, liquidation, |
14864
|
conservation, or dissolution of a health maintenance |
14865
|
organization shall be conducted under the supervision of the |
14866
|
department, which shall have all power with respect thereto |
14867
|
granted to it under the laws governing the rehabilitation, |
14868
|
liquidation, reorganization, conservation, or dissolution of |
14869
|
life insurance companies. |
14870
|
(2) The officedepartmentmay contract, at reasonable fees |
14871
|
for work performed, with qualified, impartial outside sources to |
14872
|
perform audits or examinations or portions thereof pertaining to |
14873
|
the qualification of an entity for issuance of a certificate of |
14874
|
authority or to determine continued compliance with the |
14875
|
requirements of this part, in which case the payment must be |
14876
|
made directly to the contracted examiner by the health |
14877
|
maintenance organization examined, in accordance with the rates |
14878
|
and terms agreed to by the officedepartmentand the examiner. |
14879
|
Any contracted assistance shall be under the direct supervision |
14880
|
of the officedepartment. The results of any contracted |
14881
|
assistance shall be subject to the review of, and approval, |
14882
|
disapproval, or modification by, the officedepartment. |
14883
|
Section 276. Section 641.28, Florida Statutes, is amended |
14884
|
to read: |
14885
|
641.28 Civil remedy.--In any civil action brought to |
14886
|
enforce the terms and conditions of a health maintenance |
14887
|
organization contract, the prevailing party is entitled to |
14888
|
recover reasonable attorney's fees and court costs. This section |
14889
|
shall not be construed to authorize a civil action against the |
14890
|
commission, office, or department, theirits employees, or the |
14891
|
Chief Financial OfficerInsurance Commissioneror against the |
14892
|
Agency for Health Care Administration, its employees, or the |
14893
|
director of the agency. |
14894
|
Section 277. Section 641.281, Florida Statutes, is amended |
14895
|
to read: |
14896
|
641.281 Injunction.--In addition to the penalties and |
14897
|
other enforcement provisions of this part, the office and |
14898
|
department, within the scope of their regulatory jurisdictions, |
14899
|
areisvested with the power to seek both temporary and |
14900
|
permanent injunctive relief when: |
14901
|
(1) A health maintenance organization is being operated by |
14902
|
any person or entity without a subsisting certificate of |
14903
|
authority. |
14904
|
(2) Any person, entity, or health maintenance organization |
14905
|
has engaged in any activity prohibited by this part or any rule |
14906
|
adopted pursuant thereto. |
14907
|
(3) Any health maintenance organization, person, or entity |
14908
|
is renewing, issuing, or delivering a health maintenance |
14909
|
contract or contracts without a subsisting certificate of |
14910
|
authority. |
14911
|
|
14912
|
|
14913
|
The office's anddepartment's authority to seek injunctive |
14914
|
relief shall not be conditioned on having conducted any |
14915
|
proceeding pursuant to chapter 120. |
14916
|
Section 278. Section 641.284, Florida Statutes, is amended |
14917
|
to read: |
14918
|
641.284 Liquidation, rehabilitation, reorganization, and |
14919
|
conservation; exclusive methods of remedy.--A delinquency |
14920
|
proceeding under part I of chapter 631, or supervision by the |
14921
|
officedepartment under ss. 624.80-624.87,constitute the sole |
14922
|
and exclusive means of liquidating, reorganizing, |
14923
|
rehabilitating, or conserving a health maintenance organization. |
14924
|
Section 279. Subsections (1), (2), and (3) of section |
14925
|
641.285, Florida Statutes, are amended to read: |
14926
|
641.285 Insolvency protection.-- |
14927
|
(1) Each health maintenance organization shall deposit |
14928
|
with the department cash or securities of the type eligible |
14929
|
under s. 625.52, which shall have at all times a market value in |
14930
|
the amount set forth in this subsection. The amount of the |
14931
|
deposit shall be reviewed annually, or more often, as the office |
14932
|
departmentdeems necessary. The market value of the deposit |
14933
|
shall be a minimum of $300,000. |
14934
|
(2) If securities or assets deposited by a health |
14935
|
maintenance organization under this part are subject to material |
14936
|
fluctuations in market value, the officedepartmentmay, in its |
14937
|
discretion, require the organization to deposit and maintain on |
14938
|
deposit additional securities or assets in an amount as may be |
14939
|
reasonably necessary to assure that the deposit will at all |
14940
|
times have a market value of not less than the amount specified |
14941
|
under this section. If for any reason the market value of assets |
14942
|
and securities of a health maintenance organization held on |
14943
|
deposit in this state under this code falls below the amount |
14944
|
required, the organization shall promptly deposit other or |
14945
|
additional assets or securities eligible for deposit sufficient |
14946
|
to cure the deficiency. If the health maintenance organization |
14947
|
has failed to cure the deficiency within 30 days after receipt |
14948
|
of notice thereof by registered or certified mail from the |
14949
|
officedepartment, the officedepartmentmay revoke the |
14950
|
certificate of authority of the health maintenance organization. |
14951
|
(3) Whenever the officedepartmentdetermines that the |
14952
|
financial condition of a health maintenance organization has |
14953
|
deteriorated to the point that the policyholders' or |
14954
|
subscribers' best interests are not being preserved by the |
14955
|
activities of a health maintenance organization, the office |
14956
|
departmentmay require such health maintenance organization to |
14957
|
deposit and maintain deposited in trust with the department for |
14958
|
the protection of the health maintenance organization's |
14959
|
policyholders, subscribers, and creditors, for such time as the |
14960
|
officedepartmentdeems necessary, securities eligible for such |
14961
|
deposit under s. 625.52 having a market value of not less than |
14962
|
the amount that the officedepartmentdetermines is necessary, |
14963
|
which amount must not be less than $100,000 or greater than $2 |
14964
|
million. The deposit required under this subsection is in |
14965
|
addition to any other deposits required of a health maintenance |
14966
|
organization pursuant to subsections (1) and (2). |
14967
|
Section 280. Section 641.29, Florida Statutes, is amended |
14968
|
to read: |
14969
|
641.29 Fees.--Every health maintenance organization shall |
14970
|
pay to the officedepartmentthe following fees: |
14971
|
(1) For filing a copy of its application for a certificate |
14972
|
of authority or amendment thereto, a nonrefundable fee in the |
14973
|
amount of $1,000. |
14974
|
(2) For filing each annual report, which must be filed on |
14975
|
computer diskettes, $150. |
14976
|
Section 281. Paragraph (b) of subsection (4) of section |
14977
|
641.3007, Florida Statutes, is amended to read: |
14978
|
641.3007 HIV infection and AIDS for contract |
14979
|
(4) UTILIZATION OF MEDICAL TESTS.-- |
14980
|
(b) Prior to testing, the health maintenance organization |
14981
|
must disclose its intent to test the person for the HIV |
14982
|
infection or for a specific sickness or medical condition |
14983
|
derived therefrom and must obtain the person's written informed |
14984
|
consent to administer the test. Written informed consent shall |
14985
|
include a fair explanation of the test, including its purpose, |
14986
|
potential uses, and limitations, and the meaning of its results |
14987
|
and the right to confidential treatment of information. Use of |
14988
|
a form approved by the officedepartmentshall raise a |
14989
|
conclusive presumption of informed consent. |
14990
|
Section 282. Section 641.305, Florida Statutes, is amended |
14991
|
to read: |
14992
|
641.305 Language used in contracts and advertisements; |
14993
|
translations.-- |
14994
|
(1)(a) All health maintenance contracts or forms shall be |
14995
|
printed in English. |
14996
|
(b) If the negotiations by a health maintenance |
14997
|
organization with a member leading up to the effectuation of a |
14998
|
health maintenance contract are conducted in a language other |
14999
|
than English, the health maintenance organization shall supply |
15000
|
to the member a written translation of the contract, which |
15001
|
translation accurately reflects the substance of the contract |
15002
|
and is in the language used to negotiate the contract. The |
15003
|
written translation shall be affixed to and shall become a part |
15004
|
of the contract or form. Any such translation shall be |
15005
|
furnished to the officedepartmentas part of the filing of the |
15006
|
health maintenance contract form. No translation of a health |
15007
|
maintenance contract form shall be approved by the department |
15008
|
unless the translation accurately reflects the substance of the |
15009
|
health maintenance contract form in translation. |
15010
|
(2) The text of all advertisements by a health maintenance |
15011
|
organization, if printed or broadcast in a language other than |
15012
|
English, also shall be available in English and shall be |
15013
|
furnished to the officedepartmentupon request. As used in |
15014
|
this subsection, the term "advertisement" means any |
15015
|
advertisement, circular, pamphlet, brochure, or other printed |
15016
|
material disclosing or disseminating advertising material or |
15017
|
information by a health maintenance organization to prospective |
15018
|
or existing subscribers and includes any radio or television |
15019
|
transmittal of an advertisement or information. |
15020
|
Section 283. Subsections (2), (3), (5), and (12) and |
15021
|
paragraphs (c) and (e) of subsection (38) of section 641.31, |
15022
|
Florida Statutes, are amended to read: |
15023
|
641.31 Health maintenance contracts.-- |
15024
|
(2) The rates charged by any health maintenance |
15025
|
organization to its subscribers shall not be excessive, |
15026
|
inadequate, or unfairly discriminatory or follow a rating |
15027
|
methodology that is inconsistent, indeterminate, or ambiguous or |
15028
|
encourages misrepresentation or misunderstanding. The |
15029
|
commissiondepartment, in accordance with generally accepted |
15030
|
actuarial practice as applied to health maintenance |
15031
|
organizations, may define by rule what constitutes excessive, |
15032
|
inadequate, or unfairly discriminatory rates and may require |
15033
|
whatever information it deems necessary to determine that a rate |
15034
|
or proposed rate meets the requirements of this subsection. |
15035
|
(3)(a) If a health maintenance organization desires to |
15036
|
amend any contract with its subscribers or any certificate or |
15037
|
member handbook, or desires to change any basic health |
15038
|
maintenance contract, certificate, grievance procedure, or |
15039
|
member handbook form, or application form where written |
15040
|
application is required and is to be made a part of the |
15041
|
contract, or printed amendment, addendum, rider, or endorsement |
15042
|
form or form of renewal certificate, it may do so, upon filing |
15043
|
with the officedepartmentthe proposed change or amendment. |
15044
|
Any proposed change shall be effective immediately, subject to |
15045
|
disapproval by the officedepartment. Following receipt of |
15046
|
notice of such disapproval or withdrawal of approval, no health |
15047
|
maintenance organization shall issue or use any form disapproved |
15048
|
by the officedepartment or as to which the officedepartment |
15049
|
has withdrawn approval. |
15050
|
(b) Any change in the rate is subject to paragraph (d) and |
15051
|
requires at least 30 days' advance written notice to the |
15052
|
subscriber. In the case of a group member, there may be a |
15053
|
contractual agreement with the health maintenance organization |
15054
|
to have the employer provide the required notice to the |
15055
|
individual members of the group. |
15056
|
(c) The officedepartmentshall disapprove any form filed |
15057
|
under this subsection, or withdraw any previous approval |
15058
|
thereof, if the form: |
15059
|
1. Is in any respect in violation of, or does not comply |
15060
|
with, any provision of this part or rule adopted thereunder. |
15061
|
2. Contains or incorporates by reference, where such |
15062
|
incorporation is otherwise permissible, any inconsistent, |
15063
|
ambiguous, or misleading clauses or exceptions and conditions |
15064
|
which deceptively affect the risk purported to be assumed in the |
15065
|
general coverage of the contract. |
15066
|
3. Has any title, heading, or other indication of its |
15067
|
provisions which is misleading. |
15068
|
4. Is printed or otherwise reproduced in such a manner as |
15069
|
to render any material provision of the form substantially |
15070
|
illegible. |
15071
|
5. Contains provisions which are unfair, inequitable, or |
15072
|
contrary to the public policy of this state or which encourage |
15073
|
misrepresentation. |
15074
|
6. Excludes coverage for human immunodeficiency virus |
15075
|
infection or acquired immune deficiency syndrome or contains |
15076
|
limitations in the benefits payable, or in the terms or |
15077
|
conditions of such contract, for human immunodeficiency virus |
15078
|
infection or acquired immune deficiency syndrome which are |
15079
|
different than those which apply to any other sickness or |
15080
|
medical condition. |
15081
|
(d) Any change in rates charged for the contract must be |
15082
|
filed with the officedepartmentnot less than 30 days in |
15083
|
advance of the effective date. At the expiration of such 30 |
15084
|
days, the rate filing shall be deemed approved unless prior to |
15085
|
such time the filing has been affirmatively approved or |
15086
|
disapproved by order of the officedepartment. The approval of |
15087
|
the filing by the officedepartmentconstitutes a waiver of any |
15088
|
unexpired portion of such waiting period. The officedepartment |
15089
|
may extend by not more than an additional 15 days the period |
15090
|
within which it may so affirmatively approve or disapprove any |
15091
|
such filing, by giving notice of such extension before |
15092
|
expiration of the initial 30-day period. At the expiration of |
15093
|
any such period as so extended, and in the absence of such prior |
15094
|
affirmative approval or disapproval, any such filing shall be |
15095
|
deemed approved. |
15096
|
(e) It is not the intent of this subsection to restrict |
15097
|
unduly the right to modify rates in the exercise of reasonable |
15098
|
business judgment. |
15099
|
(5) Every subscriber shall receive a clear and |
15100
|
understandable description of the method of the health |
15101
|
maintenance organization for resolving subscriber grievances, |
15102
|
and the method shall be set forth in the contract, certificate, |
15103
|
and member handbook. The organization shall also furnish, at |
15104
|
the time of initial enrollment and when necessary due to |
15105
|
substantial changes to the grievance process a separate and |
15106
|
additional communication prepared or approved by the office |
15107
|
departmentnotifying the contract holder of a group contract or |
15108
|
subscriber of an individual contract of their rights and |
15109
|
responsibilities under the grievance process. |
15110
|
(12) Each health maintenance contract, certificate, or |
15111
|
member handbook shall state that emergency services and care |
15112
|
shall be provided to subscribers in emergency situations not |
15113
|
permitting treatment through the health maintenance |
15114
|
organization's providers, without prior notification to and |
15115
|
approval of the organization. Not less than 75 percent of the |
15116
|
reasonable charges for covered services and supplies shall be |
15117
|
paid by the organization, up to the subscriber contract benefit |
15118
|
limits. Payment also may be subject to additional applicable |
15119
|
copayment provisions, not to exceed $100 per claim. The health |
15120
|
maintenance contract, certificate, or member handbook shall |
15121
|
contain the definitions of "emergency services and care" and |
15122
|
"emergency medical condition" as specified in s. 641.19(6)(7) |
15123
|
and (7)(8), shall describe procedures for determination by the |
15124
|
health maintenance organization of whether the services qualify |
15125
|
for reimbursement as emergency services and care, and shall |
15126
|
contain specific examples of what does constitute an emergency. |
15127
|
In providing for emergency services and care as a covered |
15128
|
service, a health maintenance organization shall be governed by |
15129
|
s. 641.513. |
15130
|
(38) |
15131
|
(c) Premiums paid in for the point-of-service riders may |
15132
|
not exceed 15 percent of total premiums for all health plan |
15133
|
products sold by the health maintenance organization offering |
15134
|
the rider. If the premiums paid for point-of-service riders |
15135
|
exceed 15 percent, the health maintenance organization must |
15136
|
notify the officedepartmentand, once this fact is known, must |
15137
|
immediately cease offering such a rider until it is in |
15138
|
compliance with the rider premium cap. |
15139
|
(e) The term "point of service" may not be used by a |
15140
|
health maintenance organization except with riders permitted |
15141
|
under this section or with forms approved by the office |
15142
|
departmentin which a point-of-service product is offered with |
15143
|
an indemnity carrier. |
15144
|
Section 284. Subsection (2) of section 641.3105, Florida |
15145
|
Statutes, is amended to read: |
15146
|
641.3105 Validity of noncomplying contracts.-- |
15147
|
(2) Any health maintenance contract delivered or issued |
15148
|
for delivery in this state covering a subscriber, which |
15149
|
subscriber, pursuant to the provisions of this part, the |
15150
|
organization may not lawfully cover under the contract, shall be |
15151
|
cancelable at any time by the organization, any provision of the |
15152
|
contract to the contrary notwithstanding; and the organization |
15153
|
shall promptly cancel the contract in accordance with the |
15154
|
request of the officedepartmenttherefor. No such illegality |
15155
|
or cancellation shall be deemed to relieve the organization of |
15156
|
any liability incurred by it under the contract while in force |
15157
|
or to prohibit the organization from retaining the pro rata |
15158
|
earned premium or rate thereon. This provision does not relieve |
15159
|
the organization from any penalty otherwise incurred by the |
15160
|
organization under this part on account of any such violation. |
15161
|
Section 285. Subsection (5), paragraph (b) of subsection |
15162
|
(7), paragraphs (a) and (e) of subsection (8), paragraph (c) of |
15163
|
subsection (9), and paragraph (b) of subsection (10) of section |
15164
|
641.31071, Florida Statutes, are amended to read: |
15165
|
641.31071 Preexisting conditions.-- |
15166
|
(5)(a) The term "creditable coverage" means, with respect |
15167
|
to an individual, coverage of the individual under any of the |
15168
|
following: |
15169
|
1. A group health plan, as defined in s. 2791 of the |
15170
|
Public Health Service Act. |
15171
|
2. Health insurance coverage consisting of medical care, |
15172
|
provided directly, through insurance or reimbursement or |
15173
|
otherwise, and including terms and services paid for as medical |
15174
|
care, under any hospital or medical service policy or |
15175
|
certificate, hospital or medical service plan contract, or |
15176
|
health maintenance contract offered by a health insurance |
15177
|
issuer. |
15178
|
3. Part A or part B of Title XVIII of the Social Security |
15179
|
Act. |
15180
|
4. Title XIX of the Social Security Act, other than |
15181
|
coverage consisting solely of benefits under s. 1928. |
15182
|
5. Chapter 55 of Title 10, United States Code. |
15183
|
6. A medical care program of the Indian Health Service or |
15184
|
of a tribal organization. |
15185
|
7. The Florida Comprehensive Health Association or another |
15186
|
state health benefit risk pool. |
15187
|
8. A health plan offered under chapter 89 of Title 5, |
15188
|
United States Code. |
15189
|
9. A public health plan as defined by rule of the |
15190
|
commissiondepartment. To the greatest extent possible, such |
15191
|
rules must be consistent with regulations adopted by the United |
15192
|
States Department of Health and Human Services. |
15193
|
10. A health benefit plan under s. 5(e) of the Peace Corps |
15194
|
Act (22 U.S.C. s. 2504(e)). |
15195
|
(b) Creditable coverage does not include coverage that |
15196
|
consists solely of one or more or any combination thereof of the |
15197
|
following excepted benefits: |
15198
|
1. Coverage only for accident, or disability income |
15199
|
insurance, or any combination thereof. |
15200
|
2. Coverage issued as a supplement to liability insurance. |
15201
|
3. Liability insurance, including general liability |
15202
|
insurance and automobile liability insurance. |
15203
|
4. Workers' compensation or similar insurance. |
15204
|
5. Automobile medical payment insurance. |
15205
|
6. Credit-only insurance. |
15206
|
7. Coverage for onsite medical clinics. |
15207
|
8. Other similar insurance coverage, specified in rules |
15208
|
adopted by the commissiondepartment, under which benefits for |
15209
|
medical care are secondary or incidental to other insurance |
15210
|
benefits. To the greatest extent possible, such rules must be |
15211
|
consistent with regulations adopted by the United States |
15212
|
Department of Health and Human Services. |
15213
|
(c) The following benefits are not subject to the |
15214
|
creditable coverage requirements, if offered separately; |
15215
|
1. Limited scope dental or vision benefits. |
15216
|
2. Benefits or long-term care, nursing home care, home |
15217
|
health care, community-based care, or any combination of these. |
15218
|
3. Such other similar, limited benefits as are specified |
15219
|
in rules adopted by the commissiondepartment. To the greatest |
15220
|
extent possible, such rules must be consistent with regulations |
15221
|
adopted by the United States Department of Health and Human |
15222
|
Services. |
15223
|
(d) The following benefits are not subject to creditable |
15224
|
coverage requirements if offered as independent, noncoordinated |
15225
|
benefits: |
15226
|
1. Coverage only for a specified disease or illness. |
15227
|
2. Hospital indemnity or other fixed indemnity insurance. |
15228
|
(e) Benefits provided through Medicare supplemental health |
15229
|
insurance, as defined under s. 1882(g)(1) of the Social Security |
15230
|
Act, coverage supplemental to the coverage provided under |
15231
|
chapter 55 of Title 10, United States Code, and similar |
15232
|
supplemental coverage provided to coverage under a group health |
15233
|
plan are not considered creditable coverage if offered as a |
15234
|
separate insurance policy. |
15235
|
(7) |
15236
|
(b) A health maintenance organization may elect to count |
15237
|
as creditable coverage, coverage of benefits within each of |
15238
|
several classes or categories of benefits specified in rules |
15239
|
adopted by the commissiondepartmentrather than as provided |
15240
|
under paragraph (a). Such election shall be made on a uniform |
15241
|
basis for all participants and beneficiaries. Under such |
15242
|
election, a health maintenance organization shall count a period |
15243
|
of creditable coverage with respect to any class or category of |
15244
|
benefits if any level of benefits is covered within such class |
15245
|
or category. |
15246
|
(8)(a) Periods of creditable coverage with respect to an |
15247
|
individual shall be established through presentation of |
15248
|
certifications described in this subsection or in such other |
15249
|
manner as may be specified in rules adopted by the commission |
15250
|
department. |
15251
|
(e) The commissiondepartmentshall adopt rules to prevent |
15252
|
an insurer's or health maintenance organization's failure to |
15253
|
provide information under this subsection with respect to |
15254
|
previous coverage of an individual from adversely affecting any |
15255
|
subsequent coverage of the individual under another group health |
15256
|
plan or health maintenance organization coverage. |
15257
|
(9) |
15258
|
(c) As an alternative to the method authorized by |
15259
|
paragraph (a), a health maintenance organization may address |
15260
|
adverse selection in a method approved by the officedepartment. |
15261
|
(10) |
15262
|
(b) The commissiondepartmentshall adopt rules that |
15263
|
provide a process whereby individuals who need to establish |
15264
|
creditable coverage for periods before July 1, 1996, and who |
15265
|
would have such coverage credited but for paragraph (a), may be |
15266
|
given credit for creditable coverage for such periods through |
15267
|
the presentation of documents or other means. |
15268
|
Section 286. Paragraph (b) of subsection (3) of section |
15269
|
641.31074, Florida Statutes, is amended to read: |
15270
|
641.31074 Guaranteed renewability of coverage.-- |
15271
|
(3) |
15272
|
(b)1. In any case in which a health maintenance |
15273
|
organization elects to discontinue offering all coverage in the |
15274
|
small group market or the large group market, or both, in this |
15275
|
state, coverage may be discontinued by the insurer only if: |
15276
|
a. The health maintenance organization provides notice to |
15277
|
the officedepartmentand to each contract holder, and |
15278
|
participants and beneficiaries covered under such coverage, of |
15279
|
such discontinuation at least 180 days prior to the date of the |
15280
|
nonrenewal of such coverage; and |
15281
|
b. All health insurance issued or delivered for issuance |
15282
|
in this state in such market is discontinued and coverage under |
15283
|
such health insurance coverage in such market is not renewed. |
15284
|
2. In the case of a discontinuation under subparagraph 1. |
15285
|
in a market, the health maintenance organization may not provide |
15286
|
for the issuance of any health maintenance organization contract |
15287
|
coverage in the market in this state during the 5-year period |
15288
|
beginning on the date of the discontinuation of the last |
15289
|
insurance contract not renewed. |
15290
|
Section 287. Subsection (2) of section 641.315, Florida |
15291
|
Statutes, is amended to read: |
15292
|
641.315 Provider contracts.-- |
15293
|
(2)(a) For all provider contracts executed after October |
15294
|
1, 1991, and within 180 days after October 1, 1991, for |
15295
|
contracts in existence as of October 1, 1991: |
15296
|
1. The contracts must require the provider to give 60 |
15297
|
days' advance written notice to the health maintenance |
15298
|
organization and the officedepartmentbefore canceling the |
15299
|
contract with the health maintenance organization for any |
15300
|
reason; and |
15301
|
2. The contract must also provide that nonpayment for |
15302
|
goods or services rendered by the provider to the health |
15303
|
maintenance organization is not a valid reason for avoiding the |
15304
|
60-day advance notice of cancellation. |
15305
|
(b) All provider contracts must provide that the health |
15306
|
maintenance organization will provide 60 days' advance written |
15307
|
notice to the provider and the officedepartmentbefore |
15308
|
canceling, without cause, the contract with the provider, except |
15309
|
in a case in which a patient's health is subject to imminent |
15310
|
danger or a physician's ability to practice medicine is |
15311
|
effectively impaired by an action by the Board of Medicine or |
15312
|
other governmental agency. |
15313
|
Section 288. Subsections (4) and (5) of section 641.3154, |
15314
|
Florida Statutes, are amended to read: |
15315
|
641.3154 Organization liability; provider billing |
15316
|
prohibited.-- |
15317
|
(4) A provider or any representative of a provider, |
15318
|
regardless of whether the provider is under contract with the |
15319
|
health maintenance organization, may not collect or attempt to |
15320
|
collect money from, maintain any action at law against, or |
15321
|
report to a credit agency a subscriber of an organization for |
15322
|
payment of services for which the organization is liable, if the |
15323
|
provider in good faith knows or should know that the |
15324
|
organization is liable. This prohibition applies during the |
15325
|
pendency of any claim for payment made by the provider to the |
15326
|
organization for payment of the services and any legal |
15327
|
proceedings or dispute resolution process to determine whether |
15328
|
the organization is liable for the services if the provider is |
15329
|
informed that such proceedings are taking place. It is presumed |
15330
|
that a provider does not know and should not know that an |
15331
|
organization is liable unless: |
15332
|
(a) The provider is informed by the organization that it |
15333
|
accepts liability; |
15334
|
(b) A court of competent jurisdiction determines that the |
15335
|
organization is liable; |
15336
|
(c) The officedepartmentor agency makes a final |
15337
|
determination that the organization is required to pay for such |
15338
|
services subsequent to a recommendation made by the Statewide |
15339
|
Provider and Subscriber Assistance Panel pursuant to s. |
15340
|
408.7056; or |
15341
|
(d) The agency issues a final order that the organization |
15342
|
is required to pay for such services subsequent to a |
15343
|
recommendation made by a resolution organization pursuant to s. |
15344
|
408.7057. |
15345
|
(5) An organization, the office,and the department shall |
15346
|
report any suspected violation of this section by a health care |
15347
|
practitioner to the Department of Health and by a facility to |
15348
|
the agency, which shall take such action as authorized by law. |
15349
|
Section 289. Subsection (12) of section 641.3155, Florida |
15350
|
Statutes, is amended to read: |
15351
|
641.3155 Prompt payment of claims.-- |
15352
|
(12) A permissible error ratio of 5 percent is established |
15353
|
for health maintenance organizations' claims payment violations |
15354
|
of paragraphs (3)(a),(b), (c), and (e) and (4)(a), (b), (c), and |
15355
|
(e). If the error ratio of a particular insurer does not exceed |
15356
|
the permissible error ratio of 5 percent for an audit period, no |
15357
|
fine shall be assessed for the noted claims violations for the |
15358
|
audit period. The error ratio shall be determined by dividing |
15359
|
the number of claims with violations found on a statistically |
15360
|
valid sample of claims for the audit period by the total number |
15361
|
of claims in the sample. If the error ratio exceeds the |
15362
|
permissible error ratio of 5 percent, a fine may be assessed |
15363
|
according to s. 624.4211 for those claims payment violations |
15364
|
which exceed the error ratio. Notwithstanding the provisions of |
15365
|
this section, the officedepartmentmay fine a health |
15366
|
maintenance organization for claims payment violations of |
15367
|
paragraphs (3)(e) and (4)(e) which create an uncontestable |
15368
|
obligation to pay the claim. The officedepartmentshall not |
15369
|
fine organizations for violations which the officedepartment |
15370
|
determines were due to circumstances beyond the organization's |
15371
|
control. |
15372
|
Section 290. Subsection (4), (6), and (7) of section |
15373
|
641.316, Florida Statutes, are amended to read: |
15374
|
641.316 Fiscal intermediary services.-- |
15375
|
(4) A fiscal intermediary services organization, as |
15376
|
described in subsection (3), shall secure and maintain a surety |
15377
|
bond on file with the officedepartment, naming the intermediary |
15378
|
as principal. The bond must be obtained from a company |
15379
|
authorized to write surety insurance in the state, and the |
15380
|
officedepartmentshall be obligee on behalf of itself and third |
15381
|
parties. The penal sum of the bond may not be less than 5 |
15382
|
percent of the funds handled by the intermediary in connection |
15383
|
with its fiscal and fiduciary services during the prior year or |
15384
|
$250,000, whichever is less. The minimum bond amount must be |
15385
|
$10,000. The condition of the bond must be that the intermediary |
15386
|
shall register with the officedepartmentand shall not |
15387
|
misappropriate funds within its control or custody as a fiscal |
15388
|
intermediary or fiduciary. The aggregate liability of the surety |
15389
|
for any and all breaches of the conditions of the bond may not |
15390
|
exceed the penal sum of the bond. The bond must be continuous in |
15391
|
form, must be renewed annually by a continuation certificate, |
15392
|
and may be terminated by the surety upon its giving 30 days' |
15393
|
written notice of termination to the officedepartment. |
15394
|
(6) Any fiscal intermediary services organization, other |
15395
|
than a fiscal intermediary services organization owned, |
15396
|
operated, or controlled by a hospital licensed under chapter |
15397
|
395, an insurer licensed under chapter 624, a third-party |
15398
|
administrator licensed under chapter 626, a prepaid limited |
15399
|
health service organization licensed under chapter 636, a health |
15400
|
maintenance organization licensed under this chapter, or |
15401
|
physician group practices as defined in s. 456.053(3)(h), must |
15402
|
register with the officedepartmentand meet the requirements of |
15403
|
this section. In order to register as a fiscal intermediary |
15404
|
services organization, the organization must comply with ss. |
15405
|
641.21(1)(c) and (d) and 641.22(6). Should the officedepartment |
15406
|
determine that the fiscal intermediary services organization |
15407
|
does not meet the requirements of this section, the registration |
15408
|
shall be denied. In the event that the registrant fails to |
15409
|
maintain compliance with the provisions of this section, the |
15410
|
officedepartmentmay revoke or suspend the registration. In |
15411
|
lieu of revocation or suspension of the registration, the office |
15412
|
departmentmay levy an administrative penalty in accordance with |
15413
|
s. 641.25. |
15414
|
(7) The commissiondepartmentshall adopt rules necessary |
15415
|
to administer this section. |
15416
|
Section 291. Subsections (1), (2), (3), and (4), paragraph |
15417
|
(b) of subsection (6), subsection (8), paragraph (c) of |
15418
|
subsection (10), subsections (11) and (12), paragraph (a) of |
15419
|
subsection (14), and subsections (15), (16), and (17) of section |
15420
|
641.35, Florida Statutes, are amended to read: |
15421
|
641.35 Assets, liabilities, and investments.-- |
15422
|
(1) ASSETS.--In any determination of the financial |
15423
|
condition of a health maintenance organization, there shall be |
15424
|
allowed as "assets" only those assets that are owned by the |
15425
|
health maintenance organization and that consist of: |
15426
|
(a) Cash or cash equivalents in the possession of the |
15427
|
health maintenance organization, or in transit under its |
15428
|
control, including the true balance of any deposit in a solvent |
15429
|
bank, savings and loan association, or trust company which is |
15430
|
domiciled in the United States. Cash equivalents are short-term, |
15431
|
highly liquid investments, with original maturities of 3 months |
15432
|
or less, which are both readily convertible to known amounts of |
15433
|
cash and so near their maturity that they present insignificant |
15434
|
risk of changes in value because of changes in interest rates. |
15435
|
(b) Investments, securities, properties, and loans |
15436
|
acquired or held in accordance with this part, and in connection |
15437
|
therewith the following items: |
15438
|
1. Interest due or accrued on any bond or evidence of |
15439
|
indebtedness which is not in default and which is not valued on |
15440
|
a basis including accrued interest. |
15441
|
2. Declared and unpaid dividends on stock and shares, |
15442
|
unless the amount of the dividends has otherwise been allowed as |
15443
|
an asset. |
15444
|
3. Interest due or accrued upon a collateral loan which is |
15445
|
not in default in an amount not to exceed 1 year's interest |
15446
|
thereon. |
15447
|
4. Interest due or accrued on deposits or certificates of |
15448
|
deposit in solvent banks, savings and loan associations, and |
15449
|
trust companies domiciled in the United States, and interest due |
15450
|
or accrued on other assets, if such interest is in the judgment |
15451
|
of the officedepartmenta collectible asset. |
15452
|
5. Interest due or accrued on current mortgage loans, in |
15453
|
an amount not exceeding in any event the amount, if any, of the |
15454
|
excess of the value of the property less delinquent taxes |
15455
|
thereon over the unpaid principal; but in no event shall |
15456
|
interest accrued for a period in excess of 90 days be allowed as |
15457
|
an asset. |
15458
|
(c) Premiums in the course of collection, not more than 3 |
15459
|
months past due, less commissions payable thereon. The |
15460
|
foregoing limitation shall not apply to premiums payable |
15461
|
directly or indirectly by any governmental body in the United |
15462
|
States or by any of their instrumentalities. |
15463
|
(d) The full amount of reinsurance recoverable from a |
15464
|
solvent reinsurer, which reinsurance is authorized under s. |
15465
|
624.610. |
15466
|
(e) Pharmaceutical and medical supply inventories. |
15467
|
(f) Goodwill created by acquisitions and mergers occurring |
15468
|
on or after January 1, 2001. |
15469
|
(g) Loans or advances by a health maintenance organization |
15470
|
to its parent or principal owner if approved by the office |
15471
|
department. |
15472
|
(h) Other assets, not inconsistent with the provisions of |
15473
|
this section, deemed by the officedepartmentto be available |
15474
|
for the payment of losses and claims, at values to be determined |
15475
|
by it. |
15476
|
|
15477
|
|
15478
|
The officedepartment, upon determining that a health |
15479
|
maintenance organization's asset has not been evaluated |
15480
|
according to applicable law or that it does not qualify as an |
15481
|
asset, shall require the health maintenance organization to |
15482
|
properly reevaluate the asset or replace the asset with an asset |
15483
|
suitable to the officedepartmentwithin 30 days of receipt of |
15484
|
written notification by the officedepartmentof this |
15485
|
determination, if the removal of the asset from the |
15486
|
organization's assets would impair the organization's solvency. |
15487
|
(2) ASSETS NOT ALLOWED.--In addition to assets impliedly |
15488
|
excluded by the provisions of subsection (1), the following |
15489
|
assets expressly shall not be allowed as assets in any |
15490
|
determination of the financial condition of a health maintenance |
15491
|
organization: |
15492
|
(a) Subscriber lists, patents, trade names, agreements not |
15493
|
to compete, and other like intangible assets. |
15494
|
(b) Any note or account receivable from or advances to |
15495
|
officers, directors, or controlling stockholders, whether |
15496
|
secured or not, and advances to employees, agents, or other |
15497
|
persons on personal security only, other than those transactions |
15498
|
authorized under paragraph (1)(g). |
15499
|
(c) Stock of the health maintenance organization owned by |
15500
|
it directly or owned by it through any entity in which the |
15501
|
organization owns or controls, directly or indirectly, more than |
15502
|
25 percent of the ownership interest. |
15503
|
(d) Leasehold improvements, nonmedical libraries, |
15504
|
stationery, literature, and nonmedical supply inventories, |
15505
|
except that leasehold improvements made prior to October 1, |
15506
|
1985, shall be allowed as an asset and shall be amortized over |
15507
|
the shortest of the following periods: |
15508
|
1. The life of the lease. |
15509
|
2. The useful life of the improvements. |
15510
|
3. The 3-year period following October 1, 1985. |
15511
|
(e) Furniture, fixtures, furnishings, vehicles, medical |
15512
|
libraries, and equipment. |
15513
|
(f) Notes or other evidences of indebtedness which are |
15514
|
secured by mortgages or deeds of trust which are in default and |
15515
|
beyond the express period specified in the instrument for curing |
15516
|
the default. |
15517
|
(g) Bonds in default for more than 60 days. |
15518
|
(h) Prepaid and deferred expenses. |
15519
|
(i) Any note, account receivable, advance, or other |
15520
|
evidence of indebtedness, or investment in: |
15521
|
1. The parent of the health maintenance organization; |
15522
|
2. Any entity directly or indirectly controlled by the |
15523
|
health maintenance organization parent; or |
15524
|
3. An affiliate of the parent or the health maintenance |
15525
|
organization, |
15526
|
|
15527
|
|
15528
|
except as allowed in subsections (1), (11), and (12). The |
15529
|
officedepartmentmay, however, allow all or a portion of such |
15530
|
asset, at values to be determined by the officedepartment, if |
15531
|
deemed by the officedepartmentto be available for the payment |
15532
|
of losses and claims. |
15533
|
(3) LIABILITIES.--In any determination of the financial |
15534
|
condition of a health maintenance organization, liabilities to |
15535
|
be charged against its assets shall include: |
15536
|
(a) The amount, estimated consistently with the provisions |
15537
|
of this part, necessary to pay all of its unpaid losses and |
15538
|
claims incurred for or on behalf of a subscriber, on or prior to |
15539
|
the end of the reporting period, whether reported or unreported, |
15540
|
including contract and premium deficiency reserves. If a health |
15541
|
maintenance organization, through a health care risk contract, |
15542
|
transfers to any entity the obligation to pay any provider for |
15543
|
any claim arising from services provided to or for the benefit |
15544
|
of any subscriber, the liabilities of the health maintenance |
15545
|
organization under this section shall include the amount of |
15546
|
those losses and claims to the extent that the provider has not |
15547
|
received payment. No liability need be established if the entity |
15548
|
has provided to the health maintenance organization a financial |
15549
|
instrument acceptable to the officedepartmentsecuring the |
15550
|
obligations under the contract or if the health maintenance |
15551
|
organization has in place an escrow or withhold agreement |
15552
|
approved by the officedepartmentwhich assures full payment of |
15553
|
those claims. Financial instruments may include irrevocable, |
15554
|
clean, and evergreen letters of credit. As used in this |
15555
|
paragraph, the term "entity" does not include this state, the |
15556
|
United States, or an agency thereof or an insurer or health |
15557
|
maintenance organization authorized in this state. |
15558
|
(b) The amount equal to the unearned portions of the gross |
15559
|
premiums charged on health maintenance contracts in force. |
15560
|
(c) Taxes, expenses, and other obligations due or accrued |
15561
|
at the date of the statement. |
15562
|
|
15563
|
|
15564
|
The officedepartment, upon determining that a health |
15565
|
maintenance organization has failed to report liabilities that |
15566
|
should have been reported, shall require a corrected report |
15567
|
which reflects the proper liabilities to be submitted by the |
15568
|
organization to the officedepartmentwithin 10 working days of |
15569
|
receipt of written notification. |
15570
|
(4) INVESTMENTS GENERALLY.--Health maintenance |
15571
|
organizations may invest their funds only in accordance with the |
15572
|
provisions of this part. Notwithstanding the provisions of this |
15573
|
part, however, the officedepartmentmay, after notice and |
15574
|
hearing, order a health maintenance organization to limit or |
15575
|
withdraw from certain investments or to discontinue certain |
15576
|
investment practices, to the extent that the officedepartment |
15577
|
finds the investment practices hazardous to the financial |
15578
|
condition of the organization. At any such hearing, the office |
15579
|
departmentshall have the burden of presenting a prima facie |
15580
|
case that the investment or investment practices are hazardous |
15581
|
to the financial condition of the organization. If the office |
15582
|
departmentpresents such a prima facie case, then it shall be |
15583
|
the organization's burden to demonstrate that the investment or |
15584
|
investment practices are not hazardous to the financial |
15585
|
condition of the organization. |
15586
|
(6) GENERAL QUALIFICATIONS.-- |
15587
|
(b) No security or investment shall be eligible for |
15588
|
purchase at a price above its market value unless it is approved |
15589
|
by the officedepartment. |
15590
|
(8) EXCESSIVE COMMISSIONS AND CERTAIN INTERESTS |
15591
|
PROHIBITED.-- |
15592
|
(a) No health maintenance organization shall pay any |
15593
|
commission or brokerage for the purchase or sale of property, |
15594
|
whether real or personal, in excess of that usual and customary |
15595
|
at the time and in the locality where the purchases or sales are |
15596
|
made. Information regarding payments of commissions and |
15597
|
brokerage shall be maintained from the date of the most recent |
15598
|
examination by the officedepartmentpursuant to s. 641.27 until |
15599
|
the date of completion of the following examination. |
15600
|
(b) No health maintenance organization shall knowingly |
15601
|
invest in or loan upon any property, directly or indirectly, |
15602
|
whether real or personal, in which any officer or director of |
15603
|
the organization has a financial interest, nor shall any |
15604
|
organization make a loan of any kind to any officer or director |
15605
|
of the organization, except that: |
15606
|
1. This paragraph shall not apply to loans in |
15607
|
circumstances in which the financial interest of the officer or |
15608
|
director is only nominal, trifling, or so remote as not to give |
15609
|
rise to a conflict of interest; and |
15610
|
2. In any case, the officedepartmentmay approve a |
15611
|
transaction between an organization and its officers or |
15612
|
directors under this paragraph if it is satisfied that: |
15613
|
a. The transaction is entered into in good faith for the |
15614
|
advantage and benefit of the organization, |
15615
|
b. The amount of the proposed investment or loan does not |
15616
|
violate any other provision of this part or exceed the |
15617
|
reasonable, normal value of the property or the interest which |
15618
|
the company proposed to acquire, |
15619
|
c. The transaction is otherwise fair and reasonable, and |
15620
|
d. The transaction will not adversely affect, to any |
15621
|
substantial degree, the liquidity of the organization's |
15622
|
investments or its ability thereafter to comply with |
15623
|
requirements of this part or the payment of its claims and |
15624
|
obligations. |
15625
|
(10) PROPERTY USED IN THE HEALTH MAINTENANCE |
15626
|
ORGANIZATION'S BUSINESS.--Real estate, including leasehold |
15627
|
estates, for the convenient accommodation of the organization's |
15628
|
business operations, including home office, branch |
15629
|
administrative offices, hospitals, medical clinics, medical |
15630
|
professional buildings, and any other facility to be used in the |
15631
|
provision of health care services, or real estate for rental to |
15632
|
any health care provider under contract with the organization to |
15633
|
provide health care services which shall be used in the |
15634
|
provision of health care services to members of the organization |
15635
|
by that provider, is acceptable as an investment on the |
15636
|
following conditions: |
15637
|
(c) The greater of the admitted value of the asset, as |
15638
|
determined by statutory accounting principles, or, if approved |
15639
|
by the officedepartment, the health maintenance organization's |
15640
|
equity in the real estate plus all encumbrances on the real |
15641
|
estate owned by the organization under this subsection, when |
15642
|
added to the value of all personal and mixed property used in |
15643
|
the organization's business, shall not exceed 75 percent of its |
15644
|
admitted assets unless, with the permission of the office |
15645
|
department, it finds that the percentage of its admitted assets |
15646
|
is insufficient to provide convenient accommodation for the |
15647
|
organization's business and the operations of the organization |
15648
|
would not otherwise be impaired. |
15649
|
(11) INVESTMENTS IN ADMINISTRATIVE AND MANAGEMENT SERVICE |
15650
|
ENTITIES AND OTHER HEALTH CARE PROVIDERS.--A health maintenance |
15651
|
organization may invest directly or indirectly in real estate, |
15652
|
common and preferred stocks, bonds or debentures, including |
15653
|
convertible debentures, or other evidences of debts of or equity |
15654
|
in an entity if the entity is owned by or, with the approval of |
15655
|
the officedepartment, under contract to the organization to |
15656
|
provide management services, administrative services, or health |
15657
|
care services for the organization, on the following conditions: |
15658
|
(a) Investments authorized under this subsection shall not |
15659
|
exceed 50 percent of admitted assets, and these investments |
15660
|
shall be included in the calculation of the overall limitation |
15661
|
in paragraph (10)(c) relating to all real and personal property. |
15662
|
(b) Investments may qualify under this section only |
15663
|
insofar as a provider of management, administrative, or health |
15664
|
care service relationship as defined herein exists. Upon |
15665
|
cessation of such relationship, each investment shall be subject |
15666
|
to the rules applicable to an investment of that type and must |
15667
|
qualify under the appropriate limitation or, failing that, |
15668
|
become ineligible and subject to disposal under subsection (17). |
15669
|
(12) EXCHANGES OF FACILITIES OR ASSETS.--Health care or |
15670
|
administrative service entities, if subsidiaries of or under |
15671
|
contract to the health maintenance organization to provide |
15672
|
administrative or health care services to the organization's |
15673
|
members, may exchange facilities or similar assets to be used in |
15674
|
the organization's business for stock of the organization. |
15675
|
However, any exchange involving an entity under contract with |
15676
|
the health maintenance organization must have the approval of |
15677
|
the officedepartmentprior to the exchange. These facilities |
15678
|
or assets shall be valued in accordance with statutory |
15679
|
accounting principles. |
15680
|
(14) SPECIAL LIMITATION INVESTMENTS.-- |
15681
|
(a) After satisfying the requirements of this part, any |
15682
|
funds of the health maintenance organization may be invested in |
15683
|
the following investments, subject to a cost limitation of 10 |
15684
|
percent of its admitted assets in each category of investment: |
15685
|
1. Anticipation obligations of political subdivisions of a |
15686
|
state.--Anticipation obligations of any political subdivision of |
15687
|
any state of the United States, including, but not limited to, |
15688
|
bond anticipation notes, tax anticipation notes, preliminary |
15689
|
loan anticipation notes, revenue anticipation notes, and |
15690
|
construction anticipation notes, for the payment of money within |
15691
|
12 months from the issuance of the obligation, on the following |
15692
|
conditions: |
15693
|
a. The anticipation notes are a direct obligation of the |
15694
|
issuer under conditions set forth in subsection (9). |
15695
|
b. The political subdivision is not in default in the |
15696
|
payment of the principal or interest on any of its direct |
15697
|
general obligations or any obligation guaranteed by such |
15698
|
political subdivision. |
15699
|
c. The anticipated funds are specifically pledged to |
15700
|
secure the obligations. |
15701
|
2. Revenue obligations of state or municipal public |
15702
|
utilities.--Obligations of any state of the United States, a |
15703
|
political subdivision thereof, or a public instrumentality of |
15704
|
any one or more of the foregoing for the payment of money, on |
15705
|
the following conditions: |
15706
|
a. The obligations are payable from revenues or earnings |
15707
|
of a public utility of such state, political subdivision, or |
15708
|
public instrumentality which are specifically pledged therefor. |
15709
|
b. The law under which the obligations are issued requires |
15710
|
that such rates for service shall be charged and collected at |
15711
|
all times so as to produce sufficient revenue or earning, |
15712
|
together with any other revenues or moneys pledged, to pay all |
15713
|
operating and maintenance charges of the public utility and all |
15714
|
principal and interest on such charges. |
15715
|
c. No prior or parity obligations payable from the |
15716
|
revenues or earnings of that public utility are in default at |
15717
|
the date of such investment. |
15718
|
3. Other revenue obligations.--Obligations of any state of |
15719
|
the United States, a political subdivision thereof, or a public |
15720
|
instrumentality of any of the foregoing for the payment of |
15721
|
money, on the following conditions: |
15722
|
a. The obligations are payable from revenues or earnings, |
15723
|
excluding revenues or earnings from public utilities, |
15724
|
specifically pledged therefor by such state, political |
15725
|
subdivision, or public instrumentality. |
15726
|
b. No prior or parity obligation of the same issuer |
15727
|
payable from revenues or earnings from the same source has been |
15728
|
in default as to principal or interest during the 5 years next |
15729
|
preceding the date of the investment, but the issuer need not |
15730
|
have been in existence for that period, and obligations acquired |
15731
|
under this paragraph may be newly issued. |
15732
|
4. Corporate stocks.--Stocks, common or preferred, of any |
15733
|
corporation created or existing under the laws of the United |
15734
|
States or any state thereof. The organization may invest in |
15735
|
stocks, common or preferred, of any corporation created or |
15736
|
existing under the laws of any foreign country if such stocks |
15737
|
are listed and traded on a national securities exchange in the |
15738
|
United States or, in the alternative, if such investment in |
15739
|
stocks of any corporation created or existing under the laws of |
15740
|
any foreign country are first approved by the officedepartment. |
15741
|
Investment in common stock of any one corporation shall not |
15742
|
exceed 3 percent of the health maintenance organization's |
15743
|
admitted assets. |
15744
|
(15) INVESTMENT OF EXCESS FUNDS.-- |
15745
|
(a) After satisfying the requirements of this part, any |
15746
|
funds of a health maintenance organization in excess of its |
15747
|
statutorily required reserves and surplus may be invested: |
15748
|
1. Without limitation in any investments otherwise |
15749
|
authorized by this part; or |
15750
|
2. In such other investments not specifically authorized |
15751
|
by this part, provided such investments do not exceed the lesser |
15752
|
of 5 percent of the health maintenance organization's admitted |
15753
|
assets or 25 percent of the amount by which a health maintenance |
15754
|
organization's surplus exceeds its statutorily required minimum |
15755
|
surplus. A health maintenance organization may exceed the |
15756
|
limitations of this subparagraph only with the prior written |
15757
|
approval of the officedepartment. |
15758
|
(b) Nothing in this section authorizes a health |
15759
|
maintenance organization to: |
15760
|
1. Invest any funds in excess of the amount by which its |
15761
|
actual surplus exceeds its statutorily required minimum surplus; |
15762
|
or |
15763
|
2. Make any investment prohibited by this code. |
15764
|
(16) PROHIBITED INVESTMENTS AND INVESTMENT UNDERWRITING.-- |
15765
|
(a) In addition to investments excluded pursuant to other |
15766
|
provisions of this act, a health maintenance organization shall |
15767
|
not directly or indirectly invest in or lend its funds upon the |
15768
|
security of: |
15769
|
1. Issued shares of its own capital stock, except in |
15770
|
connection with a plan approved by the officedepartmentfor |
15771
|
purchase of the shares by the organization's officers, |
15772
|
employees, or agents. However, no such stock shall constitute an |
15773
|
asset of the organization in any determination of its financial |
15774
|
condition. |
15775
|
2. Except with the consent of the officedepartment, |
15776
|
securities issued by any corporation or enterprise the |
15777
|
controlling interest of which is, or will after such acquisition |
15778
|
by the organization be, held directly or indirectly by the |
15779
|
organization or any combination of the organization and its |
15780
|
directors, officers, parent corporation, subsidiaries, or |
15781
|
controlling stockholders. Investments in health care providers |
15782
|
under subsections (11) and(12) shall not be subject to this |
15783
|
provision. |
15784
|
3. Any note or other evidence of indebtedness of any |
15785
|
director, officer, or controlling stockholder of the health |
15786
|
maintenance organization. |
15787
|
(b) No health maintenance organization shall underwrite or |
15788
|
participate in the underwriting of an offering of securities or |
15789
|
property by any other person. |
15790
|
(17) TIME LIMIT FOR DISPOSAL OF INELIGIBLE PROPERTY AND |
15791
|
SECURITIES; EFFECT OF FAILURE TO DISPOSE.-- |
15792
|
(a) Any property or securities lawfully acquired by a |
15793
|
health maintenance organization which it could not otherwise |
15794
|
have invested in or loaned its funds upon at the time of such |
15795
|
acquisition shall be disposed of within 6 months from the date |
15796
|
of acquisition, unless within such period the security has |
15797
|
attained to the standard of eligibility; except that any |
15798
|
security or property acquired under any agreement of merger or |
15799
|
consolidation may be retained for a longer period if so provided |
15800
|
in the plan for such merger or consolidation, as approved by the |
15801
|
officedepartment. Upon application by the organization and |
15802
|
proof to the officedepartmentthat forced sale of any such |
15803
|
property or security would materially injure the interests of |
15804
|
the health maintenance organization, the officedepartmentshall |
15805
|
extend the disposal period for an additional reasonable time. |
15806
|
(b) Notwithstanding the provisions of paragraph (a), any |
15807
|
ineligible property or securities shall not be allowed as an |
15808
|
asset of the organization. |
15809
|
Section 292. Section 641.36, Florida Statutes, is amended |
15810
|
to read: |
15811
|
641.36 Adoption of rules; penalty for violation.--The |
15812
|
commissiondepartmentshall adopt rules necessary to carry out |
15813
|
the provisions of this part. The officedepartmentshall |
15814
|
collect and make available all health maintenance organization |
15815
|
rules adopted by the commissiondepartment. Any violation of a |
15816
|
rule adopted under this section shall subject the violating |
15817
|
entity to the provisions of s. 641.23. |
15818
|
Section 293. Subsections (1), (2), and (5) of section |
15819
|
641.365, Florida Statutes, are amended to read: |
15820
|
641.365 Dividends.-- |
15821
|
(1)(a) A health maintenance organization shall not pay any |
15822
|
dividend or distribute cash or other property to stockholders |
15823
|
except out of that part of its available and accumulated surplus |
15824
|
funds which is derived from realized net operating profits on |
15825
|
its business and net realized capital gains. |
15826
|
(b) Unless prior written approval is obtained from the |
15827
|
officedepartment, a health maintenance organization may not pay |
15828
|
or declare any dividend or distribute cash or other property to |
15829
|
or on behalf of any stockholder if, immediately before or after |
15830
|
such distribution, the health maintenance organization's |
15831
|
available and accumulated surplus funds, which are derived from |
15832
|
realized net operating profits on its business and net realized |
15833
|
gains, are or would be less than zero. |
15834
|
(c) A health maintenance organization may make dividend |
15835
|
payments or distributions to stockholders without the prior |
15836
|
written approval of the officedepartmentwhen: |
15837
|
1. The dividend is equal to or less than the greater of: |
15838
|
a. Ten percent of the health maintenance organization's |
15839
|
accumulated surplus funds which are derived from realized net |
15840
|
operating profits on its business and net realized capital gains |
15841
|
as of the immediate preceding calendar year; or |
15842
|
b. The health maintenance organization's entire net |
15843
|
operating profit and realized net capital gains derived during |
15844
|
the immediately preceding calendar year. |
15845
|
2. The health maintenance organization will have surplus |
15846
|
equal to or exceeding 115 percent of the minimum required |
15847
|
statutory surplus after the dividend or distribution is made. |
15848
|
3. The health maintenance organization has filed a notice |
15849
|
with the officedepartmentat least 30 days prior to the |
15850
|
dividend payment or distribution, or such shorter period of time |
15851
|
as approved by the officedepartmenton a case-by-case basis. |
15852
|
4. The notice includes a certification by an officer of |
15853
|
the health maintenance organization attesting that after payment |
15854
|
of the dividend or distribution the health maintenance |
15855
|
organization will have at least 115 percent of required |
15856
|
statutory surplus. |
15857
|
5. The health maintenance organization has negative |
15858
|
retained earnings, statutory surplus in excess of $50 million, |
15859
|
and statutory surplus greater than or equal to 150 percent of |
15860
|
its required statutory surplus before and after the dividend |
15861
|
distribution is made based upon the health maintenance |
15862
|
organization's most recently filed annual financial statement. |
15863
|
(2) The officedepartmentshall not approve a dividend or |
15864
|
distribution in excess of the maximum amount allowed in |
15865
|
subsection(1) unless it determines that the distribution or |
15866
|
dividend would not jeopardize the financial condition of the |
15867
|
health maintenance organization, considering: |
15868
|
(a) The liquidity, quality, and diversification of the |
15869
|
health maintenance organization's assets and the effect on its |
15870
|
ability to meet its obligations. |
15871
|
(b) Any reduction of investment portfolio and investment |
15872
|
income. |
15873
|
(c) History of capital contributions. |
15874
|
(d) Prior dividend distributions of the health maintenance |
15875
|
organization. |
15876
|
(e) Whether the dividend is only a pass-through dividend |
15877
|
from a subsidiary of the health maintenance organization. |
15878
|
(5) The officedepartmentmay revoke or suspend the |
15879
|
certificate of authority of a health maintenance organization |
15880
|
which has declared or paid such an illegal dividend. |
15881
|
Section 294. Section 641.385, Florida Statutes, is amended |
15882
|
to read: |
15883
|
641.385 Order to discontinue certain advertising.--If in |
15884
|
the opinion of the officedepartmentany advertisement by a |
15885
|
health maintenance organization violates any of the provisions |
15886
|
of this part, the department may enter an immediate order |
15887
|
requiring that the use of the advertisement be discontinued. If |
15888
|
requested by the health maintenance organization, the office |
15889
|
departmentshall conduct a hearing within 10 days of the entry |
15890
|
of such order. If, after the hearing or by agreement with the |
15891
|
health maintenance organization, a final determination is made |
15892
|
that the advertising was in fact violative of any provision of |
15893
|
this part, the officedepartmentmay, in lieu of revocation of |
15894
|
the certificate of authority, require the publication of a |
15895
|
corrective advertisement; impose an administrative penalty of up |
15896
|
to $10,000; and, in the case of an initial solicitation, require |
15897
|
that the health maintenance organization, prior to accepting any |
15898
|
application received in response to the advertisement, provide |
15899
|
an acceptable clarification of the advertisement to each |
15900
|
individual applicant. |
15901
|
Section 295. Subsection (1) of section 641.39001, Florida |
15902
|
Statutes, is amended to read: |
15903
|
641.39001 Soliciting or accepting new or renewal health |
15904
|
maintenance contracts by insolvent or impaired health |
15905
|
maintenance organization prohibited; penalty.-- |
15906
|
(1) Whether or not delinquency proceedings as to a health |
15907
|
maintenance organization have been or are to be initiated, a |
15908
|
director or officer of a health maintenance organization, except |
15909
|
with the written permission of the officeDepartment of |
15910
|
Insurance, may not authorize or permit the health maintenance |
15911
|
organization to solicit or accept new or renewal health |
15912
|
maintenance contracts or provider contracts in this state after |
15913
|
the director or officer knew, or reasonably should have known, |
15914
|
that the health maintenance organization was insolvent or |
15915
|
impaired. As used in this section, the term "impaired" means |
15916
|
that the health maintenance organization does not meet the |
15917
|
requirements of s. 641.225. |
15918
|
Section 296. Subsections (6) and (10) of section 641.3903, |
15919
|
Florida Statutes, are amended to read: |
15920
|
641.3903 Unfair methods of competition and unfair or |
15921
|
deceptive acts or practices defined.--The following are defined |
15922
|
as unfair methods of competition and unfair or deceptive acts or |
15923
|
practices: |
15924
|
(6) FAILURE TO MAINTAIN COMPLAINT-HANDLING |
15925
|
PROCEDURES.--Failure of any person to maintain a complete record |
15926
|
of all the complaints received since the date of the most recent |
15927
|
examination of the health maintenance organization by the office |
15928
|
department. For the purposes of this subsection, the term |
15929
|
"complaint" means any written communication primarily expressing |
15930
|
a grievance and requesting a remedy to the grievance. |
15931
|
(10) ILLEGAL DEALINGS IN PREMIUMS; EXCESS OR REDUCED |
15932
|
CHARGES FOR HEALTH MAINTENANCE COVERAGE.-- |
15933
|
(a) Knowingly collecting any sum as a premium or charge |
15934
|
for health maintenance coverage which is not then provided or is |
15935
|
not in due course to be provided, subject to acceptance of the |
15936
|
risk by the health maintenance organization, by a health |
15937
|
maintenance contract issued by a health maintenance organization |
15938
|
as permitted by this part. |
15939
|
(b) Knowingly collecting as a premium or charge for health |
15940
|
maintenance coverage any sum in excess of or less than the |
15941
|
premium or charge applicable to health maintenance coverage, in |
15942
|
accordance with the applicable classifications and rates as |
15943
|
filed with the officedepartment, and as specified in the health |
15944
|
maintenance contract. |
15945
|
Section 297. Section 641.3905, Florida Statutes, is |
15946
|
amended to read: |
15947
|
641.3905 General powers and duties of the department and |
15948
|
office.--In addition to the powers and duties set forth in s. |
15949
|
624.307, the department and office shall each have the power |
15950
|
within its respective regulatory jurisdictionto examine and |
15951
|
investigate the affairs of every person, entity, or health |
15952
|
maintenance organization in order to determine whether the |
15953
|
person, entity, or health maintenance organization is operating |
15954
|
in accordance with the provisions of this part or has been or is |
15955
|
engaged in any unfair method of competition or in any unfair or |
15956
|
deceptive act or practice prohibited by s. 641.3901, and each |
15957
|
shall have the powers and duties specified in ss. 641.3907- |
15958
|
641.3913 in connection therewith. |
15959
|
Section 298. Section 641.3907, Florida Statutes, is |
15960
|
amended to read: |
15961
|
641.3907 Defined unfair practices; hearings, witnesses, |
15962
|
appearances, production of books, and service of process.-- |
15963
|
(1) Whenever the department or officehas reason to |
15964
|
believe that any person, entity, or health maintenance |
15965
|
organization has engaged, or is engaging, in this state in any |
15966
|
unfair method of competition or any unfair or deceptive act or |
15967
|
practice as defined in s. 641.3903 or is operating a health |
15968
|
maintenance organization without a certificate of authority as |
15969
|
required by this part and that a proceeding by it in respect |
15970
|
thereto would be to the interest of the public, the department |
15971
|
or officeshall conduct or cause to have conducted a hearing in |
15972
|
accordance with chapter 120. |
15973
|
(2) The department or office, a duly empowered hearing |
15974
|
officer, or an administrative law judge shall, during the |
15975
|
conduct of such hearing, have those powers enumerated in s. |
15976
|
120.569; however, the penalties for failure to comply with a |
15977
|
subpoena or with an order directing discovery shall be limited |
15978
|
to a fine not to exceed $1,000 per violation. |
15979
|
(3) Statements of charges, notices, and orders under this |
15980
|
part may be served by anyone duly authorized by the department |
15981
|
or office, either in the manner provided by law for service of |
15982
|
process in civil actions or by certifying and mailing a copy |
15983
|
thereof to the person, entity, or health maintenance |
15984
|
organization affected by the statement, notice, order, or other |
15985
|
process at her or his or its residence or principal office or |
15986
|
place of business. The verified return by the person so serving |
15987
|
such statement, notice, order, or other process, setting forth |
15988
|
the manner of the service, shall be proof of the same, and the |
15989
|
return postcard receipt for such statement, notice, order, or |
15990
|
other process, certified and mailed as aforesaid, shall be proof |
15991
|
of service of the same. |
15992
|
Section 299. Section 641.3909, Florida Statutes, is |
15993
|
amended to read: |
15994
|
641.3909 Cease and desist and penalty orders.--After the |
15995
|
hearing provided in s. 641.3907, the department or officeshall |
15996
|
enter a final order in accordance with s. 120.569. If it is |
15997
|
determined that the person, entity, or health maintenance |
15998
|
organization charged has engaged in an unfair or deceptive act |
15999
|
or practice or the unlawful operation of a health maintenance |
16000
|
organization without a subsisting certificate of authority, the |
16001
|
department or officeshall also issue an order requiring the |
16002
|
violator to cease and desist from engaging in such method of |
16003
|
competition, act, or practice or unlawful operation of a health |
16004
|
maintenance organization. Further, if the act or practice |
16005
|
constitutes a violation of s. 641.3155, s. 641.3901, or s. |
16006
|
641.3903, the department or officemay, at its discretion, order |
16007
|
any one or more of the following: |
16008
|
(1) Suspension or revocation of the health maintenance |
16009
|
organization's certificate of authority if it knew, or |
16010
|
reasonably should have known, it was in violation of this part. |
16011
|
(2) If it is determined that the person or entity charged |
16012
|
has engaged in the business of operating a health maintenance |
16013
|
organization without a certificate of authority, an |
16014
|
administrative penalty not to exceed $1,000 for each health |
16015
|
maintenance contract offered or effectuated. |
16016
|
Section 300. Section 641.3911, Florida Statutes, is |
16017
|
amended to read: |
16018
|
641.3911 Appeals from the department or office.--Any |
16019
|
person, entity, or health maintenance organization subject to an |
16020
|
order of the department or officeunder s. 641.3909 or s. |
16021
|
641.3913 may obtain a review of the order by filing an appeal |
16022
|
therefrom in accordance with the provisions and procedures for |
16023
|
appeal under s. 120.68. |
16024
|
Section 301. Section 641.3913, Florida Statutes, is |
16025
|
amended to read: |
16026
|
641.3913 Penalty for violation of cease and desist |
16027
|
orders.--Any person, entity, or health maintenance organization |
16028
|
which violates a cease and desist order of the department or |
16029
|
officeunder s. 641.3909 while such order is in effect, after |
16030
|
notice and hearing as provided in s. 641.3907, shall be subject, |
16031
|
at the discretion of the department or office, to any one or |
16032
|
more of the following: |
16033
|
(1) A monetary penalty of not more than $200,000 as to all |
16034
|
matters determined in such hearing. |
16035
|
(2) Suspension or revocation of the health maintenance |
16036
|
organization's certificate of authority. |
16037
|
Section 302. Section 641.3917, Florida Statutes, is |
16038
|
amended to read: |
16039
|
641.3917 Civil liability.--The provisions of this part are |
16040
|
cumulative to rights under the general civil and common law, and |
16041
|
no action of the department or officeshall abrogate such rights |
16042
|
to damage or other relief in any court. |
16043
|
Section 303. Subsections (3), (10), and (14) of section |
16044
|
641.3922, Florida Statutes, are amended to read: |
16045
|
641.3922 Conversion contracts; conditions.--Issuance of a |
16046
|
converted contract shall be subject to the following conditions: |
16047
|
(3) CONVERSION PREMIUM.--The premium for the converted |
16048
|
contract shall be determined in accordance with premium rates |
16049
|
applicable to the age and class of risk of each person to be |
16050
|
covered under the converted contract and to the type and amount |
16051
|
of coverage provided. However, the premium for the converted |
16052
|
contract may not exceed 200 percent of the standard risk rate, |
16053
|
as established by the officedepartmentunder s. 627.6675(3). |
16054
|
The mode of payment for the converted contract shall be |
16055
|
quarterly or more frequently at the option of the organization, |
16056
|
unless otherwise mutually agreed upon between the subscriber and |
16057
|
the organization. |
16058
|
(10) ALTERNATE PLANS.--The health maintenance organization |
16059
|
shall offer a standard health benefit plan as established |
16060
|
pursuant to s. 627.6699(12). The health maintenance organization |
16061
|
may, at its option, also offer alternative plans for group |
16062
|
health conversion in addition to those required by this section, |
16063
|
provided any alternative plan is approved by the office |
16064
|
departmentor is a converted policy, approved under s. 627.6675 |
16065
|
and issued by an insurance company authorized to transact |
16066
|
insurance in this state. Approval by the officedepartmentof an |
16067
|
alternative plan shall be based on compliance by the alternative |
16068
|
plan with the provisions of this part and the rules promulgated |
16069
|
thereunder, applicable provisions of the Florida Insurance Code |
16070
|
and rules promulgated thereunder, and any other applicable law. |
16071
|
(14) NOTIFICATION.--A notification of the conversion |
16072
|
privilege shall be included in each health maintenance contract |
16073
|
and in any certificate or member's handbook. The organization |
16074
|
shall mail an election and premium notice form, including an |
16075
|
outline of coverage, on a form approved by the office |
16076
|
department, within 14 days after any individual who is eligible |
16077
|
for a converted health maintenance contract gives notice to the |
16078
|
organization that the individual is considering applying for the |
16079
|
converted contract or otherwise requests such information. The |
16080
|
outline of coverage must contain a description of the principal |
16081
|
benefits and coverage provided by the contract and its principal |
16082
|
exclusions and limitations, including, but not limited to, |
16083
|
deductibles and coinsurance. |
16084
|
Section 304. Section 641.402, Florida Statutes, is amended |
16085
|
to read: |
16086
|
641.402 Definitions.--As used in this part, the term: |
16087
|
(1) "Basic services" includes any of the following: |
16088
|
emergency care, physician care other than hospital inpatient |
16089
|
physician services, ambulatory diagnostic treatment, and |
16090
|
preventive health care services. |
16091
|
(2) "Department" means the Department of Insurance. |
16092
|
(2)(3) "Guaranteeing organization" means an organization |
16093
|
thatwhich is domiciled in the United States; thatwhichhas |
16094
|
authorized service of process against it; and thatwhichhas |
16095
|
appointed the Chief Financial OfficerInsurance Commissioner and |
16096
|
Treasureras its agent for service of process in connection with |
16097
|
any cause of action arising in this state, based upon any |
16098
|
guarantee entered into under this part. |
16099
|
(3)(4)"Insolvent" or "insolvency" means the inability of |
16100
|
a prepaid health clinic to discharge its liabilities as they |
16101
|
become due in the normal course of business. |
16102
|
(4)(5)"Prepaid health clinic" means any organization |
16103
|
authorized under this part which provides, either directly or |
16104
|
through arrangements with other persons, basic services to |
16105
|
persons enrolled with such organization, on a prepaid per capita |
16106
|
or prepaid aggregate fixed-sum basis, including those basic |
16107
|
services which subscribers might reasonably require to maintain |
16108
|
good health. However, no clinic thatwhichprovides or contracts |
16109
|
for, either directly or indirectly, inpatient hospital services, |
16110
|
hospital inpatient physician services, or indemnity against the |
16111
|
cost of such services shall be a prepaid health clinic. |
16112
|
(5)(6)"Prepaid health clinic contract" means any contract |
16113
|
entered into by a prepaid health clinic with a subscriber or |
16114
|
group of subscribers to provide any of the basic services in |
16115
|
exchange for a prepaid per capita or prepaid aggregate fixed |
16116
|
sum. |
16117
|
(6)(7)"Provider" means any physician or person other than |
16118
|
a hospital that furnishes health care services and is licensed |
16119
|
or authorized to practice in this state. |
16120
|
(7)(8)"Reporting period" means the particular span of |
16121
|
time by or for which accounts are redeemed on an annualized |
16122
|
basis. |
16123
|
(8)(9)"Subscriber" means an individual who has |
16124
|
contracted, or on whose behalf a contract has been entered into, |
16125
|
with a prepaid health clinic for health care services. |
16126
|
(9)(10)"Surplus" means total unencumbered assets in |
16127
|
excess of total liabilities. Surplus includes capital stock, |
16128
|
capital in excess of par, and retained earnings and may include |
16129
|
surplus notes. |
16130
|
(10)(11) "Surplus notes" means debt thatwhichhas been |
16131
|
guaranteed by the United States Government or its agencies or |
16132
|
debt thatwhichhas been subordinated to all claims of |
16133
|
subscribers and general creditors of the prepaid health clinic. |
16134
|
Section 305. Section 641.403, Florida Statutes, is amended |
16135
|
to read: |
16136
|
641.403 Rulemaking authority.--The commission may |
16137
|
Department of Insurance has authority toadopt rules pursuant to |
16138
|
ss. 120.536(1) and 120.54 to implement the provisions of this |
16139
|
part. |
16140
|
Section 306. Section 641.405, Florida Statutes, is amended |
16141
|
to read: |
16142
|
641.405 Application for certificate of authority to |
16143
|
operate prepaid health clinic.-- |
16144
|
(1) No person may operate a prepaid health clinic without |
16145
|
first obtaining a certificate of authority from the office |
16146
|
department. The officedepartmentshall not issue a certificate |
16147
|
of authority to any applicant which does not possess a valid |
16148
|
Health Care Provider Certificate issued by the Agency for Health |
16149
|
Care Administration. |
16150
|
(2) Each application for a certificate of authority shall |
16151
|
be on such form as the commissiondepartmentprescribes, and |
16152
|
such application shall be accompanied by: |
16153
|
(a) A copy of the basic organizational document of the |
16154
|
applicant, if any, such as the articles of incorporation, |
16155
|
articles of association, partnership agreement, trust agreement, |
16156
|
or other applicable document, and all amendments to such |
16157
|
document. |
16158
|
(b) A copy of the constitution, bylaws, rules and |
16159
|
regulations, or similar form of document, if any, regulating the |
16160
|
conduct of the affairs of the applicant. |
16161
|
(c) A list of the names, addresses, and official |
16162
|
capacities with the applicant of the persons who are to be |
16163
|
responsible for the conduct of the affairs of the clinic, |
16164
|
including all members of the governing body, the officers and |
16165
|
directors in the case of a corporation, and the partners or |
16166
|
associates in the case of a partnership or association. Such |
16167
|
persons shall fully disclose to the officedepartmentand the |
16168
|
governing body of the clinic the extent and nature of any |
16169
|
contracts or arrangements between them and the clinic, including |
16170
|
any possible conflicts of interest. |
16171
|
(d) A statement generally describing the clinic and its |
16172
|
operations. |
16173
|
(e) Each form of prepaid health clinic contract that the |
16174
|
applicant proposes to offer the subscribers, showing for each |
16175
|
form of contract the benefits to which the subscribers are |
16176
|
entitled, together with a table of the rates charged, or |
16177
|
proposed to be charged. |
16178
|
(f) A copy of the applicant's Health Care Provider |
16179
|
Certificate from the Agency for Health Care Administration, |
16180
|
issued pursuant to part III of this chapter. |
16181
|
(g) A financial statement prepared on the basis of |
16182
|
generally accepted accounting principles, except that surplus |
16183
|
notes acceptable to the officedepartmentmay be included in the |
16184
|
calculation of surplus. |
16185
|
Section 307. Section 641.406, Florida Statutes, is amended |
16186
|
to read: |
16187
|
641.406 Issuance of certificate of authority.--The office |
16188
|
departmentshall issue a certificate of authority for a prepaid |
16189
|
health clinic to any applicant filing a properly completed |
16190
|
application in conformity with s. 641.405, upon payment of the |
16191
|
prescribed fees and upon the office'sdepartment'sbeing |
16192
|
satisfied that: |
16193
|
(1) As a condition precedent to the issuance of any |
16194
|
certificate, the applicant has obtained a Health Care Provider |
16195
|
Certificate from the Agency for Health Care Administration |
16196
|
pursuant to part III of this chapter. |
16197
|
(2) The proposed rates are actuarially sound for the |
16198
|
benefits provided, including administrative costs. |
16199
|
(3) The applicant has met the minimum surplus requirements |
16200
|
of s. 641.407. |
16201
|
(4) The procedures for offering basic services and |
16202
|
offering and terminating contracts to subscribers will not |
16203
|
unfairly discriminate on the basis of age, health, or economic |
16204
|
status. However, this subsection does not prohibit reasonable |
16205
|
underwriting classifications for the purposes of establishing |
16206
|
contract rates, nor does it prohibit experience rating. |
16207
|
(5) The procedures for offering basic services and |
16208
|
offering and terminating contracts to subscribers will not |
16209
|
discriminate on the basis of sex, race, or national origin. |
16210
|
(6) The applicant furnishes evidence of adequate insurance |
16211
|
coverage or an adequate plan for self-insurance to respond to |
16212
|
claims for injuries arising out of the furnishing of basic |
16213
|
services. |
16214
|
(7) The ownership, control, or management of the applicant |
16215
|
is competent and trustworthy and possesses managerial experience |
16216
|
that would make the proposed clinic operation beneficial to the |
16217
|
subscribers. The officedepartmentshall not grant or continue |
16218
|
authority to transact the business of a prepaid health clinic in |
16219
|
this state at any time during which the officedepartmenthas |
16220
|
good reason to believe that the ownership, control, or |
16221
|
management of the clinic is under the control of any person |
16222
|
whose business operations are or have been marked by business |
16223
|
practices or conduct that is to the detriment of the public, |
16224
|
stockholders, investors, or creditors; by the improper |
16225
|
manipulation of assets or of accounts; or by bad faith. |
16226
|
(8) The application and the applicant are in conformity |
16227
|
with all requirements of this part. |
16228
|
Section 308. Section 641.4065, Florida Statutes, is |
16229
|
amended to read: |
16230
|
641.4065 Insurance business not authorized.--Nothing in |
16231
|
the Florida Insurance Code or this part shall be deemed to |
16232
|
authorize any prepaid health clinic to transact any insurance |
16233
|
business other than that issuing prepaid health clinic contracts |
16234
|
or otherwise to engage in any other type of insurance unless it |
16235
|
is authorized under a certificate of authority issued by the |
16236
|
officedepartmentunder the provisions of the Florida Insurance |
16237
|
Code. |
16238
|
Section 309. Subsection (2) of section 641.407, Florida |
16239
|
Statutes, is amended to read: |
16240
|
641.407 Minimum surplus.-- |
16241
|
(2) In lieu of having any minimum surplus, the prepaid |
16242
|
health clinic may provide a written guaranty to assure payment |
16243
|
of covered subscriber claims if the guaranteeing organization |
16244
|
has been in operation for at least 3 years and has a surplus, |
16245
|
not including land, buildings, and equipment, equal to the |
16246
|
product of 2 times the amount of the required statutory surplus. |
16247
|
Such guaranteeing organization and such written guaranty must be |
16248
|
acceptable to, and approved by, the officedepartment. The |
16249
|
officedepartmentshall consider the likelihood of the payment |
16250
|
of subscriber claims in granting or withholding such approval. |
16251
|
Section 310. Section 641.409, Florida Statutes, is amended |
16252
|
to read: |
16253
|
641.409 Insolvency protection.-- |
16254
|
(1) Every prepaid health clinic shall comply with one of |
16255
|
the following paragraphs: |
16256
|
(a) The prepaid health clinic shall secure insurance to |
16257
|
the satisfaction of the officedepartmentto protect subscribers |
16258
|
in the event the prepaid health clinic is unable to meet its |
16259
|
obligations to subscribers under the terms of any prepaid health |
16260
|
clinic contract issued to a subscriber. |
16261
|
(b) The prepaid health clinic shall file with the office |
16262
|
departmenta surety bond issued by an authorized surety insurer. |
16263
|
The bond shall be for the same purpose as the insurance in lieu |
16264
|
of which the bond is filed. The officedepartmentshall not |
16265
|
approve any bond under the terms of which the protection |
16266
|
afforded against insolvency is not equivalent to the protection |
16267
|
afforded by such insurance. The bond shall guarantee that the |
16268
|
prepaid health clinic will faithfully and truly perform all the |
16269
|
conditions of any prepaid health clinic contract. No such bond |
16270
|
shall be canceled or subject to cancellation unless at least 60 |
16271
|
days' notice of the cancellation, in writing, is filed with the |
16272
|
officedepartment. In the event that the notice of termination |
16273
|
of the bond is filed with the officedepartment, the prepaid |
16274
|
health clinic insured under the bond shall, within 30 days of |
16275
|
the filing of the notice of termination, provide the office |
16276
|
departmentwith a replacement bond meeting the requirements of |
16277
|
this part or secure insurance as required by paragraph (a). The |
16278
|
cancellation of a bond does not relieve the obligation of the |
16279
|
issuer of the bond for claims arising out of contracts issued |
16280
|
prior to the cancellation of the bond unless a replacement bond |
16281
|
or insurance is secured. In no event shall the issuer's |
16282
|
aggregate liability under the bond exceed the face amount of the |
16283
|
bond. If, within 30 days of filing the notice of termination, a |
16284
|
replacement bond or insurance has not been secured and filed |
16285
|
with the officedepartment, the officedepartmentshall suspend |
16286
|
the certificate of the prepaid health clinic until the deposit |
16287
|
requirements are satisfied. Whenever the prepaid health clinic |
16288
|
ceases to do business in this state and furnishes to the office |
16289
|
departmentsatisfactory proof that it has discharged or |
16290
|
otherwise adequately provided for all of its obligations to its |
16291
|
subscribers, the officedepartmentshall release any bond filed |
16292
|
by the prepaid health clinic. |
16293
|
(2) In determining the sufficiency of the insurance |
16294
|
required under paragraph (1)(a) or the surety bond required |
16295
|
under paragraph (1)(b), the officedepartmentmay consider the |
16296
|
number of subscribers, the basic services included in subscriber |
16297
|
contracts, and the cost of providing such basic services to |
16298
|
subscribers in the geographic area served. |
16299
|
(3) Every prepaid health clinic shall deposit with the |
16300
|
department a cash deposit in the amount of $30,000 to guarantee |
16301
|
that the obligations to the subscribers will be performed. |
16302
|
Section 311. Section 641.41, Florida Statutes, is amended |
16303
|
to read: |
16304
|
641.41 Annual report of prepaid health clinic; |
16305
|
administrative penalty.-- |
16306
|
(1) Each prepaid health clinic shall file a report with |
16307
|
the officedepartment, annually on or before March 1, or within |
16308
|
3 months of the end of the reporting period of the clinic, or |
16309
|
within such extension of time for the filing of the report as |
16310
|
the officedepartment, for good cause, may grant. The report of |
16311
|
the prepaid health clinic must be filed on forms prescribed by |
16312
|
the commissiondepartmentand must be verified under oath by two |
16313
|
executive officers of the clinic or, if the clinic is not a |
16314
|
corporation, verified under oath by two persons who are |
16315
|
principal managing directors of the affairs of the clinic. The |
16316
|
report of the clinic shall show the condition of the clinic on |
16317
|
the last day of the immediately preceding reporting period. |
16318
|
Such report shall include: |
16319
|
(a) A financial statement of the clinic, including its |
16320
|
balance sheet and a statement of operations for the preceding |
16321
|
year; |
16322
|
(b) A list of the name and residence address of every |
16323
|
person responsible for the conduct of the affairs of the clinic, |
16324
|
together with a disclosure of the extent and nature of any |
16325
|
contract or arrangement between such person and the clinic, |
16326
|
including any possible conflicts of interest; |
16327
|
(c) The number of prepaid health clinic contracts issued |
16328
|
and outstanding, and the number of prepaid health clinic |
16329
|
contracts terminated and a compilation of the reasons for such |
16330
|
terminations; |
16331
|
(d) Such statistical information as is requested by the |
16332
|
commission or officedepartment, which information shows the |
16333
|
rates of the clinic for all basic services provided under |
16334
|
prepaid health clinic contracts; |
16335
|
(e) The number and amount of damage claims for medical |
16336
|
injury initiated against the clinic and any of the providers |
16337
|
engaged by it during the reporting year, broken down into claims |
16338
|
with and without formal legal process, and the disposition, if |
16339
|
any, of each such claim; and |
16340
|
(f) Such other information relating to the performance of |
16341
|
the clinic as is required by the commission or office |
16342
|
department. |
16343
|
(2) Any clinic which neglects to file the annual report in |
16344
|
the form and within the time required by this section is subject |
16345
|
to an administrative penalty, not to exceed $100 for each day |
16346
|
during which the neglect continues; and, upon notice by the |
16347
|
officedepartmentto that effect, the authority of the clinic to |
16348
|
do business in this state shall cease while such default |
16349
|
continues. |
16350
|
Section 312. Section 641.412, Florida Statutes, is amended |
16351
|
to read: |
16352
|
641.412 Fees.-- |
16353
|
(1) Every prepaid health clinic shall pay to the office |
16354
|
departmentthe following fees: |
16355
|
(a) For filing a copy of its application for a certificate |
16356
|
of authority or an amendment to such certificate, a |
16357
|
nonrefundable fee in the amount of $150. |
16358
|
(b) For filing each annual report, a fee in the amount of |
16359
|
$150. |
16360
|
(2) The fees charged under this section shall be |
16361
|
distributed as follows: |
16362
|
(a) One-third of the total amount of fees shall be |
16363
|
distributed to the Agency for Health Care Administration; and |
16364
|
(b) Two-thirds of the total amount of fees shall be |
16365
|
distributed to the officeDepartment of Insurance. |
16366
|
Section 313. Section 641.418, Florida Statutes, is amended |
16367
|
to read: |
16368
|
641.418 Examination of prepaid health clinic by the office |
16369
|
department.--The officedepartmentshall examine the affairs, |
16370
|
transactions, accounts, business records, and assets of any |
16371
|
prepaid health clinic as often as the officedepartmentdeems it |
16372
|
expedient for the protection of the people of this state. Every |
16373
|
clinic shall submit its books and records and take other |
16374
|
appropriate action as may be necessary to facilitate an |
16375
|
examination. However, medical records of individuals and |
16376
|
records of physicians providing services under contracts to the |
16377
|
clinic are not subject to audit, although such records may be |
16378
|
subject to subpoena by court order upon a showing of good cause. |
16379
|
For the purpose of examinations, the officedepartmentmay |
16380
|
administer oaths to and examine the officers and agents of a |
16381
|
clinic concerning its business and affairs. The expenses for |
16382
|
the examination of each clinic by the officedepartmentare |
16383
|
subject to the same terms and conditions that apply to insurers |
16384
|
under part II of chapter 624. In no event shall the expenses of |
16385
|
all examinations exceed the maximum amount of $15,000 per year. |
16386
|
Section 314. Subsections (2), (3), (5), and (7) of section |
16387
|
641.42, Florida Statutes, is amended to read: |
16388
|
641.42 Prepaid health clinic contracts.-- |
16389
|
(2) The rates charged by any clinic to its subscribers |
16390
|
shall not be excessive, inadequate, or unfairly discriminatory. |
16391
|
The commissiondepartment, in accordance with generally accepted |
16392
|
actuarial practice, may define by rule what constitutes |
16393
|
excessive, inadequate, or unfairly discriminatory rates and may |
16394
|
require whatever information the commissiondepartmentdeems |
16395
|
necessary to determine that a rate or proposed rate meets the |
16396
|
requirements of this subsection. |
16397
|
(3) No clinic shall issue or agree to issue any prepaid |
16398
|
health clinic contract to a subscriber unless the contract has |
16399
|
first been filed with, and approved by, the officedepartment. |
16400
|
(5) Every subscriber shall receive a clear and |
16401
|
understandable description of the method of the clinic for |
16402
|
resolving subscriber grievances; such method shall be set forth |
16403
|
in the contract and shall be approved by the officedepartment |
16404
|
on the basis of its underlying fairness. |
16405
|
(7)(a) If a clinic desires to amend any contract with any |
16406
|
of its subscribers or desires to change any rate charged for the |
16407
|
contract, the clinic may do so, upon filing with the office |
16408
|
departmentthe proposed amendment or change in rates. |
16409
|
(b) No prepaid health clinic contract form or application |
16410
|
form when written application is required and is to be made a |
16411
|
part of the policy or contract, or no printed amendment, |
16412
|
addendum, rider, or endorsement form or form of renewal |
16413
|
certificate, shall be delivered or issued for delivery in this |
16414
|
state, unless the form has been filed with the officedepartment |
16415
|
at its offices in Tallahasseeby or in behalf of the clinic |
16416
|
which proposes to use such form and has been approved by the |
16417
|
officedepartment. Every such filing shall be made not less than |
16418
|
30 days in advance of any such use or delivery. At the |
16419
|
expiration of such 30 days, the form so filed shall be deemed |
16420
|
approved unless prior to the end of the 30 days the form has |
16421
|
been affirmatively approved or disapproved by the office |
16422
|
department. The approval of any such form by the office |
16423
|
departmentconstitutes a waiver of any unexpired portion of such |
16424
|
waiting period. The officedepartmentmay extend by not more |
16425
|
than an additional 15 days the period within which the office |
16426
|
departmentmay so affirmatively approve or disapprove any such |
16427
|
form, by giving notice of such extension before the expiration |
16428
|
of the initial 30-day period. At the expiration of any such |
16429
|
period as so extended, and in the absence of such prior |
16430
|
affirmative approval or disapproval, such form shall be deemed |
16431
|
approved. The officedepartmentmay, for cause, withdraw a |
16432
|
previous approval. No clinic shall issue or use any form which |
16433
|
has been disapproved by the officedepartmentor any form for |
16434
|
which the officedepartmenthas withdrawn approval. |
16435
|
(c) The officedepartmentshall disapprove any form filed |
16436
|
under this subsection, or withdraw any previous approval of the |
16437
|
form, only if the form: |
16438
|
1. Is in any respect in violation of, or does not comply |
16439
|
with, any provision of this part or rule adopted under this |
16440
|
part. |
16441
|
2. Contains or incorporates by reference, where such |
16442
|
incorporation is otherwise permissible, any inconsistent, |
16443
|
ambiguous, or misleading clauses, or exceptions and conditions |
16444
|
which deceptively affect the risk purported to be assumed in the |
16445
|
general coverage of the contract. |
16446
|
3. Has a misleading title, misleading heading, or other |
16447
|
indication of the provisions of the form which is misleading. |
16448
|
4. Is printed or otherwise reproduced in such manner as to |
16449
|
render any material provision of the form substantially |
16450
|
illegible. |
16451
|
5. Provides benefits which are unreasonable in relation to |
16452
|
the rate charged or contains provisions which are unfair, |
16453
|
inequitable, or contrary to the public policy of this state or |
16454
|
encourage misrepresentation. |
16455
|
(d) In determining whether the benefits are reasonable in |
16456
|
relation to the rate charged, the officedepartment, in |
16457
|
accordance with reasonable actuarial techniques, shall consider: |
16458
|
1. Past loss experience and prospective loss experience. |
16459
|
2. Allocation of expenses. |
16460
|
3. Risk and contingency margins, along with justification |
16461
|
of such margins. |
16462
|
4. Acquisition costs. |
16463
|
5. Other factors deemed appropriate by the office |
16464
|
department, based on sound actuarial techniques. |
16465
|
Section 315. Section 641.421, Florida Statutes, is amended |
16466
|
to read: |
16467
|
641.421 Language used in contracts and advertisements; |
16468
|
translations.-- |
16469
|
(1)(a) All prepaid health clinic contracts or forms shall |
16470
|
be printed in English. |
16471
|
(b) If the negotiations by a prepaid health clinic with a |
16472
|
subscriber leading up to the effectuation of a prepaid health |
16473
|
clinic contract are conducted in a language other than English, |
16474
|
the prepaid health clinic shall supply to the subscriber a |
16475
|
written translation of the contract, which translation |
16476
|
accurately reflects the substance of the contract and is in the |
16477
|
language used to negotiate the contract. Any such translation |
16478
|
shall be furnished to the officedepartmentas part of the |
16479
|
filing of the prepaid health clinic contract form and shall be |
16480
|
approved by the officedepartmentprior to use. No translation |
16481
|
of a prepaid health clinic contract form shall be approved by |
16482
|
the officedepartmentunless the translation accurately reflects |
16483
|
the substance of the prepaid health clinic contract form in |
16484
|
translation. When a translation of a prepaid health clinic |
16485
|
contract is used, the translation shall clearly and |
16486
|
conspicuously state on its face and in the language of the |
16487
|
translation: |
16488
|
READ THIS FIRST |
16489
|
This is a translation of the document that you are about |
16490
|
to sign. |
16491
|
|
16492
|
(2) All advertisements by a prepaid health clinic, if |
16493
|
printed or broadcast in a language other than English, also |
16494
|
shall be available in English and shall be furnished to the |
16495
|
officedepartmentupon request. As used in this subsection, the |
16496
|
term "advertisement" means any advertisement, circular, |
16497
|
pamphlet, brochure, or other printed material disclosing or |
16498
|
disseminating advertising material or information by a clinic to |
16499
|
prospective or existing subscribers and includes any radio or |
16500
|
television transmittal of an advertisement or information. |
16501
|
Section 316. Subsection (2) of section 641.424, Florida |
16502
|
Statutes, is amended to read: |
16503
|
641.424 Validity of noncomplying contracts.-- |
16504
|
(2) Any contract delivered or issued for delivery in this |
16505
|
state covering a subscriber resident, located, or to be |
16506
|
performed in this state, which subscriber, pursuant to the |
16507
|
provisions of this part, the clinic may not lawfully provide |
16508
|
under such a contract, is cancelable at any time by the clinic, |
16509
|
any provision of the contract to the contrary notwithstanding; |
16510
|
and the clinic shall promptly cancel the contract in accordance |
16511
|
with the request of the officedepartmentfor such cancellation. |
16512
|
No such illegality or cancellation shall be deemed to relieve |
16513
|
the clinic of any liability incurred by the clinic under the |
16514
|
contract while the contract was in force or to prohibit the |
16515
|
clinic from retaining the pro rata earned premium on the |
16516
|
contract. This provision does not relieve the clinic from any |
16517
|
penalty otherwise incurred by the clinic under this part on |
16518
|
account of any such violation. |
16519
|
Section 317. Section 641.437, Florida Statutes, is amended |
16520
|
to read: |
16521
|
641.437 Investigatory power of officedepartment.--The |
16522
|
officedepartmenthas the power to examine and investigate the |
16523
|
affairs of every person, entity, or prepaid health clinic in |
16524
|
order to determine whether the person, entity, or prepaid health |
16525
|
clinic is operating in accordance with the provisions of this |
16526
|
part or has been or is engaged in any unfair method of |
16527
|
competition or any unfair or deceptive act or practice |
16528
|
prohibited by s. 641.44. |
16529
|
Section 318. Section 641.443, Florida Statutes, is amended |
16530
|
to read: |
16531
|
641.443 Temporary restraining orders.-- |
16532
|
(1) The officedepartmentis vested with the power to seek |
16533
|
a temporary restraining order: |
16534
|
(a) On behalf of the officedepartmentor on behalf of a |
16535
|
subscriber or subscribers of a prepaid health clinic that is |
16536
|
being operated by a person or entity without a subsisting |
16537
|
certificate of authority; or |
16538
|
(b) On behalf of the officedepartmentor on behalf of a |
16539
|
subscriber or subscribers to whom a prepaid health clinic, |
16540
|
person, or entity is issuing, delivering, or renewing prepaid |
16541
|
health clinic contracts without an existing certificate of |
16542
|
authority. |
16543
|
(2) The officedepartmentand the Agency for Health Care |
16544
|
Administration are each vested with the power to seek a |
16545
|
temporary restraining order on their behalf or on behalf of a |
16546
|
subscriber or subscribers of a prepaid health clinic that is |
16547
|
being operated in violation of any provision of this part or any |
16548
|
rule promulgated under this part, or any other applicable law or |
16549
|
rule. |
16550
|
Section 319. Section 641.444, Florida Statutes, is amended |
16551
|
to read: |
16552
|
641.444 Injunction.--In addition to the penalties and |
16553
|
other enforcement provisions of this part, if a person, entity, |
16554
|
or prepaid health clinic has engaged in any activity prohibited |
16555
|
by this part or any rule adopted pursuant to this part, the |
16556
|
officedepartmentmay resort to a proceeding for injunction in |
16557
|
the circuit court of the county where such person, entity, or |
16558
|
prepaid health clinic is located or has her or his or its |
16559
|
principal place of business; and the officedepartmentmay apply |
16560
|
in such court for such temporary and permanent orders as the |
16561
|
officedepartmentmay deem necessary to restrain the person, |
16562
|
entity, or prepaid health clinic from engaging in any such |
16563
|
activity, until the person, entity, or prepaid health clinic |
16564
|
complies with the provisions and rules. |
16565
|
Section 320. Section 641.445, Florida Statutes, is amended |
16566
|
to read: |
16567
|
641.445 Defined practices; hearings, witnesses, |
16568
|
appearances, production of books, and service of process.-- |
16569
|
(1) Whenever the officedepartmenthas reason to believe |
16570
|
that a person, entity, or prepaid health clinic has engaged, or |
16571
|
is engaging, in this state in any unfair method of competition |
16572
|
or any unfair or deceptive act or practice as defined in s. |
16573
|
641.441, or is operating a prepaid health clinic without a |
16574
|
certificate of authority as required by this part or otherwise |
16575
|
operating in violation of any provision of this part or rule |
16576
|
adopted pursuant to this part, and that a proceeding by the |
16577
|
officedepartmentin respect thereto would be in the interest of |
16578
|
the public, the officedepartmentshall conduct, or cause to |
16579
|
have conducted, a hearing in accordance with chapter 120. |
16580
|
(2) The officedepartment, a duly empowered hearing |
16581
|
officer, or an administrative law judge shall, during the |
16582
|
conduct of such hearing, have those powers enumerated in s. |
16583
|
120.569; however, the penalty for the failure to comply with a |
16584
|
subpoena or with an order directing discovery is limited to a |
16585
|
fine not to exceed $1,000 per violation. |
16586
|
(3) A statement of charges, notice, or order under this |
16587
|
part may be served by anyone duly authorized by the office |
16588
|
department, either in the manner provided by law for service of |
16589
|
process in civil actions or by certifying and mailing a copy of |
16590
|
the statement of charges, notice, or order to the person, |
16591
|
entity, or prepaid health clinic affected by the statement, |
16592
|
notice, or order or other process at his or her or its residence |
16593
|
or principal office or place of business. The verified return |
16594
|
by the person so serving such statement, notice, or order or |
16595
|
other process, setting forth the manner of the service, is proof |
16596
|
of such service; and the return postcard receipt for such |
16597
|
statement, notice, or order or other process, certified and |
16598
|
mailed as provided in this subsection, is proof of the service |
16599
|
of the statement, notice, or order or other process. |
16600
|
Section 321. Section 641.446, Florida Statutes, is amended |
16601
|
to read: |
16602
|
641.446 Cease and desist and penalty orders.--After the |
16603
|
hearing provided in s. 641.445, the officedepartmentshall |
16604
|
enter a final order in accordance with s. 120.569. If it is |
16605
|
determined that the person, entity, or prepaid health clinic |
16606
|
charged has engaged in an unfair or deceptive act or practice or |
16607
|
the unlawful operation of a prepaid health clinic, the office |
16608
|
departmentalso shall issue an order requiring the violator to |
16609
|
cease and desist from engaging in such method of competition, |
16610
|
act, or practice or unlawful operation of a prepaid health |
16611
|
clinic. Furthermore, the officedepartmentmay, at its |
16612
|
discretion, order any one or more of the following: |
16613
|
(1) The suspension or revocation of the certificate of |
16614
|
authority of the prepaid health clinic if it knew, or reasonably |
16615
|
should have known, that it was in violation of this part. |
16616
|
(2) If it is determined that the person or entity charged |
16617
|
has engaged in the business of operating a prepaid health clinic |
16618
|
without a certificate of authority, an administrative penalty |
16619
|
not to exceed $1,000 for each prepaid health clinic contract |
16620
|
offered or effectuated. |
16621
|
Section 322. Section 641.447, Florida Statutes, is amended |
16622
|
to read: |
16623
|
641.447 Appeal from departmentalorder.--Any person, |
16624
|
entity, or prepaid health clinic that is subject to an order of |
16625
|
the officedepartmentunder s. 641.446 may obtain a review of |
16626
|
the order by filing an appeal from the order in accordance with |
16627
|
the provisions and procedures for appeal under s. 120.68. |
16628
|
Section 323. Section 641.448, Florida Statutes, is amended |
16629
|
to read: |
16630
|
641.448 Penalty for violation of cease and desist |
16631
|
order.--Any person, entity, or prepaid health clinic that |
16632
|
violates a cease and desist order of the officedepartmentunder |
16633
|
s. 641.446 while such order is in effect, after notice and |
16634
|
hearing as provided in s. 641.445, is subject, at the discretion |
16635
|
of the officedepartment, to any one or more of the following: |
16636
|
(1) A monetary penalty of not more than $50,000 as to all |
16637
|
matters determined in such hearing. |
16638
|
(2) The suspension or revocation of the certificate of |
16639
|
authority of the prepaid health clinic. |
16640
|
Section 324. Section 641.45, Florida Statutes, is amended |
16641
|
to read: |
16642
|
641.45 Revocation or cancellation of certificate of |
16643
|
authority; suspension of authority to enroll new subscribers; |
16644
|
terms of suspension.-- |
16645
|
(1) The maintenance of a valid and current Health Care |
16646
|
Provider Certificate issued pursuant to part III of this chapter |
16647
|
is a condition of the maintenance of a valid and current |
16648
|
certificate of authority issued by the officedepartmentto |
16649
|
operate a prepaid health clinic. Revocation or nonrenewal of a |
16650
|
Health Care Provider Certificate shall be deemed to be an |
16651
|
automatic and immediate cancellation of a prepaid health |
16652
|
clinic's certificate of authority. |
16653
|
(2) The officedepartmentmay suspend the authority of a |
16654
|
clinic to enroll new subscribers or revoke any certificate of |
16655
|
authority issued to a prepaid health clinic, or order compliance |
16656
|
within 60 days, if the officedepartmentfinds that any of the |
16657
|
following conditions exist: |
16658
|
(a) The clinic is not operating in compliance with this |
16659
|
part or any rule promulgated under this part. |
16660
|
(b) The plan is no longer actuarially sound or the clinic |
16661
|
does not have the minimum surplus as required by this part. |
16662
|
(c) The existing contract rates are excessive, inadequate, |
16663
|
or unfairly discriminatory. |
16664
|
(d) The clinic has advertised, merchandised, or attempted |
16665
|
to merchandise its services in such a manner as to misrepresent |
16666
|
its services or capacity for services or has engaged in |
16667
|
deceptive, misleading, or unfair practices with respect to |
16668
|
advertising or merchandising. |
16669
|
(e) The organization is insolvent. |
16670
|
(f) The clinic has not complied with the grievance |
16671
|
procedures for subscribers that are set forth in any prepaid |
16672
|
health clinic contract. |
16673
|
(g) The clinic has not fully satisfied a judgment against |
16674
|
the clinic within 10 days of the entry of the judgment by any |
16675
|
court in the state or, in the case of an appeal from such |
16676
|
judgment, has not fully satisfied the judgment within 60 days |
16677
|
after affirmance of the judgment by the appellate court. |
16678
|
(3) The officedepartmentshall, in its order suspending |
16679
|
the authority of a clinic to enroll new subscribers, specify the |
16680
|
period during which the suspension is to be in effect and the |
16681
|
conditions, if any, which must be met by the clinic prior to |
16682
|
reinstatement of its authority to enroll new subscribers. The |
16683
|
order of suspension is subject to rescission or modification by |
16684
|
further order of the officedepartmentprior to the expiration |
16685
|
of the suspension period. Reinstatement shall not be made unless |
16686
|
requested by the clinic; however, the officedepartmentshall |
16687
|
not grant reinstatement if it finds that the circumstances for |
16688
|
which the suspension occurred still exist or are likely to |
16689
|
recur. |
16690
|
Section 325. Section 641.452, Florida Statutes, is amended |
16691
|
to read: |
16692
|
641.452 Administrative penalty in lieu of suspension or |
16693
|
revocation of certificate of authority.--The officedepartment |
16694
|
may, in lieu of suspension or revocation of a certificate of |
16695
|
authority, levy an administrative penalty in an amount not more |
16696
|
than $10,000 for each violation by a prepaid health clinic. In |
16697
|
levying such fine, the officedepartmentshall consider the |
16698
|
number of members and total revenues of the clinic and whether |
16699
|
the violation was committed knowingly and willfully. |
16700
|
Section 326. Section 641.453, Florida Statutes, is amended |
16701
|
to read: |
16702
|
641.453 Civil liability.--The provisions of this part are |
16703
|
cumulative to the rights under the general civil law and common |
16704
|
law, and no action of the officedepartmentshall abrogate such |
16705
|
rights to damages or other relief in any court. |
16706
|
Section 327. Section 641.454, Florida Statutes, is amended |
16707
|
to read: |
16708
|
641.454 Civil action to enforce prepaid health clinic |
16709
|
contract; attorney's fees; court costs.--In any civil action |
16710
|
brought to enforce the terms and conditions of a prepaid health |
16711
|
clinic contract, the prevailing party is entitled to recover |
16712
|
reasonable attorney's fees and court costs. This section shall |
16713
|
not be construed to authorize a civil action against the |
16714
|
commission or officedepartment, or theirits employees, or the |
16715
|
Insurance Commissioner and Treasureror against the Agency for |
16716
|
Health Care Administration, the employees of the Agency for |
16717
|
Health Care Administration, or the Secretary of Health Care |
16718
|
Administration. |
16719
|
Section 328. Section 641.455, Florida Statutes, is amended |
16720
|
to read: |
16721
|
641.455 Disposition of moneys collected under this |
16722
|
part.--Fees, administrative penalties, examination expenses, and |
16723
|
other sums collected by the officedepartmentunder this part |
16724
|
shall be deposited to the credit of the Insurance Commissioner's |
16725
|
Regulatory Trust Fund; however, fees, examination expenses, and |
16726
|
other sums collected by, or allocated to, the Agency for Health |
16727
|
Care Administration under this part shall be deposited to the |
16728
|
credit of the General Revenue Fund. |
16729
|
Section 329. Section 641.457, Florida Statutes, is amended |
16730
|
to read: |
16731
|
641.457 Exemption for certain operational prepaid health |
16732
|
clinics.--The provisions of this part do not apply to those |
16733
|
prepaid health clinics providing the services defined in ss. |
16734
|
641.40 through 641.459, which clinics have been continuously |
16735
|
engaged in providing such services since January 1, 1947, |
16736
|
provided that any prepaid health clinic claiming an exemption |
16737
|
under this section notifiednotifies the former Department of |
16738
|
Insuranceof its claim on or before January 1, 1985. This |
16739
|
exemption will terminate upon a change in controlling ownership |
16740
|
of the organization. |
16741
|
Section 330. Section 641.48, Florida Statutes, is amended |
16742
|
to read: |
16743
|
641.48 Purpose and application of part.--The purpose of |
16744
|
this part is to ensure that health maintenance organizations and |
16745
|
prepaid health clinics deliver high-quality health care to their |
16746
|
subscribers. To achieve this purpose, this part requires all |
16747
|
such organizations to obtain a health care provider certificate |
16748
|
from the agency as a condition precedent to obtaining a |
16749
|
certificate of authority to do business in Florida from the |
16750
|
officeDepartment of Insurance, under part I or part II of this |
16751
|
chapter. |
16752
|
Section 331. Subsection (2) of section 641.49, Florida |
16753
|
Statutes, is amended to read: |
16754
|
641.49 Certification of health maintenance organization |
16755
|
and prepaid health clinic as health care providers; application |
16756
|
procedure.-- |
16757
|
(2) The officeDepartment of Insuranceshall not issue a |
16758
|
certificate of authority under part I or part II of this chapter |
16759
|
to any applicant which does not possess a valid health care |
16760
|
provider certificate issued by the agency under this part. |
16761
|
Section 332. Subsection (4) of section 641.495, Florida |
16762
|
Statutes, is amended to read: |
16763
|
641.495 Requirements for issuance and maintenance of |
16764
|
certificate.-- |
16765
|
(4) The organization shall ensure that the health care |
16766
|
services it provides to subscribers, including physician |
16767
|
services as required by s. 641.19(12)(13)(d) and (e), are |
16768
|
accessible to the subscribers, with reasonable promptness, with |
16769
|
respect to geographic location, hours of operation, provision of |
16770
|
after-hours service, and staffing patterns within generally |
16771
|
accepted industry norms for meeting the projected subscriber |
16772
|
needs. The health maintenance organization must provide |
16773
|
treatment authorization 24 hours a day, 7 days a week. Requests |
16774
|
for treatment authorization may not be held pending unless the |
16775
|
requesting provider contractually agrees to take a pending or |
16776
|
tracking number. |
16777
|
Section 333. Subsections (7), (8), and (11) of section |
16778
|
641.511, Florida Statutes, are amended to read: |
16779
|
641.511 Subscriber grievance reporting and resolution |
16780
|
requirements.-- |
16781
|
(7) Each organization shall send to the agency a copy of |
16782
|
its quarterly grievance reports submitted to the office |
16783
|
Department of Insurancepursuant to s. 408.7056(12). |
16784
|
(8) The agency shall investigate all reports of unresolved |
16785
|
quality of care grievances received from: |
16786
|
(a) Annual and quarterly grievance reports submitted by |
16787
|
the organization to the officeDepartment of Insurance. |
16788
|
(b) Review requests of subscribers whose grievances remain |
16789
|
unresolved after the subscriber has followed the full grievance |
16790
|
procedure of the organization. |
16791
|
(11) Each organization, as part of its contract with any |
16792
|
provider, must require the provider to post a consumer |
16793
|
assistance notice prominently displayed in the reception area of |
16794
|
the provider and clearly noticeable by all patients. The |
16795
|
consumer assistance notice must state the addresses and toll- |
16796
|
free telephone numbers of the Agency for Health Care |
16797
|
Administration, the Statewide Provider and Subscriber Assistance |
16798
|
Program, and the Department of Financial ServicesInsurance. The |
16799
|
consumer assistance notice must also clearly state that the |
16800
|
address and toll-free telephone number of the organization's |
16801
|
grievance department shall be provided upon request. The agency |
16802
|
may adoptis authorized to promulgaterules to implement this |
16803
|
section. |
16804
|
Section 334. Subsections (1), (3), and (6) of section |
16805
|
641.512, Florida Statutes, are amended to read: |
16806
|
641.512 Accreditation and external quality assurance |
16807
|
assessment.-- |
16808
|
(1)(a) To promote the quality of health care services |
16809
|
provided by health maintenance organizations and prepaid health |
16810
|
clinics in this state, the officedepartmentshall require each |
16811
|
health maintenance organization and prepaid health clinic to be |
16812
|
accredited within 1 year of the organization's receipt of its |
16813
|
certificate of authority and to maintain accreditation by an |
16814
|
accreditation organization approved by the officedepartment, as |
16815
|
a condition of doing business in the state. |
16816
|
(b) In the event that no accreditation organization can be |
16817
|
approved by the officedepartment, the officedepartmentshall |
16818
|
require each health maintenance organization and prepaid health |
16819
|
clinic to have an external quality assurance assessment |
16820
|
performed by a review organization approved by the office |
16821
|
department, as a condition of doing business in the state. The |
16822
|
assessment shall be conducted within 1 year of the |
16823
|
organization's receipt of its certificate of authority and every |
16824
|
2 years thereafter, or when the officedepartmentdeems |
16825
|
additional assessments necessary. |
16826
|
(3) A representative of the officedepartmentshall |
16827
|
accompany the accreditation or review organization throughout |
16828
|
the accreditation or assessment process, but shall not |
16829
|
participate in the final accreditation or assessment |
16830
|
determination. The accreditation or review organization shall |
16831
|
monitor and evaluate the quality and appropriateness of patient |
16832
|
care, the organization's pursuance of opportunities to improve |
16833
|
patient care and resolve identified problems, and the |
16834
|
effectiveness of the internal quality assurance program required |
16835
|
for health maintenance organization and prepaid health clinic |
16836
|
certification pursuant to s. 641.49(3)(p). |
16837
|
(6) The accreditation or review organization shall issue a |
16838
|
written report of its findings to the health maintenance |
16839
|
organization's or prepaid health clinic's board of directors. A |
16840
|
copy of the report shall be submitted to the officedepartment |
16841
|
by the organization within 30 business days of its receipt by |
16842
|
the health maintenance organization or prepaid health clinic. |
16843
|
Section 335. Section 641.52, Florida Statutes, is amended |
16844
|
to read: |
16845
|
641.52 Revocation of certificate; suspension of new |
16846
|
enrollment; suspension of the health care provider certificate; |
16847
|
administrative fine; notice of action to the officeDepartment |
16848
|
of Insurance; penalty for use of unlicensed providers.-- |
16849
|
(1) The agency may suspend the authority of an |
16850
|
organization to enroll new subscribers or revoke the health care |
16851
|
provider certificate of any organization, or order compliance |
16852
|
within a time certain, if it finds that any of the following |
16853
|
conditions exist: |
16854
|
(a) The organization is in substantial violation of its |
16855
|
contracts. |
16856
|
(b) The organization is unable to fulfill its obligations |
16857
|
under outstanding contracts entered into with its subscribers. |
16858
|
(c) The organization knowingly utilizes a provider who is |
16859
|
furnishing or has furnished health care services and who does |
16860
|
not have a subsisting license or other authority to practice or |
16861
|
furnish health care services in this state. |
16862
|
(d) The organization no longer meets the requirements for |
16863
|
the certificate as originally issued. |
16864
|
(e) The organization has violated any lawful rule or order |
16865
|
of the agency or any provision of this part. |
16866
|
(f) The organization has refused to be examined or to |
16867
|
produce its accounts, records, and files for examination or to |
16868
|
perform any other legal obligation as to such examination, when |
16869
|
required by the agency. |
16870
|
(g) The organization has not, after given reasonable |
16871
|
notice, maintained accreditation or received favorable external |
16872
|
quality assurance reviews under s. 641.512 or, following an |
16873
|
investigation under s. 641.515, has been determined to not |
16874
|
materially meet requirements under this part. |
16875
|
(2) Revocation of an organization's certificate shall be |
16876
|
for a period of 2 years. After 2 years, the organization may |
16877
|
apply for a new certificate by compliance with all application |
16878
|
requirements applicable to first-time applicants. |
16879
|
(3) Suspension of an organization's authority to enroll |
16880
|
new subscribers shall be for such period, not to exceed 1 year, |
16881
|
as is fixed by the agency. The agency shall, in its order |
16882
|
suspending the authority of an organization to enroll new |
16883
|
subscribers, specify the period during which the suspension is |
16884
|
to be in effect and the conditions, if any, which must be met by |
16885
|
the organization prior to reinstatement of its authority to |
16886
|
enroll new subscribers. The order of suspension is subject to |
16887
|
rescission or modification by further order of the agency prior |
16888
|
to the expiration of the suspension period. Authority to enroll |
16889
|
new subscribers shall not be reinstated unless requested by the |
16890
|
organization; however, the agency may not grant reinstatement if |
16891
|
it finds that the circumstances for which the suspension of |
16892
|
authority to enroll new subscribers occurred still exist or are |
16893
|
likely to recur. |
16894
|
(4) The agency may suspend the health care provider |
16895
|
certificate issued to an organization. The agency shall, in its |
16896
|
order suspending the health care provider certificate, specify |
16897
|
the period during which the suspension is to be in effect and |
16898
|
the conditions, if any, which must be met by the organization |
16899
|
for reinstatement. Upon expiration of the suspension period, the |
16900
|
organization's certificate automatically reinstates unless the |
16901
|
agency finds that the causes of the suspension have not been |
16902
|
removed or that the organization is otherwise not in compliance |
16903
|
with this part. If the agency makes such a finding, the health |
16904
|
care provider certificate shall not be reinstated and is |
16905
|
considered to have expired as of the end of the suspension |
16906
|
period. |
16907
|
(5) If the agency finds that one or more grounds exist for |
16908
|
the revocation or suspension of a certificate issued under this |
16909
|
part, the agency may, in lieu of such revocation or suspension, |
16910
|
impose a fine upon the organization. With respect to any |
16911
|
nonwillful violation, the fine may not exceed $2,500 per |
16912
|
violation. Such fines may not exceed an aggregate amount of |
16913
|
$25,000 for all nonwillful violations arising out of the same |
16914
|
action. With respect to any knowing and willful violation of a |
16915
|
lawful order or rule of the agency or a provision of this part, |
16916
|
the agency may impose a fine upon the organization in an amount |
16917
|
not to exceed $20,000 for each such violation. Such fines may |
16918
|
not exceed an aggregate amount of $250,000 for all knowing and |
16919
|
willful violations arising out of the same action. The agency |
16920
|
shall, by January 1, 1997, adopt by rule penalty categories that |
16921
|
specify varying ranges of fines for willful violations and for |
16922
|
nonwillful violations. |
16923
|
(6) The agency shall immediately notify the office |
16924
|
Department of Insurancewhenever it issues an administrative |
16925
|
complaint or an order or otherwise initiates legal proceedings |
16926
|
resulting in or which may result in suspension or revocation of |
16927
|
an organization's health care provider certificate or suspension |
16928
|
of new enrollment. |
16929
|
(7) Any organization that knowingly utilizes the services |
16930
|
of a provider who is not licensed or otherwise authorized by law |
16931
|
to provide such services is guilty of a felony of the third |
16932
|
degree, punishable as provided in s. 775.082, s. 775.083, or s. |
16933
|
775.084. |
16934
|
Section 336. Subsection (2) of section 641.54, Florida |
16935
|
Statutes, is amended to read: |
16936
|
641.54 Information disclosure.-- |
16937
|
(2) The list shall be made available, upon request, to the |
16938
|
officedepartment. The list shall also be made available, upon |
16939
|
request: |
16940
|
(a) With respect to negotiation, application, or |
16941
|
effectuation of a group health maintenance contract, to the |
16942
|
employer or other person who will hold the contract on behalf of |
16943
|
the subscriber group. The list may be restricted to include |
16944
|
only physicians and hospitals in the group's geographic area. |
16945
|
(b) With respect to an individual health maintenance |
16946
|
contract or any contract offered to a person who is entitled to |
16947
|
have payments for health care costs made under Medicare, to the |
16948
|
person considering or making application to, or under contract |
16949
|
with, the health maintenance organization. The list may be |
16950
|
restricted to include only physicians and hospitals in the |
16951
|
person's geographic area. |
16952
|
Section 337. Subsection (4) of section 641.55, Florida |
16953
|
Statutes, is amended to read: |
16954
|
641.55 Internal risk management program.-- |
16955
|
(4) The Agency for Health Care Administration shall adopt |
16956
|
rules necessary to carry out the provisions of this section, |
16957
|
including rules governing the establishment of required internal |
16958
|
risk management programs to meet the needs of individual |
16959
|
organizations and each specific organization type governed by |
16960
|
this part. The officeDepartment of Insuranceshall assist the |
16961
|
agency in preparing these rules. Each internal risk management |
16962
|
program shall include the use of incident reports to be filed |
16963
|
with the risk manager. The risk manager shall have free access |
16964
|
to all organization or provider medical records. The incident |
16965
|
reports shall be considered to be a part of the workpapers of |
16966
|
the attorney defending the organization in litigation relating |
16967
|
thereto and shall be subject to discovery, but not be admissible |
16968
|
as evidence in court, nor shall any person filing an incident |
16969
|
report be subject to civil suit by virtue of the incident report |
16970
|
and the matters it contains. As a part of each internal risk |
16971
|
management program, the incident reports shall be utilized to |
16972
|
develop categories of incidents which identify problem areas. |
16973
|
Once identified, procedures must be adjusted to correct these |
16974
|
problem areas. |
16975
|
|
16976
|
|
16977
|
The gross data compiled under this section or s. 395.0197 shall |
16978
|
be furnished by the agency upon request to organizations to be |
16979
|
utilized for risk management purposes. The agency shall adopt |
16980
|
rules necessary to carry out the provisions of this section. |
16981
|
Section 338. Subsection (2) of section 641.58, Florida |
16982
|
Statutes, is amended to read: |
16983
|
641.58 Regulatory assessment; levy and amount; use of |
16984
|
funds; tax returns; penalty for failure to pay.-- |
16985
|
(2) The officeDepartment of Insuranceshall determine the |
16986
|
amount of gross premiums for the purposes of the regulatory |
16987
|
assessment, and then the agency shall determine on or before |
16988
|
December 1 of each year the regulatory assessment percentage |
16989
|
necessary to be imposed for that calendar year, payable on or |
16990
|
before the following April 1, as herein prescribed, to provide |
16991
|
the funds appropriated to the agency to carry out the provisions |
16992
|
of subsection (4). |
16993
|
Section 339. Subsections (3) and (4) of section 642.0475, |
16994
|
Florida Statutes, are amended to read: |
16995
|
642.0475 Civil remedy.-- |
16996
|
(3) As a condition precedent to bringing an action under |
16997
|
this section, the officedepartmentand the person against whom |
16998
|
the action is to be brought shall be given notice of the |
16999
|
violation. The notice shall state with specificity the facts |
17000
|
which allegedly constitute the violation and the law which the |
17001
|
plaintiff is relying upon. No action shall lie if, within 30 |
17002
|
days thereafter, the damages are paid or the circumstances |
17003
|
giving rise to the violation are corrected. |
17004
|
(4) This section shall not be construed to authorize a |
17005
|
class action suit against a legal expense insurance corporation |
17006
|
or a civil action against the department, commission, or office |
17007
|
or theirits employees, or the Insurance Commissioner. |
17008
|
Section 340. Section 651.119, Florida Statutes, is amended |
17009
|
to read: |
17010
|
651.119 Assistance to persons affected by closure due to |
17011
|
liquidation or pending liquidation.-- |
17012
|
(1) If a facility closes and ceases to operate as a result |
17013
|
of liquidation or pending liquidation and residents are forced |
17014
|
to relocate, the department shall become a creditor of the |
17015
|
facility for the purpose of providing moving expenses for |
17016
|
displaced residents and such other care or services as is made |
17017
|
possible by the unencumbered assets of the facility. To the |
17018
|
extent that another provider provides, as approved by the office |
17019
|
department, direct assistance to such residents, the cost of |
17020
|
such direct assistance shall be offset against reserves pursuant |
17021
|
to subsection (4). The department shall provide proportional |
17022
|
reimbursements of such costs to the respective providers from |
17023
|
such unencumbered assets. |
17024
|
(2) If the moneys and direct assistance made available |
17025
|
under subsection(1) are not sufficient to cover moving costs, |
17026
|
the officedepartmentmay seek voluntary contributions from the |
17027
|
reserves maintained by providers under s. 651.035 in amounts |
17028
|
approved by the officedepartmentto provide for the moving |
17029
|
expenses of the residents in moving to another residence within |
17030
|
the state. |
17031
|
(3) If the moneys and direct assistance provided under |
17032
|
subsections (1) and(2) are not sufficient to provide for the |
17033
|
moving expenses of displaced residents in moving to other |
17034
|
residences within the state, the officedepartmentmay levy pro |
17035
|
rata assessments on the reserves of providers maintained under |
17036
|
s. 651.035 for such moving expenses of any displaced resident |
17037
|
who lacks sufficient assets to pay for such moving expenses. The |
17038
|
assessments for such moving expenses on any particular provider |
17039
|
may not exceed for any 12-month period an aggregate of 1 percent |
17040
|
of the unencumbered portion of the reserves maintained by the |
17041
|
provider under s. 651.035. If the officedepartmentdetermines |
17042
|
that payment of an assessment under this subsection would impair |
17043
|
the financial standing of a facility or its residents, the |
17044
|
officedepartmentmay waive or temporarily defer all or part of |
17045
|
the assessment with respect to that provider. The office |
17046
|
departmentshall apply any moneys voluntarily paid by a provider |
17047
|
under subsection (1) or subsection (2) to satisfaction of |
17048
|
assessments under this subsection. |
17049
|
(4) The officedepartmentshall permanently reduce the |
17050
|
reserves required of a provider under s. 651.035 to the extent |
17051
|
of the provider's costs under subsection (1), voluntary |
17052
|
contributions under subsection (2), and assessments under |
17053
|
subsection (3). However, the officedepartmentshall thereafter |
17054
|
raise the reserve requirements of a provider to the extent of |
17055
|
reimbursements paid to the provider under subsection (1) unless |
17056
|
such increase would raise the reserve requirement above the |
17057
|
amount required under s. 651.035. |
17058
|
(5) No payment, contribution, or assessment may be paid by |
17059
|
a provider under this section if the release of funds from the |
17060
|
reserves of the provider would violate a bond or lending |
17061
|
commitment or covenant. |
17062
|
(6) Moneys received under this section for the support of |
17063
|
residents shall be kept in a separate fund maintained and |
17064
|
administered by the department. The Continuing Care Advisory |
17065
|
Council shall monitor the collection and use of such funds and |
17066
|
shall advise the office ordepartment on plans for resident |
17067
|
relocation. The council shall seek the assistance of providers |
17068
|
licensed under this chapter and other service providers in |
17069
|
locating alternative housing and care arrangements. |
17070
|
(7) For the purposes of this section, "moving expenses" |
17071
|
means transportation expenses and the cost of packing and |
17072
|
relocating personal belongings. |
17073
|
Section 341. Section 252.62, Florida Statutes, is amended |
17074
|
to read: |
17075
|
252.62 Director of Office of Financial Institutions and |
17076
|
Securities RegulationComptroller'spowers in a state of |
17077
|
emergency.-- |
17078
|
(1) It is the purpose and intent of this section to |
17079
|
provide the Director of the Office of Financial Institutions and |
17080
|
Securities Regulation of the Financial Services Commission |
17081
|
Comptroller, as head of the Department of Banking and Finance, |
17082
|
the authority to make temporary modifications to or suspensions |
17083
|
of the financial institutions codes in order to expedite the |
17084
|
recovery of communities affected by a disaster or other |
17085
|
emergency and in order to encourage financial institutions to |
17086
|
meet the credit, deposit, and other financial needs of such |
17087
|
communities. |
17088
|
(2)(a) When the Governor declares a state of emergency |
17089
|
pursuant to s. 252.36, the Director of the Office of Financial |
17090
|
Institutions and Securities RegulationComptrollermay issue: |
17091
|
1. One or more general orders applicable to all financial |
17092
|
institutions that are subject to the financial institutions |
17093
|
codes and that serve any portion of the area of the state under |
17094
|
the state of emergency; or |
17095
|
2. One or more specific orders to particular financial |
17096
|
institutions that are subject to the financial institution codes |
17097
|
and that normally derive more than 60 percent of their deposits |
17098
|
from persons in the area of the state under the state of |
17099
|
emergency, |
17100
|
|
17101
|
which orders may modify or suspend, as to those institutions, |
17102
|
all or any part of the financial institutions codes, as defined |
17103
|
in s. 655.005, or any applicable rule, consistent with the |
17104
|
stated purposes of the financial institutions codes and with |
17105
|
maintaining the safety and soundness of the financial |
17106
|
institutions system in this state. |
17107
|
(b) An order issued by the directorComptrollerunder this |
17108
|
section becomes effective upon issuance and continues for 120 |
17109
|
days unless it is terminated by the directorComptroller. The |
17110
|
directorComptrollermay extend an order for one additional |
17111
|
period of 120 days if he or shethe Comptrollerdetermines that |
17112
|
the emergency conditions that gave rise to the Comptroller's |
17113
|
initial order still exist. The Legislature, by concurrent |
17114
|
resolution, may terminate any order issued under this section. |
17115
|
(3) The directorComptrollershall publish, in the next |
17116
|
available publication of the Florida Administrative Weekly, a |
17117
|
copy of the text of any order issued under this section, |
17118
|
together with a statement describing the modification or |
17119
|
suspension and explaining how the modification or suspension |
17120
|
will facilitate recovery from the emergency and maintain the |
17121
|
safety and soundness of financial institutions in this state. |
17122
|
Section 342. Section 288.778, Florida Statutes, is amended |
17123
|
to read: |
17124
|
288.778 Office of Financial Institutions and Securities |
17125
|
RegulationDepartment of Banking and Finance.--The Office of |
17126
|
Financial Institutions and Securities RegulationDepartment of |
17127
|
Banking and Financeshall review the corporation's activities |
17128
|
once every 24 months to determine compliance with this part and |
17129
|
other related laws and rules and to evaluate the corporation's |
17130
|
operations. The officedepartmentshall prepare a report based |
17131
|
on its review and evaluation with recommendation for any |
17132
|
corrective action. The president shall submit to the office |
17133
|
departmentregular reports on the corporation's activities. The |
17134
|
content and frequency of such reports shall be determined by the |
17135
|
officedepartment. The officedepartmentshall charge a fee for |
17136
|
conducting the review and evaluation and preparing the related |
17137
|
report, which fee shall not be in excess of the examination fee |
17138
|
paid by financial institutions chartered or licensed under the |
17139
|
financial institutions code of this state. |
17140
|
Section 343. Paragraphs (c) and (e) through (p) of |
17141
|
subsection (3), paragraphs (a), (b),(c), (d), (g), and (h) of |
17142
|
subsection (4), paragraph (b) of subsection (5), subsection (7), |
17143
|
paragraphs (a) and (c) of subsection (8), paragraph (b) of |
17144
|
subsection (9), paragraphs (a) through (e), (h), and (j) of |
17145
|
subsection (10), subsections (12), (13), and (14), paragraphs |
17146
|
(a), (c), (d), (e), and (g) of subsection (15), and subsection |
17147
|
(17) of section 288.99, Florida Statutes, are amended to read: |
17148
|
288.99 Certified Capital Company Act.-- |
17149
|
(3) DEFINITIONS.--As used in this section, the term: |
17150
|
(c) "Certified capital company" means a corporation, |
17151
|
partnership, or limited liability company which: |
17152
|
1. Is certified by the officedepartmentin accordance |
17153
|
with this act. |
17154
|
2. Receives investments of certified capital from two or |
17155
|
more unaffiliated certified investors. |
17156
|
3. Makes qualified investments as its primary activity. |
17157
|
(e) "Commission" means the Financial Services Commission |
17158
|
"Department" means the Department of Banking and Finance. |
17159
|
(f) "Director" means the director of the Office of |
17160
|
Tourism, Trade, and Economic Development. |
17161
|
(f)(g)"Early stage technology business" means a qualified |
17162
|
business that is: |
17163
|
1. Involved, at the time of the certified capital |
17164
|
company's initial investment in such business, in activities |
17165
|
related to developing initial product or service offerings, such |
17166
|
as prototype development or the establishment of initial |
17167
|
production or service processes; |
17168
|
2. Less than 2 years old and has, together with its |
17169
|
affiliates, less than $3 million in annual revenues for the |
17170
|
fiscal year immediately preceding the initial investment by the |
17171
|
certified capital company on a consolidated basis, as determined |
17172
|
in accordance with generally accepted accounting principles; |
17173
|
3. The Florida Black Business Investment Board; |
17174
|
4. Any entity that is majority owned by the Florida Black |
17175
|
Business Investment Board; or |
17176
|
5. Any entity in which the Florida Black Business |
17177
|
Investment Board holds a majority voting interest on the board |
17178
|
of directors. |
17179
|
(g)(h) "Office" means the Office of Financial Institutions |
17180
|
and Securities Regulation of the commissionTourism, Trade, and |
17181
|
Economic Development. |
17182
|
(h)(i)"Premium tax liability" means any liability |
17183
|
incurred by an insurance company under the provisions of ss. |
17184
|
624.509 and 624.5091. |
17185
|
(i)(j)"Principal" means an executive officer of a |
17186
|
corporation, partner of a partnership, manager of a limited |
17187
|
liability company, or any other person with equivalent executive |
17188
|
functions. |
17189
|
(j)(k)"Qualified business" means the Digital Divide Trust |
17190
|
Fund established under the State of Florida Technology Office or |
17191
|
a business that meets the following conditions as evidenced by |
17192
|
documentation required by commissiondepartmentrule: |
17193
|
1. The business is headquartered in this state and its |
17194
|
principal business operations are located in this state or at |
17195
|
least 75 percent of the employees are employed in the state. |
17196
|
2. At the time a certified capital company makes an |
17197
|
initial investment in a business, the business would qualify for |
17198
|
investment under 13 C.F.R. s. 121.301(c), which is involved in |
17199
|
manufacturing, processing or assembling products, conducting |
17200
|
research and development, or providing services. |
17201
|
3. At the time a certified capital company makes an |
17202
|
initial investment in a business, the business certifies in an |
17203
|
affidavit that: |
17204
|
a. The business is unable to obtain conventional |
17205
|
financing, which means that the business has failed in an |
17206
|
attempt to obtain funding for a loan from a bank or other |
17207
|
commercial lender or that the business cannot reasonably be |
17208
|
expected to qualify for such financing under the standards of |
17209
|
commercial lending; |
17210
|
b. The business plan for the business projects that the |
17211
|
business is reasonably expected to achieve in excess of $25 |
17212
|
million in sales revenue within 5 years after the initial |
17213
|
investment, or the business is located in a designated Front |
17214
|
Porch community, enterprise zone, urban high crime area, rural |
17215
|
job tax credit county, or nationally recognized historic |
17216
|
district; |
17217
|
c. The business will maintain its headquarters in this |
17218
|
state for the next 10 years and any new manufacturing facility |
17219
|
financed by a qualified investment will remain in this state for |
17220
|
the next 10 years, or the business is located in a designated |
17221
|
Front Porch community, enterprise zone, urban high crime area, |
17222
|
rural job tax credit county, or nationally recognized historic |
17223
|
district; and |
17224
|
d. The business has fewer than 200 employees and at least |
17225
|
75 percent of the employees are employed in this state. For |
17226
|
purposes of this subsection, the term also includes the Florida |
17227
|
Black Business Investment Board, any entity majority owned by |
17228
|
the Florida Black Business Investment Board, or any entity in |
17229
|
which the Florida Black Business Investment Board holds a |
17230
|
majority voting interest on the board of directors. |
17231
|
4. The term does not include: |
17232
|
a. Any business predominantly engaged in retail sales, |
17233
|
real estate development, insurance, banking, lending, or oil and |
17234
|
gas exploration. |
17235
|
b. Any business predominantly engaged in professional |
17236
|
services provided by accountants, lawyers, or physicians. |
17237
|
c. Any company that has no historical revenues and either |
17238
|
has no specific business plan or purpose or has indicated that |
17239
|
its business plan is solely to engage in a merger or acquisition |
17240
|
with any unidentified company or other entity. |
17241
|
d. Any company that has a strategic plan to grow through |
17242
|
the acquisition of firms with substantially similar business |
17243
|
which would result in the planned net loss of Florida-based jobs |
17244
|
over a 12-month period after the acquisition as determined by |
17245
|
the officedepartment. |
17246
|
(k)(l)"Qualified debt instrument" means a debt |
17247
|
instrument, or a hybrid of a debt instrument, issued by a |
17248
|
certified capital company, at par value or a premium, with an |
17249
|
original maturity date of at least 5 years after the date of |
17250
|
issuance, a repayment schedule which is no faster than a level |
17251
|
principal amortization over a 5-year period, and interest, |
17252
|
distribution, or payment features which are not related to the |
17253
|
profitability of the certified capital company or the |
17254
|
performance of the certified capital company's investment |
17255
|
portfolio. |
17256
|
(l)(m)"Qualified distribution" means any distribution or |
17257
|
payment by a certified capital company for: |
17258
|
1. Reasonable costs and expenses, including, but not |
17259
|
limited to, professional fees, of forming and syndicating the |
17260
|
certified capital company, if no such costs or expenses are paid |
17261
|
to a certified investor, except as provided in subparagraph |
17262
|
(4)(f)2., and the total cash, cash equivalents, and other |
17263
|
current assets permitted by sub-subparagraph (5)(b)3.g. that can |
17264
|
be converted into cash within 5 business days available to the |
17265
|
certified capital company at the time of receipt of certified |
17266
|
capital from certified investors, after deducting the costs and |
17267
|
expenses of forming and syndicating the certified capital |
17268
|
company, including any payments made over time for obligations |
17269
|
incurred at the time of receipt of certified capital but |
17270
|
excluding other future qualified distributions and payments made |
17271
|
under paragraph (9)(a), are an amount equal to or greater than |
17272
|
50 percent of the total certified capital allocated to the |
17273
|
certified capital pursuant to subsection (7); |
17274
|
2. Reasonable costs of managing and operating the |
17275
|
certified capital company, not exceeding 5 percent of the |
17276
|
certified capital in any single year, including an annual |
17277
|
management fee in an amount that does not exceed 2.5 percent of |
17278
|
the certified capital of the certified capital company; |
17279
|
3. Reasonable and necessary fees in accordance with |
17280
|
industry custom for professional services, including, but not |
17281
|
limited to, legal and accounting services, related to the |
17282
|
operation of the certified capital company; or |
17283
|
4. Any projected increase in federal or state taxes, |
17284
|
including penalties and interest related to state and federal |
17285
|
income taxes, of the equity owners of a certified capital |
17286
|
company resulting from the earnings or other tax liability of |
17287
|
the certified capital company to the extent that the increase is |
17288
|
related to the ownership, management, or operation of a |
17289
|
certified capital company. |
17290
|
(m)(n)1. "Qualified investment" means the investment of |
17291
|
cash by a certified capital company in a qualified business for |
17292
|
the purchase of any debt, equity, or hybrid security, including |
17293
|
a debt instrument or security that has the characteristics of |
17294
|
debt but which provides for conversion into equity or equity |
17295
|
participation instruments such as options or warrants. |
17296
|
2. The term does not include: |
17297
|
a. Any investment made after the effective date of this |
17298
|
act the contractual terms of which require the repayment of any |
17299
|
portion of the principal in instances, other than default as |
17300
|
determined by commissiondepartmentrule, within 12 months |
17301
|
following the initial investment by the certified capital |
17302
|
company unless such investment has a repayment schedule no |
17303
|
faster than a level principal amortization of at least 2 years; |
17304
|
b. Any "follow-on" or "add-on" investment except for the |
17305
|
amount by which the new investment is in addition to the amount |
17306
|
of the certified capital company's initial investment returned |
17307
|
to it other than in the form of interest, dividends, or other |
17308
|
types of profit participation or distributions; or |
17309
|
c. Any investment in a qualified business or affiliate of |
17310
|
a qualified business that exceeds 15 percent of certified |
17311
|
capital. |
17312
|
(n)(o)"Program One" means the $150 million in premium tax |
17313
|
credits issued under this section in 1999, the allocation of |
17314
|
such credits under this section, and the regulation of certified |
17315
|
capital companies and investments made by them hereunder. |
17316
|
(o)(p)"Program Two" means the $150 million in premium tax |
17317
|
credits to be issued under subsection (17), the allocation of |
17318
|
such credits under this section, and the regulation of certified |
17319
|
capital companies and investments made by them hereunder. |
17320
|
(4) CERTIFICATION; GROUNDS FOR DENIAL OR |
17321
|
DECERTIFICATION.-- |
17322
|
(a) To operate as a certified capital company, a |
17323
|
corporation, partnership, or limited liability company must be |
17324
|
certified by the Department of Banking and Finance or the office |
17325
|
pursuant to this act. |
17326
|
(b) An applicant for certification as a certified capital |
17327
|
company must file a verified application with the Department of |
17328
|
Banking and Financeon or before December 1, 1998, a date |
17329
|
determined in rules adopted pursuant to subsection (17) in the |
17330
|
case of applicants for Program Two, in a form which the |
17331
|
commissiondepartmentmay prescribe by rule. The applicant shall |
17332
|
submit a nonrefundable application fee of $7,500 to the office |
17333
|
department. The applicant shall provide: |
17334
|
1. The name of the applicant and the address of its |
17335
|
principal office and each office in this state. |
17336
|
2. The applicant's form and place of organization and the |
17337
|
relevant organizational documents, bylaws, and amendments or |
17338
|
restatements of such documents, bylaws, or amendments. |
17339
|
3. Evidence from the Department of State that the |
17340
|
applicant is registered with the Department of State as required |
17341
|
by law, maintains an active status with the Department of State, |
17342
|
and has not been dissolved or had its registration revoked, |
17343
|
canceled, or withdrawn. |
17344
|
4. The applicant's proposed method of doing business. |
17345
|
5. The applicant's financial condition and history, |
17346
|
including an audit report on the financial statements prepared |
17347
|
in accordance with generally accepted accounting principles. The |
17348
|
applicant must have, at the time of application for |
17349
|
certification, an equity capitalization of at least $500,000 in |
17350
|
the form of cash or cash equivalents. The applicant must |
17351
|
maintain this equity capitalization until the applicant receives |
17352
|
an allocation of certified capital pursuant to this act. If the |
17353
|
date of the application is more than 90 days after preparation |
17354
|
of the applicant's fiscal year-end financial statements, the |
17355
|
applicant may file financial statements reviewed by an |
17356
|
independent certified public accountant for the period |
17357
|
subsequent to the audit report, together with the audited |
17358
|
financial statement for the most recent fiscal year. If the |
17359
|
applicant has been in business less than 12 months, and has not |
17360
|
prepared an audited financial statement, the applicant may file |
17361
|
a financial statement reviewed by an independent certified |
17362
|
public accountant. |
17363
|
6. Copies of any offering materials used or proposed to be |
17364
|
used by the applicant in soliciting investments of certified |
17365
|
capital from certified investors. |
17366
|
(c) Within 60 days after receipt of a verified |
17367
|
application, the officedepartmentshall grant or deny |
17368
|
certification as a certified capital company. If the office |
17369
|
departmentdenies certification within the time period |
17370
|
specified, the officedepartmentshall inform the applicant of |
17371
|
the grounds for the denial. If the officedepartmenthas not |
17372
|
granted or denied certification within the time specified, the |
17373
|
application shall be deemed approved. The officedepartment |
17374
|
shall approve the application if the officedepartmentfinds |
17375
|
that: |
17376
|
1. The applicant satisfies the requirements of paragraph |
17377
|
(b). |
17378
|
2. No evidence exists that the applicant has committed any |
17379
|
act specified in paragraph (d). |
17380
|
3. At least two of the principals have a minimum of 5 |
17381
|
years of experience making venture capital investments out of |
17382
|
private equity funds, with not less than $20 million being |
17383
|
provided by third-party investors for investment in the early |
17384
|
stage of operating businesses. At least one full-time manager or |
17385
|
principal of the certified capital company who has such |
17386
|
experience must be primarily located in an office of the |
17387
|
certified capital company which is based in this state. |
17388
|
4. The applicant's proposed method of doing business and |
17389
|
raising certified capital as described in its offering materials |
17390
|
and other materials submitted to the officedepartmentconforms |
17391
|
with the requirements of this section. |
17392
|
(d) The officedepartmentmay deny certification or |
17393
|
decertify a certified capital company if the grounds for |
17394
|
decertification are not removed or corrected within 90 days |
17395
|
after the notice of such grounds is received by the certified |
17396
|
capital company. The officedepartmentmay deny certification or |
17397
|
decertify a certified capital company if the certified capital |
17398
|
company fails to maintain common stock or paid-in capital of at |
17399
|
least $500,000, or if the officedepartmentdetermines that the |
17400
|
applicant, or any principal or director of the certified capital |
17401
|
company, has: |
17402
|
1. Violated any provision of this section; |
17403
|
2. Made a material misrepresentation or false statement or |
17404
|
concealed any essential or material fact from any person during |
17405
|
the application process or with respect to information and |
17406
|
reports required of certified capital companies under this |
17407
|
section; |
17408
|
3. Been convicted of, or entered a plea of guilty or nolo |
17409
|
contendere to, a crime against the laws of this state or any |
17410
|
other state or of the United States or any other country or |
17411
|
government, including a fraudulent act in connection with the |
17412
|
operation of a certified capital company, or in connection with |
17413
|
the performance of fiduciary duties in another capacity; |
17414
|
4. Been adjudicated liable in a civil action on grounds of |
17415
|
fraud, embezzlement, misrepresentation, or deceit; or |
17416
|
5.a. Been the subject of any decision, finding, |
17417
|
injunction, suspension, prohibition, revocation, denial, |
17418
|
judgment, or administrative order by any court of competent |
17419
|
jurisdiction, administrative law judge, or any state or federal |
17420
|
agency, national securities, commodities, or option exchange, or |
17421
|
national securities, commodities, or option association, |
17422
|
involving a material violation of any federal or state |
17423
|
securities or commodities law or any rule or regulation adopted |
17424
|
under such law, or any rule or regulation of any national |
17425
|
securities, commodities, or options exchange, or national |
17426
|
securities, commodities, or options association; or |
17427
|
b. Been the subject of any injunction or adverse |
17428
|
administrative order by a state or federal agency regulating |
17429
|
banking, insurance, finance or small loan companies, real |
17430
|
estate, mortgage brokers, or other related or similar |
17431
|
industries. |
17432
|
(g) On or before December 31 of each year, each certified |
17433
|
capital company shall pay to the officedepartmentan annual, |
17434
|
nonrefundable renewal certification fee of $5,000. If a |
17435
|
certified capital company fails to pay its renewal fee by the |
17436
|
specified deadline, the company must pay a late fee of $5,000 in |
17437
|
addition to the renewal fee on or by January 31 of each year in |
17438
|
order to continue its certification in the program. On or before |
17439
|
April 30 of each year, each certified capital company shall file |
17440
|
audited financial statements with the officedepartment. No |
17441
|
renewal fees shall be required within 6 months after the date of |
17442
|
initial certification. |
17443
|
(h) The commission and officedepartmentshall administer |
17444
|
and provide for the enforcement of certification requirements |
17445
|
for certified capital companies as provided in this act. The |
17446
|
commissiondepartmentmay adopt any rules necessary to carry out |
17447
|
its duties, obligations, and powers related to certification, |
17448
|
renewal of certification, or decertification of certified |
17449
|
capital companies and the commission and officemay perform any |
17450
|
other acts necessary for the proper administration and |
17451
|
enforcement of such duties, obligations, and powers. |
17452
|
(5) INVESTMENTS BY CERTIFIED CAPITAL COMPANIES.-- |
17453
|
(b) All capital not invested in qualified investments by |
17454
|
the certified capital company: |
17455
|
1. Must be held in a financial institution as defined by |
17456
|
s. 655.005(1)(h) or held by a broker-dealer registered under s. |
17457
|
517.12, except as set forth in sub-subparagraph 3.g. |
17458
|
2. Must not be invested in a certified investor of the |
17459
|
certified capital company or any affiliate of the certified |
17460
|
investor of the certified capital company, except for an |
17461
|
investment permitted by sub-subparagraph 3.g., provided |
17462
|
repayment terms do not permit the obligor to directly or |
17463
|
indirectly manage or control the investment decisions of the |
17464
|
certified capital company. |
17465
|
3. Must be invested only in: |
17466
|
a. Any United States Treasury obligations; |
17467
|
b. Certificates of deposit or other obligations, maturing |
17468
|
within 3 years after acquisition of such certificates or |
17469
|
obligations, issued by any financial institution or trust |
17470
|
company incorporated under the laws of the United States; |
17471
|
c. Marketable obligations, maturing within 10 years or |
17472
|
less after the acquisition of such obligations, which are rated |
17473
|
"A" or better by any nationally recognized credit rating agency; |
17474
|
d. Mortgage-backed securities, with an average life of 5 |
17475
|
years or less, after the acquisition of such securities, which |
17476
|
are rated "A" or better by any nationally recognized credit |
17477
|
rating agency; |
17478
|
e. Collateralized mortgage obligations and real estate |
17479
|
mortgage investment conduits that are direct obligations of an |
17480
|
agency of the United States Government; are not private-label |
17481
|
issues; are in book-entry form; and do not include the classes |
17482
|
of interest only, principal only, residual, or zero; |
17483
|
f. Interests in money market funds, the portfolio of which |
17484
|
is limited to cash and obligations described in sub- |
17485
|
subparagraphs a.-d.; or |
17486
|
g. Obligations that are issued by an insurance company |
17487
|
that is not a certified investor of the certified capital |
17488
|
company making the investment, that has provided a guarantee |
17489
|
indemnity bond, insurance policy, or other payment undertaking |
17490
|
in favor of the certified capital company's certified investors |
17491
|
as permitted by subparagraph (3)(l)(m)1. or an affiliate of such |
17492
|
insurance company as defined by subparagraph (3)(a)3. that is |
17493
|
not a certified investor of the certified capital company making |
17494
|
the investment, provided that such obligations are: |
17495
|
(I) Issued or guaranteed as to principal by an entity |
17496
|
whose senior debt is rated "AA" or better by Standard & Poor's |
17497
|
Ratings Group or such other nationally recognized credit rating |
17498
|
agency as the commissiondepartmentmay by rule determine. |
17499
|
(II) Not subordinated to other unsecured indebtedness of |
17500
|
the issuer or the guarantor. |
17501
|
(III) Invested by such issuing entity in accordance with |
17502
|
sub-subparagraphs 3.a.-f. |
17503
|
(IV) Readily convertible into cash within 5 business days |
17504
|
for the purpose of making a qualified investment unless such |
17505
|
obligations are held to provide a guarantee, indemnity bond, |
17506
|
insurance policy, or other payment undertaking in favor of the |
17507
|
certified capital company's certified investors as permitted by |
17508
|
subparagraph (3)(l)(m)1. |
17509
|
(7) ANNUAL TAX CREDIT; MAXIMUM AMOUNT; ALLOCATION |
17510
|
PROCESS.-- |
17511
|
(a) The total amount of tax credits which may be allocated |
17512
|
by the Office of Tourism, Trade, and Economic Developmentshall |
17513
|
not exceed $150 million with respect to Program One and $150 |
17514
|
million with respect to Program Two. The total amount of tax |
17515
|
credits which may be used by certified investors under this act |
17516
|
shall not exceed $15 million annually with respect to credits |
17517
|
earned under Program One and $15 million annually with respect |
17518
|
to credits earned under Program Two. |
17519
|
(b) The Office of Tourism, Trade, and Economic Development |
17520
|
shall be responsible for allocating premium tax credits as |
17521
|
provided for in this act to certified capital companies. |
17522
|
(c) Each certified capital company must apply to the |
17523
|
Office of Tourism, Trade, and Economic Developmentfor an |
17524
|
allocation of premium tax credits for potential certified |
17525
|
investors on a form developed by the Office of Tourism, Trade, |
17526
|
and Economic Developmentwith the cooperation of the Department |
17527
|
of Revenue. The form shall be accompanied by an affidavit from |
17528
|
each potential certified investor confirming that the potential |
17529
|
certified investor has agreed to make an investment of certified |
17530
|
capital in a certified capital company up to a specified amount, |
17531
|
subject only to the receipt of a premium tax credit allocation |
17532
|
pursuant to this subsection. No certified capital company shall |
17533
|
submit premium tax allocation claims on behalf of certified |
17534
|
investors that in the aggregate would exceed the total dollar |
17535
|
amount appropriated by the Legislature for the specific program. |
17536
|
No allocation shall be made to the potential investors of a |
17537
|
certified capital company under Program Two unless such |
17538
|
certified capital company has filed premium tax allocation |
17539
|
claims of not less than $15 million in the aggregate. |
17540
|
(d) The Office of Tourism, Trade, and Economic Development |
17541
|
shall inform each certified capital company of its share of |
17542
|
total premium tax credits available for allocation to each of |
17543
|
its potential investors. |
17544
|
(e) If a certified capital company does not receive |
17545
|
certified capital equaling the amount of premium tax credits |
17546
|
allocated to a potential certified investor for which the |
17547
|
investor filed a premium tax allocation claim within 10 business |
17548
|
days after the investor received a notice of allocation, the |
17549
|
certified capital company shall notify the Office of Tourism, |
17550
|
Trade, and Economic Developmentby overnight common carrier |
17551
|
delivery service of the company's failure to receive the |
17552
|
capital. That portion of the premium tax credits allocated to |
17553
|
the certified capital company shall be forfeited. If the Office |
17554
|
of Tourism, Trade, and Economic Developmentmust make a pro rata |
17555
|
allocation under paragraph (f), thattheoffice shall reallocate |
17556
|
such available credits among the other certified capital |
17557
|
companies on the same pro rata basis as the initial allocation. |
17558
|
(f) If the total amount of capital committed by all |
17559
|
certified investors to certified capital companies in premium |
17560
|
tax allocation claims under Program Two exceeds the aggregate |
17561
|
cap on the amount of credits that may be awarded under Program |
17562
|
Two, the premium tax credits that may be allowed to any one |
17563
|
certified investor under Program Two shall be allocated using |
17564
|
the following ratio: |
17565
|
A/B = X/>$150,000,000 |
17566
|
|
17567
|
|
17568
|
where the letter "A" represents the total amount of certified |
17569
|
capital certified investors have agreed to invest in any one |
17570
|
certified capital company under Program Two, the letter "B" |
17571
|
represents the aggregate amount of certified capital that all |
17572
|
certified investors have agreed to invest in all certified |
17573
|
capital companies under Program Two, the letter "X" is the |
17574
|
numerator and represents the total amount of premium tax credits |
17575
|
and certified capital that may be allocated to a certified |
17576
|
capital company on a date determined by rule adopted by the |
17577
|
commissiondepartmentpursuant to subsection (17), and $150 |
17578
|
million is the denominator and represents the total amount of |
17579
|
premium tax credits and certified capital that may be allocated |
17580
|
to all certified investors under Program Two. Any such premium |
17581
|
tax credits are not first available for utilization until annual |
17582
|
filings are made in 2001 for calendar year 2000 in the case of |
17583
|
Program One, and the tax credits may be used at a rate not to |
17584
|
exceed 10 percent annually per program. |
17585
|
(g) The maximum amount of certified capital for which |
17586
|
premium tax allocation claims may be filed on behalf of any |
17587
|
certified investor and its affiliates by one or more certified |
17588
|
capital companies may not exceed $15 million for Program One and |
17589
|
$22.5 million for Program Two. |
17590
|
(h) To the extent that less than $150 million in certified |
17591
|
capital is raised in connection with the procedure set forth in |
17592
|
paragraphs (c)-(g), the commissiondepartmentmay adopt rules to |
17593
|
allow a subsequent allocation of the remaining premium tax |
17594
|
credits authorized under this section. |
17595
|
(i) The Office of Tourism, Trade, and Economic Development |
17596
|
shall issue a certification letter for each certified investor, |
17597
|
showing the amount invested in the certified capital company |
17598
|
under each program. The applicable certified capital company |
17599
|
shall attest to the validity of the certification letter. |
17600
|
(8) ANNUAL TAX CREDIT; CLAIM PROCESS.-- |
17601
|
(a) On an annual basis, on or before January 31, each |
17602
|
certified capital company shall file with the officedepartment |
17603
|
and the Office of Tourism, Trade, and Economic Development, in |
17604
|
consultation with the officedepartment, on a form prescribed by |
17605
|
the Office of Tourism, Trade, and Economic Development, for each |
17606
|
calendar year: |
17607
|
1. The total dollar amount the certified capital company |
17608
|
received from certified investors, the identity of the certified |
17609
|
investors, and the amount received from each certified investor |
17610
|
during the immediately preceding calendar year. |
17611
|
2. The total dollar amount the certified capital company |
17612
|
invested and the amount invested in qualified businesses, |
17613
|
together with the identity and location of those businesses and |
17614
|
the amount invested in each qualified business during the |
17615
|
immediately preceding calendar year. |
17616
|
3. For informational purposes only, the total number of |
17617
|
permanent, full-time jobs either created or retained by the |
17618
|
qualified business during the immediately preceding calendar |
17619
|
year, the average wage of the jobs created or retained, the |
17620
|
industry sectors in which the qualified businesses operate, and |
17621
|
any additional capital invested in qualified businesses from |
17622
|
sources other than certified capital companies. |
17623
|
(c) The Office of Tourism, Trade, and Economic Development |
17624
|
shall review the form, and any supplemental documentation, |
17625
|
submitted by each certified capital company for the purpose of |
17626
|
verifying: |
17627
|
1. That the businesses in which certified capital has been |
17628
|
invested by the certified capital company are in fact qualified |
17629
|
businesses, and that the amount of certified capital invested by |
17630
|
the certified capital company is as represented in the form. |
17631
|
2. The amount of certified capital invested in the |
17632
|
certified capital company by the certified investors. |
17633
|
3. The amount of premium tax credit available to certified |
17634
|
investors. |
17635
|
(9) REQUIREMENT FOR 100 PERCENT INVESTMENT; STATE |
17636
|
PARTICIPATION.-- |
17637
|
(b) Cumulative distributions from a certified capital |
17638
|
company from funds related to a particular program to its |
17639
|
certified investors and equity holders under such program, other |
17640
|
than qualified distributions, in excess of the certified capital |
17641
|
company's original certified capital raised under such program |
17642
|
and any additional capital contributions to the certified |
17643
|
capital company with respect to such program may be audited by a |
17644
|
nationally recognized certified public accounting firm |
17645
|
acceptable to the officedepartment, at the expense of the |
17646
|
certified capital company, if the officedepartmentdirects such |
17647
|
audit be conducted. The audit shall determine whether aggregate |
17648
|
cumulative distributions from the funds related to a particular |
17649
|
program made by the certified capital company to all certified |
17650
|
investors and equity holders under such program, other than |
17651
|
qualified distributions, have equaled the sum of the certified |
17652
|
capital company's original certified capital raised under such |
17653
|
program and any additional capital contributions to the |
17654
|
certified capital company with respect to such program. If at |
17655
|
the time of any such distribution made by the certified capital |
17656
|
company, such distribution taken together with all other such |
17657
|
distributions from the funds related to such program made by the |
17658
|
certified capital company, other than qualified distributions, |
17659
|
exceeds in the aggregate the sum of the certified capital |
17660
|
company's original certified capital raised under such program |
17661
|
and any additional capital contributions to the certified |
17662
|
capital company with respect to such program, as determined by |
17663
|
the audit, the certified capital company shall pay to the |
17664
|
Department of Revenue 10 percent of the portion of such |
17665
|
distribution in excess of such amount. Payments to the |
17666
|
Department of Revenue by a certified capital company pursuant to |
17667
|
this paragraph shall not exceed the aggregate amount of tax |
17668
|
credits used by all certified investors in such certified |
17669
|
capital company for such program. |
17670
|
(10) DECERTIFICATION.-- |
17671
|
(a) The officedepartmentshall conduct an annual review |
17672
|
of each certified capital company to determine if the certified |
17673
|
capital company is abiding by the requirements of certification, |
17674
|
to advise the certified capital company as to the eligibility |
17675
|
status of its qualified investments, and to ensure that no |
17676
|
investment has been made in violation of this act. The cost of |
17677
|
the annual review shall be paid by each certified capital |
17678
|
company. |
17679
|
(b) Nothing contained in this subsection shall be |
17680
|
construed to limit the Chief Financial Officer's or the office's |
17681
|
Comptroller'sauthority to conduct audits of certified capital |
17682
|
companies as deemed appropriate and necessary. |
17683
|
(c) Any material violation of this section, or a finding |
17684
|
that the certified capital company or any principal or director |
17685
|
thereof has committed any act specified in paragraph (4)(d), |
17686
|
shall be grounds for decertification of the certified capital |
17687
|
company. If the officedepartmentdetermines that a certified |
17688
|
capital company is no longer in compliance with the |
17689
|
certification requirements of this act, the officedepartment |
17690
|
shall, by written notice, inform the officers of such company |
17691
|
that the company may be subject to decertification 90 days after |
17692
|
the date of mailing of the notice, unless the deficiencies are |
17693
|
corrected and such company is again found to be in compliance |
17694
|
with all certification requirements. |
17695
|
(d) At the end of the 90-day grace period, if the |
17696
|
certified capital company is still not in compliance with the |
17697
|
certification requirements, the officedepartmentmay issue a |
17698
|
notice to revoke or suspend the certification or to impose an |
17699
|
administrative fine. The officedepartmentshall advise each |
17700
|
respondent of the right to an administrative hearing under |
17701
|
chapter 120 prior to final action by the officedepartment. |
17702
|
(e) If the officedepartmentrevokes a certification, such |
17703
|
revocation shall also deny, suspend, or revoke the |
17704
|
certifications of all affiliates of the certified capital |
17705
|
company. |
17706
|
(h) The Office of Tourism, Trade, and Economic Development |
17707
|
shall send written notice to the address of each certified |
17708
|
investor whose premium tax credit has been subject to recapture |
17709
|
or forfeiture, using the address last shown on the last premium |
17710
|
tax filing. |
17711
|
(j) The certified investor shall file with the Department |
17712
|
of Revenue an amended return or such other report as the |
17713
|
commissiondepartment may prescribe by ruleregulationand pay |
17714
|
any required tax, not later than 60 days after such |
17715
|
decertification has been agreed to or finally determined, |
17716
|
whichever shall first occur. |
17717
|
(12) REPORTING REQUIREMENTS.--The Office of Tourism, |
17718
|
Trade, and Economic Developmentshall report on an annual basis |
17719
|
to the Governor, the President of the Senate, and the Speaker of |
17720
|
the House of Representatives on or before April 1: |
17721
|
(a) The total dollar amount each certified capital company |
17722
|
received from all certified investors and any other investor, |
17723
|
the identity of the certified investors, and the total amount of |
17724
|
premium tax credit used by each certified investor for the |
17725
|
previous calendar year. |
17726
|
(b) The total dollar amount invested by each certified |
17727
|
capital company and that portion invested in qualified |
17728
|
businesses, the identity and location of those businesses, the |
17729
|
amount invested in each qualified business, and the total number |
17730
|
of permanent, full-time jobs created or retained by each |
17731
|
qualified business. |
17732
|
(c) The return for the state as a result of the certified |
17733
|
capital company investments, including the extent to which: |
17734
|
1. Certified capital company investments have contributed |
17735
|
to employment growth. |
17736
|
2. The wage level of businesses in which certified capital |
17737
|
companies have invested exceed the average wage for the county |
17738
|
in which the jobs are located. |
17739
|
3. The investments of the certified capital companies in |
17740
|
qualified businesses have contributed to expanding or |
17741
|
diversifying the economic base of the state. |
17742
|
(13) FEES.--All fees and charges of any nature collected |
17743
|
by the officedepartmentpursuant to this act shall be paid into |
17744
|
the State Treasury and credited to the General Revenue Fund. |
17745
|
(14) RULEMAKING AUTHORITY.-- |
17746
|
(a) The Department of Revenue may by rule prescribe forms |
17747
|
and procedures for the tax credit filings, audits, and |
17748
|
forfeiture of premium tax credits described in this section, and |
17749
|
for certified capital company payments under paragraph (9)(b). |
17750
|
(b) The commission and the Office of Tourism, Trade, and |
17751
|
Economic Development may adopt any rules necessary to carry out |
17752
|
their respectiveitsduties, obligations, and powers related to |
17753
|
the administration, review, and reporting provisions of this |
17754
|
section and may perform any other acts necessary for the proper |
17755
|
administration and enforcement of such duties, obligations, and |
17756
|
powers. |
17757
|
(15)(a) CONFIDENTIALITY OF INVESTIGATION AND REVIEW |
17758
|
INFORMATION.--Except as otherwise provided by this section, any |
17759
|
information relating to an investigation or officedepartment |
17760
|
review of a certified capital company, including any consumer |
17761
|
complaint, is confidential and exempt from the provisions of s. |
17762
|
119.07(1) and s. 24(a), Art. I of the State Constitution until |
17763
|
the investigation or review is complete or ceases to be active. |
17764
|
Such information shall remain confidential and exempt from the |
17765
|
provisions of s. 119.07(1) and s. 24(a), Art. I of the State |
17766
|
Constitution after the investigation or review is complete or |
17767
|
ceases to be active if the information is submitted to any law |
17768
|
enforcement or administrative agency for further investigation, |
17769
|
and shall remain confidential and exempt from the provisions of |
17770
|
s. 119.07(1) and s. 24(a), Art. I of the State Constitution |
17771
|
until that agency's investigation is complete or ceases to be |
17772
|
active. For purposes of this subsection, an investigation or |
17773
|
review shall be considered "active" so long as the office |
17774
|
department, a law enforcement agency, or an administrative |
17775
|
agency is proceeding with reasonable dispatch and has a |
17776
|
reasonable good faith belief that the investigation may lead to |
17777
|
the filing of an administrative, civil, or criminal proceeding. |
17778
|
This section shall not be construed to prohibit disclosure of |
17779
|
information which is required by law to be filed with the office |
17780
|
departmentand which, but for the investigation, would otherwise |
17781
|
be subject to s. 119.07(1). |
17782
|
(c) Nothing in this section shall be construed to prohibit |
17783
|
the officedepartmentfrom providing information to any law |
17784
|
enforcement or administrative agency. Any law enforcement or |
17785
|
administrative agency receiving confidential information in |
17786
|
connection with its official duties shall maintain the |
17787
|
confidentiality of the information so long as it would otherwise |
17788
|
be confidential. |
17789
|
(d) In the event officedepartmentpersonnel are or have |
17790
|
been involved in an investigation or review of such nature as to |
17791
|
endanger their lives or physical safety or that of their |
17792
|
families, the home addresses, telephone numbers, places of |
17793
|
employment, and photographs of such personnel, together with the |
17794
|
home addresses, telephone numbers, photographs, and places of |
17795
|
employment of spouses and children of such personnel and the |
17796
|
names and locations of schools and day care facilities attended |
17797
|
by the children of such personnel are confidential and exempt |
17798
|
from s. 119.07(1). |
17799
|
(e) All information obtained by the officedepartmentfrom |
17800
|
any person which is only made available to the officedepartment |
17801
|
on a confidential or similarly restricted basis shall be |
17802
|
confidential and exempt from s. 119.07(1). This exemption shall |
17803
|
not be construed to prohibit disclosure of information which is |
17804
|
specifically required by law to be filed with the office |
17805
|
departmentor which is otherwise subject to s. 119.07(1). |
17806
|
(g) A privilege against civil liability is granted to a |
17807
|
person with regard to information or evidence furnished to the |
17808
|
officedepartment, unless such person acts in bad faith or with |
17809
|
malice in providing such information or evidence. |
17810
|
(17) Notwithstanding the limitations set forth in |
17811
|
paragraph (7)(a), in the first fiscal year in which the total |
17812
|
insurance premium tax collections as determined by the Revenue |
17813
|
Estimating Conference exceed collections for fiscal year 2000- |
17814
|
2001 by more than the total amount of tax credits issued |
17815
|
pursuant to this section which were used by certified investors |
17816
|
in that year, the Office of Tourism, Trade, and Economic |
17817
|
Developmentmay allocate to certified investors in accordance |
17818
|
with paragraph (7)(a) tax credits for Program Two. The |
17819
|
commissiondepartmentshall establish, by rule, a date and |
17820
|
procedures by which certified capital companies must file |
17821
|
applications for allocations of such additional premium tax |
17822
|
credits, which date shall be no later than 180 days from the |
17823
|
date of determination by the Revenue Estimating Conference. With |
17824
|
respect to new certified capital invested and premium tax |
17825
|
credits earned pursuant to this subsection, the schedule |
17826
|
specified in subparagraphs (5)(a)1.-4. is satisfied by |
17827
|
investments by December 31 of the 2nd, 3rd, 4th, and 5th |
17828
|
calendar year, respectively, after the date established by the |
17829
|
commissiondepartmentfor applications of additional premium tax |
17830
|
credits. The commissiondepartmentshall adopt rules by which an |
17831
|
entity not already certified as a certified capital company may |
17832
|
apply for certification as a certified capital company for |
17833
|
participation in this additional allocation. The insurance |
17834
|
premium tax credit authorized by Program Two may not be used by |
17835
|
certified investors until the annual return due March 1, 2004, |
17836
|
and may be used on all subsequent returns and estimated |
17837
|
payments; however, notwithstanding the provisions of s. |
17838
|
624.5092(2)(b), the installments of taxes due and payable on |
17839
|
April 15, 2004, and June 15, 2004, shall be based on the net tax |
17840
|
due in 2003 not taking into account credits granted pursuant to |
17841
|
this section for Program Two. |
17842
|
Section 344. Paragraph (c) of subsection (1) of section |
17843
|
289.051, Florida Statutes, is amended to read: |
17844
|
289.051 Membership of financial institutions; loans to |
17845
|
corporation, limitations.-- |
17846
|
(1) Any financial institution may request membership in |
17847
|
the corporation by making application to the board of directors |
17848
|
on such form and in such manner as said board of directors may |
17849
|
require, and membership shall become effective upon acceptance |
17850
|
of such application by said board. Each member of the |
17851
|
corporation shall make loans to the corporation as and when |
17852
|
called upon by it to do so, on such terms and other conditions |
17853
|
as shall be approved from time to time by the board of |
17854
|
directors, subject to the following conditions: |
17855
|
(c) The total amount outstanding on loans to the |
17856
|
corporation made by any member at any one time, when added to |
17857
|
the amount of the investment in the capital stock of the |
17858
|
corporation then held by such member, shall not exceed: |
17859
|
1. Twenty percent of the total amount then outstanding on |
17860
|
loans to the corporation by all members, including, in said |
17861
|
total amount outstanding, amounts validly called for loan but |
17862
|
not yet loaned. |
17863
|
2. The following limit, to be determined as of the time |
17864
|
such member becomes a member on the basis of the audited balance |
17865
|
sheet of such member at the close of its fiscal year immediately |
17866
|
preceding its application for membership, or, in the case of an |
17867
|
insurance company, its last annual statement to the Office of |
17868
|
Insurance Regulation of the Financial Services Commission |
17869
|
Department of Insurance: 2.5 percent of the capital and surplus |
17870
|
of commercial banks and trust companies; 0.5 percent of the |
17871
|
total outstanding loans made by savings and loan associations |
17872
|
and building and loan associations; 2.5 percent of the capital |
17873
|
and unassigned surplus of stock insurance companies, except fire |
17874
|
insurance companies; 2.5 percent of the unassigned surplus of |
17875
|
mutual insurance companies, except fire insurance companies; 0.1 |
17876
|
percent of the assets of fire insurance companies; and such |
17877
|
limits as may be approved by the board of directors of the |
17878
|
corporation for other financial institutions. |
17879
|
Section 345. Subsection (1) of section 289.081, Florida |
17880
|
Statutes, is amended to read: |
17881
|
289.081 Amendments to articles of incorporation.-- |
17882
|
(1) The articles of incorporation may be amended by the |
17883
|
votes of the stockholders and the members of the corporation, |
17884
|
voting separately by classes, and such amendments shall require |
17885
|
approval by the affirmative vote of two-thirds of the votes to |
17886
|
which the stockholders shall be entitled and two-thirds of the |
17887
|
votes to which the members shall be entitled. No amendment of |
17888
|
the articles of incorporation which is inconsistent with the |
17889
|
general purposes expressed herein, or which authorizes any |
17890
|
additional class of capital stock to be issued, or which |
17891
|
eliminates or curtails the right of the Office of Financial |
17892
|
Institutions and Securities Regulation of the Financial Services |
17893
|
CommissionDepartment of Banking and Financeto examine the |
17894
|
corporation or the obligation of the corporation to make reports |
17895
|
as provided in s. 289.121, shall be made. No amendment of the |
17896
|
articles of incorporation which increases the obligation of a |
17897
|
member to make loans to the corporation, or makes any change in |
17898
|
the principal amount, interest rate, maturity date, or in the |
17899
|
security or credit position of any outstanding loan of a member |
17900
|
to the corporation, or affects a member's right to withdraw from |
17901
|
membership as provided herein, or affects a member's voting |
17902
|
rights as provided herein, shall be made without the consent of |
17903
|
each member affected by such amendment. |
17904
|
Section 346. Section 289.121, Florida Statutes, is amended |
17905
|
to read: |
17906
|
289.121 Periodic examinations; reports.--The corporation |
17907
|
shall be examined at least once annually by the Office of |
17908
|
Financial Institutions and Securities Regulation of the |
17909
|
Financial Services CommissionDepartment of Banking and Finance |
17910
|
and shall make reports of its condition not less than annually |
17911
|
to that officesaid departmentand more frequently upon call of |
17912
|
the officedepartment, which in turn shall make copies of such |
17913
|
reports available to the Office of Insurance Regulation of the |
17914
|
Financial Services CommissionDepartment of Insuranceand the |
17915
|
Governor; and the corporation shall also furnish such other |
17916
|
information as may from time to time be required by the Office |
17917
|
of Financial Institutions and Securities RegulationDepartment |
17918
|
of Banking and Financeand Department of State. The corporation |
17919
|
shall pay the actual cost of said examinations. The office |
17920
|
Department of Banking and Financeshall exercise the same power |
17921
|
and authority over corporations organized under this act as is |
17922
|
exercised over financial institutions under the provisions of |
17923
|
the financial institutions codes, when such codes are not in |
17924
|
conflict with this act. |
17925
|
Section 347. Paragraph (d) of subsection (1) of section |
17926
|
420.101, Florida Statutes, is amended to read: |
17927
|
420.101 Housing Development Corporation of Florida; |
17928
|
creation, membership, and purposes.-- |
17929
|
(1) Twenty-five or more persons, a majority of whom shall |
17930
|
be residents of this state, who may desire to create a housing |
17931
|
development corporation under the provisions of this part for |
17932
|
the purpose of promoting and developing housing and advancing |
17933
|
the prosperity and economic welfare of the state and, to that |
17934
|
end, to exercise the powers and privileges hereinafter provided, |
17935
|
may be incorporated by filing in the Department of State, as |
17936
|
hereinafter provided, articles of incorporation. The articles |
17937
|
of incorporation shall contain: |
17938
|
(d) The names and post office addresses of the members of |
17939
|
the first board of directors. The first board of directors shall |
17940
|
be elected by and from the stockholders of the corporation and |
17941
|
shall consist of 21 members. However, fourfiveof such members |
17942
|
shall consist of the following persons, who shall be nonvoting |
17943
|
members: the secretary of the Department of Community Affairs or |
17944
|
her or his designee; the head of the Department of Financial |
17945
|
ServicesBanking and Finance or her or his designee; the head of |
17946
|
the Department of Insurance or her or his designee;one state |
17947
|
senator appointed by the President of the Senate; and one |
17948
|
representative appointed by the Speaker of the House of |
17949
|
Representatives. |
17950
|
Section 348. Section 494.00125, Florida Statutes, is |
17951
|
amended to read: |
17952
|
494.00125 Confidentiality of information relating to |
17953
|
investigations and examinations.-- |
17954
|
(1)(a) Except as otherwise provided by this section, |
17955
|
information relative to an investigation or examination by the |
17956
|
officedepartmentpursuant to this chapter, including any |
17957
|
consumer complaint received by the office or the Department of |
17958
|
Financial Services, is confidential and exempt from s. 119.07(1) |
17959
|
until the investigation or examination is completed or ceases to |
17960
|
be active. The information compiled by the officedepartmentin |
17961
|
such an investigation or examination shall remain confidential |
17962
|
and exempt from s. 119.07(1) after the office'sdepartment's |
17963
|
investigation or examination is completed or ceases to be active |
17964
|
if the officedepartmentsubmits the information to any law |
17965
|
enforcement or administrative agency for further investigation. |
17966
|
Such information shall remain confidential and exempt from s. |
17967
|
119.07(1) until that agency's investigation is completed or |
17968
|
ceases to be active. For purposes of this section, an |
17969
|
investigation or examination shall be considered "active" so |
17970
|
long as the officedepartmentor any law enforcement or |
17971
|
administrative agency is proceeding with reasonable dispatch and |
17972
|
has a reasonable good faith belief that the investigation or |
17973
|
examination may lead to the filing of an administrative, civil, |
17974
|
or criminal proceeding or to the denial or conditional grant of |
17975
|
a license. This section shall not be construed to prohibit |
17976
|
disclosure of information which is required by law to be filed |
17977
|
with the officedepartmentand which, but for the investigation |
17978
|
or examination, would be subject to s. 119.07(1). |
17979
|
(b) Except as necessary for the officedepartmentto |
17980
|
enforce the provisions of this chapter, a consumer complaint and |
17981
|
other information relative to an investigation or examination |
17982
|
shall remain confidential and exempt from s. 119.07(1) after the |
17983
|
investigation or examination is completed or ceases to be active |
17984
|
to the extent disclosure would: |
17985
|
1. Jeopardize the integrity of another active |
17986
|
investigation or examination. |
17987
|
2. Reveal the name, address, telephone number, social |
17988
|
security number, or any other identifying number or information |
17989
|
of any complainant, customer, or account holder. |
17990
|
3. Disclose the identity of a confidential source. |
17991
|
4. Disclose investigative techniques or procedures. |
17992
|
5. Reveal a trade secret as defined in s. 688.002. |
17993
|
(c) In the event that officedepartmentpersonnel are or |
17994
|
have been involved in an investigation or examination of such |
17995
|
nature as to endanger their lives or physical safety or that of |
17996
|
their families, then the home addresses, telephone numbers, |
17997
|
places of employment, and photographs of such personnel, |
17998
|
together with the home addresses, telephone numbers, |
17999
|
photographs, and places of employment of spouses and children of |
18000
|
such personnel and the names and locations of schools and day |
18001
|
care facilities attended by the children of such personnel are |
18002
|
confidential and exempt from s. 119.07(1). |
18003
|
(d) Nothing in this section shall be construed to prohibit |
18004
|
the officedepartmentfrom providing information to any law |
18005
|
enforcement or administrative agency. Any law enforcement or |
18006
|
administrative agency receiving confidential information in |
18007
|
connection with its official duties shall maintain the |
18008
|
confidentiality of the information so long as it would otherwise |
18009
|
be confidential. |
18010
|
(e) All information obtained by the officedepartmentfrom |
18011
|
any person which is only made available to the officedepartment |
18012
|
on a confidential or similarly restricted basis shall be |
18013
|
confidential and exempt from s. 119.07(1). This exemption shall |
18014
|
not be construed to prohibit disclosure of information which is |
18015
|
required by law to be filed with the officedepartmentor which |
18016
|
is otherwise subject to s. 119.07(1). |
18017
|
(2) If information subject to subsection (1) is offered in |
18018
|
evidence in any administrative, civil, or criminal proceeding, |
18019
|
the presiding officer may, in her or his discretion, prevent the |
18020
|
disclosure of information which would be confidential pursuant |
18021
|
to paragraph (1)(b). |
18022
|
(3) A privilege against civil liability is granted to a |
18023
|
person who furnishes information or evidence to the office |
18024
|
department, unless such person acts in bad faith or with malice |
18025
|
in providing such information or evidence. |
18026
|
Section 349. Subsection (7) of section 494.00421, Florida |
18027
|
Statutes, is amended to read: |
18028
|
494.00421 Fees earned upon obtaining a bona fide |
18029
|
commitment.--Notwithstanding the provisions of ss. 494.001- |
18030
|
494.0077, any mortgage brokerage business which contracts to |
18031
|
receive from a borrower a mortgage brokerage fee upon obtaining |
18032
|
a bona fide commitment shall accurately disclose in the mortgage |
18033
|
brokerage agreement: |
18034
|
(7)(a) The following statement, in no less than 12-point |
18035
|
boldface type immediately above the signature lines for the |
18036
|
borrowers: |
18037
|
|
18038
|
|
18039
|
"You are entering into a contract with a mortgage brokerage |
18040
|
business to obtain a bona fide mortgage loan commitment under |
18041
|
the same terms and conditions as stated hereinabove or in a |
18042
|
separate executed good faith estimate form. If the mortgage |
18043
|
brokerage business obtains a bona fide commitment under the same |
18044
|
terms and conditions, you will be obligated to pay the mortgage |
18045
|
brokerage business fees, including, but not limited to, a |
18046
|
mortgage brokerage fee, even if you choose not to complete the |
18047
|
loan transaction. If the provisions of s. 494.00421, Florida |
18048
|
Statutes, are not met, the mortgage brokerage fee can only be |
18049
|
earned upon the funding of the mortgage loan. The borrower may |
18050
|
contact the Department of Financial ServicesBanking and |
18051
|
Finance, Tallahassee, Florida, regarding any complaints that the |
18052
|
borrower may have against the mortgage broker or the mortgage |
18053
|
brokerage business. The telephone number of the department as |
18054
|
set by rule of the departmentis: . . . [insert telephone |
18055
|
number] . . . ." |
18056
|
(b) Paragraph (a) does not apply to nonresidential |
18057
|
mortgage loan commitments in excess of $1 million. |
18058
|
Section 350. Subsection (7) of section 517.021, Florida |
18059
|
Statutes, is amended, present subsections (8)-(20) of said |
18060
|
section are renumbered as subsections (9)-(21), respectively, |
18061
|
and a new subsection (8) is added to that section to read: |
18062
|
517.021 Definitions.--When used in this chapter, unless |
18063
|
the context otherwise indicates, the following terms have the |
18064
|
following respective meanings: |
18065
|
(7) "Commission" means the Financial Services Commission |
18066
|
"Department" means the Department of Banking and Finance. |
18067
|
(8) "Office" means the Office of Financial Institutions |
18068
|
and Securities Regulation of the commission. |
18069
|
Section 351. Section 517.03, Florida Statutes, is amended |
18070
|
to read: |
18071
|
517.03 Rulemaking; immunity for acts in conformity with |
18072
|
rules.-- |
18073
|
(1) The officeDepartment of Banking and Financeshall |
18074
|
administer and provide for the enforcement of all the provisions |
18075
|
of this chapter. The commission maydepartment has authority to |
18076
|
adopt rules pursuant to ss. 120.536(1) and 120.54 to implement |
18077
|
the provisions of this chapter conferring powers or duties upon |
18078
|
the officeit, including, without limitation, adopting rules and |
18079
|
forms governing reports. The commissiondepartmentshall also |
18080
|
have the nonexclusive power to define by rule any term, whether |
18081
|
or not used in this chapter, insofar as the definition is not |
18082
|
inconsistent with the provisions of this chapter. |
18083
|
(2) No provision of this chapter imposing liability shall |
18084
|
apply to an act done, or omitted to be done, in conformity with |
18085
|
a rule of the commissiondepartmentin existence at the time of |
18086
|
the act or omission, even though such rule may thereafter be |
18087
|
amended or repealed or determined by judicial or other authority |
18088
|
to be invalid for any reason. |
18089
|
Section 352. Section 517.051, Florida Statutes, is amended |
18090
|
to read: |
18091
|
517.051 Exempt securities.--The exemptions provided herein |
18092
|
from the registration requirements of s. 517.07 are self- |
18093
|
executing and do not require any filing with the office |
18094
|
departmentprior to claiming such exemption. Any person who |
18095
|
claims entitlement to any of these exemptions bears the burden |
18096
|
of proving such entitlement in any proceeding brought under this |
18097
|
chapter. The registration provisions of s. 517.07 do not apply |
18098
|
to any of the following securities: |
18099
|
(1) A security issued or guaranteed by the United States |
18100
|
or any territory or insular possession of the United States, by |
18101
|
the District of Columbia, or by any state of the United States |
18102
|
or by any political subdivision or agency or other |
18103
|
instrumentality thereof; provided that no person shall directly |
18104
|
or indirectly offer or sell securities, other than general |
18105
|
obligation bonds, under this subsection if the issuer or |
18106
|
guarantor is in default or has been in default any time after |
18107
|
December 31, 1975, as to principal or interest: |
18108
|
(a) With respect to an obligation issued by the issuer or |
18109
|
successor of the issuer; or |
18110
|
(b) With respect to an obligation guaranteed by the |
18111
|
guarantor or successor of the guarantor, |
18112
|
|
18113
|
except by an offering circular containing a full and fair |
18114
|
disclosure as prescribed by rule of the commissiondepartment. |
18115
|
(2) A security issued or guaranteed by any foreign |
18116
|
government with which the United States is maintaining |
18117
|
diplomatic relations at the time of the sale or offer of sale of |
18118
|
the security, or by any state, province, or political |
18119
|
subdivision thereof having the power of taxation or assessment, |
18120
|
which security is recognized at the time it is offered for sale |
18121
|
in this state as a valid obligation by such foreign government |
18122
|
or by such state, province, or political subdivision thereof |
18123
|
issuing the security. |
18124
|
(3) A security issued or guaranteed by: |
18125
|
(a) A national bank, a federally chartered savings and |
18126
|
loan association, or a federally chartered savings bank, or the |
18127
|
initial subscription for equity securities in such national |
18128
|
bank, federally chartered savings and loan association, or |
18129
|
federally chartered savings bank; |
18130
|
(b) Any federal land bank, joint-stock land bank, or |
18131
|
national farm loan association under the provisions of the |
18132
|
Federal Farm Loan Act of July 17, 1916; |
18133
|
(c) An international bank of which the United States is a |
18134
|
member; or |
18135
|
(d) A corporation created and acting as an instrumentality |
18136
|
of the government of the United States. |
18137
|
(4) A security issued or guaranteed, as to principal, |
18138
|
interest, or dividend, by a corporation owning or operating a |
18139
|
railroad or any other public service utility; provided that such |
18140
|
corporation is subject to regulation or supervision whether as |
18141
|
to its rates and charges or as to the issue of its own |
18142
|
securities by a public commission, board, or officer of the |
18143
|
government of the United States, of any state, territory, or |
18144
|
insular possession of the United States, of any municipality |
18145
|
located therein, of the District of Columbia, or of the Dominion |
18146
|
of Canada or of any province thereof; also equipment securities |
18147
|
based on chattel mortgages, leases, or agreements for |
18148
|
conditional sale of cars, motive power, or other rolling stock |
18149
|
mortgaged, leased, or sold to or furnished for the use of or |
18150
|
upon such railroad or other public service utility corporation |
18151
|
or where the ownership or title of such equipment is pledged or |
18152
|
retained in accordance with the provisions of the laws of the |
18153
|
United States or of any state or of the Dominion of Canada to |
18154
|
secure the payment of such equipment securities; and also bonds, |
18155
|
notes, or other evidences of indebtedness issued by a holding |
18156
|
corporation and secured by collateral consisting of any |
18157
|
securities hereinabove described; provided, further, that the |
18158
|
collateral securities equal in fair value at least 125 percent |
18159
|
of the par value of the bonds, notes, or other evidences of |
18160
|
indebtedness so secured. |
18161
|
(5) A security issued or guaranteed by any of the |
18162
|
following which are subject to the examination, supervision, or |
18163
|
control of this state or of the Federal Deposit Insurance |
18164
|
Corporation or the National Credit Union Association: |
18165
|
(a) A bank, |
18166
|
(b) A trust company, |
18167
|
(c) A savings institution, |
18168
|
(d) A building or savings and loan association, |
18169
|
(e) An international development bank, or |
18170
|
(f) A credit union; |
18171
|
|
18172
|
or the initial subscription for equity securities of any |
18173
|
institution listed in paragraphs (a)-(f), provided such |
18174
|
institution is subject to the examination, supervision, or |
18175
|
control of this state. |
18176
|
(6) A security, other than common stock, providing for a |
18177
|
fixed return, which security has been outstanding in the hands |
18178
|
of the public for a period of not less than 5 years, and upon |
18179
|
which security no default in payment of principal or failure to |
18180
|
pay the fixed return has occurred for an immediately preceding |
18181
|
period of 5 years. |
18182
|
(7) Securities of nonprofit agricultural cooperatives |
18183
|
organized under the laws of this state when the securities are |
18184
|
sold or offered for sale to persons principally engaged in |
18185
|
agricultural production or selling agricultural products. |
18186
|
(8) A note, draft, bill of exchange, or banker's |
18187
|
acceptance having a unit amount of $25,000 or more which arises |
18188
|
out of a current transaction, or the proceeds of which have been |
18189
|
or are to be used for current transactions, and which has a |
18190
|
maturity period at the time of issuance not exceeding 9 months |
18191
|
exclusive of days of grace, or any renewal thereof which has a |
18192
|
maturity period likewise limited. This subsection applies only |
18193
|
to prime quality negotiable commercial paper of a type not |
18194
|
ordinarily purchased by the general public; that is, paper |
18195
|
issued to facilitate well-recognized types of current |
18196
|
operational business requirements and of a type eligible for |
18197
|
discounting by Federal Reserve banks. |
18198
|
(9) A security issued by a corporation organized and |
18199
|
operated exclusively for religious, educational, benevolent, |
18200
|
fraternal, charitable, or reformatory purposes and not for |
18201
|
pecuniary profit, no part of the net earnings of which |
18202
|
corporation inures to the benefit of any private stockholder or |
18203
|
individual, or any security of a fund that is excluded from the |
18204
|
definition of an investment company under s. 3(c)(10)(B) of the |
18205
|
Investment Company Act of 1940; provided that no person shall |
18206
|
directly or indirectly offer or sell securities under this |
18207
|
subsection except by an offering circular containing full and |
18208
|
fair disclosure, as prescribed by the rules of the commission |
18209
|
department, of all material information, including, but not |
18210
|
limited to, a description of the securities offered and terms of |
18211
|
the offering, a description of the nature of the issuer's |
18212
|
business, a statement of the purpose of the offering and the |
18213
|
intended application by the issuer of the proceeds thereof, and |
18214
|
financial statements of the issuer prepared in conformance with |
18215
|
generally accepted accounting principles. Section 6(c) of the |
18216
|
Philanthropy Protection Act of 1995, Pub. L. No. 104-62, shall |
18217
|
not preempt any provision of this chapter. |
18218
|
(10) Any insurance or endowment policy or annuity contract |
18219
|
or optional annuity contract or self-insurance agreement issued |
18220
|
by a corporation, insurance company, reciprocal insurer, or risk |
18221
|
retention group subject to the supervision of the insurance |
18222
|
regulatorcommissioner or bank regulatorcommissioner, or any |
18223
|
agency or officer performing like functions, of any state or |
18224
|
territory of the United States or the District of Columbia. |
18225
|
Section 353. Section 517.061, Florida Statutes, is amended |
18226
|
to read: |
18227
|
517.061 Exempt transactions.--The exemption for each |
18228
|
transaction listed below is self-executing and does not require |
18229
|
any filing with the officedepartmentprior to claiming such |
18230
|
exemption. Any person who claims entitlement to any of the |
18231
|
exemptions bears the burden of proving such entitlement in any |
18232
|
proceeding brought under this chapter. The registration |
18233
|
provisions of s. 517.07 do not apply to any of the following |
18234
|
transactions; however, such transactions are subject to the |
18235
|
provisions of ss. 517.301, 517.311, and 517.312: |
18236
|
(1) At any judicial, executor's, administrator's, |
18237
|
guardian's, or conservator's sale, or at any sale by a receiver |
18238
|
or trustee in insolvency or bankruptcy, or any transaction |
18239
|
incident to a judicially approved reorganization in which a |
18240
|
security is issued in exchange for one or more outstanding |
18241
|
securities, claims, or property interests. |
18242
|
(2) By or for the account of a pledgeholder or mortgagee |
18243
|
selling or offering for sale or delivery in the ordinary course |
18244
|
of business and not for the purposes of avoiding the provisions |
18245
|
of this chapter, to liquidate a bona fide debt, a security |
18246
|
pledged in good faith as security for such debt. |
18247
|
(3) The isolated sale or offer for sale of securities when |
18248
|
made by or on behalf of a vendor not the issuer or underwriter |
18249
|
of the securities, who, being the bona fide owner of such |
18250
|
securities, disposes of her or his own property for her or his |
18251
|
own account, and such sale is not made directly or indirectly |
18252
|
for the benefit of the issuer or an underwriter of such |
18253
|
securities or for the direct or indirect promotion of any scheme |
18254
|
or enterprise with the intent of violating or evading any |
18255
|
provision of this chapter. For purposes of this subsection, |
18256
|
isolated offers or sales include, but are not limited to, an |
18257
|
isolated offer or sale made by or on behalf of a vendor of |
18258
|
securities not the issuer or underwriter of the securities if: |
18259
|
(a) The offer or sale of securities is in a transaction |
18260
|
satisfying all of the requirements of subparagraphs (11)(a)1., |
18261
|
2., 3., and 4. and paragraph(11)(b); or |
18262
|
(b) The offer or sale of securities is in a transaction |
18263
|
exempt under s. 4(1) of the Securities Act of 1933, as amended. |
18264
|
|
18265
|
For purposes of this subsection, any person, including, without |
18266
|
limitation, a promoter or affiliate of an issuer, shall not be |
18267
|
deemed an underwriter, an issuer, or a person acting for the |
18268
|
direct or indirect benefit of the issuer or an underwriter with |
18269
|
respect to any securities of the issuer which she or he has |
18270
|
owned beneficially for at least 1 year. |
18271
|
(4) The distribution by a corporation, trust, or |
18272
|
partnership, actively engaged in the business authorized by its |
18273
|
charter or other organizational articles or agreement, of |
18274
|
securities to its stockholders or other equity security holders, |
18275
|
partners, or beneficiaries as a stock dividend or other |
18276
|
distribution out of earnings or surplus. |
18277
|
(5) The issuance of securities to such equity security |
18278
|
holders or other creditors of a corporation, trust, or |
18279
|
partnership in the process of a reorganization of such |
18280
|
corporation or entity, made in good faith and not for the |
18281
|
purpose of avoiding the provisions of this chapter, either in |
18282
|
exchange for the securities of such equity security holders or |
18283
|
claims of such creditors or partly for cash and partly in |
18284
|
exchange for the securities or claims of such equity security |
18285
|
holders or creditors. |
18286
|
(6) Any transaction involving the distribution of the |
18287
|
securities of an issuer exclusively among its own security |
18288
|
holders, including any person who at the time of the transaction |
18289
|
is a holder of any convertible security, any nontransferable |
18290
|
warrant, or any transferable warrant which is exercisable within |
18291
|
not more than 90 days of issuance, when no commission or other |
18292
|
remuneration is paid or given directly or indirectly in |
18293
|
connection with the sale or distribution of such additional |
18294
|
securities. |
18295
|
(7) The offer or sale of securities to a bank, trust |
18296
|
company, savings institution, insurance company, dealer, |
18297
|
investment company as defined by the Investment Company Act of |
18298
|
1940, pension or profit-sharing trust, or qualified |
18299
|
institutional buyer as defined by rule of the commission |
18300
|
departmentin accordance with Securities and Exchange Commission |
18301
|
Rule 144A (17 C.F.R. 230.144(A)(a)), whether any of such |
18302
|
entities is acting in its individual or fiduciary capacity; |
18303
|
provided that such offer or sale of securities is not for the |
18304
|
direct or indirect promotion of any scheme or enterprise with |
18305
|
the intent of violating or evading any provision of this |
18306
|
chapter. |
18307
|
(8) The sale of securities from one corporation to another |
18308
|
corporation provided that: |
18309
|
(a) The sale price of the securities is $50,000 or more; |
18310
|
and |
18311
|
(b) The buyer and seller corporations each have assets of |
18312
|
$500,000 or more. |
18313
|
(9) The offer or sale of securities from one corporation |
18314
|
to another corporation, or to security holders thereof, pursuant |
18315
|
to a vote or consent of such security holders as may be provided |
18316
|
by the articles of incorporation and the applicable corporate |
18317
|
statutes in connection with mergers, share exchanges, |
18318
|
consolidations, or sale of corporate assets. |
18319
|
(10) The issuance of notes or bonds in connection with the |
18320
|
acquisition of real property or renewals thereof, if such notes |
18321
|
or bonds are issued to the sellers of, and are secured by all or |
18322
|
part of, the real property so acquired. |
18323
|
(11)(a) The offer or sale, by or on behalf of an issuer, |
18324
|
of its own securities, which offer or sale is part of an |
18325
|
offering made in accordance with all of the following |
18326
|
conditions: |
18327
|
1. There are no more than 35 purchasers, or the issuer |
18328
|
reasonably believes that there are no more than 35 purchasers, |
18329
|
of the securities of the issuer in this state during an offering |
18330
|
made in reliance upon this subsection or, if such offering |
18331
|
continues for a period in excess of 12 months, in any |
18332
|
consecutive 12-month period. |
18333
|
2. Neither the issuer nor any person acting on behalf of |
18334
|
the issuer offers or sells securities pursuant to this |
18335
|
subsection by means of any form of general solicitation or |
18336
|
general advertising in this state. |
18337
|
3. Prior to the sale, each purchaser or the purchaser's |
18338
|
representative, if any, is provided with, or given reasonable |
18339
|
access to, full and fair disclosure of all material information. |
18340
|
4. No person defined as a "dealer" in this chapter is paid |
18341
|
a commission or compensation for the sale of the issuer's |
18342
|
securities unless such person is registered as a dealer under |
18343
|
this chapter. |
18344
|
5. When sales are made to five or more persons in this |
18345
|
state, any sale in this state made pursuant to this subsection |
18346
|
is voidable by the purchaser in such sale either within 3 days |
18347
|
after the first tender of consideration is made by such |
18348
|
purchaser to the issuer, an agent of the issuer, or an escrow |
18349
|
agent or within 3 days after the availability of that privilege |
18350
|
is communicated to such purchaser, whichever occurs later. |
18351
|
(b) The following purchasers are excluded from the |
18352
|
calculation of the number of purchasers under subparagraph |
18353
|
(a)1.: |
18354
|
1. Any relative or spouse, or relative of such spouse, of |
18355
|
a purchaser who has the same principal residence as such |
18356
|
purchaser. |
18357
|
2. Any trust or estate in which a purchaser, any of the |
18358
|
persons related to such purchaser specified in subparagraph 1., |
18359
|
and any corporation specified in subparagraph 3. collectively |
18360
|
have more than 50 percent of the beneficial interest (excluding |
18361
|
contingent interest). |
18362
|
3. Any corporation or other organization of which a |
18363
|
purchaser, any of the persons related to such purchaser |
18364
|
specified in subparagraph 1., and any trust or estate specified |
18365
|
in subparagraph 2. collectively are beneficial owners of more |
18366
|
than 50 percent of the equity securities or equity interest. |
18367
|
4. Any purchaser who makes a bona fide investment of |
18368
|
$100,000 or more, provided such purchaser or the purchaser's |
18369
|
representative receives, or has access to, the information |
18370
|
required to be disclosed by subparagraph (a)3. |
18371
|
5. Any accredited investor, as defined by rule of the |
18372
|
commissiondepartmentin accordance with Securities and Exchange |
18373
|
Commission Regulation 230.501 (17 C.F.R. 230.501). |
18374
|
(c)1. For purposes of determining which offers and sales |
18375
|
of securities constitute part of the same offering under this |
18376
|
subsection and are therefore deemed to be integrated with one |
18377
|
another: |
18378
|
a. Offers or sales of securities occurring more than 6 |
18379
|
months prior to an offer or sale of securities made pursuant to |
18380
|
this subsection shall not be considered part of the same |
18381
|
offering, provided there are no offers or sales by or for the |
18382
|
issuer of the same or a similar class of securities during such |
18383
|
6-month period. |
18384
|
b. Offers or sales of securities occurring at any time |
18385
|
after 6 months from an offer or sale made pursuant to this |
18386
|
subsection shall not be considered part of the same offering, |
18387
|
provided there are no offers or sales by or for the issuer of |
18388
|
the same or a similar class of securities during such 6-month |
18389
|
period. |
18390
|
2. Offers or sales which do not satisfy the conditions of |
18391
|
any of the provisions of subparagraph 1. may or may not be part |
18392
|
of the same offering, depending on the particular facts and |
18393
|
circumstances in each case. The commissiondepartment may, but |
18394
|
is not required to,adopt a rule or rules indicating what |
18395
|
factors should be considered in determining whether offers and |
18396
|
sales not qualifying for the provisions of subparagraph 1. are |
18397
|
part of the same offering for purposes of this subsection. |
18398
|
(d) Offers or sales of securities made pursuant to, and in |
18399
|
compliance with, any other subsection of this section or any |
18400
|
subsection of s. 517.051 shall not be considered part of an |
18401
|
offering pursuant to this subsection, regardless of when such |
18402
|
offers and sales are made. |
18403
|
(12) The sale of securities by a bank or trust company |
18404
|
organized or incorporated under the laws of the United States or |
18405
|
this state at a profit to such bank or trust company of not more |
18406
|
than 2 percent of the total sale price of such securities; |
18407
|
provided that there is no solicitation of this business by such |
18408
|
bank or trust company where such bank or trust company acts as |
18409
|
agent in the purchase or sale of such securities. |
18410
|
(13) An unsolicited purchase or sale of securities on |
18411
|
order of, and as the agent for, another by a dealer registered |
18412
|
with the Department of Banking and Financepursuant to the |
18413
|
provisions of s. 517.12; provided that this exemption applies |
18414
|
solely and exclusively to such registered dealers and does not |
18415
|
authorize or permit the purchase or sale of securities on order |
18416
|
of, and as agent for, another by any person other than a dealer |
18417
|
so registered; and provided, further, that such purchase or sale |
18418
|
is not directly or indirectly for the benefit of the issuer or |
18419
|
an underwriter of such securities or for the direct or indirect |
18420
|
promotion of any scheme or enterprise with the intent of |
18421
|
violation or evading any provision of this chapter. |
18422
|
(14) The offer or sale of shares of a corporation which |
18423
|
represent ownership, or entitle the holders of the shares to |
18424
|
possession and occupancy, of specific apartment units in |
18425
|
property owned by such corporation and organized and operated on |
18426
|
a cooperative basis, solely for residential purposes. |
18427
|
(15) The offer or sale of securities under a bona fide |
18428
|
employer-sponsored stock option, stock purchase, pension, |
18429
|
profit-sharing, savings, or other benefit plan when offered only |
18430
|
to employees of the sponsoring organization or to employees of |
18431
|
its controlled subsidiaries. |
18432
|
(16) The sale by or through a registered dealer of any |
18433
|
securities option if at the time of the sale of the option: |
18434
|
(a) The performance of the terms of the option is |
18435
|
guaranteed by any dealer registered under the federal Securities |
18436
|
Exchange Act of 1934, as amended, which guaranty and dealer are |
18437
|
in compliance with such requirements or rules as may be approved |
18438
|
or adopted by the commissiondepartment; or |
18439
|
(b) Such options transactions are cleared by the Options |
18440
|
Clearing Corporation or any other clearinghouse recognized by |
18441
|
the officedepartment; and |
18442
|
(c) The option is not sold by or for the benefit of the |
18443
|
issuer of the underlying security; and |
18444
|
(d) The underlying security may be purchased or sold on a |
18445
|
recognized securities exchange or is quoted on the National |
18446
|
Association of Securities Dealers Automated Quotation System; |
18447
|
and |
18448
|
(e) Such sale is not directly or indirectly for the |
18449
|
purpose of providing or furthering any scheme to violate or |
18450
|
evade any provisions of this chapter. |
18451
|
(17)(a) The offer or sale of securities, as agent or |
18452
|
principal, by a dealer registered pursuant to s. 517.12, when |
18453
|
such securities are offered or sold at a price reasonably |
18454
|
related to the current market price of such securities, provided |
18455
|
such securities are: |
18456
|
1. Securities of an issuer for which reports are required |
18457
|
to be filed by s. 13 or s. 15(d) of the Securities Exchange Act |
18458
|
of 1934, as amended; |
18459
|
2. Securities of a company registered under the Investment |
18460
|
Company Act of 1940, as amended; |
18461
|
3. Securities of an insurance company, as that term is |
18462
|
defined in s. 2(a)(17) of the Investment Company Act of 1940, as |
18463
|
amended; |
18464
|
4. Securities, other than any security that is a federal |
18465
|
covered security pursuant to s. 18(b)(1) of the Securities Act |
18466
|
of 1933 and is not subject to any registration or filing |
18467
|
requirements under this act, which appear in any list of |
18468
|
securities dealt in on any stock exchange registered pursuant to |
18469
|
the Securities Exchange Act of 1934, as amended, and which |
18470
|
securities have been listed or approved for listing upon notice |
18471
|
of issuance by such exchange, and also all securities senior to |
18472
|
any securities so listed or approved for listing upon notice of |
18473
|
issuance, or represented by subscription rights which have been |
18474
|
so listed or approved for listing upon notice of issuance, or |
18475
|
evidences of indebtedness guaranteed by companies any stock of |
18476
|
which is so listed or approved for listing upon notice of |
18477
|
issuance, such securities to be exempt only so long as such |
18478
|
listings or approvals remain in effect. The exemption provided |
18479
|
for herein does not apply when the securities are suspended from |
18480
|
listing approval for listing or trading. |
18481
|
(b) The exemption provided in this subsection does not |
18482
|
apply if the sale is made for the direct or indirect benefit of |
18483
|
an issuer or controlling persons of such issuer or if such |
18484
|
securities constitute the whole or part of an unsold allotment |
18485
|
to, or subscription or participation by, a dealer as an |
18486
|
underwriter of such securities. |
18487
|
(c) This exemption shall not be available for any |
18488
|
securities which have been denied registration by the department |
18489
|
pursuant to s. 517.111. Additionally, the officedepartmentmay |
18490
|
deny this exemption with reference to any particular security, |
18491
|
other than a federal covered security, by order published in |
18492
|
such manner as the officedepartmentfinds proper. |
18493
|
(18) The offer or sale of any security effected by or |
18494
|
through a person registered pursuant to s. 517.12(17). |
18495
|
(19) Other transactions defined by rules as transactions |
18496
|
exempted from the registration provisions of s. 517.07, which |
18497
|
rules the commissiondepartment may, but is not required to, |
18498
|
adopt from time to time, but only after a finding by the office |
18499
|
departmentthat the application of the provisions of s. 517.07 |
18500
|
to a particular transaction is not necessary in the public |
18501
|
interest and for the protection of investors because of the |
18502
|
small dollar amount of securities involved or the limited |
18503
|
character of the offering. In conjunction with its adoption of |
18504
|
such rules, the commissiondepartmentmay also provide in such |
18505
|
rules that persons selling or offering for sale the exempted |
18506
|
securities are exempt from the registration requirements of s. |
18507
|
517.12. No rule so adopted may have the effect of narrowing or |
18508
|
limiting any exemption provided for by statute in the other |
18509
|
subsections of this section. |
18510
|
(20) Any nonissuer transaction by a registered associated |
18511
|
person of a registered dealer, and any resale transaction by a |
18512
|
sponsor of a unit investment trust registered under the |
18513
|
Investment Company Act of 1940, in a security of a class that |
18514
|
has been outstanding in the hands of the public for at least 90 |
18515
|
days; provided, at the time of the transaction: |
18516
|
(a) The issuer of the security is actually engaged in |
18517
|
business and is not in the organization stage or in bankruptcy |
18518
|
or receivership and is not a blank check, blind pool, or shell |
18519
|
company whose primary plan of business is to engage in a merger |
18520
|
or combination of the business with, or an acquisition of, any |
18521
|
unidentified person; |
18522
|
(b) The security is sold at a price reasonably related to |
18523
|
the current market price of the security; |
18524
|
(c) The security does not constitute the whole or part of |
18525
|
an unsold allotment to, or a subscription or participation by, |
18526
|
the broker-dealer as an underwriter of the security; |
18527
|
(d) A nationally recognized securities manual designated |
18528
|
by rule of the commission or order of the officedepartmentor a |
18529
|
document filed with the Securities and Exchange Commission that |
18530
|
is publicly available through the commission's electronic data |
18531
|
gathering and retrieval system contains: |
18532
|
1. A description of the business and operations of the |
18533
|
issuer; |
18534
|
2. The names of the issuer's officers and directors, if |
18535
|
any, or, in the case of an issuer not domiciled in the United |
18536
|
States, the corporate equivalents of such persons in the |
18537
|
issuer's country of domicile; |
18538
|
3. An audited balance sheet of the issuer as of a date |
18539
|
within 18 months before such transaction or, in the case of a |
18540
|
reorganization or merger in which parties to the reorganization |
18541
|
or merger had such audited balance sheet, a pro forma balance |
18542
|
sheet; and |
18543
|
4. An audited income statement for each of the issuer's |
18544
|
immediately preceding 2 fiscal years, or for the period of |
18545
|
existence of the issuer, if in existence for less than 2 years |
18546
|
or, in the case of a reorganization or merger in which the |
18547
|
parties to the reorganization or merger had such audited income |
18548
|
statement, a pro forma income statement; and |
18549
|
(e) The issuer of the security has a class of equity |
18550
|
securities listed on a national securities exchange registered |
18551
|
under the Securities Exchange Act of 1934 or designated for |
18552
|
trading on the National Association of Securities Dealers |
18553
|
Automated Quotation System, unless: |
18554
|
1. The issuer of the security is a unit investment trust |
18555
|
registered under the Investment Company Act of 1940; |
18556
|
2. The issuer of the security has been engaged in |
18557
|
continuous business, including predecessors, for at least 3 |
18558
|
years; or |
18559
|
3. The issuer of the security has total assets of at least |
18560
|
$2 million based on an audited balance sheet as of a date within |
18561
|
18 months before such transaction or, in the case of a |
18562
|
reorganization or merger in which parties to the reorganization |
18563
|
or merger had such audited balance sheet, a pro forma balance |
18564
|
sheet. |
18565
|
Section 354. Section 517.07, Florida Statutes, is amended |
18566
|
to read: |
18567
|
517.07 Registration of securities.-- |
18568
|
(1) It is unlawful and a violation of this chapter for any |
18569
|
person to sell or offer to sell a security within this state |
18570
|
unless the security is exempt under s. 517.051, is sold in a |
18571
|
transaction exempt under s. 517.061, is a federal covered |
18572
|
security, or is registered pursuant to this chapter. |
18573
|
(2) No securities that are required to be registered under |
18574
|
this chapter shall be sold or offered for sale within this state |
18575
|
unless such securities have been registered pursuant to this |
18576
|
chapter and unless prior to each sale the purchaser is furnished |
18577
|
with a prospectus meeting the requirements of rules adopted by |
18578
|
the commissiondepartment. |
18579
|
(3) The officedepartmentshall issue a permit when |
18580
|
registration has been granted by the officedepartment. A |
18581
|
permit to sell securities is effective for 1 year from the date |
18582
|
it was granted. Registration of securities shall be deemed to |
18583
|
include the registration of rights to subscribe to such |
18584
|
securities if the application under s. 517.081 or s. 517.082 for |
18585
|
registration of such securities includes a statement that such |
18586
|
rights are to be issued. |
18587
|
(4) A record of the registration of securities shall be |
18588
|
kept byin the office of the department, in which register of |
18589
|
securities shall also be recorded any orders entered by the |
18590
|
officedepartmentwith respect to such securities. Such |
18591
|
register, and all information with respect to the securities |
18592
|
registered therein, shall be open to public inspection. |
18593
|
(5) Notwithstanding any other provision of this section, |
18594
|
offers of securities required to be registered by this section |
18595
|
may be made in this state before the registration of such |
18596
|
securities if the offers are made in conformity with rules |
18597
|
adopted by the commissiondepartment. |
18598
|
Section 355. Subsections (2), (3), (4), and (5) of section |
18599
|
517.075, Florida Statutes, are amended to read: |
18600
|
517.075 Cuba, prospectus disclosure of doing business |
18601
|
with, required.-- |
18602
|
(2) Any disclosure required by subsection (1) must |
18603
|
include: |
18604
|
(a) The name of such person, affiliate, or government with |
18605
|
which the issuer does business and the nature of that business; |
18606
|
(b) A statement that the information is accurate as of the |
18607
|
date the securities were effective with the United States |
18608
|
Securities and Exchange Commission or with the office |
18609
|
department, whichever date is later; and |
18610
|
(c) A statement that current information concerning the |
18611
|
issuer's business dealings with the government of Cuba or with |
18612
|
any person or affiliate located in Cuba may be obtained from the |
18613
|
officeDepartment of Banking and Finance, which statement must |
18614
|
include the address and phone number of the officedepartment. |
18615
|
(3) If an issuer commences engaging in business with the |
18616
|
government of Cuba or with any person or affiliate located in |
18617
|
Cuba, after the date issuer's securities become effective with |
18618
|
the Securities and Exchange Commission or with the office |
18619
|
department, whichever date is later, or if the information |
18620
|
reported in the prospectus concerning that business changes in |
18621
|
any material way, the issuer must provide the officedepartment |
18622
|
notice of that business or change, as appropriate, in a manner |
18623
|
form acceptable to the officedepartment. The commission |
18624
|
departmentshall prescribe by rule a form for persons to use to |
18625
|
report the commencement of such business or any change in such |
18626
|
business which occurs after the effective registration of such |
18627
|
securities. This form must include, at a minimum, the |
18628
|
information required by subsection (2). The information reported |
18629
|
on the form must be kept current. Information is current if |
18630
|
reported to the officedepartmentwithin 90 days after the |
18631
|
commencement of business or within 90 days after the change |
18632
|
occurs with respect to previously reported information. |
18633
|
(4) The officedepartmentshall provide, upon request, a |
18634
|
copy of any form filed with the officedepartmentunder |
18635
|
subsection (3) to any person requesting the form. |
18636
|
(5) Each securities offering sold in violation of this |
18637
|
section, and each failure of an issuer to timely file the form |
18638
|
required by subsection (3), subjects the issuer to a fine of up |
18639
|
to $5,000. Any fine collected under this section shall be |
18640
|
deposited into the Anti-Fraud Trust Fund of the office |
18641
|
Department of Banking and Finance. |
18642
|
Section 356. Section 517.081, Florida Statutes, is amended |
18643
|
to read: |
18644
|
517.081 Registration procedure.-- |
18645
|
(1) All securities required by this chapter to be |
18646
|
registered before being sold in this state and not entitled to |
18647
|
registration by notification shall be registered in the manner |
18648
|
provided by this section. |
18649
|
(2) The officedepartmentshall receive and act upon |
18650
|
applications to have securities registered and the commission |
18651
|
may prescribe forms on which it may require such applications to |
18652
|
be submitted. Applications shall be duly signed by the |
18653
|
applicant, sworn to by any person having knowledge of the facts, |
18654
|
and filed with the officedepartment. The commissiondepartment |
18655
|
may establish, by rule, procedures for depositing fees and |
18656
|
filing documents by electronic means provided such procedures |
18657
|
provide the officedepartmentwith the information and data |
18658
|
required by this section. An application may be made either by |
18659
|
the issuer of the securities for which registration is applied |
18660
|
or by any registered dealer desiring to sell the same within the |
18661
|
state. |
18662
|
(3) The officedepartmentmay require the applicant to |
18663
|
submit to the officedepartmentthe following information |
18664
|
concerning the issuer and such other relevant information as the |
18665
|
officedepartmentmay in its judgment deem necessary to enable |
18666
|
it to ascertain whether such securities shall be registered |
18667
|
pursuant to the provisions of this section: |
18668
|
(a) The names and addresses of the directors, trustees, |
18669
|
and officers, if the issuer be a corporation, association, or |
18670
|
trust; of all the partners, if the issuer be a partnership; or |
18671
|
of the issuer, if the issuer be an individual. |
18672
|
(b) The location of the issuer's principal business office |
18673
|
and of its principal office in this state, if any. |
18674
|
(c) The general character of the business actually to be |
18675
|
transacted by the issuer and the purposes of the proposed issue. |
18676
|
(d) A statement of the capitalization of the issuer. |
18677
|
(e) A balance sheet showing the amount and general |
18678
|
character of its assets and liabilities on a day not more than |
18679
|
90 days prior to the date of filing such balance sheet or such |
18680
|
longer period of time, not exceeding 6 months, as the office |
18681
|
departmentmay permit at the written request of the issuer on a |
18682
|
showing of good cause therefor. |
18683
|
(f) A detailed statement of the plan upon which the issuer |
18684
|
proposes to transact business. |
18685
|
(g)1. A specimen copy of the security and a copy of any |
18686
|
circular, prospectus, advertisement, or other description of |
18687
|
such securities. |
18688
|
2. The commissiondepartmentshall adopt a form for a |
18689
|
simplified offering circular to be used solely by corporations |
18690
|
to register, under this section, securities of the corporation |
18691
|
that are sold in offerings in which the aggregate offering price |
18692
|
in any consecutive 12-month period does not exceed the amount |
18693
|
provided in s. 3(b) of the Securities Act of 1933. The |
18694
|
following issuers shall not be eligible to submit a simplified |
18695
|
offering circular adopted pursuant to this subparagraph: |
18696
|
a. An issuer seeking to register securities for resale by |
18697
|
persons other than the issuer. |
18698
|
b. An issuer who is subject to any of the |
18699
|
disqualifications described in 17 C.F.R. s. 230.262, adopted |
18700
|
pursuant to the Securities Act of 1933, or who has been or is |
18701
|
engaged or is about to engage in an activity that would be |
18702
|
grounds for denial, revocation, or suspension under s. 517.111. |
18703
|
For purposes of this subparagraph, an issuer includes an |
18704
|
issuer's director, officer, shareholder who owns at least 10 |
18705
|
percent of the shares of the issuer, promoter, or selling agent |
18706
|
of the securities to be offered or any officer, director, or |
18707
|
partner of such selling agent. |
18708
|
c. An issuer who is a development-stage company that |
18709
|
either has no specific business plan or purpose or has indicated |
18710
|
that its business plan is to merge with an unidentified company |
18711
|
or companies. |
18712
|
d. An issuer of offerings in which the specific business |
18713
|
or properties cannot be described. |
18714
|
e. Any issuer the officedepartmentdetermines is |
18715
|
ineligible if the form would not provide full and fair |
18716
|
disclosure of material information for the type of offering to |
18717
|
be registered by the issuer. |
18718
|
f. Any corporation which has failed to provide the office |
18719
|
departmentthe reports required for a previous offering |
18720
|
registered pursuant to this subparagraph. |
18721
|
|
18722
|
|
18723
|
As a condition precedent to qualifying for use of the |
18724
|
simplified offering circular, a corporation shall agree to |
18725
|
provide the officedepartmentwith an annual financial report |
18726
|
containing a balance sheet as of the end of the issuer's fiscal |
18727
|
year and a statement of income for such year, prepared in |
18728
|
accordance with generally accepted accounting principles and |
18729
|
accompanied by an independent accountant's report. If the |
18730
|
issuer has more than 100 security holders at the end of a fiscal |
18731
|
year, the financial statements must be audited. Annual financial |
18732
|
reports must be filed with the officedepartmentwithin 90 days |
18733
|
after the close of the issuer's fiscal year for each of the |
18734
|
first 5 years following the effective date of the registration. |
18735
|
(h) A statement of the amount of the issuer's income, |
18736
|
expenses, and fixed charges during the last fiscal year or, if |
18737
|
in actual business less than 1 year, then for such time as the |
18738
|
issuer has been in actual business. |
18739
|
(i) A statement of the issuer's cash sources and |
18740
|
application during the last fiscal year or, if in actual |
18741
|
business less than 1 year, then for such time as the issuer has |
18742
|
been in actual business. |
18743
|
(j) A statement showing the maximum price at which such |
18744
|
security is proposed to be sold, together with the maximum |
18745
|
amount of commission, including expenses, or other form of |
18746
|
remuneration to be paid in cash or otherwise, directly or |
18747
|
indirectly, for or in connection with the sale or offering for |
18748
|
sale of such securities. |
18749
|
(k) A copy of the opinion or opinions of counsel |
18750
|
concerning the legality of the issue or other matters which the |
18751
|
officedepartmentmay determine to be relevant to the issue. |
18752
|
(l) A detailed statement showing the items of cash, |
18753
|
property, services, patents, good will, and any other |
18754
|
consideration in payment for which such securities have been or |
18755
|
are to be issued. |
18756
|
(m) The amount of securities to be set aside and disposed |
18757
|
of and a statement of all securities issued from time to time |
18758
|
for promotional purposes. |
18759
|
(n) If the issuer is a corporation, there shall be filed |
18760
|
with the application a copy of its articles of incorporation |
18761
|
with all amendments and of its existing bylaws, if not already |
18762
|
on file in the officedepartment. If the issuer is a trustee, |
18763
|
there shall be filed with the application a copy of all |
18764
|
instruments by which the trust is created or declared and in |
18765
|
which it is accepted and acknowledged. If the issuer is a |
18766
|
partnership, unincorporated association, joint-stock company, or |
18767
|
any other form of organization whatsoever, there shall be filed |
18768
|
with the application a copy of its articles of partnership or |
18769
|
association and all other papers pertaining to its organization, |
18770
|
if not already on file in the officedepartment. |
18771
|
(4) All of the statements, exhibits, and documents of |
18772
|
every kind required by the departmentunder this section, except |
18773
|
properly certified public documents, shall be verified by the |
18774
|
oath of the applicant or of the issuer in such manner and form |
18775
|
as may be required by the commissiondepartment. |
18776
|
(5) The commissiondepartmentmay by rule fix the maximum |
18777
|
discounts, commissions, expenses, remuneration, and other |
18778
|
compensation to be paid in cash or otherwise, not to exceed 20 |
18779
|
percent, directly or indirectly, for or in connection with the |
18780
|
sale or offering for sale of such securities in this state. |
18781
|
(6) An issuer filing an application under this section |
18782
|
shall, at the time of filing, pay the officedepartmenta |
18783
|
nonreturnable fee of $1,000 per application. |
18784
|
(7) If upon examination of any application the office |
18785
|
departmentshall find that the sale of the security referred to |
18786
|
therein would not be fraudulent and would not work or tend to |
18787
|
work a fraud upon the purchaser, that the terms of the sale of |
18788
|
such securities would be fair, just, and equitable, and that the |
18789
|
enterprise or business of the issuer is not based upon unsound |
18790
|
business principles, it shall record the registration of such |
18791
|
security in the register of securities; and thereupon such |
18792
|
security so registered may be sold by any registered dealer, |
18793
|
subject, however, to the further order of the officedepartment. |
18794
|
Section 357. Section 517.082, Florida Statutes, is amended |
18795
|
to read: |
18796
|
517.082 Notification registration.-- |
18797
|
(1) Except as provided in subsection (3), securities |
18798
|
offered or sold pursuant to a registration statement filed under |
18799
|
the Securities Act of 1933 shall be entitled to registration by |
18800
|
notification in the manner provided in subsection (2), provided |
18801
|
that prior to the offer or sale the registration statement has |
18802
|
become effective. |
18803
|
(2) An application for registration by notification shall |
18804
|
be filed with the officedepartment, shall contain the following |
18805
|
information, and shall be accompanied by the following: |
18806
|
(a) An application to sell executed by the issuer, any |
18807
|
person on whose behalf the offering is made, a dealer registered |
18808
|
under this chapter, or any duly authorized agent of any such |
18809
|
person, setting forth the name and address of the applicant, the |
18810
|
name and address of the issuer, and the title of the securities |
18811
|
to be offered and sold; |
18812
|
(b) Copies of such documents filed with the Securities and |
18813
|
Exchange Commission as the Financial Services Commission |
18814
|
departmentmay by rule require; |
18815
|
(c) An irrevocable written consent to service as required |
18816
|
by s. 517.101; and |
18817
|
(d) A nonreturnable fee of $1,000 per application. |
18818
|
|
18819
|
|
18820
|
A registration under this section becomes effective when the |
18821
|
federal registration statement becomes effective or as of the |
18822
|
date the application is filed with the officedepartment, |
18823
|
whichever is later, provided that, in addition to the items |
18824
|
listed in paragraphs (a)-(d), the officedepartmenthas received |
18825
|
written notification of effective registration under the |
18826
|
Securities Act of 1933 or the Investment Company Act of 1940 |
18827
|
within 10 business days from the date federal registration is |
18828
|
granted. Failure to provide all the information required by |
18829
|
this subsection to the officedepartmentwithin 60 days of the |
18830
|
date the registration statement becomes effective with the |
18831
|
Securities and Exchange Commission shall be a violation of this |
18832
|
chapter. |
18833
|
(3) Except for units of limited partnership interests or |
18834
|
such other securities as the commissiondepartmentdescribes by |
18835
|
rule as exempt from this subsection due to high investment |
18836
|
quality, the provisions of this section may not be used to |
18837
|
register securities if the offering price at the time of |
18838
|
effectiveness with the Securities and Exchange Commission is $5 |
18839
|
or less per share, unless such securities are listed or |
18840
|
designated, or approved for listing or designation upon notice |
18841
|
of issuance, on a stock exchange registered pursuant to the |
18842
|
Securities Exchange Act of 1934 or on the National Association |
18843
|
of Securities Dealers Automated Quotation (NASDAQ) System, or |
18844
|
unless such securities are of the same issuer and of senior or |
18845
|
substantially equal rank to securities so listed or designated. |
18846
|
(4) In lieu of filing with the officedepartmentthe |
18847
|
application, fees, and documents for registration required by |
18848
|
subsection (2), the commissiondepartmentmay establish, by |
18849
|
rule, procedures for depositing fees and filing documents by |
18850
|
electronic means, provided such procedures provide the office |
18851
|
departmentwith the information and data required by this |
18852
|
section. |
18853
|
Section 358. Section 517.101, Florida Statutes, is amended |
18854
|
to read: |
18855
|
517.101 Consent to service.-- |
18856
|
(1) Upon any initial application for registration under s. |
18857
|
517.081 or s. 517.082 or upon request of the officedepartment, |
18858
|
the issuer shall file with such application the irrevocable |
18859
|
written consent of the issuer that in suits, proceedings, and |
18860
|
actions growing out of the violation of any provision of this |
18861
|
chapter, the service on the officedepartmentof a notice, |
18862
|
process, or pleading therein, authorized by the laws of this |
18863
|
state, shall be as valid and binding as if due service had been |
18864
|
made on the issuer. |
18865
|
(2) Any such action shall be brought either in the county |
18866
|
of the plaintiff's residence or in the county in which the |
18867
|
officedepartmenthas its official headquarters. The written |
18868
|
consent shall be authenticated by the seal of said issuer, if it |
18869
|
has a seal, and by the acknowledged signature of a member of the |
18870
|
copartnership or company, or by the acknowledged signature of |
18871
|
any officer of the incorporated or unincorporated association, |
18872
|
if it be an incorporated or unincorporated association, duly |
18873
|
authorized by resolution of the board of directors, trustees, or |
18874
|
managers of the corporation or association, and shall in such |
18875
|
case be accompanied by a duly certified copy of the resolution |
18876
|
of the board of directors, trustees, or managers of the |
18877
|
corporation or association, authorizing the officers to execute |
18878
|
the same. In case any process or pleadings mentioned in this |
18879
|
chapter are served upon the officedepartment, it shall be by |
18880
|
duplicate copies, one of which shall be filed in the office |
18881
|
department and another immediately forwarded by the office |
18882
|
departmentby registered mail to the principal office of the |
18883
|
issuer against which said process or pleadings are directed. |
18884
|
Section 359. Section 517.111, Florida Statutes, is amended |
18885
|
to read: |
18886
|
517.111 Revocation or denial of registration of |
18887
|
securities.-- |
18888
|
(1) The officedepartmentmay revoke or suspend the |
18889
|
registration of any security, or may deny any application to |
18890
|
register securities, if upon examination into the affairs of the |
18891
|
issuer of such security it shall appear that: |
18892
|
(a) The issuer is insolvent; |
18893
|
(b) The issuer or any officer, director, or control person |
18894
|
of the issuer has violated any provision of this chapter or any |
18895
|
rule made hereunder or any order of the officedepartmentof |
18896
|
which such issuer has notice; |
18897
|
(c) The issuer or any officer, director, or control person |
18898
|
of the issuer has been or is engaged or is about to engage in |
18899
|
fraudulent transactions; |
18900
|
(d) The issuer or any officer, director, or control person |
18901
|
of the issuer has been found guilty of a fraudulent act in |
18902
|
connection with any sale of securities, has engaged, is engaged, |
18903
|
or is about to engage, in making a fictitious sale or purchase |
18904
|
of any security, or in any practice or sale of any security |
18905
|
which is fraudulent or a violation of any law; |
18906
|
(e) The issuer or any officer, director, or control person |
18907
|
of the issuer has had a final judgment entered against such |
18908
|
issuer or person in a civil action on the grounds of fraud, |
18909
|
embezzlement, misrepresentation, or deceit; |
18910
|
(f) The issuer or any officer, director, or control person |
18911
|
of the issuer has demonstrated any evidence of unworthiness; |
18912
|
(g) The issuer or any officer, director, or control person |
18913
|
of the issuer is in any other way dishonest or has made any |
18914
|
fraudulent representations or failed to disclose any material |
18915
|
information in any prospectus or in any circular or other |
18916
|
literature that has been distributed concerning the issuer or |
18917
|
its securities; |
18918
|
(h) The security registered or sought to be registered is |
18919
|
the subject of an injunction entered by a court of competent |
18920
|
jurisdiction or is the subject of an administrative stop-order |
18921
|
or similar order prohibiting the offer or sale of the security; |
18922
|
(i) For any security for which registration has been |
18923
|
applied pursuant to s. 517.081, the terms of the offer or sale |
18924
|
of such securities would not be fair, just, or equitable; or |
18925
|
(j) The issuer or any person acting on behalf of the |
18926
|
issuer has failed to timely complete any application for |
18927
|
registration filed with the officedepartmentpursuant to the |
18928
|
provisions of s. 517.081 or s. 517.082 or any rule adopted under |
18929
|
such sections. |
18930
|
|
18931
|
In making such examination, the officedepartmentshall have |
18932
|
access to and may compel the production of all the books and |
18933
|
papers of such issuer and may administer oaths to and examine |
18934
|
the officers of such issuer or any other person connected |
18935
|
therewith as to its business and affairs and may also require a |
18936
|
balance sheet exhibiting the assets and liabilities of any such |
18937
|
issuer or its income statement, or both, to be certified to by a |
18938
|
public accountant either of this state or of any other state |
18939
|
where the issuer's business is located. Whenever the office |
18940
|
deemsdepartment may deemit necessary, it may also require such |
18941
|
balance sheet or income statement, or both, to be made more |
18942
|
specific in such particulars as the officedepartmentmay |
18943
|
require. |
18944
|
(2) If any issuer shall refuse to permit an examination to |
18945
|
be made by the officedepartment, it shall be proper ground for |
18946
|
revocation of registration. |
18947
|
(3) If the office deemsdepartment shall deemit |
18948
|
necessary, it may enter an order suspending the right to sell |
18949
|
securities pending any investigation, provided that the order |
18950
|
shall state the office'sdepartment'sgrounds for taking such |
18951
|
action. |
18952
|
(4) Notice of the entry of such order shall be given by |
18953
|
mail, personally, by telephone confirmed in writing, or by |
18954
|
telegraph to the issuer. Before such order is made final, the |
18955
|
issuer applying for registration shall, on application, be |
18956
|
entitled to a hearing. |
18957
|
(5) The officedepartmentmay deny any request to |
18958
|
terminate any registration or to withdraw any application for |
18959
|
registration if the officedepartmentbelieves that an act which |
18960
|
would be grounds for denial, suspension, or revocation under |
18961
|
this chapter has been committed. |
18962
|
Section 360. Section 517.12, Florida Statutes, is amended |
18963
|
to read: |
18964
|
517.12 Registration of dealers, associated persons, |
18965
|
investment advisers, and branch offices.-- |
18966
|
(1) No dealer, associated person, or issuer of securities |
18967
|
shall sell or offer for sale any securities in or from offices |
18968
|
in this state, or sell securities to persons in this state from |
18969
|
offices outside this state, by mail or otherwise, unless the |
18970
|
person has been registered with the officedepartmentpursuant |
18971
|
to the provisions of this section. The officedepartmentshall |
18972
|
not register any person as an associated person of a dealer |
18973
|
unless the dealer with which the applicant seeks registration is |
18974
|
lawfully registered with the officedepartmentpursuant to this |
18975
|
chapter. |
18976
|
(2) The registration requirements of this section do not |
18977
|
apply to the issuers of securities exempted by s. 517.051(1)-(8) |
18978
|
and (10). |
18979
|
(3) Except as otherwise provided in s. 517.061(11)(a)4., |
18980
|
(13), (16), (17), or (19), the registration requirements of this |
18981
|
section do not apply in a transaction exempted by s. 517.061(1)- |
18982
|
(12), (14), and (15). |
18983
|
(4) No investment adviser or associated person of an |
18984
|
investment adviser or federal covered adviser shall engage in |
18985
|
business from offices in this state, or render investment advice |
18986
|
to persons of this state, by mail or otherwise, unless the |
18987
|
federal covered adviser has made a notice filing with the office |
18988
|
departmentpursuant to s. 517.1201 or the investment adviser is |
18989
|
registered pursuant to the provisions of this chapter and |
18990
|
associated persons of the federal covered adviser or investment |
18991
|
adviser have been registered with the officedepartmentpursuant |
18992
|
to this section. The officedepartmentshall not register any |
18993
|
person or an associated person of a federal covered adviser or |
18994
|
an investment adviser unless the federal covered adviser or |
18995
|
investment adviser with which the applicant seeks registration |
18996
|
is in compliance with the notice filing requirements of s. |
18997
|
517.1201 or is lawfully registered with the officedepartment |
18998
|
pursuant to this chapter. A dealer or associated person who is |
18999
|
registered pursuant to this section may render investment advice |
19000
|
upon notification to and approval from the officedepartment. |
19001
|
(5) No dealer or investment adviser shall conduct business |
19002
|
from a branch office within this state unless the branch office |
19003
|
is registered with the officedepartmentpursuant to the |
19004
|
provisions of this section. |
19005
|
(6) A dealer, associated person, investment adviser, or |
19006
|
branch office, in order to obtain registration, must file with |
19007
|
the officedepartment a written application, on a form which the |
19008
|
commissiondepartmentmay by rule prescribe, verified under |
19009
|
oath. The commissiondepartmentmay establish, by rule, |
19010
|
procedures for depositing fees and filing documents by |
19011
|
electronic means provided such procedures provide the office |
19012
|
departmentwith the information and data required by this |
19013
|
section. Each dealer or investment adviser must also file an |
19014
|
irrevocable written consent to service of civil process similar |
19015
|
to that provided for in s. 517.101. The application shall |
19016
|
contain such information as the commission or officedepartment |
19017
|
may require concerning such matters as: |
19018
|
(a) The name of the applicant and the address of its |
19019
|
principal office and each office in this state. |
19020
|
(b) The applicant's form and place of organization; and, |
19021
|
if the applicant is a corporation, a copy of its articles of |
19022
|
incorporation and amendments to the articles of incorporation |
19023
|
or, if a partnership, a copy of the partnership agreement. |
19024
|
(c) The applicant's proposed method of doing business and |
19025
|
financial condition and history, including a certified financial |
19026
|
statement showing all assets and all liabilities, including |
19027
|
contingent liabilities of the applicant as of a date not more |
19028
|
than 90 days prior to the filing of the application. |
19029
|
(d) The names and addresses of all associated persons of |
19030
|
the applicant to be employed in this state and the offices to |
19031
|
which they will be assigned. |
19032
|
(7) The application shall also contain such information as |
19033
|
the commission or officedepartmentmay require about the |
19034
|
applicant; any partner, officer, or director of the applicant or |
19035
|
any person having a similar status or performing similar |
19036
|
functions; any person directly or indirectly controlling the |
19037
|
applicant; or any employee of a dealer or of an investment |
19038
|
adviser rendering investment advisory services. Each applicant |
19039
|
shall file a complete set of fingerprints taken by an authorized |
19040
|
law enforcement officer. Such fingerprints shall be submitted |
19041
|
to the Department of Law Enforcement or the Federal Bureau of |
19042
|
Investigation for state and federal processing. The commission |
19043
|
departmentmay waive, by rule, the requirement that applicants |
19044
|
must file a set of fingerprints or the requirement that such |
19045
|
fingerprints must be processed by the Department of Law |
19046
|
Enforcement or the Federal Bureau of Investigation. The |
19047
|
commission or officedepartmentmay require information about |
19048
|
any such applicant or person concerning such matters as: |
19049
|
(a) His or her full name, and any other names by which he |
19050
|
or she may have been known, and his or her age, photograph, |
19051
|
qualifications, and educational and business history. |
19052
|
(b) Any injunction or administrative order by a state or |
19053
|
federal agency, national securities exchange, or national |
19054
|
securities association involving a security or any aspect of the |
19055
|
securities business and any injunction or administrative order |
19056
|
by a state or federal agency regulating banking, insurance, |
19057
|
finance, or small loan companies, real estate, mortgage brokers, |
19058
|
or other related or similar industries, which injunctions or |
19059
|
administrative orders relate to such person. |
19060
|
(c) His or her conviction of, or plea of nolo contendere |
19061
|
to, a criminal offense or his or her commission of any acts |
19062
|
which would be grounds for refusal of an application under s. |
19063
|
517.161. |
19064
|
(d) The names and addresses of other persons of whom the |
19065
|
officedepartmentmay inquire as to his or her character, |
19066
|
reputation, and financial responsibility. |
19067
|
(8) The commission or officedepartmentmay require the |
19068
|
applicant or one or more principals or general partners, or |
19069
|
natural persons exercising similar functions, or any associated |
19070
|
person applicant to successfully pass oral or written |
19071
|
examinations. Because any principal, manager, supervisor, or |
19072
|
person exercising similar functions shall be responsible for the |
19073
|
acts of the associated persons affiliated with a dealer or |
19074
|
investment adviser, the examination standards may be higher for |
19075
|
a dealer, office manager, principal, or person exercising |
19076
|
similar functions than for a nonsupervisory associated person. |
19077
|
The commissiondepartmentmay waive the examination process when |
19078
|
it determines that such examinations are not in the public |
19079
|
interest. The officedepartmentshall waive the examination |
19080
|
requirements for any person who has passed any tests as |
19081
|
prescribed in s. 15(b)(7) of the Securities Exchange Act of 1934 |
19082
|
that relates to the position to be filled by the applicant. |
19083
|
(9)(a) All dealers, except securities dealers who are |
19084
|
designated by the Federal Reserve Bank of New York as primary |
19085
|
government securities dealers or securities dealers registered |
19086
|
as issuers of securities, shall comply with the net capital and |
19087
|
ratio requirements imposed pursuant to the Securities Exchange |
19088
|
Act of 1934. The commissiondepartmentmay by rule require a |
19089
|
dealer to file with the officedepartmentany financial or |
19090
|
operational information that is required to be filed by the |
19091
|
Securities Exchange Act of 1934 or any rules adopted under such |
19092
|
act. |
19093
|
(b) The commissiondepartmentmay by rule require the |
19094
|
maintenance of a minimum net capital for securities dealers who |
19095
|
are designated by the Federal Reserve Bank of New York as |
19096
|
primary government securities dealers and securities dealers |
19097
|
registered as issuers of securities and investment advisers, or |
19098
|
prescribe a ratio between net capital and aggregate |
19099
|
indebtedness, to assure adequate protection for the investing |
19100
|
public. The provisions of this section shall not apply to any |
19101
|
investment adviser that maintains its principal place of |
19102
|
business in a state other than this state, provided such |
19103
|
investment adviser is registered in the state where it maintains |
19104
|
its principal place of business and is in compliance with such |
19105
|
state's net capital requirements. |
19106
|
(10) An applicant for registration shall pay an assessment |
19107
|
fee of $200, in the case of a dealer or investment adviser, or |
19108
|
$40, in the case of an associated person. The assessment fee of |
19109
|
an associated person shall be reduced to $30, but only after the |
19110
|
officedepartmentdetermines, by final order, that sufficient |
19111
|
funds have been allocated to the Securities Guaranty Fund |
19112
|
pursuant to s. 517.1203 to satisfy all valid claims filed in |
19113
|
accordance with s. 517.1203(2) and after all amounts payable |
19114
|
under any service contract entered into by the officedepartment |
19115
|
pursuant to s. 517.1204, and all notes, bonds, certificates of |
19116
|
indebtedness, other obligations, or evidences of indebtedness |
19117
|
secured by such notes, bonds, certificates of indebtedness, or |
19118
|
other obligations, have been paid or provision has been made for |
19119
|
the payment of such amounts, notes, bonds, certificates of |
19120
|
indebtedness, other obligations, or evidences of indebtedness. |
19121
|
An associated person not having current fingerprint cards filed |
19122
|
with the National Association of Securities Dealers or a |
19123
|
national securities exchange registered with the Securities and |
19124
|
Exchange Commission shall be assessed an additional fee to cover |
19125
|
the cost for said fingerprint cards to be processed by the |
19126
|
officedepartment. Such fee shall be determined by rule of the |
19127
|
commissiondepartment. Each dealer and each investment adviser |
19128
|
shall pay an assessment fee of $100 for each office in this |
19129
|
state, except its designated principal office. Such fees become |
19130
|
the revenue of the state, except for those assessments provided |
19131
|
for under s. 517.131(1) until such time as the Securities |
19132
|
Guaranty Fund satisfies the statutory limits, and are not |
19133
|
returnable in the event that registration is withdrawn or not |
19134
|
granted. |
19135
|
(11) If the officedepartmentfinds that the applicant is |
19136
|
of good repute and character and has complied with the |
19137
|
provisions of this chapter and the rules made pursuant hereto, |
19138
|
it shall register the applicant. The registration of each |
19139
|
dealer, investment adviser, and associated person will expire on |
19140
|
December 31, and the registration of each branch office will |
19141
|
expire on March 31, of the year in which it became effective |
19142
|
unless the registrant has renewed its registration on or before |
19143
|
that date. Registration may be renewed by furnishing such |
19144
|
information as the commissiondepartmentmay require, together |
19145
|
with payment of the fee required in subsection (10) for dealers, |
19146
|
investment advisers, associated persons, or branch offices and |
19147
|
the payment of any amount lawfully due and owing to the office |
19148
|
department pursuant to any order of the officedepartmentor |
19149
|
pursuant to any agreement with the officedepartment. Any |
19150
|
dealer, investment adviser, or associated person registrant who |
19151
|
has not renewed a registration by the time the current |
19152
|
registration expires may request reinstatement of such |
19153
|
registration by filing with the officedepartment, on or before |
19154
|
January 31 of the year following the year of expiration, such |
19155
|
information as may be required by the commissiondepartment, |
19156
|
together with payment of the fee required in subsection (10) for |
19157
|
dealers, investment advisers, or associated persons and a late |
19158
|
fee equal to the amount of such fee. Any reinstatement of |
19159
|
registration granted by the officedepartmentduring the month |
19160
|
of January shall be deemed effective retroactive to January 1 of |
19161
|
that year. |
19162
|
(12)(a) The officedepartmentmay issue a license to a |
19163
|
dealer, investment adviser, associated person, or branch office |
19164
|
to evidence registration under this chapter. The office |
19165
|
department may require the return to the officedepartmentof |
19166
|
any license it may issue prior to issuing a new license. |
19167
|
(b) Every dealer, investment adviser, or federal covered |
19168
|
adviser shall promptly file with the officedepartment, as |
19169
|
prescribed by rules adopted by the commissiondepartment, notice |
19170
|
as to the termination of employment of any associated person |
19171
|
registered for such dealer or investment adviser in this state |
19172
|
and shall also furnish the reason or reasons for such |
19173
|
termination. |
19174
|
(c) Each dealer or investment adviser shall designate in |
19175
|
writing to, and register with, the officedepartmenta manager |
19176
|
for each office the dealer or investment adviser has in this |
19177
|
state. |
19178
|
(13) Changes in registration occasioned by changes in |
19179
|
personnel of a partnership or in the principals, copartners, |
19180
|
officers, or directors of any dealer or investment adviser or by |
19181
|
changes of any material fact or method of doing business shall |
19182
|
be reported by written amendment in such form and at such time |
19183
|
as the commissiondepartmentmay specify. In any case in which |
19184
|
a person or a group of persons, directly or indirectly or acting |
19185
|
by or through one or more persons, proposes to purchase or |
19186
|
acquire a controlling interest in a registered dealer or |
19187
|
investment adviser, such person or group shall submit an initial |
19188
|
application for registration as a dealer or investment adviser |
19189
|
prior to such purchase or acquisition. The commissiondepartment |
19190
|
shall adopt rules providing for waiver of the application |
19191
|
required by this subsection where control of a registered dealer |
19192
|
or investment adviser is to be acquired by another dealer or |
19193
|
investment adviser registered under this chapter or where the |
19194
|
application is otherwise unnecessary in the public interest. |
19195
|
(14) Every dealer, investment adviser, or branch office |
19196
|
registered or required to be registered with the office |
19197
|
departmentshall keep records of all currency transactions in |
19198
|
excess of $10,000 and shall file reports, as prescribed under |
19199
|
the financial recordkeeping regulations in 31 C.F.R. part 103, |
19200
|
with the officedepartmentwhen transactions occur in or from |
19201
|
this state. All reports required by this subsection to be filed |
19202
|
with the officedepartmentshall be confidential and exempt from |
19203
|
s. 119.07(1) except that any law enforcement agency or the |
19204
|
Department of Revenue shall have access to, and shall be |
19205
|
authorized to inspect and copy, such reports. |
19206
|
(15) In lieu of filing with the officedepartmentthe |
19207
|
applications specified in subsection (6), the fees required by |
19208
|
subsection(10), and the termination notices required by |
19209
|
subsection (12), the commissiondepartmentmay by rule establish |
19210
|
procedures for the deposit of such fees and documents with the |
19211
|
Central Registration Depository of the National Association of |
19212
|
Securities Dealers, Inc., as developed under contract with the |
19213
|
North American Securities Administrators Association, Inc.; |
19214
|
provided, however, that such procedures shall provide the office |
19215
|
departmentwith the information and data as required by this |
19216
|
section. |
19217
|
(16) Except for securities dealers who are designated by |
19218
|
the Federal Reserve Bank of New York as primary government |
19219
|
securities dealers or securities dealers registered as issuers |
19220
|
of securities, every applicant for initial or renewal |
19221
|
registration as a securities dealer and every person registered |
19222
|
as a securities dealer shall be registered as a broker or dealer |
19223
|
with the Securities and Exchange Commission and shall be subject |
19224
|
to insurance coverage by the Securities Investor Protection |
19225
|
Corporation. |
19226
|
(17)(a) A dealer that is located in Canada and has no |
19227
|
office or other physical presence in this state may, provided |
19228
|
the dealer is registered in accordance with this section, effect |
19229
|
transactions in securities with or for, or induce or attempt to |
19230
|
induce the purchase or sale of any security by: |
19231
|
1. A person from Canada who temporarily resides in this |
19232
|
state and with whom the Canadian dealer had a bona fide dealer- |
19233
|
client relationship before the person entered the United States; |
19234
|
or |
19235
|
2. A person from Canada who is a resident of this state, |
19236
|
and whose transactions are in a self-directed tax advantage |
19237
|
retirement plan in Canada of which the person is the holder or |
19238
|
contributor. |
19239
|
(b) An associated person who represents a Canadian dealer |
19240
|
registered under this section may, provided the agent is |
19241
|
registered in accordance with this section, effect transactions |
19242
|
in securities in this state as permitted for a dealer, under |
19243
|
subsection (a). |
19244
|
(c) A Canadian dealer may register under this section |
19245
|
provided that such dealer: |
19246
|
1. Files an application in the form required by the |
19247
|
jurisdiction in which the dealer has a head office. |
19248
|
2. Files a consent to service of process. |
19249
|
3. Is registered as a dealer in good standing in the |
19250
|
jurisdiction from which it is effecting transactions into this |
19251
|
state and files evidence of such registration with the office |
19252
|
department. |
19253
|
4. Is a member of a self-regulatory organization or stock |
19254
|
exchange in Canada. |
19255
|
(d) An associated person who represents a Canadian dealer |
19256
|
registered under this section in effecting transactions in |
19257
|
securities in this state may register under this section |
19258
|
provided that such person: |
19259
|
1. Files an application in the form required by the |
19260
|
jurisdiction in which the dealer has its head office. |
19261
|
2. Is registered in good standing in the jurisdiction from |
19262
|
which he or she is effecting transactions into this state and |
19263
|
files evidence of such registration with the officedepartment. |
19264
|
(e) If the officedepartmentfinds that the applicant is |
19265
|
of good repute and character and has complied with the |
19266
|
provisions of this chapter, the officedepartmentshall register |
19267
|
the applicant. |
19268
|
(f) A Canadian dealer registered under this section shall: |
19269
|
1. Maintain its provincial or territorial registration and |
19270
|
its membership in a self-regulatory organization or stock |
19271
|
exchange in good standing. |
19272
|
2. Provide the officedepartmentupon request with its |
19273
|
books and records relating to its business in this state as a |
19274
|
dealer. |
19275
|
3. Provide the officedepartmentnotice of each civil, |
19276
|
criminal, or administrative action initiated against the dealer. |
19277
|
4. Disclose to its clients in this state that the dealer |
19278
|
and its agents are not subject to the full regulatory |
19279
|
requirements under this chapter. |
19280
|
5. Correct any inaccurate information within 30 days, if |
19281
|
the information contained in the application form becomes |
19282
|
inaccurate for any reason before or after the dealer becomes |
19283
|
registered. |
19284
|
(g) An associated person of a Canadian dealer registered |
19285
|
under this section shall: |
19286
|
1. Maintain provincial or territorial registration in good |
19287
|
standing. |
19288
|
2. Provide the officedepartmentwith notice of each |
19289
|
civil, criminal, or administrative action initiated against such |
19290
|
person. |
19291
|
3. Through the dealer, correct any inaccurate information |
19292
|
within 30 days, if the information contained in the application |
19293
|
form becomes inaccurate for any reason before or after the |
19294
|
associated person becomes registered. |
19295
|
(h) Renewal applications for Canadian dealers and |
19296
|
associated persons under this section must be filed before |
19297
|
December 31 each year. Every applicant for registration or |
19298
|
renewal registration under this section shall pay the fee for |
19299
|
dealers and associated persons under this chapter. |
19300
|
(18) Every dealer or associated person registered or |
19301
|
required to be registered with the officedepartmentshall |
19302
|
satisfy any continuing education requirements established by |
19303
|
rule pursuant to law. |
19304
|
(19) The registration requirements of this section which |
19305
|
apply to investment advisers and associated persons do not apply |
19306
|
to a commodity trading adviser who: |
19307
|
(a) Is registered as such with the Commodity Futures |
19308
|
Trading Commission pursuant to the Commodity Exchange Act. |
19309
|
(b) Advises or exercises trading discretion, with respect |
19310
|
to foreign currency options listed and traded exclusively on the |
19311
|
Philadelphia Stock Exchange, on behalf of an "appropriate |
19312
|
person" as defined by the Commodity Exchange Act. |
19313
|
|
19314
|
|
19315
|
The exemption provided in this subsection does not apply to a |
19316
|
commodity trading adviser who engages in other activities that |
19317
|
require registration under this chapter. |
19318
|
(20) The registration requirements of this section do not |
19319
|
apply to any general lines insurance agent or life insurance |
19320
|
agent licensed under chapter 626individuals licensed under s. |
19321
|
626.041 or its successor statute, or s. 626.051 or its successor |
19322
|
statute, for the sale of a security as defined in s. |
19323
|
517.021(20)(19)(g), if the individual is directly authorized by |
19324
|
the issuer to offer or sell the security on behalf of the issuer |
19325
|
and the issuer is a federally chartered savings bank subject to |
19326
|
regulation by the Federal Deposit Insurance Corporation. Actions |
19327
|
under this subsection shall constitute activity under the |
19328
|
insurance agent's license for purposes of ss. 626.611 and |
19329
|
626.621. |
19330
|
Section 361. Section 517.1201, Florida Statutes, is |
19331
|
amended to read: |
19332
|
517.1201 Notice filing requirements for federal covered |
19333
|
advisers.-- |
19334
|
(1) It is unlawful for a person to transact business in |
19335
|
this state as a federal covered adviser unless such person has |
19336
|
made a notice filing with the officedepartment. A notice |
19337
|
filing under this section shall consist of a copy of those |
19338
|
documents that have been filed or are required to be filed by |
19339
|
the federal covered adviser with the Securities and Exchange |
19340
|
Commission that the Financial Services Commissiondepartmentby |
19341
|
rule requires to be filed, together with a consent to service of |
19342
|
process and a filing fee of $200. The commissiondepartmentmay |
19343
|
establish by rule procedures for the deposit of fees and the |
19344
|
filing of documents to be made through electronic means, if the |
19345
|
procedures provide to the officedepartmentthe information and |
19346
|
data required by this section. |
19347
|
(2) A notice filing shall be effective upon receipt. A |
19348
|
notice filing shall expire on December 31 of the year in which |
19349
|
the filing became effective unless the federal covered adviser |
19350
|
has renewed the filing on or before that date. A federal covered |
19351
|
adviser may renew a notice filing by furnishing to the office |
19352
|
departmentsuch information that has been filed or is required |
19353
|
to be filed with the Securities and Exchange Commission, as the |
19354
|
Financial Services Commission or officedepartmentmay require, |
19355
|
together with a renewal fee of $200 and the payment of any |
19356
|
amount due and owing the officedepartmentpursuant to any |
19357
|
agreement with the officedepartment. Any federal covered |
19358
|
adviser who has not renewed a notice filing by the time a |
19359
|
current notice filing expires may request reinstatement of such |
19360
|
notice filing by filing with the officedepartment, on or before |
19361
|
January 31 of the year following the year the notice filing |
19362
|
expires, such information that has been filed or is required to |
19363
|
be filed with the Securities and Exchange Commission as may be |
19364
|
required by the Financial Services Commission or office |
19365
|
department, together with the payment of $200 and a late fee |
19366
|
equal to $200. Any reinstatement of a notice filing granted by |
19367
|
the officedepartmentduring the month of January shall be |
19368
|
deemed effective retroactive to January 1 of that year. |
19369
|
(3) The commissiondepartmentmay require, by rule, a |
19370
|
federal covered adviser who has made a notice filing pursuant to |
19371
|
this section to file with the officedepartmentcopies of any |
19372
|
amendments filed or required to be filed with the Securities and |
19373
|
Exchange Commission. |
19374
|
(4) The officedepartmentmay issue a permit to evidence |
19375
|
the effectiveness of a notice filing for a federal covered |
19376
|
adviser. |
19377
|
(5) A notice filing may be terminated by filing notice of |
19378
|
such termination with the officedepartment. Unless another |
19379
|
date is specified by the federal covered adviser, such notice |
19380
|
shall be effective upon its receipt by the officedepartment. |
19381
|
(6) All fees collected under this section become the |
19382
|
revenue of the state, except for those assessments provided for |
19383
|
under s. 517.131(1) until such time as the Securities Guaranty |
19384
|
Fund satisfies the statutory limits, and are not returnable in |
19385
|
the event that a notice filing is withdrawn. |
19386
|
Section 362. Section 517.1203, Florida Statutes, is |
19387
|
amended to read: |
19388
|
517.1203 Allocation and disbursement of assessment fees.-- |
19389
|
(1) Notwithstanding s. 517.131(1), an additional amount |
19390
|
equal to 25 percent of all revenues received as assessment fees |
19391
|
pursuant to s. 517.12(10) and (11) from persons applying for or |
19392
|
renewing registrations as associated persons shall be allocated |
19393
|
to the Securities Guaranty Fund and disbursed as provided in |
19394
|
this section. This allocation shall continue until the office |
19395
|
departmentdetermines, by final order, that sufficient funds |
19396
|
have been allocated to the Securities Guaranty Fund pursuant to |
19397
|
this section to satisfy all valid claims filed in accordance |
19398
|
with subsection (2) and until all amounts payable under any |
19399
|
service contract entered into by the officedepartmentpursuant |
19400
|
to s. 517.1204, and all notes, bonds, certificates of |
19401
|
indebtedness, other obligations, or evidences of indebtedness |
19402
|
secured by such notes, bonds, certificates of indebtedness, or |
19403
|
other obligations, have been paid or provision has been made for |
19404
|
the payment of such amounts, notes, bonds, certificates of |
19405
|
indebtedness, other obligations, or evidences of indebtedness. |
19406
|
This assessment fee shall be part of the regular license fee and |
19407
|
shall be transferred to or deposited into the Securities |
19408
|
Guaranty Fund. The moneys allocated to the Securities Guaranty |
19409
|
Fund under this section shall not be included in the calculation |
19410
|
of the allocation of the assessment fees referred to in s. |
19411
|
517.131(1)(b). Moneys allocated under this section in excess of |
19412
|
the valid claims filed pursuant to subsection (2) shall be |
19413
|
allocated to the Anti-Fraud Trust Fund. |
19414
|
(2)(a) Notwithstanding the provisions of ss. 517.131 and |
19415
|
517.141, moneys allocated to the Securities Guaranty Fund under |
19416
|
this section shall be used to pay amounts payable under any |
19417
|
service contract entered into by the officedepartmentpursuant |
19418
|
to s. 517.1204, subject to annual appropriation by the |
19419
|
Legislature, and to pay investors who have filed claims with the |
19420
|
Department of Banking and Finance after October 1, 1996, and on |
19421
|
or before December 31, 1998, who have: |
19422
|
1. Received a final judgment against an associated person |
19423
|
of GIC Government Securities, Inc., based upon allegations which |
19424
|
would amount to a violation of s. 517.07 or s. 517.301; or |
19425
|
2. Demonstrated to the former Department of Banking and |
19426
|
Finance or officethat the claimant has suffered monetary |
19427
|
damages as a result of the acts or actions of GIC Government |
19428
|
Securities, Inc., or any associated person thereof, based upon |
19429
|
allegations which would amount to a violation of s. 517.07 or s. |
19430
|
517.301. |
19431
|
(b)1. Claims shall be paid in the order that they were |
19432
|
have been filed with the former Department of Banking and |
19433
|
Finance, unless the department hasnoticed its intent to deny |
19434
|
the claim in whole or in part. If a notice of intent to deny a |
19435
|
claim in whole or in part wasisissued, the claim shall not be |
19436
|
paid until a final order has been entered which is not subject |
19437
|
to an order staying its effect. |
19438
|
2. If at any time the money in the Securities Guaranty |
19439
|
Fund allocated under this section is insufficient to satisfy any |
19440
|
valid claim or portion of a valid claim approved by the |
19441
|
department or office under this section, the officedepartment |
19442
|
shall prorate the payment based upon the ratio that the person's |
19443
|
claim bears to the total approved claims filed on the same day. |
19444
|
The officedepartmentshall satisfy the unpaid claims as soon |
19445
|
as a sufficient amount of money has been deposited in or |
19446
|
transferred to the fund as provided in this section. |
19447
|
3. A claimant shall not be substantially affected by the |
19448
|
payment of another person's claim. |
19449
|
(c) Claims shall be limited to the amount of the |
19450
|
investment, reduced by any amounts received from a bankruptcy |
19451
|
proceeding or from any other source. If an investor is deceased, |
19452
|
the award shall be made to the surviving spouse. If the investor |
19453
|
and surviving spouse are both deceased, the award shall be made |
19454
|
pursuant to the laws of descent and distribution. Neither the |
19455
|
officedepartmentnor the Investment Fraud Restoration Financing |
19456
|
Corporation shall make payment to assignees, secured parties, |
19457
|
lien creditors, or other such entities. |
19458
|
(3) In rendering a determination, the officedepartment |
19459
|
may rely on records from the bankruptcy proceeding regarding GIC |
19460
|
Government Securities, Inc., unless there is good cause to |
19461
|
believe that the record is not genuine. |
19462
|
(4) Amounts deposited into the Securities Guaranty Fund |
19463
|
pursuant to this section shall be applied to or allocated for |
19464
|
payment of amounts payable by the officedepartmentpursuant to |
19465
|
paragraph (2)(a), under a service contract entered into by the |
19466
|
officedepartmentpursuant to s. 517.1204, subject to annual |
19467
|
appropriation by the Legislature, before making or providing for |
19468
|
any other disbursements from the fund. |
19469
|
Section 363. Subsection (2), paragraph (e) of subsection |
19470
|
(3), and subsections (4), (5), and(6) of section 517.1204, |
19471
|
Florida Statutes, are amended to read: |
19472
|
517.1204 Investment Fraud Restoration Financing |
19473
|
Corporation.-- |
19474
|
(2) The corporation shall be governed by a board of |
19475
|
directors consisting of the director of the office or his or her |
19476
|
designeeassistant comptroller, the Secretary of Elderly Affairs |
19477
|
or the secretary's designee, and the executive director of the |
19478
|
Department of Veterans' Affairs or the executive director's |
19479
|
designee. The executive director of the State Board of |
19480
|
Administration shall be the chief executive officer of the |
19481
|
corporation and shall direct and supervise the administrative |
19482
|
affairs of the corporation and shall control, direct, and |
19483
|
supervise the operation of the corporation. The corporation |
19484
|
shall also have such other officers as may be determined by the |
19485
|
board of directors. |
19486
|
(3) The corporation shall have all the powers of a |
19487
|
corporate body under the laws of this state to the extent not |
19488
|
inconsistent with or restricted by the provisions of this |
19489
|
section, including, but not limited to, the power to: |
19490
|
(e) Elect or appoint and employ such officers, agents, and |
19491
|
employees as the corporation deems advisable to operate and |
19492
|
manage the affairs of the corporation, which officers, agents, |
19493
|
and employees may be officers or employees of the office |
19494
|
departmentand the state agencies represented on the board of |
19495
|
directors of the corporation. |
19496
|
(4) The corporation is authorized to enter into one or |
19497
|
more service contracts with the officedepartmentpursuant to |
19498
|
which the corporation shall provide services to the office |
19499
|
departmentin connection with financing the functions and |
19500
|
activities provided for in s. 517.1203. The officedepartment |
19501
|
may enter into one or more such service contracts with the |
19502
|
corporation and provide for payments under such contracts |
19503
|
pursuant to s. 517.1203(2)(a), subject to annual appropriation |
19504
|
by the Legislature. The proceeds from such service contracts |
19505
|
may be used for the costs and expenses of administration of the |
19506
|
corporation after payments as set forth in subsection(5). Each |
19507
|
service contract shall have a term not to exceed 15 years and |
19508
|
shall terminate no later than July 1, 2021. The aggregate |
19509
|
amount payable from the Securities Guaranty Fund under all such |
19510
|
service contracts shall not exceed the amount provided by s. |
19511
|
517.1203(1). In compliance with provisions of s. 287.0641 and |
19512
|
other applicable provisions of law, the obligations of the |
19513
|
officedepartmentunder such service contracts shall not |
19514
|
constitute a general obligation of the state or a pledge of the |
19515
|
faith and credit or taxing power of the state nor shall such |
19516
|
obligations be construed in any manner as an obligation of the |
19517
|
State Board of Administration or entities for which it invests |
19518
|
funds, other than the officedepartmentas provided in this |
19519
|
section, but shall be payable solely from amounts available in |
19520
|
the Securities Guaranty Fund, subject to annual appropriation. |
19521
|
In compliance with this subsection and s. 287.0582, such service |
19522
|
contracts shall expressly include the following statement: "The |
19523
|
State of Florida's performance and obligation to pay under this |
19524
|
contract is contingent upon an annual appropriation by the |
19525
|
Legislature." |
19526
|
(5) The corporation may issue and incur notes, bonds, |
19527
|
certificates of indebtedness, or other obligations or evidences |
19528
|
of indebtedness payable from and secured by amounts payable to |
19529
|
the corporation by the officedepartmentunder a service |
19530
|
contract entered into pursuant to subsection (4) for the purpose |
19531
|
of the simultaneous payment of all claims approved pursuant to |
19532
|
s. 517.1203. The term of any such note, bond, certificate of |
19533
|
indebtedness, or other obligation or evidence of indebtedness |
19534
|
shall not exceed 15 years. The corporation may select a |
19535
|
financing team and issue obligations through competitive bidding |
19536
|
or negotiated contracts, whichever is most cost-effective. Any |
19537
|
such indebtedness of the corporation shall not constitute a debt |
19538
|
or obligation of the state or a pledge of the faith and credit |
19539
|
or taxing power of the state, but shall be payable from and |
19540
|
secured by payments made by the officedepartmentunder the |
19541
|
service contract pursuant to subsection (4). |
19542
|
(6) The corporation shall pay all claims approved pursuant |
19543
|
to s. 517.1203 as determined by and at the direction of the |
19544
|
officedepartment. |
19545
|
Section 364. Section 517.121, Florida Statutes, is amended |
19546
|
to read: |
19547
|
517.121 Books and records requirements; examinations.-- |
19548
|
(1) A dealer, investment adviser, branch office, or |
19549
|
associated person shall maintain such books and records as the |
19550
|
commissiondepartmentmay prescribe by rule. |
19551
|
(2) The officedepartmentshall, at intermittent periods, |
19552
|
examine the affairs and books and records of each registered |
19553
|
dealer, investment adviser, branch office, or associated person, |
19554
|
or require such records and reports to be submitted to it as |
19555
|
requiredit may require by rule of the commission, to determine |
19556
|
compliance with this act. |
19557
|
Section 365. Paragraph (a) of subsection (1), paragraphs |
19558
|
(b) and (e) of subsection (3), and subsection (4) of section |
19559
|
517.131, Florida Statutes, are amended to read: |
19560
|
517.131 Securities Guaranty Fund.-- |
19561
|
(1)(a) The Chief Financial OfficerTreasurershall |
19562
|
establish a Securities Guaranty Fund. An amount not exceeding |
19563
|
20 percent of all revenues received as assessment fees pursuant |
19564
|
to s. 517.12(10) and (11) for dealers and investment advisers or |
19565
|
s. 517.1201 for federal covered advisers and an amount not |
19566
|
exceeding 10 percent of all revenues received as assessment fees |
19567
|
pursuant to s. 517.12(10) and (11) for associated persons shall |
19568
|
be allocated to the fund. An additional amount not exceeding |
19569
|
3.5 percent of all revenues received as assessment fees for |
19570
|
associated persons pursuant to s. 517.12(10) and (11) shall be |
19571
|
allocated to the Securities Guaranty Fund but only after the |
19572
|
officedepartmentdetermines, by final order, that sufficient |
19573
|
funds have been allocated to the fund pursuant to s. 517.1203 to |
19574
|
satisfy all valid claims filed in accordance with s. 517.1203(2) |
19575
|
and after all amounts payable under any service contract entered |
19576
|
into by the officedepartmentpursuant to s. 517.1204, and all |
19577
|
notes, bonds, certificates of indebtedness, other obligations, |
19578
|
or evidences of indebtedness secured by such notes, bonds, |
19579
|
certificates of indebtedness, or other obligations, have been |
19580
|
paid or provision has been made for the payment of such amounts, |
19581
|
notes, bonds, certificates of indebtedness, other obligations, |
19582
|
or evidences of indebtedness. This assessment fee shall be part |
19583
|
of the regular license fee and shall be transferred to or |
19584
|
deposited in the Securities Guaranty Fund. |
19585
|
(3) Any person is eligible to seek recovery from the |
19586
|
Securities Guaranty Fund if: |
19587
|
(b) Such person has made all reasonable searches and |
19588
|
inquiries to ascertain whether the judgment debtor possesses |
19589
|
real or personal property or other assets subject to being sold |
19590
|
or applied in satisfaction of the judgment, and by her or his |
19591
|
search the person has discovered no property or assets; or she |
19592
|
or he has discovered property and assets and has taken all |
19593
|
necessary action and proceedings for the application thereof to |
19594
|
the judgment, but the amount thereby realized was insufficient |
19595
|
to satisfy the judgment. To verify compliance with such |
19596
|
condition, the officedepartmentmay require such person to have |
19597
|
a writ of execution be issued upon such judgment and may further |
19598
|
require a showing that no personal or real property of the |
19599
|
judgment debtor liable to be levied upon in complete |
19600
|
satisfaction of the judgment can be found. |
19601
|
(e) The officedepartmentwaives compliance with the |
19602
|
requirements of paragraph (a) or paragraph (b). The office |
19603
|
departmentmay waive such compliance if the dealer, investment |
19604
|
adviser, or associated person which is the subject of the claim |
19605
|
filed with the officedepartmentis the subject of any |
19606
|
proceeding in which a receiver has been appointed by a court of |
19607
|
competent jurisdiction. If the officedepartmentwaives such |
19608
|
compliance, the officedepartmentmay, upon petition by the |
19609
|
debtor or the court-appointed trustee, examiner, or receiver, |
19610
|
distribute funds from the Securities Guaranty Fund up to the |
19611
|
amount allowed under s. 517.141. Any waiver granted pursuant to |
19612
|
this section shall be considered a judgment for purposes of |
19613
|
complying with the requirements of this section and of s. |
19614
|
517.141. |
19615
|
(4) Any person who files an action that may result in the |
19616
|
disbursement of funds from the Securities Guaranty Fund pursuant |
19617
|
to the provisions of s. 517.141 shall give written notice by |
19618
|
certified mail to the officedepartmentas soon as practicable |
19619
|
after such action has been filed. The failure to give such |
19620
|
notice shall not bar a payment from the Securities Guaranty Fund |
19621
|
if all of the conditions specified in subsection (3) are |
19622
|
satisfied. |
19623
|
Section 366. Section 517.141, Florida Statutes, is amended |
19624
|
to read: |
19625
|
517.141 Payment from the fund.-- |
19626
|
(1) Any person who meets all of the conditions prescribed |
19627
|
in s. 517.131 may apply to the officedepartmentfor payment to |
19628
|
be made to such person from the Securities Guaranty Fund in the |
19629
|
amount equal to the unsatisfied portion of such person's |
19630
|
judgment or $10,000, whichever is less, but only to the extent |
19631
|
and amount reflected in the judgment as being actual or |
19632
|
compensatory damages, excluding costs and attorney's fees. |
19633
|
(2) Regardless of the number of claimants involved, |
19634
|
payments for claims shall be limited in the aggregate to |
19635
|
$100,000 against any one dealer, investment adviser, or |
19636
|
associated person. If the total claims exceed the aggregate |
19637
|
limit of $100,000, the officedepartmentshall prorate the |
19638
|
payment based upon the ratio that the person's claim bears to |
19639
|
the total claims filed. |
19640
|
(3) No payment shall be made on any claim against any one |
19641
|
dealer, investment adviser, or associated person before the |
19642
|
expiration of 2 years from the date any claimant is found by the |
19643
|
officedepartmentto be eligible for recovery pursuant to this |
19644
|
section. If during this 2-year period more than one claim is |
19645
|
filed against the same dealer, investment adviser, or associated |
19646
|
person, or if the officedepartmentreceives notice pursuant to |
19647
|
s. 517.131(4) that an action against the same dealer, investment |
19648
|
adviser, or associated person is pending, all such claims and |
19649
|
notices of pending claims received during this period against |
19650
|
the same dealer, investment adviser, or associated person may be |
19651
|
handled by the officedepartmentas provided in this section. |
19652
|
Two years after the first claimant against that same dealer, |
19653
|
investment adviser, or associated person applies for payment |
19654
|
pursuant to this section: |
19655
|
(a) The officedepartmentshall determine those persons |
19656
|
eligible for payment or for potential payment in the event of a |
19657
|
pending action. All such persons may be entitled to receive |
19658
|
their pro rata shares of the fund as provided in this section. |
19659
|
(b) Those persons who meet all the conditions prescribed |
19660
|
in s. 517.131 and who have applied for payment pursuant to this |
19661
|
section will be entitled to receive their pro rata shares of the |
19662
|
total disbursement. |
19663
|
(c) Those persons who have filed notice with the office |
19664
|
departmentof a pending claim pursuant to s. 517.131(4) but who |
19665
|
are not yet eligible for payment from the fund will be entitled |
19666
|
to receive their pro rata shares of the total disbursement once |
19667
|
they have complied with subsection (1). However, in the event |
19668
|
that the amounts they are eligible to receive pursuant to |
19669
|
subsection (1) are less than their pro rata shares as determined |
19670
|
under this section, any excess shall be distributed pro rata to |
19671
|
those persons entitled to disbursement under this subsection |
19672
|
whose pro rata shares of the total disbursement were less than |
19673
|
the amounts of their claims. |
19674
|
(4) Individual claims filed by persons owning the same |
19675
|
joint account, or claims stemming from any other type of account |
19676
|
maintained by a particular licensee on which more than one name |
19677
|
appears, shall be treated as the claims of one eligible claimant |
19678
|
with respect to payment from the fund. If a claimant who has |
19679
|
obtained a judgment which qualifies for disbursement under s. |
19680
|
517.131 has maintained more than one account with the dealer, |
19681
|
investment adviser, or associated person who is the subject of |
19682
|
the claims, for purposes of disbursement of the fund, all such |
19683
|
accounts, whether joint or individual, shall be considered as |
19684
|
one account and shall entitle such claimant to only one |
19685
|
distribution from the fund not to exceed the lesser of $10,000 |
19686
|
or the unsatisfied portion of such claimant's judgment as |
19687
|
provided in subsection (1). To the extent that a claimant |
19688
|
obtains more than one judgment against a dealer, investment |
19689
|
adviser, or one or more associated persons arising out of the |
19690
|
same transactions, occurrences, or conduct or out of the |
19691
|
dealer's, investment adviser's, or associated person's handling |
19692
|
of the claimant's account, such judgments shall be consolidated |
19693
|
for purposes of this section and shall entitle the claimant to |
19694
|
only one disbursement from the fund not to exceed the lesser of |
19695
|
$10,000 or the unsatisfied portion of such claimant's judgment |
19696
|
as provided in subsection (1). |
19697
|
(5) If the final judgment which gave rise to the claim is |
19698
|
overturned in any appeal or in any collateral proceeding, the |
19699
|
claimant shall reimburse the fund all amounts paid to the |
19700
|
claimant on the claim. Such reimbursement shall be paid to the |
19701
|
officedepartmentwithin 60 days after the final resolution of |
19702
|
the appellate or collateral proceedings, with the 60-day period |
19703
|
commencing on the date the final order or decision is entered in |
19704
|
such proceedings. |
19705
|
(6) If a claimant receives payments in excess of that |
19706
|
which is permitted under this chapter, the claimant shall |
19707
|
reimburse the fund such excess within 60 days after the claimant |
19708
|
receives such excess payment or after the payment is determined |
19709
|
to be in excess of that permitted by law, whichever is later. |
19710
|
(7) The officedepartmentmay institute legal proceedings |
19711
|
to enforce compliance with this section and with s. 517.131 to |
19712
|
recover moneys owed to the fund, and shall be entitled to |
19713
|
recover interest, costs, and attorney's fees in any action |
19714
|
brought pursuant to this section in which the officedepartment |
19715
|
prevails. |
19716
|
(8) If at any time the money in the Securities Guaranty |
19717
|
Fund is insufficient to satisfy any valid claim or portion of a |
19718
|
valid claim approved by the officedepartment, the office |
19719
|
departmentshall satisfy such unpaid claim or portion of such |
19720
|
valid claim as soon as a sufficient amount of money has been |
19721
|
deposited in or transferred to the fund. When there is more |
19722
|
than one unsatisfied claim outstanding, such claims shall be |
19723
|
paid in the order in which the claims were approved by final |
19724
|
order of the officedepartment, which order is not subject to an |
19725
|
appeal or other pending proceeding. |
19726
|
(9) Upon receipt by the claimant of the payment from the |
19727
|
Securities Guaranty Fund, the claimant shall assign any |
19728
|
additional right, title, and interest in the judgment, to the |
19729
|
extent of such payment, to the officedepartment. If the |
19730
|
provisions of s. 517.131(3)(e) apply, the claimant must assign |
19731
|
to the officedepartmentany right, title, and interest in the |
19732
|
debt to the extent of any payment by the officedepartmentfrom |
19733
|
the Securities Guaranty Fund. |
19734
|
(10) All payments and disbursements made from the |
19735
|
Securities Guaranty Fund shall be made by the Chief Financial |
19736
|
OfficerTreasurer upon authorizationa voucher signed by the |
19737
|
director of the officeComptroller, as head of the department, |
19738
|
or such agent as she or he may designate. |
19739
|
Section 367. Section 517.151, Florida Statutes, is amended |
19740
|
to read: |
19741
|
517.151 Investments of the fund.--The funds of the |
19742
|
Securities Guaranty Fund shall be invested by the Chief |
19743
|
Financial OfficerTreasurerunder the same limitations as other |
19744
|
state funds, and the interest earned thereon shall be deposited |
19745
|
to the credit of the fund and available for the same purpose as |
19746
|
other moneys deposited in the Securities Guaranty Fund. |
19747
|
Section 368. Subsection (1), (3), and (5), and paragraph |
19748
|
(b) of subsection (6) of section 517.161, Florida Statutes, are |
19749
|
amended to read: |
19750
|
517.161 Revocation, denial, or suspension of registration |
19751
|
of dealer, investment adviser, associated person, or branch |
19752
|
office.-- |
19753
|
(1) Registration under s. 517.12 may be denied or any |
19754
|
registration granted may be revoked, restricted, or suspended by |
19755
|
the officedepartment if the officedepartmentdetermines that |
19756
|
such applicant or registrant: |
19757
|
(a) Has violated any provision of this chapter or any rule |
19758
|
or order made under this chapter; |
19759
|
(b) Has made a material false statement in the application |
19760
|
for registration; |
19761
|
(c) Has been guilty of a fraudulent act in connection with |
19762
|
rendering investment advice or in connection with any sale of |
19763
|
securities, has been or is engaged or is about to engage in |
19764
|
making fictitious or pretended sales or purchases of any such |
19765
|
securities or in any practice involving the rendering of |
19766
|
investment advice or the sale of securities which is fraudulent |
19767
|
or in violation of the law; |
19768
|
(d) Has made a misrepresentation or false statement to, or |
19769
|
concealed any essential or material fact from, any person in the |
19770
|
rendering of investment advice or the sale of a security to such |
19771
|
person; |
19772
|
(e) Has failed to account to persons interested for all |
19773
|
money and property received; |
19774
|
(f) Has not delivered, after a reasonable time, to persons |
19775
|
entitled thereto securities held or agreed to be delivered by |
19776
|
the dealer, broker, or investment adviser, as and when paid for, |
19777
|
and due to be delivered; |
19778
|
(g) Is rendering investment advice or selling or offering |
19779
|
for sale securities through any associated person not registered |
19780
|
in compliance with the provisions of this chapter; |
19781
|
(h) Has demonstrated unworthiness to transact the business |
19782
|
of dealer, investment adviser, or associated person; |
19783
|
(i) Has exercised management or policy control over or |
19784
|
owned 10 percent or more of the securities of any dealer or |
19785
|
investment adviser that has been declared bankrupt, or had a |
19786
|
trustee appointed under the Securities Investor Protection Act; |
19787
|
or is, in the case of a dealer or investment adviser, insolvent; |
19788
|
(j) Has been convicted of, or has entered a plea of guilty |
19789
|
or nolo contendere to, a crime against the laws of this state or |
19790
|
any other state or of the United States or of any other country |
19791
|
or government which relates to registration as a dealer, |
19792
|
investment adviser, issuer of securities, associated person, or |
19793
|
branch office; which relates to the application for such |
19794
|
registration; or which involves moral turpitude or fraudulent or |
19795
|
dishonest dealing; |
19796
|
(k) Has had a final judgment entered against her or him in |
19797
|
a civil action upon grounds of fraud, embezzlement, |
19798
|
misrepresentation, or deceit; |
19799
|
(l) Is of bad business repute; or |
19800
|
(m) Has been the subject of any decision, finding, |
19801
|
injunction, suspension, prohibition, revocation, denial, |
19802
|
judgment, or administrative order by any court of competent |
19803
|
jurisdiction, administrative law judge, or by any state or |
19804
|
federal agency, national securities, commodities, or option |
19805
|
exchange, or national securities, commodities, or option |
19806
|
association, involving a violation of any federal or state |
19807
|
securities or commodities law or any rule or regulation |
19808
|
promulgated thereunder, or any rule or regulation of any |
19809
|
national securities, commodities, or options exchange or |
19810
|
national securities, commodities, or options association, or has |
19811
|
been the subject of any injunction or adverse administrative |
19812
|
order by a state or federal agency regulating banking, |
19813
|
insurance, finance or small loan companies, real estate, |
19814
|
mortgage brokers, or other related or similar industries. For |
19815
|
purposes of this subsection, the officedepartmentmay not deny |
19816
|
registration to any applicant who has been continuously |
19817
|
registered with the officedepartmentfor 5 years from the entry |
19818
|
of such decision, finding, injunction, suspension, prohibition, |
19819
|
revocation, denial, judgment, or administrative order provided |
19820
|
such decision, finding, injunction, suspension, prohibition, |
19821
|
revocation, denial, judgment, or administrative order has been |
19822
|
timely reported to the officedepartment pursuant to the |
19823
|
commission'sdepartment's rules and regulations. |
19824
|
(3) In the event the officedepartmentdetermines to deny |
19825
|
an application or revoke a registration, it shall enter a final |
19826
|
order with its findings on the register of dealers and |
19827
|
associated persons; and denial, suspension, or revocation of the |
19828
|
registration of a dealer or investment adviser shall also deny, |
19829
|
suspend, or revoke the registration of all her or his associated |
19830
|
persons. |
19831
|
(5) The officedepartmentmay deny any request to |
19832
|
terminate or withdraw any application or registration if the |
19833
|
officedepartmentbelieves that an act which would be a ground |
19834
|
for denial, suspension, restriction, or revocation under this |
19835
|
chapter has been committed. |
19836
|
(6) Registration under s. 517.12 may be denied or any |
19837
|
registration granted may be suspended or restricted if an |
19838
|
applicant or registrant is charged, in a pending enforcement |
19839
|
action or pending criminal prosecution, with any conduct that |
19840
|
would authorize denial or revocation under subsection (1). |
19841
|
(b) Any order of suspension or restriction under this |
19842
|
subsection shall: |
19843
|
1. Take effect only after a hearing, unless no hearing is |
19844
|
requested by the registrant or unless the suspension or |
19845
|
restriction is made in accordance with s. 120.60(6). |
19846
|
2. Contain a finding that evidence of a prima facie case |
19847
|
supports the charge made in the enforcement action or criminal |
19848
|
prosecution. |
19849
|
3. Operate for no longer than 10 days beyond receipt of |
19850
|
notice by the officedepartmentof termination with respect to |
19851
|
the registrant of the enforcement action or criminal |
19852
|
prosecution. |
19853
|
Section 369. Section 517.181, Florida Statutes, is amended |
19854
|
to read: |
19855
|
517.181 Escrow agreement.-- |
19856
|
(1) If the statement containing information as to |
19857
|
securities to be registered, as provided for in s. 517.081, |
19858
|
shall disclose that any such securities or any securities senior |
19859
|
thereto shall have been or shall be intended to be issued for |
19860
|
any patent right, copyright, trademark, process, formula, or |
19861
|
goodwill; for organization or promotion fees or expenses; or for |
19862
|
goodwill or going-concern value or other intangible assets, then |
19863
|
the amount and nature thereof shall be fully set forth, and the |
19864
|
officedepartmentmay require that such securities so issued in |
19865
|
payment of such patent right, copyright, trademark, process, |
19866
|
formula, or goodwill; for organization or promotion fees or |
19867
|
expenses; or for other intangible assets shall be delivered in |
19868
|
escrow to the officedepartmentor other depository satisfactory |
19869
|
to the officedepartmentunder an escrow agreement. The escrow |
19870
|
agreement shall be in a form suitable to the officedepartment |
19871
|
and shall provide for the escrow or impoundment of such |
19872
|
securities for a reasonable length of time determined by the |
19873
|
officedepartmentto be in the best interest of other |
19874
|
shareholders. The securities subject to escrow shall also |
19875
|
include any dividend, cash, or stock that may be paid during the |
19876
|
life of the escrow and any stock issued through, or by reason |
19877
|
of, any stock split, exchange of shares, recapitalization, |
19878
|
merger, consolidation, reorganization, or similar combination or |
19879
|
subdivision in substitution for or in lieu of any stock subject |
19880
|
to this provision; and in case of dissolution or insolvency |
19881
|
during the time such securities are held in escrow, the owners |
19882
|
of such securities shall not participate in the assets until |
19883
|
after the owners of all other securities shall have been paid in |
19884
|
full. |
19885
|
(2) Any securities held in escrow under this section on |
19886
|
November 1, 1978, may be released to the owners thereof upon |
19887
|
request, if satisfactory financial data is submitted to the |
19888
|
officedepartmentshowing that the issuer is currently operating |
19889
|
on sound business principles and has net income in accordance |
19890
|
with criteria-implementing rules of the commissiondepartment |
19891
|
relating to escrow of securities. At any time, the office |
19892
|
departmentmay review any existing escrow agreement made under |
19893
|
this section and determine that the same may be amended in order |
19894
|
to permit a subsequent release of the securities upon terms and |
19895
|
conditions which are just and equitable as defined by said |
19896
|
rules. |
19897
|
(3) When it shall appear from information available to the |
19898
|
officedepartmentthat the issuer of securities held in escrow |
19899
|
has been dissolved or disbanded or is defunct or no longer |
19900
|
actively engaged in business and such securities are of no |
19901
|
value, the officedepartment, after giving at least 60 days' |
19902
|
notice in at least one newspaper of general circulation and |
19903
|
after giving interested parties opportunity for hearing, may |
19904
|
enter its order authorizing the destruction of said securities. |
19905
|
Any affected escrow agent may rely on such order and shall not |
19906
|
be required to determine the validity or sufficiency thereof. |
19907
|
Section 370. Section 517.191, Florida Statutes, is amended |
19908
|
to read: |
19909
|
517.191 Injunction to restrain violations.-- |
19910
|
(1) When it appearsshall appear to the officedepartment, |
19911
|
either upon complaint or otherwise, that a person has engaged or |
19912
|
is about to engage in any act or practice constituting a |
19913
|
violation of this chapter or a rule or order hereunder, the |
19914
|
officedepartmentmay investigate; and whenever it shall believe |
19915
|
from evidence satisfactory to it that any such person has |
19916
|
engaged, is engaged, or is about to engage in any act or |
19917
|
practice constituting a violation of this chapter or a rule or |
19918
|
order hereunder, the officedepartmentmay, in addition to any |
19919
|
other remedies, bring action in the name and on behalf of the |
19920
|
state against such person and any other person concerned in or |
19921
|
in any way participating in or about to participate in such |
19922
|
practices or engaging therein or doing any act or acts in |
19923
|
furtherance thereof or in violation of this chapter to enjoin |
19924
|
such person or persons from continuing such fraudulent practices |
19925
|
or engaging therein or doing any act or acts in furtherance |
19926
|
thereof or in violation of this chapter. In any such court |
19927
|
proceedings, the officedepartmentmay apply for, and on due |
19928
|
showing be entitled to have issued, the court's subpoena |
19929
|
requiring forthwith the appearance of any defendant and her or |
19930
|
his employees, associated persons, or agents and the production |
19931
|
of documents, books, and records that may appear necessary for |
19932
|
the hearing of such petition, to testify or give evidence |
19933
|
concerning the acts or conduct or things complained of in such |
19934
|
application for injunction. In such action, the equity courts |
19935
|
shall have jurisdiction of the subject matter, and a judgment |
19936
|
may be entered awarding such injunction as may be proper. |
19937
|
(2) In addition to all other means provided by law for the |
19938
|
enforcement of any temporary restraining order, temporary |
19939
|
injunction, or permanent injunction issued in any such court |
19940
|
proceedings, the court shall have the power and jurisdiction, |
19941
|
upon application of the officedepartment, to impound and to |
19942
|
appoint a receiver or administrator for the property, assets, |
19943
|
and business of the defendant, including, but not limited to, |
19944
|
the books, records, documents, and papers appertaining thereto. |
19945
|
Such receiver or administrator, when appointed and qualified, |
19946
|
shall have all powers and duties as to custody, collection, |
19947
|
administration, winding up, and liquidation of said property and |
19948
|
business as shall from time to time be conferred upon her or him |
19949
|
by the court. In any such action, the court may issue orders |
19950
|
and decrees staying all pending suits and enjoining any further |
19951
|
suits affecting the receiver's or administrator's custody or |
19952
|
possession of the said property, assets, and business or, in its |
19953
|
discretion, may with the consent of the presiding judge of the |
19954
|
circuit require that all such suits be assigned to the circuit |
19955
|
court judge appointing the said receiver or administrator. |
19956
|
(3) In addition to any other remedies provided by this |
19957
|
chapter, the officedepartmentmay apply to the court hearing |
19958
|
this matter for an order of restitution whereby the defendants |
19959
|
in such action shall be ordered to make restitution of those |
19960
|
sums shown by the officedepartmentto have been obtained by |
19961
|
them in violation of any of the provisions of this chapter. |
19962
|
Such restitution shall, at the option of the court, be payable |
19963
|
to the administrator or receiver appointed pursuant to this |
19964
|
section or directly to the persons whose assets were obtained in |
19965
|
violation of this chapter. |
19966
|
Section 371. Section 517.201, Florida Statutes, is amended |
19967
|
to read: |
19968
|
517.201 Investigations; examinations; subpoenas; hearings; |
19969
|
witnesses.-- |
19970
|
(1) The officedepartment: |
19971
|
(a) May make investigations and examinations within or |
19972
|
outside of this state as it deems necessary: |
19973
|
1. To determine whether a person has violated or is about |
19974
|
to violate any provision of this chapter or a rule or order |
19975
|
hereunder; or |
19976
|
2. To aid in the enforcement of this chapter. |
19977
|
(b) May require or permit a person to file a statement in |
19978
|
writing, under oath or otherwise as the officedepartment |
19979
|
determines, as to all the facts and circumstances concerning the |
19980
|
matter to be investigated. |
19981
|
(2) When it is proposed to conduct an investigation or |
19982
|
examination, the officedepartmentmay gather evidence in the |
19983
|
matter. The officedepartmentmay administer oaths, examine |
19984
|
witnesses, and issue subpoenas. |
19985
|
(3) Subpoenas for witnesses whose evidence is deemed |
19986
|
material to any investigation or examination may be issued by |
19987
|
the officedepartment under the seal of the officedepartment, |
19988
|
or by any county court judge or clerk of the circuit court or |
19989
|
county court, commanding such witnesses to be or appear before |
19990
|
the officedepartmentat a time and place to be therein named |
19991
|
and to bring such books, records, and documents as may be |
19992
|
specified or to submit such books, records, and documents to |
19993
|
inspection; and such subpoenas may be served by an authorized |
19994
|
representative of the officedepartment. |
19995
|
(4)(a) In the event of substantial noncompliance with a |
19996
|
subpoena or subpoena duces tecum issued or caused to be issued |
19997
|
by the officedepartment pursuant to this section, the office |
19998
|
departmentmay petition the circuit court of the county in which |
19999
|
the person subpoenaed resides or has its principal place of |
20000
|
business for an order requiring the subpoenaed person to appear |
20001
|
and testify and to produce such books, records, and documents as |
20002
|
are specified in such subpoena duces tecum. The court may grant |
20003
|
injunctive relief restraining the issuance, sale or offer for |
20004
|
sale, purchase or offer to purchase, promotion, negotiation, |
20005
|
advertisement, or distribution in or from offices in this state |
20006
|
of securities or investments by a person or agent, employee, |
20007
|
broker, partner, officer, director, or stockholder thereof, and |
20008
|
may grant such other relief, including, but not limited to, the |
20009
|
restraint, by injunction or appointment of a receiver, of any |
20010
|
transfer, pledge, assignment, or other disposition of such |
20011
|
person's assets or any concealment, alteration, destruction, or |
20012
|
other disposition of subpoenaed books, records, or documents, as |
20013
|
the court deems appropriate, until such person has fully |
20014
|
complied with such subpoena or subpoena duces tecum and the |
20015
|
officedepartmenthas completed its investigation or |
20016
|
examination. The officedepartmentis entitled to the summary |
20017
|
procedure provided in s. 51.011, and the court shall advance the |
20018
|
cause on its calendar. Costs incurred by the officedepartment |
20019
|
to obtain an order granting, in whole or in part, such petition |
20020
|
for enforcement of a subpoena or subpoena duces tecum shall be |
20021
|
taxed against the subpoenaed person, and failure to comply with |
20022
|
such order shall be a contempt of court. |
20023
|
(b) When it shall appear to the officedepartmentthat the |
20024
|
compliance with a subpoena or subpoena duces tecum issued or |
20025
|
caused to be issued by the officedepartmentpursuant to this |
20026
|
section is essential and otherwise unavailable to an |
20027
|
investigation or examination, the officedepartment, in addition |
20028
|
to the other remedies provided for herein, may, by verified |
20029
|
petition setting forth the facts, apply to the circuit court of |
20030
|
the county in which the subpoenaed person resides or has its |
20031
|
principal place of business for a writ of ne exeat. The court |
20032
|
shall thereupon direct the issuance of the writ against the |
20033
|
subpoenaed person requiring sufficient bond conditioned on |
20034
|
compliance with the subpoena or subpoena duces tecum. The court |
20035
|
shall cause to be endorsed on the writ a suitable amount of bond |
20036
|
on payment of which the person named in the writ shall be freed, |
20037
|
having a due regard to the nature of the case. |
20038
|
(5) Witnesses shall be entitled to the same fees and |
20039
|
mileage as they may be entitled by law for attending as |
20040
|
witnesses in the circuit court, except where such examination or |
20041
|
investigation is held at the place of business or residence of |
20042
|
the witness. |
20043
|
Section 372. Subsections (1) and (3) of section 517.2015, |
20044
|
Florida Statutes, are amended to read: |
20045
|
517.2015 Confidentiality of information relating to |
20046
|
investigations and examinations.-- |
20047
|
(1)(a) Except as otherwise provided by this section, |
20048
|
information relative to an investigation or examination by the |
20049
|
officedepartmentpursuant to this chapter, including any |
20050
|
consumer complaint, is confidential and exempt from s. 119.07(1) |
20051
|
until the investigation or examination is completed or ceases to |
20052
|
be active. The information compiled by the officedepartmentin |
20053
|
such an investigation or examination shall remain confidential |
20054
|
and exempt from s. 119.07(1) after the office'sdepartment's |
20055
|
investigation or examination is completed or ceases to be active |
20056
|
if the officedepartmentsubmits the information to any law |
20057
|
enforcement or administrative agency or regulatory organization |
20058
|
for further investigation. Such information shall remain |
20059
|
confidential and exempt from s. 119.07(1) until that agency's or |
20060
|
organization's investigation is completed or ceases to be |
20061
|
active. For purposes of this section, an investigation or |
20062
|
examination shall be considered "active" so long as the office |
20063
|
departmentor any law enforcement or administrative agency or |
20064
|
regulatory organization is proceeding with reasonable dispatch |
20065
|
and has a reasonable good faith belief that the investigation or |
20066
|
examination may lead to the filing of an administrative, civil, |
20067
|
or criminal proceeding or to the denial or conditional grant of |
20068
|
a license, registration, or permit. This section shall not be |
20069
|
construed to prohibit disclosure of information which is |
20070
|
required by law to be filed with the officedepartmentand |
20071
|
which, but for the investigation or examination, would be |
20072
|
subject to s. 119.07(1). |
20073
|
(b) Except as necessary for the officedepartmentto |
20074
|
enforce the provisions of this chapter, a consumer complaint and |
20075
|
other information relative to an investigation or examination |
20076
|
shall remain confidential and exempt from s. 119.07(1) after the |
20077
|
investigation or examination is completed or ceases to be active |
20078
|
to the extent disclosure would: |
20079
|
1. Jeopardize the integrity of another active |
20080
|
investigation or examination. |
20081
|
2. Reveal the name, address, telephone number, social |
20082
|
security number, or any other identifying number or information |
20083
|
of any complainant, customer, or account holder. |
20084
|
3. Disclose the identity of a confidential source. |
20085
|
4. Disclose investigative techniques or procedures. |
20086
|
5. Reveal a trade secret as defined in s. 688.002. |
20087
|
(c) In the event that officedepartmentpersonnel are or |
20088
|
have been involved in an investigation or examination of such |
20089
|
nature as to endanger their lives or physical safety or that of |
20090
|
their families, then the home addresses, telephone numbers, |
20091
|
places of employment, and photographs of such personnel, |
20092
|
together with the home addresses, telephone numbers, |
20093
|
photographs, and places of employment of spouses and children of |
20094
|
such personnel and the names and locations of schools and day |
20095
|
care facilities attended by the children of such personnel are |
20096
|
confidential and exempt from s. 119.07(1). |
20097
|
(d) Nothing in this section shall be construed to prohibit |
20098
|
the officedepartmentfrom providing information to any law |
20099
|
enforcement or administrative agency or regulatory organization. |
20100
|
Any law enforcement or administrative agency or regulatory |
20101
|
organization receiving confidential information in connection |
20102
|
with its official duties shall maintain the confidentiality of |
20103
|
the information so long as it would otherwise be confidential. |
20104
|
(e) All information obtained by the officedepartmentfrom |
20105
|
any person which is only made available to the officedepartment |
20106
|
on a confidential or similarly restricted basis shall be |
20107
|
confidential and exempt from s. 119.07(1). This exemption shall |
20108
|
not be construed to prohibit disclosure of information which is |
20109
|
required by law to be filed with the officedepartmentor which |
20110
|
is otherwise subject to s. 119.07(1). |
20111
|
(3) A privilege against civil liability is granted to a |
20112
|
person who furnishes information or evidence to the office |
20113
|
department, unless such person acts in bad faith or with malice |
20114
|
in providing such information or evidence. |
20115
|
Section 373. Section 517.221, Florida Statutes, is amended |
20116
|
to read: |
20117
|
517.221 Cease and desist orders.-- |
20118
|
(1) The officedepartmentmay issue and serve upon a |
20119
|
person a cease and desist order whenever the officedepartment |
20120
|
has reason to believe that such person is violating, has |
20121
|
violated, or is about to violate any provision of this chapter, |
20122
|
any rule or order promulgated by the commission or office |
20123
|
department, or any written agreement entered into with the |
20124
|
officedepartment. |
20125
|
(2) Whenever the officedepartmentfinds that conduct |
20126
|
described in subsection (1) presents an immediate danger to the |
20127
|
public requiring an immediate final order, it may issue an |
20128
|
emergency cease and desist order reciting with particularity the |
20129
|
facts underlying such findings. The emergency cease and desist |
20130
|
order is effective immediately upon service of a copy of the |
20131
|
order on the respondent named therein and remains effective for |
20132
|
90 days. If the officedepartmentbegins nonemergency cease and |
20133
|
desist proceedings under subsection (1), the emergency cease and |
20134
|
desist order remains effective until conclusion of the |
20135
|
proceedings under ss. 120.569 and 120.57. |
20136
|
(3) The officedepartmentmay impose and collect an |
20137
|
administrative fine against any person found to have violated |
20138
|
any provision of this chapter, any rule or order promulgated by |
20139
|
the commission or officedepartment, or any written agreement |
20140
|
entered into with the officedepartmentin an amount not to |
20141
|
exceed $5,000 for each such violation. All fines collected |
20142
|
hereunder shall be deposited as received in the Anti-Fraud Trust |
20143
|
Fund. |
20144
|
Section 374. Subsection (1) of section 517.241, Florida |
20145
|
Statutes, is amended to read: |
20146
|
517.241 Remedies.-- |
20147
|
(1) Any person aggrieved by a final order of the office |
20148
|
departmentmay have the order reviewed as provided by chapter |
20149
|
120, the Administrative Procedure Act. |
20150
|
Section 375. Paragraph (c) of subsection (1) and paragraph |
20151
|
(b) of subsection (2) of section 517.301, Florida Statutes, are |
20152
|
amended to read: |
20153
|
517.301 Fraudulent transactions; falsification or |
20154
|
concealment of facts.-- |
20155
|
(1) It is unlawful and a violation of the provisions of |
20156
|
this chapter for a person: |
20157
|
(c) In any matter within the jurisdiction of the office |
20158
|
department, to knowingly and willfully falsify, conceal, or |
20159
|
cover up, by any trick, scheme, or device, a material fact, make |
20160
|
any false, fictitious, or fraudulent statement or |
20161
|
representation, or make or use any false writing or document, |
20162
|
knowing the same to contain any false, fictitious, or fraudulent |
20163
|
statement or entry. |
20164
|
(2) For purposes of ss. 517.311 and 517.312 and this |
20165
|
section, the term "investment" means any commitment of money or |
20166
|
property principally induced by a representation that an |
20167
|
economic benefit may be derived from such commitment, except |
20168
|
that the term "investment" does not include a commitment of |
20169
|
money or property for: |
20170
|
(b) The purchase of tangible personal property through a |
20171
|
person not engaged in telephone solicitation, where said |
20172
|
property is offered and sold in accordance with the following |
20173
|
conditions: |
20174
|
1. There are no specific representations or guarantees |
20175
|
made by the offeror or seller as to the economic benefit to be |
20176
|
derived from the purchase; |
20177
|
2. The tangible property is delivered to the purchaser |
20178
|
within 30 days after sale, except that such 30-day period may be |
20179
|
extended by the officedepartmentif market conditions so |
20180
|
warrant; and |
20181
|
3. The seller has offered the purchaser a full refund |
20182
|
policy in writing, exercisable by the purchaser within 10 days |
20183
|
of the date of delivery of such tangible personal property, |
20184
|
except that the amount of such refund in no event shall exceed |
20185
|
the bid price in effect at the time the property is returned to |
20186
|
the seller. If the applicable sellers' market is closed at the |
20187
|
time the property is returned to the seller for a refund, the |
20188
|
amount of such refund shall be based on the bid price for such |
20189
|
property at the next opening of such market. |
20190
|
Section 376. Subsection (3) of section 517.302, Florida |
20191
|
Statutes, is amended to read: |
20192
|
517.302 Criminal penalties; alternative fine; Anti-Fraud |
20193
|
Trust Fund; time limitation for criminal prosecution.-- |
20194
|
(3) In lieu of a fine otherwise authorized by law, a |
20195
|
person who has been convicted of or who has pleaded guilty or no |
20196
|
contest to having engaged in conduct in violation of the |
20197
|
provisions of this chapter may be sentenced to pay a fine that |
20198
|
does not exceed the greater of three times the gross value |
20199
|
gained or three times the gross loss caused by such conduct, |
20200
|
plus court costs and the costs of investigation and prosecution |
20201
|
reasonably incurred. |
20202
|
(a) There is created within the officedepartmenta trust |
20203
|
fund to be known as the Anti-Fraud Trust Fund. Any amounts |
20204
|
assessed as costs of investigation and prosecution under this |
20205
|
subsection shall be deposited in the trust fund. Funds deposited |
20206
|
in such trust fund shall be used, when authorized by |
20207
|
appropriation, for investigation and prosecution of |
20208
|
administrative, civil, and criminal actions arising under the |
20209
|
provisions of this chapter. Funds may also be used to improve |
20210
|
the public's awareness and understanding of prudent investing. |
20211
|
(b) The officedepartmentshall report to the Executive |
20212
|
Office of the Governor annually by November 15, the amounts |
20213
|
deposited into the Anti-Fraud Trust Fund during the previous |
20214
|
fiscal year. The Executive Office of the Governor shall |
20215
|
distribute these reports to the President of the Senate and the |
20216
|
Speaker of the House of Representatives. |
20217
|
Section 377. Subsections (1) and (2) of section 517.313, |
20218
|
Florida Statutes, are amended to read: |
20219
|
517.313 Destroying certain records; reproduction.-- |
20220
|
(1) The commission and office maydepartment is authorized |
20221
|
tophotograph, microphotograph, or reproduce on film or prints |
20222
|
documents, records, data, and information of a permanent |
20223
|
character. |
20224
|
(2) The commission and office maydepartment is authorized |
20225
|
to destroy any of said documents after audit of the officehas |
20226
|
been completed for the period embracing the dates of said |
20227
|
instruments, after complying with the provisions of chapter 119. |
20228
|
Section 378. Section 517.315, Florida Statutes, is amended |
20229
|
to read: |
20230
|
517.315 Fees.--All fees and charges of any nature |
20231
|
collected by the officedepartmentpursuant to this chapter, |
20232
|
except the fees and charges collected pursuant to s. 517.131, |
20233
|
shall be paid into the State Treasury and credited to the |
20234
|
General Revenue Fund; and an appropriation shall be made |
20235
|
annually of necessary funds for the administration of the |
20236
|
provisions of this chapter. |
20237
|
Section 379. Section 517.32, Florida Statutes, is amended |
20238
|
to read: |
20239
|
517.32 Exemption from excise tax, certain obligations to |
20240
|
pay.--There shall be exempt from all excise taxes imposed by |
20241
|
chapter 201 all promissory notes, nonnegotiable notes, and other |
20242
|
written obligations to pay money bearing dates subsequent to |
20243
|
July 1, 1957, when the maker thereof is a security dealer |
20244
|
registered by the officedepartmentunder this chapter and when |
20245
|
such promissory note, nonnegotiable note or notes, or other |
20246
|
written obligation to pay money shall be for the duration of 30 |
20247
|
days or less and secured by pledge or deposit, as collateral |
20248
|
security for the payment thereof, security or securities as |
20249
|
defined in s. 517.021, provided all excise taxes imposed by |
20250
|
chapter 201 shall have been paid upon such collateral security. |
20251
|
Section 380. Section 520.996, Florida Statutes, is amended |
20252
|
to read: |
20253
|
520.996 Investigations and complaints.-- |
20254
|
(1)(a) The officedepartmentor its agent may, at |
20255
|
intermittent periods, make such investigations and examinations |
20256
|
of any licensee or other person as it deems necessary to |
20257
|
determine compliance with this chapter. For such purposes, it |
20258
|
may examine the books, accounts, records, and other documents or |
20259
|
matters of any licensee or other person. It shall have the power |
20260
|
to compel the production of all relevant books, records, and |
20261
|
other documents and materials relative to an examination or |
20262
|
investigation. Such investigations and examinations shall not |
20263
|
be made more often than once during any 12-month period unless |
20264
|
the officedepartmenthas good and sufficient reason to believe |
20265
|
the licensee is not complying with the provisions of this |
20266
|
chapter. Such examination fee shall be calculated on an hourly |
20267
|
basis and shall be rounded to the nearest hour. |
20268
|
(b) The officedepartmentshall conduct all examinations |
20269
|
at a convenient location in this state unless the office |
20270
|
departmentdetermines that it is more effective or cost- |
20271
|
efficient to perform an examination at the licensee's out-of- |
20272
|
state location. For an examination performed at the licensee's |
20273
|
out-of-state location, the licensee shall pay the travel expense |
20274
|
and per diem subsistence at the rate provided by law for up to |
20275
|
thirty 8-hour days per year for each examiner who participates |
20276
|
in such an examination. However, if the examination involves or |
20277
|
reveals possible fraudulent conduct of the licensee, the |
20278
|
licensee shall pay the travel expenses and per diem subsistence |
20279
|
provided by law, without limitation, for each participating |
20280
|
examiner. |
20281
|
(2) The examination expenses incurred by the office |
20282
|
departmentin each examination shall be paid by the licensee |
20283
|
examined. The expenses of the officedepartmentincurred in |
20284
|
each examination of a home improvement finance seller or of an |
20285
|
employee representing such home improvement finance seller shall |
20286
|
be paid by the home improvement finance seller. Expenses |
20287
|
incurred for each examination of a sales finance company shall |
20288
|
be paid by it. The examination expenses shall be paid by such |
20289
|
licensee examined or such other person obligated to pay such |
20290
|
examination expenses within 30 days after demand therefor by the |
20291
|
officedepartment. |
20292
|
(3) Any retail buyer or owner having reason to believe |
20293
|
that the provisions of this chapter have been violated may file |
20294
|
with the office or the Department of Financial Servicesa |
20295
|
written complaint setting forth the details of such alleged |
20296
|
violations and the officedepartmentupon receipt of such |
20297
|
complaint, may inspect the pertinent books, records, letters, |
20298
|
and contracts of the licensee and of the seller involved, |
20299
|
relating to such specific written complaint. |
20300
|
Section 381. Section 520.9965, Florida Statutes, is |
20301
|
amended to read: |
20302
|
520.9965 Confidentiality of information relating to |
20303
|
investigations and examinations.-- |
20304
|
(1)(a) Except as otherwise provided by this section, |
20305
|
information relative to an investigation or examination by the |
20306
|
officedepartmentpursuant to this chapter, including any |
20307
|
consumer complaint received by the office or the Department of |
20308
|
Financial Services, is confidential and exempt from s. 119.07(1) |
20309
|
until the investigation or examination is completed or ceases to |
20310
|
be active. The information compiled by the officedepartmentin |
20311
|
such an investigation or examination shall remain confidential |
20312
|
and exempt from s. 119.07(1) after the office'sdepartment's |
20313
|
investigation or examination is completed or ceases to be active |
20314
|
if the officedepartmentsubmits the information to any law |
20315
|
enforcement or administrative agency for further investigation. |
20316
|
Such information shall remain confidential and exempt from s. |
20317
|
119.07(1) until that agency's investigation is completed or |
20318
|
ceases to be active. For purposes of this section, an |
20319
|
investigation or examination shall be considered "active" so |
20320
|
long as the officedepartmentor any law enforcement or |
20321
|
administrative agency is proceeding with reasonable dispatch and |
20322
|
has a reasonable good faith belief that the investigation or |
20323
|
examination may lead to the filing of an administrative, civil, |
20324
|
or criminal proceeding or to the denial or conditional grant of |
20325
|
a license, registration, or permit. This section shall not be |
20326
|
construed to prohibit disclosure of information which is |
20327
|
required by law to be filed with the officedepartmentand |
20328
|
which, but for the investigation or examination, would be |
20329
|
subject to s. 119.07(1). |
20330
|
(b) Except as necessary for the officedepartmentto |
20331
|
enforce the provisions of this chapter, a consumer complaint and |
20332
|
other information relative to an investigation or examination |
20333
|
shall remain confidential and exempt from s. 119.07(1) after the |
20334
|
investigation or examination is completed or ceases to be active |
20335
|
to the extent disclosure would: |
20336
|
1. Jeopardize the integrity of another active |
20337
|
investigation or examination. |
20338
|
2. Reveal the name, address, telephone number, social |
20339
|
security number, or any other identifying number or information |
20340
|
of any complainant, customer, or account holder. |
20341
|
3. Disclose the identity of a confidential source. |
20342
|
4. Disclose investigative techniques or procedures. |
20343
|
5. Reveal a trade secret as defined in s. 688.002. |
20344
|
(c) In the event that officedepartment personnel or |
20345
|
personnel of the former Department of Banking and Financeare or |
20346
|
have been involved in an investigation or examination of such |
20347
|
nature as to endanger their lives or physical safety or that of |
20348
|
their families, then the home addresses, telephone numbers, |
20349
|
places of employment, and photographs of such personnel, |
20350
|
together with the home addresses, telephone numbers, |
20351
|
photographs, and places of employment of spouses and children of |
20352
|
such personnel and the names and locations of schools and day |
20353
|
care facilities attended by the children of such personnel are |
20354
|
confidential and exempt from s. 119.07(1). |
20355
|
(d) Nothing in this section shall be construed to prohibit |
20356
|
the officedepartmentfrom providing information to any law |
20357
|
enforcement or administrative agency. Any law enforcement or |
20358
|
administrative agency receiving confidential information in |
20359
|
connection with its official duties shall maintain the |
20360
|
confidentiality of the information so long as it would otherwise |
20361
|
be confidential. |
20362
|
(e) All information obtained by the officedepartmentfrom |
20363
|
any person which is only made available to the officedepartment |
20364
|
on a confidential or similarly restricted basis shall be |
20365
|
confidential and exempt from s. 119.07(1). This exemption shall |
20366
|
not be construed to prohibit disclosure of information which is |
20367
|
required by law to be filed with the officedepartmentor which |
20368
|
is otherwise subject to s. 119.07(1). |
20369
|
(2) If information subject to subsection (1) is offered in |
20370
|
evidence in any administrative, civil, or criminal proceeding, |
20371
|
the presiding officer may, in his or her discretion, prevent the |
20372
|
disclosure of information which would be confidential pursuant |
20373
|
to paragraph (1)(b). |
20374
|
(3) A privilege against civil liability is granted to a |
20375
|
person who furnishes information or evidence to the office |
20376
|
department, unless such person acts in bad faith or with malice |
20377
|
in providing such information or evidence. |
20378
|
Section 382. Paragraph (b) of subsection (2) of section |
20379
|
527.008, Florida Statutes, is amended to read: |
20380
|
537.008 Title loan agreement.-- |
20381
|
(2) The following information shall also be printed on all |
20382
|
title loan agreements: |
20383
|
(b) The name and address of the Department of Financial |
20384
|
Servicesas well as a telephone number to which consumers may |
20385
|
address complaints. |
20386
|
Section 383. Section 537.009, Florida Statutes, is amended |
20387
|
to read: |
20388
|
537.009 Recordkeeping; reporting; safekeeping of |
20389
|
property.-- |
20390
|
(1) Every title loan lender shall maintain, at the |
20391
|
lender's title loan office, such books, accounts, and records of |
20392
|
the business conducted under the license issued for such place |
20393
|
of business as will enable the officedepartmentto determine |
20394
|
the licensee's compliance with this act. |
20395
|
(2) The officedepartmentmay authorize the maintenance of |
20396
|
books, accounts, and records at a location other than the |
20397
|
lender's title loan office. The officedepartmentmay require |
20398
|
books, accounts, and records to be produced and available at a |
20399
|
reasonable and convenient location in this state within a |
20400
|
reasonable period of time after such a request. |
20401
|
(3) The title loan lender shall maintain the original copy |
20402
|
of each completed title loan agreement on the title loan office |
20403
|
premises, and shall not obliterate, discard, or destroy any such |
20404
|
original copy, for a period of at least 2 years after making the |
20405
|
final entry on any loan recorded in such office or after ana |
20406
|
department examination by the Office of Financial Institutions |
20407
|
and Securities Regulation, whichever is later. |
20408
|
(4) Loan property which is delivered to a title loan |
20409
|
lender shall be securely stored and maintained at the title loan |
20410
|
office unless the loan property has been forwarded to the |
20411
|
appropriate state agency for the purpose of having a lien |
20412
|
recorded or deleted. |
20413
|
(5) The commissiondepartmentmay prescribe by rule the |
20414
|
books, accounts, and records, and the minimum information to be |
20415
|
shown in the books, accounts, and records, of licensees so that |
20416
|
such records will enable the officedepartmentto determine |
20417
|
compliance with the provisions of this act. |
20418
|
Section 384. Subsection (2) and paragraph (c) of |
20419
|
subsection (4) of section 537.011, Florida Statutes, are amended |
20420
|
to read: |
20421
|
537.011 Title loan charges.-- |
20422
|
(2) The annual percentage rate that may be charged for a |
20423
|
title loan may equal, but not exceed, the annual percentage rate |
20424
|
that must be computed and disclosed as required by the federal |
20425
|
Truth in Lending Act and Regulation Z of the Board of Governors |
20426
|
of the Federal Reserve System. The maximum annual percentage |
20427
|
rate of interest that may be charged is 12 times the maximum |
20428
|
monthly rate, and the maximum monthly rate must be computed on |
20429
|
the basis of one-twelfth of the annual rate for each full month. |
20430
|
The commissionDepartment of Banking and Financeshall establish |
20431
|
by rule the rate for each day in a fraction of a month when the |
20432
|
period for which the charge is computed is more or less than 1 |
20433
|
month. |
20434
|
(4) Any interest contracted for or received, directly or |
20435
|
indirectly, by a title loan lender, or an agent of the title |
20436
|
loan lender, in excess of the amounts authorized under this |
20437
|
chapter is prohibited and may not be collected by the title loan |
20438
|
lender or an agent of the title loan lender. |
20439
|
(c) The officedepartmentmay order a title loan lender, |
20440
|
or an agent of the title loan lender, to comply with the |
20441
|
provisions of paragraphs (a) and (b). |
20442
|
Section 385. Paragraphs (b), (f), and (n) of subsection |
20443
|
(1) of section 537.013, Florida Statutes, are amended to read: |
20444
|
537.013 Prohibited acts.-- |
20445
|
(1) A title loan lender, or any agent or employee of a |
20446
|
title loan lender, shall not: |
20447
|
(b) Refuse to allow the officedepartmentto inspect |
20448
|
completed title loan agreements, extensions of such agreements, |
20449
|
or loan property during the ordinary operating hours of the |
20450
|
title loan lender's business or other times acceptable to both |
20451
|
parties. |
20452
|
(f) Fail to exercise reasonable care, as defined by |
20453
|
commissiondepartmentrule, in the safekeeping of loan property |
20454
|
or of titled personal property repossessed pursuant to this act. |
20455
|
(n) Act as a title loan lender under this act within a |
20456
|
place of business in which the licensee solicits or engages in |
20457
|
business outside the scope of this act if the officedepartment |
20458
|
determines that the licensee's operation of and conduct |
20459
|
pertaining to such other business results in an evasion of this |
20460
|
act. Upon making such a determination, the officedepartment |
20461
|
shall order the licensee to cease and desist from such evasion; |
20462
|
provided, no licensee shall engage in the pawnbroker business. |
20463
|
Section 386. Section 537.016, Florida Statutes, is amended |
20464
|
to read: |
20465
|
537.016 Subpoenas; enforcement actions; rules.-- |
20466
|
(1) The officedepartmentmay issue and serve subpoenas to |
20467
|
compel the attendance of witnesses and the production of |
20468
|
documents, papers, books, records, and other evidence before the |
20469
|
officedepartment in any matter pertaining to this act. The |
20470
|
officedepartmentmay administer oaths and affirmations to any |
20471
|
person whose testimony is required. If any person refuses to |
20472
|
testify; produce books, records, and documents; or otherwise |
20473
|
refuses to obey a subpoena issued under this section, the office |
20474
|
departmentmay enforce the subpoena in the same manner as |
20475
|
subpoenas issued under the Administrative Procedure Act are |
20476
|
enforced. Witnesses are entitled to the same fees and mileage as |
20477
|
they are entitled to by law for attending as witnesses in the |
20478
|
circuit court, unless such examination or investigation is held |
20479
|
at the place of business or residence of the witness. |
20480
|
(2) In addition to any other powers conferred upon the |
20481
|
officedepartment to enforce or administer this act, the office |
20482
|
departmentmay: |
20483
|
(a) Bring an action in any court of competent jurisdiction |
20484
|
to enforce or administer this act, any rule or order adopted |
20485
|
under this act, or any written agreement entered into with the |
20486
|
officedepartment. In such action, the officedepartmentmay |
20487
|
seek any relief at law or equity, including a temporary or |
20488
|
permanent injunction, appointment of a receiver or |
20489
|
administrator, or an order of restitution. |
20490
|
(b) Issue and serve upon a person an order requiring such |
20491
|
person to cease and desist and take corrective action whenever |
20492
|
the officedepartmentfinds that such person is violating, has |
20493
|
violated, or is about to violate any provision of this act, any |
20494
|
rule or order adopted under this act, or any written agreement |
20495
|
entered into with the officedepartment. |
20496
|
(c) Whenever the officedepartmentfinds that conduct |
20497
|
described in paragraph (b) presents an immediate danger to the |
20498
|
public health, safety, or welfare requiring an immediate final |
20499
|
order, the officedepartmentmay issue an emergency cease and |
20500
|
desist order reciting with particularity the facts underlying |
20501
|
such findings. The emergency cease and desist order is effective |
20502
|
immediately upon service of a copy of the order on the |
20503
|
respondent named in the order and shall remain effective for 90 |
20504
|
days. If the officedepartmentbegins nonemergency proceedings |
20505
|
under paragraph (b), the emergency cease and desist order |
20506
|
remains effective until the conclusion of the proceedings under |
20507
|
ss. 120.569 and 120.57. |
20508
|
(3) The commissiondepartmentmay adopt rules to |
20509
|
administer this act. |
20510
|
Section 387. Section 537.017, Florida Statutes, is amended |
20511
|
to read: |
20512
|
537.017 Investigations and complaints.-- |
20513
|
(1) The officedepartmentmay make any investigation and |
20514
|
examination of any licensee or other person the office |
20515
|
departmentdeems necessary to determine compliance with this |
20516
|
act. For such purposes, the officedepartmentmay examine the |
20517
|
books, accounts, records, and other documents or matters of any |
20518
|
licensee or other person. The officedepartmentmay compel the |
20519
|
production of all relevant books, records, and other documents |
20520
|
and materials relative to an examination or investigation. |
20521
|
Examinations shall not be made more often than once during any |
20522
|
12-month period unless the officedepartmenthas reason to |
20523
|
believe the licensee is not complying with the provisions of |
20524
|
this act. |
20525
|
(2) The officedepartmentshall conduct all examinations |
20526
|
at a convenient location in this state unless the office |
20527
|
departmentdetermines that it is more effective or cost- |
20528
|
efficient to perform an examination at the licensee's out-of- |
20529
|
state location. For an examination performed at the licensee's |
20530
|
out-of-state location, the licensee shall pay the travel expense |
20531
|
and per diem subsistence at the rate provided by law for up to |
20532
|
thirty 8-hour days per year for each officedepartmentexaminer |
20533
|
who participates in such an examination. However, if the |
20534
|
examination involves or reveals possible fraudulent conduct by |
20535
|
the licensee, the licensee shall pay the travel expenses and per |
20536
|
diem subsistence provided by law, without limitation, for each |
20537
|
participating examiner. |
20538
|
(3) Any person having reason to believe that any provision |
20539
|
of this act has been violated may file with the Department of |
20540
|
Financial Services or the officea written complaint setting |
20541
|
forth the details of such alleged violation, and the office |
20542
|
departmentmay investigate such complaint. |
20543
|
Section 388. Section 559.725, Florida Statutes, is amended |
20544
|
to read: |
20545
|
559.725 Consumer complaints; administrative duties.-- |
20546
|
(1) The Division of Consumer Services of the Department of |
20547
|
Agriculture and Consumer Servicesshall serve as the registry |
20548
|
for receiving and maintaining records of inquiries, |
20549
|
correspondence, and complaints from consumers concerning any and |
20550
|
all persons who collect debts, including consumer collection |
20551
|
agencies. |
20552
|
(2) The division shall classify complaints by type and |
20553
|
identify the number of written complaints against persons |
20554
|
collecting or attempting to collect debts in this state, |
20555
|
including credit grantors collecting their own debts, debt |
20556
|
collectors generally, and, specifically, consumer collection |
20557
|
agencies as distinguished from other persons who collect debts |
20558
|
such as commercial debt collection agencies regulated under part |
20559
|
V of this chapter. The division shall identify the nature and |
20560
|
number of various kinds of written complaints, including |
20561
|
specifically those alleging violations of s. 559.72. |
20562
|
(3) The division shall inform and furnish relevant |
20563
|
information to the appropriate regulatory body of the state, or |
20564
|
The Florida Bar in the case of attorneys, when any consumer debt |
20565
|
collector exempt from registration under this part has been |
20566
|
named in five or more written consumer complaints alleging |
20567
|
violations of s. 559.72 within a 12-month period. |
20568
|
(4) The division shall furnish a form to each complainant |
20569
|
whose complaint concerns an alleged violation of s. 559.72 by a |
20570
|
consumer collection agency. Such form may be filed with the |
20571
|
officeDepartment of Banking and Finance. The form shall |
20572
|
identify the accused consumer collection agency and provide for |
20573
|
the complainant's summary of the nature of the alleged violation |
20574
|
and facts which allegedly support the complaint. The form shall |
20575
|
include a provision for the complainant to state under oath |
20576
|
before a notary public that the allegations therein made are |
20577
|
true. |
20578
|
(5) Upon receipt of such sworn complaint, the office |
20579
|
departmentshall promptly furnish a copy of the sworn complaint |
20580
|
to the accused consumer collection agency. |
20581
|
(6) The officedepartmentshall investigate sworn |
20582
|
complaints by direct written communication with the complainant |
20583
|
and the affected consumer collection agency. In addition, the |
20584
|
officedepartmentshall attempt to resolve each sworn complaint |
20585
|
and shall record the resolution of such complaints. |
20586
|
(7) Periodically, the officedepartmentshall identify |
20587
|
consumer collection agencies that have unresolved sworn consumer |
20588
|
complaints from five or more different consumers within a 12- |
20589
|
month period under the provisions of this part. |
20590
|
(8) The officedepartmentshall issue a written warning |
20591
|
notice to the accused consumer collection agency if the office |
20592
|
departmentis unable to resolve all such sworn complaints and |
20593
|
fewer than five unresolved complaints remain. Such notice shall |
20594
|
include a statement that the warning may constitute evidence in |
20595
|
any future investigation of similar complaints against that |
20596
|
agency and in any future administrative determination of the |
20597
|
imposition of other administrative remedies available to the |
20598
|
officedepartmentunder this part. |
20599
|
(9) The officedepartmentmay issue a written reprimand |
20600
|
when five or more such unresolved sworn complaints against a |
20601
|
consumer collection agency collectively fall short of |
20602
|
constituting apparent repeated violations that warrant more |
20603
|
serious administrative sanctions. Such reprimand shall include a |
20604
|
statement that the reprimand may constitute evidence in any |
20605
|
future investigation of similar complaints against that agency |
20606
|
and in any future administrative determination of the imposition |
20607
|
of other administrative remedies available to the office |
20608
|
department. |
20609
|
(10) The officedepartmentshall issue a notice of intent |
20610
|
either to revoke or suspend the registration or to impose an |
20611
|
administrative fine when the officedepartmentpreliminarily |
20612
|
determines that repeated violations of s. 559.72 by an accused |
20613
|
registrant have occurred which would warrant more serious |
20614
|
administrative sanctions being imposed under this part. The |
20615
|
officedepartmentshall advise each registrant of the right to |
20616
|
require an administrative hearing under chapter 120, prior to |
20617
|
the agency's final action on the matter as authorized by s. |
20618
|
559.730. |
20619
|
(11) The officedepartmentshall advise the appropriate |
20620
|
state attorney, or the Attorney General in the case of an out- |
20621
|
of-state consumer debt collector, of any determination by the |
20622
|
officedepartmentof a violation of the requirements of this |
20623
|
part by any consumer collection agency which is not registered |
20624
|
as required by this part. The officedepartmentshall furnish |
20625
|
the state attorney or Attorney General with the office's |
20626
|
department'sinformation concerning the alleged violations of |
20627
|
such requirements. |
20628
|
Section 389. Section 560.128, Florida Statutes, is amended |
20629
|
to read: |
20630
|
560.128 Consumer disclosure.-- |
20631
|
(1) Every money transmitter and authorized vendor shall |
20632
|
provide each consumer of a money transmitter transaction a toll- |
20633
|
free telephone number for the purpose of consumer contacts; |
20634
|
however, in lieu of such toll-free telephone number, the money |
20635
|
transmitter or authorized vendor may provide the address and |
20636
|
telephone number of the office and the Division of Consumer |
20637
|
Services of the Department of Financial Servicesdepartment. |
20638
|
(2) The commissiondepartmentmay by rule require every |
20639
|
money transmitter to display its registration at each location, |
20640
|
including the location of each person designated by the |
20641
|
registrant as an authorized vendor, where the money transmitter |
20642
|
engages in the activities authorized by the registration. |
20643
|
Section 390. Section 560.129, Florida Statutes, is amended |
20644
|
to read: |
20645
|
560.129 Confidentiality.-- |
20646
|
(1) For purposes of this section, the definitions |
20647
|
contained in s. 560.103, as created by chapter 94-238, Laws of |
20648
|
Florida, and chapter 94-354, Laws of Florida, apply. |
20649
|
(1)(2)(a) Except as otherwise provided in this section, |
20650
|
all information concerning an investigation or examination by |
20651
|
the officedepartmentpursuant to this chapter, including any |
20652
|
consumer complaint received by the office or the Department of |
20653
|
Financial Services, is confidential and exempt from s. 119.07(1) |
20654
|
and s. 24(a), Art. I of the State Constitution until the |
20655
|
investigation or examination ceases to be active. For purposes |
20656
|
of this section, an investigation or examination is considered |
20657
|
"active" so long as the officedepartmentor any other |
20658
|
administrative, regulatory, or law enforcement agency of any |
20659
|
jurisdiction is proceeding with reasonable dispatch and has a |
20660
|
reasonable good faith belief that action may be initiated by the |
20661
|
officedepartmentor other administrative, regulatory, or law |
20662
|
enforcement agency. |
20663
|
(b) Notwithstanding paragraph (a), all information |
20664
|
obtained by the officedepartmentin the course of its |
20665
|
investigation or examination which is a trade secret, as defined |
20666
|
in s. 688.002, or which is personal financial information shall |
20667
|
remain confidential. If any administrative, civil, or criminal |
20668
|
proceeding against the money transmitter or a money transmitter- |
20669
|
affiliated party is initiated and the officedepartmentseeks to |
20670
|
use matter that a registrant believes to be a trade secret or |
20671
|
personal financial information, such records shall be subject to |
20672
|
an in camera review by the administrative law judge, if the |
20673
|
matter is before the Division of Administrative Hearings, or a |
20674
|
judge of any court of this state, any other state, or the United |
20675
|
States, as appropriate, for the purpose of determining if the |
20676
|
matter is a trade secret or is personal financial information. |
20677
|
If it is determined that the matter is a trade secret, the |
20678
|
matter shall remain confidential. If it is determined that the |
20679
|
matter is personal financial information, the matter shall |
20680
|
remain confidential unless the administrative law judge or judge |
20681
|
determines that, in the interests of justice, the matter should |
20682
|
become public. |
20683
|
(c) If any administrative, civil, or criminal proceeding |
20684
|
against the money transmitter or a money transmitter-affiliated |
20685
|
party results in an acquittal or the dismissal of all of the |
20686
|
allegations against the money transmitter or a money |
20687
|
transmitter-affiliated party, upon the request of any party, the |
20688
|
administrative law judge or the judge may order all or a portion |
20689
|
of the record of the proceeding to be sealed, and it shall |
20690
|
thereafter be confidential and exempt from s. 119.07(1) and s. |
20691
|
24(a), Art. I of the State Constitution. |
20692
|
(d) Except as necessary for the officedepartmentor any |
20693
|
other administrative, regulatory, or law enforcement agency of |
20694
|
any jurisdiction to enforce the provisions of this chapter or |
20695
|
the law of any other state or the United States, a consumer |
20696
|
complaint and other information concerning an investigation or |
20697
|
examination shall remain confidential and exempt from s. |
20698
|
119.07(1) and s. 24(a), Art. I of the State Constitution after |
20699
|
the investigation or examination ceases to be active to the |
20700
|
extent that disclosure would: |
20701
|
1. Jeopardize the integrity of another active |
20702
|
investigation; |
20703
|
2. Reveal personal financial information; |
20704
|
3. Reveal the identity of a confidential source; or |
20705
|
4. Reveal investigative techniques or procedures. |
20706
|
(2)(3)This section does not prevent or restrict: |
20707
|
(a) Furnishing records or information to any appropriate |
20708
|
regulatory agency if such agency adheres to the confidentiality |
20709
|
provisions of the code; |
20710
|
(b) Furnishing records or information to an independent |
20711
|
third party or a certified public accountant who has been |
20712
|
approved by the officedepartmentto conduct an examination |
20713
|
under s. 560.118(1)(b), if the independent third party or |
20714
|
certified public accountant adheres to the confidentiality |
20715
|
provisions of the code; or |
20716
|
(c) Reporting any suspected criminal activity, with |
20717
|
supporting documents and information, to appropriate law |
20718
|
enforcement or prosecutorial agencies. |
20719
|
(3)(4)All quarterly reports submitted by a money |
20720
|
transmitter to the officedepartmentunder s. 560.118(2)(b) are |
20721
|
confidential and exempt from s. 119.07(1) and s. 24(a), Art. I |
20722
|
of the State Constitution. |
20723
|
(4)(5)Examination reports, investigatory records, |
20724
|
applications, and related information compiled by the office |
20725
|
department, or photographic copies thereof, shall be retained by |
20726
|
the officedepartmentfor a period of at least 10 years. |
20727
|
(5)(6)Any person who willfully discloses information made |
20728
|
confidential by this section commits a felony of the third |
20729
|
degree, punishable as provided in s. 775.082 or s. 775.083. |
20730
|
Section 391. Subsection (3), paragraph (b) of subsection |
20731
|
(19), paragraph (b) of subsection(22), and subsection (23) of |
20732
|
section 560.404, Florida Statutes, are amended to read: |
20733
|
560.404 Requirements for deferred presentment |
20734
|
transactions.-- |
20735
|
(3) Each written agreement shall contain the following |
20736
|
information, in addition to any information the commission |
20737
|
departmentrequires by rule: |
20738
|
(a) The name or trade name, address, and telephone number |
20739
|
of the deferred presentment provider and the name and title of |
20740
|
the person who signs the agreement on behalf of the deferred |
20741
|
presentment provider. |
20742
|
(b) The date the deferred presentment transaction was |
20743
|
made. |
20744
|
(c) The amount of the drawer's check. |
20745
|
(d) The length of deferral period. |
20746
|
(e) The last day of the deferment period. |
20747
|
(f) The address and telephone number of the office and the |
20748
|
Division of Consumer Services of the Department of Financial |
20749
|
Servicesdepartment. |
20750
|
(g) A clear description of the drawer's payment |
20751
|
obligations under the deferred presentment transaction. |
20752
|
(h) The transaction number assigned by the office's |
20753
|
department'sdatabase. |
20754
|
(19) A deferred presentment provider may not enter into a |
20755
|
deferred presentment transaction with a person who has an |
20756
|
outstanding deferred presentment transaction with that provider |
20757
|
or with any other deferred presentment provider, or with a |
20758
|
person whose previous deferred presentment transaction with that |
20759
|
provider or with any other provider has been terminated for less |
20760
|
than 24 hours. The deferred presentment provider must verify |
20761
|
such information as follows: |
20762
|
(b) The deferred presentment provider shall access the |
20763
|
office'sdepartment'sdatabase established pursuant to |
20764
|
subsection (23) and shall verify whether any other deferred |
20765
|
presentment provider has an outstanding deferred presentment |
20766
|
transaction with a particular person or has terminated a |
20767
|
transaction with that person within the previous 24 hours. Prior |
20768
|
to the time that the officedepartmenthas implemented such a |
20769
|
database, the deferred presentment provider may rely upon the |
20770
|
written verification of the drawer as provided in subsection |
20771
|
(20). |
20772
|
(22) |
20773
|
(b) At the commencement of the grace period, the deferred |
20774
|
presentment provider shall provide the drawer: |
20775
|
1. Verbal notice of the availability of the grace period |
20776
|
consistent with the written notice in subsection (20). |
20777
|
2. A list of approved consumer credit counseling agencies |
20778
|
prepared by the officedepartment. The department shall prepare |
20779
|
the list by October 1, 2001. The officedepartmentlist shall |
20780
|
include nonprofit consumer credit counseling agencies affiliated |
20781
|
with the National Foundation for Credit Counseling which provide |
20782
|
credit counseling services to Florida residents in person, by |
20783
|
telephone, or through the Internet. The officedepartmentlist |
20784
|
must include phone numbers for the agencies, the counties served |
20785
|
by the agencies, and indicate the agencies that provide |
20786
|
telephone counseling and those that provide Internet counseling. |
20787
|
The officedepartmentshall update the list at least once each |
20788
|
year. |
20789
|
3. The following notice in at least 14-point type in |
20790
|
substantially the following form: |
20791
|
|
20792
|
AS A CONDITION OF OBTAINING A GRACE PERIOD EXTENDING THE TERM OF |
20793
|
YOUR DEFERRED PRESENTMENT AGREEMENT FOR AN ADDITIONAL 60 DAYS, |
20794
|
UNTIL [DATE], WITHOUT ANY ADDITIONAL FEES, YOU MUST COMPLETE |
20795
|
CONSUMER CREDIT COUNSELING PROVIDED BY AN AGENCY INCLUDED ON THE |
20796
|
LIST THAT WILL BE PROVIDED TO YOU BY THIS PROVIDER. YOU MAY ALSO |
20797
|
AGREE TO COMPLY WITH AND ADHERE TO A REPAYMENT PLAN APPROVED BY |
20798
|
THE AGENCY. THE COUNSELING MAY BE IN PERSON, BY TELEPHONE, OR |
20799
|
THROUGH THE INTERNET. YOU MUST NOTIFY US WITHIN SEVEN (7) DAYS, |
20800
|
BY [DATE], THAT YOU HAVE MADE AN APPOINTMENT WITH SUCH A |
20801
|
CONSUMER CREDIT COUNSELING AGENCY. YOU MUST ALSO NOTIFY US |
20802
|
WITHIN SIXTY (60) DAYS, BY [DATE], THAT YOU HAVE COMPLETED THE |
20803
|
CONSUMER CREDIT COUNSELING. WE MAY VERIFY THIS INFORMATION WITH |
20804
|
THE AGENCY. IF YOU FAIL TO PROVIDE EITHER THE 7-DAY OR 60-DAY |
20805
|
NOTICE, OR IF YOU HAVE NOT MADE THE APPOINTMENT OR COMPLETED THE |
20806
|
COUNSELING WITHIN THE TIME REQUIRED, WE MAY DEPOSIT OR PRESENT |
20807
|
YOUR CHECK FOR PAYMENT AND PURSUE ALL LEGALLY AVAILABLE CIVIL |
20808
|
MEANS TO ENFORCE THE DEBT. |
20809
|
(23) On or before March 1, 2002, the officedepartment |
20810
|
shall implement a common database with real-time access through |
20811
|
an Internet connection for deferred presentment providers, as |
20812
|
provided in this subsection. The database must be accessible to |
20813
|
the officedepartmentand the deferred presentment providers to |
20814
|
verify whether any deferred presentment transactions are |
20815
|
outstanding for a particular person. Deferred presentment |
20816
|
providers shall submit such data before entering into each |
20817
|
deferred presentment transaction in such format as the |
20818
|
commissiondepartmentshall require by rule, including the |
20819
|
drawer's name, social security number or employment |
20820
|
authorization alien number, address, driver's license number, |
20821
|
amount of the transaction, date of transaction, the date that |
20822
|
the transaction is closed, and such additional information as is |
20823
|
required by the commissiondepartment. The commissiondepartment |
20824
|
may impose a fee not to exceed $1 per transaction for data |
20825
|
required to be submitted by a deferred presentment provider. A |
20826
|
deferred presentment provider may rely on the information |
20827
|
contained in the database as accurate and is not subject to any |
20828
|
administrative penalty or civil liability as a result of relying |
20829
|
on inaccurate information contained in the database. The |
20830
|
commissiondepartmentmay adopt rules to administer and enforce |
20831
|
the provisions of this section and to assure that the database |
20832
|
is used by deferred presentment providers in accordance with |
20833
|
this section. |
20834
|
Section 392. Section 609.05, Florida Statutes, is amended |
20835
|
to read: |
20836
|
609.05 Qualification with Office of Financial Institutions |
20837
|
and Securities RegulationDepartment of Banking and |
20838
|
Finance.--Before any person may offer for sale, barter or sell |
20839
|
any unit, share, contract, note, bond, mortgage, oil or mineral |
20840
|
lease or other security of an association doing business under |
20841
|
what is known as a "declaration of trust" in this state, such |
20842
|
person shall procure from the Office of Financial Institutions |
20843
|
and Securities Regulation of the Financial Services Commission |
20844
|
Department of Banking and Financea permit to offer for sale and |
20845
|
sell such securities, which permit shall be applied for and |
20846
|
granted under the same conditions as like permits are applied |
20847
|
for and granted to corporations. |
20848
|
Section 393. Section 655.012, Florida Statutes, is amended |
20849
|
to read: |
20850
|
655.012 General supervisory powers of the department; |
20851
|
rulemaking; seal.-- |
20852
|
(1)In addition to other powers conferred by the financial |
20853
|
institutions codes, the officedepartmentshall have: |
20854
|
|
20855
|
(a)(1)General supervision over all state financial |
20856
|
institutions, their subsidiaries, and service corporations. |
20857
|
(b)(2)Access to all books and records of all persons over |
20858
|
whom the officedepartmentexercises general supervision as is |
20859
|
necessary for the performance of the duties and functions of the |
20860
|
officedepartmentprescribed by the financial institutions |
20861
|
codes. |
20862
|
(c)(3)Power to issue orders and declaratory statements, |
20863
|
disseminate information, and otherwise exercise its discretion |
20864
|
to effectuate the purposes, policies, and provisions of the |
20865
|
financial institutions codes. |
20866
|
(2) In addition to other powers conferred by the financial |
20867
|
institutions codes, the commission shall have the powerandto |
20868
|
adopt rules pursuant to ss. 120.536(1) and 120.54 to implement |
20869
|
the provisions of such codes. |
20870
|
(3) The office shall have an official seal by which its |
20871
|
proceedings are authenticated. |
20872
|
Section 394. This act shall not affect the validity of any |
20873
|
administrative or judicial action involving the Department of |
20874
|
Banking and Finance or the Department of Insurance occurring |
20875
|
prior to, or pending on, January 7, 2003, and the Department of |
20876
|
Financial Services or the Financial Services Commission, or the |
20877
|
respective office, shall be substituted as a party in interest |
20878
|
on any such pending action. |
20879
|
Section 395. Any certificate of authority, license, form, |
20880
|
rate, or other filing or action that was approved or authorized |
20881
|
by the Department of Insurance or the Department of Banking and |
20882
|
Finance, or that was otherwise lawfully in use prior to January |
20883
|
7, 2003, may continue to be used or be effective as originally |
20884
|
authorized or permitted, until the Chief Financial Officer, the |
20885
|
Department of Financial Services, the Financial Services |
20886
|
Commission, or either of the respective offices, otherwise |
20887
|
prescribes.
|
20888
|
Section 396. In the event of any conflict between any |
20889
|
provision of this act and any provision of other legislation |
20890
|
enacted during the 2003 Regular Session, the provisions of this |
20891
|
act shall control. |
20892
|
Section 397. This act shall take effect upon becoming a |
20893
|
law. |