HOUSE AMENDMENT Bill No. HB 999 CS
1	CHAMBER ACTION
2	Senate House
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12	Representative Negron offered the following:
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14	Amendment (with title amendment)
15	Between lines 327 and 328, insert:
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17	Section 3. Subsection (2) and paragraph (d) of subsection
18	(3) of section 641.31, Florida Statutes, are amended to read:
19	641.31 Health maintenance contracts.--
20	(2) The rates charged by any health maintenance
21	organization to its subscribers shall not be excessive,
22	inadequate, or unfairly discriminatory or follow a rating
23	methodology that is inconsistent, indeterminate, or ambiguous or
24	encourages misrepresentation or misunderstanding. A law
25	restricting or limiting deductibles, coinsurance, copayments, or
26	annual or lifetime maximum payments shall not apply to any
27	health maintenance organization contract offered or delivered to
28	an individual or a group of 51 or more persons that provides
29	coverage as described in s.641.31071(5)(a)2.department, in
30	accordance with generally accepted actuarial practice as applied
31	to health maintenance organizations, may define by rule what
32	constitutes excessive, inadequate, or unfairly discriminatory
33	rates and may require whatever information it deems necessary to
34	determine that a rate or proposed rate meets the requirements of
35	this subsection.
36	(3)
37	(d) Any change in rates charged for the contract must be
38	filed with the department not less than 30 days in advance of
39	the effective date. At the expiration of such 30 days, the rate
40	filing shall be deemed approved unless prior to such time the
41	filing has been affirmatively approved or disapproved by order
42	of the department. The approval of the filing by the department
43	constitutes a waiver of any unexpired portion of such waiting
44	period. The department may extend by not more than an additional
45	15 days the period within which it may so affirmatively approve
46	or disapprove any such filing, by giving notice of such
47	extension before expiration of the initial 30-day period. At the
48	expiration of any such period as so extended, and in the absence
49	of such prior affirmative approval or disapproval, any such
50	filing shall be deemed approved. This paragraph does not apply
51	to group health contracts effectuated and delivered in this
52	state insuring groups of 51 or more persons, except for Medicare
53	supplement insurance, long-term care insurance, and any coverage
54	under which the increase in claims costs over the lifetime of
55	the contract due to advancing age or duration is refunded in the
56	premium.
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59	================= T I T L E A M E N D M E N T =================
60	Remove line(s) 24, and insert:
61	circumstances; amending s. 641.31, F.S.; specifying
62	nonapplication of certain health maintenance contract filing
63	requirements to certain group health insurance policies, with
64	exceptions; providing an effective date.