Senate Bill sb2214

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    Florida Senate - 2005                                  SB 2214

    By Senator Saunders





    37-1168A-05                                        See HB 1081

  1                      A bill to be entitled

  2         An act relating to discount medical plan

  3         organizations; amending s. 636.202, F.S.;

  4         revising a definition; amending s. 636.204,

  5         F.S.; revising provisions relating to licensure

  6         requirements to do business as a discount

  7         medical plan organization; amending s. 636.206,

  8         F.S.; providing that discount medical plan

  9         organizations are not subject to the Florida

10         Insurance Code for purposes of examination and

11         investigation; creating s. 636.207, F.S.;

12         providing for applicability of pt. II of ch.

13         636, F.S.; amending s. 636.208, F.S.; revising

14         provisions relating to reimbursement of certain

15         charges and fees upon cancellation of

16         membership in the plan; amending s. 636.210,

17         F.S.; revising prohibitions relating to

18         advertising; amending s. 636.212, F.S.;

19         revising provisions relating to disclosures to

20         prospective members; amending s. 636.214, F.S.;

21         revising provisions relating to provider

22         agreements; amending s. 636.216, F.S.;

23         providing conditions for approval of charges

24         and forms; deleting a provision relating to

25         request for a hearing; amending s. 636.218,

26         F.S.; revising requirements for information to

27         be included in annual reports; creating s.

28         636.223, F.S.; providing for administrative

29         penalties; amending s. 636.228, F.S.;

30         specifying marketing requirements of discount

31         medical plans; providing limitations; amending

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1         s. 636.230, F.S.; specifying fee disclosure

 2         requirements for bundling discount medical

 3         plans with other products; amending s. 636.236,

 4         F.S.; requiring discount medical plan

 5         organizations to maintain surety bonds;

 6         providing conditions for substituting deposited

 7         securities for surety bonds; amending s.

 8         636.238, F.S.; revising penalties; repealing s.

 9         636.242, F.S., relating to civil remedies;

10         providing an effective date.

11  

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

13  

14         Section 1.  Subsection (2) of section 636.202, Florida

15  Statutes, is amended to read:

16         636.202  Definitions.--As used in this part, the term:

17         (2)  "Discount medical plan organization" means an

18  entity which, in exchange for fees, dues, charges, or other

19  consideration, provides access for plan members to providers

20  of medical services and the right to receive medical services

21  from those providers at a discount. The term "discount medical

22  plan" does not include any product regulated under chapter

23  627, chapter 641, or part I of this chapter.

24         Section 2.  Subsections (1) and (2) of section 636.204,

25  Florida Statutes, are amended to read:

26         636.204  License required.--

27         (1)  Before doing business in this state as a discount

28  medical plan organization, an entity must be a corporation, a

29  limited liability company incorporated under the laws of this

30  state, or, if a partnership or foreign entity corporation,

31  authorized to transact business in this state, and must be

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  licensed by the office possess a license as a discount medical

 2  plan organization or be licensed by the office pursuant to

 3  chapter 624, part I of chapter 636, or chapter 641 from the

 4  office.

 5         (2)  An application for a license to operate as a

 6  discount medical plan organization must be filed with the

 7  office on a form prescribed by the commission. Such

 8  application must be sworn to by an officer or authorized

 9  representative of the applicant and be accompanied by the

10  following, if applicable:

11         (a)  A copy of the applicant's articles of

12  incorporation, including all amendments, or other organizing

13  documents.

14         (b)  A copy of the applicant's corporation's bylaws.

15         (c)  A list of the names, addresses, official

16  positions, and biographical information of the individuals who

17  are responsible for conducting the applicant's affairs,

18  including, but not limited to, all members of the board of

19  directors, board of trustees, executive committee, or other

20  governing board or committee, the officers, contracted

21  management company personnel, and any person or entity owning

22  or having the right to acquire 10 percent or more of the

23  voting securities of the applicant. Such listing must fully

24  disclose the extent and nature of any contracts or

25  arrangements between any individual who is responsible for

26  conducting the applicant's affairs and the discount medical

27  plan organization, including any possible conflicts of

28  interest.

29         (d)  A complete biographical statement, on forms

30  prescribed by the commission, an independent investigation

31  report, and a set of fingerprints, as provided in chapter 624,

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  with respect to each individual identified under paragraph

 2  (c).

 3         (e)  A statement generally describing the applicant,

 4  its facilities and personnel, and the medical services to be

 5  offered.

 6         (f)  A copy of the form of all contracts made or to be

 7  made between the applicant and any providers or provider

 8  networks regarding the provision of medical services to

 9  members.

10         (g)  A copy of the form of any contract made or

11  arrangement to be made between the applicant and any person

12  listed in paragraph (c).

13         (h)  A copy of the form of any contract made or to be

14  made between the applicant and any person, corporation,

15  partnership, or other entity for the performance on the

16  applicant's behalf of any function, including, but not limited

17  to, marketing, administration, enrollment, investment

18  management, and subcontracting for the provision of health

19  services to members.

20         (i)  A copy of the applicant's most recent financial

21  statements audited by an independent certified public

22  accountant. An applicant that is a subsidiary of a parent

23  entity that prepares audited financial statements reflecting

24  the consolidated operations of the parent entity and the

25  subsidiary may submit a copy of the parent entity's most

26  recent audited financial statements if the parent entity also

27  issues a written guaranty that the minimum capital

28  requirements of the applicant required by this part will be

29  met.

30         (j)  A description of the proposed method of marketing.

31  

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1         (k)  A description of the subscriber complaint

 2  procedures to be established and maintained.

 3         (l)  The fee for issuance of a license.

 4         (m)  Such other information as the commission or office

 5  may reasonably require to make the determinations required by

 6  this part.

 7         Section 3.  Section 636.206, Florida Statutes, is

 8  amended to read:

 9         636.206  Examinations and investigations.--

10         (1)  The office may examine or investigate the business

11  and affairs of any discount medical plan organization. The

12  office may order any discount medical plan organization or

13  applicant to produce any records, books, files, advertising

14  and solicitation materials, or other information and may take

15  statements under oath to determine whether the discount

16  medical plan organization or applicant is in violation of the

17  law or is acting contrary to the public interest. The expenses

18  incurred in conducting any examination or investigation must

19  be paid by the discount medical plan organization or

20  applicant. Examinations and investigations must be conducted

21  as provided in chapter 624, and discount medical plan

22  organizations are subject to all applicable provisions of the

23  insurance code.

24         (2)  Failure by the discount medical plan organization

25  to pay the expenses incurred under subsection (1) is grounds

26  for denial or revocation.

27         Section 4.  Section 636.207, Florida Statutes, is

28  created to read:

29         636.207  Applicability of part.--Except as otherwise

30  provided in this part, discount medical plan organizations are

31  

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  governed by the provisions of this part and are exempt from

 2  the Florida Insurance Code unless specifically referenced.

 3         Section 5.  Section 636.208, Florida Statutes, is

 4  amended to read:

 5         636.208  Fees; charges; reimbursement.--

 6         (1)  A discount medical plan organization may charge a

 7  periodic charge as well as a reasonable one-time processing

 8  fee for a discount medical plan and a periodic charge. If a

 9  discount medical plan charges for a time period in excess of 1

10  month, the plan must, in the event of cancellation of the

11  membership by either party, make a pro rata reimbursement of

12  the fees to the member.

13         (2)  If the member cancels his or her membership in the

14  discount medical plan organization within the first 30 days

15  after the effective date of enrollment in the plan, the member

16  shall receive a reimbursement of all periodic charges upon

17  return of the discount card to the discount medical plan

18  organization.

19         (3)  If the discount medical plan organization cancels

20  a membership for any reason other than nonpayment of fees by

21  the member, the discount medical plan organization shall make

22  a pro rata reimbursement of all periodic charges to the

23  member.

24         (4)  In addition to the reimbursement of periodic

25  charges for the reasons stated in subsections (2) and (3), a

26  discount medical plan organization shall also reimburse the

27  member for any portion of a one-time processing fee that

28  exceeds $30 per year.

29         Section 6.  Paragraphs (a) and (b) of subsection (1) of

30  section 636.210, Florida Statutes, are amended to read:

31  

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1         636.210  Prohibited activities of a discount medical

 2  plan organization.--

 3         (1)  A discount medical plan organization may not:

 4         (a)  Use in its advertisements, marketing material,

 5  brochures, and discount cards the term "insurance" except as

 6  otherwise provided in this part or as a disclaimer of any

 7  relationship between discount medical plan organization

 8  benefits and insurance;

 9         (b)  Use in its advertisements, marketing material,

10  brochures, and discount cards the terms "health plan,"

11  "coverage," "copay," "copayments," "preexisting conditions,"

12  "guaranteed issue," "premium," "enrollment," "PPO," "preferred

13  provider organization," or other terms in a manner that could

14  reasonably mislead a person into believing the discount

15  medical plan was health insurance;

16         Section 7.  Section 636.212, Florida Statutes, is

17  amended to read:

18         636.212  Disclosures.--The following disclosures must

19  be made in writing to any prospective member and must be on

20  the first page of any advertisements, marketing materials, or

21  brochures relating to a discount medical plan. The disclosures

22  must be printed in not less than 12-point type or no smaller

23  than the largest type on the page if larger than 12-point

24  type:

25         (1)  That the plan is not a health insurance policy.

26         (2)  That the plan provides discounts at certain health

27  care providers for medical services.

28         (3)  That the plan does not make payments directly to

29  the providers of medical services.

30         (4)  That the plan member is obligated to pay for all

31  health care services but will receive a discount from those

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  health care providers who have contracted with the discount

 2  plan organization.

 3         (5)  The corporate name and address the locations of

 4  the licensed discount medical plan organization.

 5  

 6  If the initial contract is made by telephone, the disclosures

 7  required by this section shall be made orally and provided in

 8  the initial written materials that describe the benefits under

 9  the discount medical plan provided to the prospective or new

10  member.

11         Section 8.  Subsections (2) and (4) of section 636.214,

12  Florida Statutes, are amended to read:

13         636.214  Provider agreements.--

14         (2)  A provider agreement between a discount medical

15  plan organization and a provider must provide the following:

16         (a)  A list of the services and products to be provided

17  at a discount.

18         (b)  The amount or amounts of the discounts or,

19  alternatively, a fee schedule which reflects the provider's

20  discounted rates.

21         (c)  That the provider will not charge members more

22  than the discounted rates.

23         (4)  The discount medical plan organization shall

24  maintain a copy of each active provider agreement into which

25  it has entered.

26         Section 9.  Section 636.216, Florida Statutes, is

27  amended to read:

28         636.216  Charge or form filings.--

29         (1)  All charges to members must be filed with the

30  office and any charge to members greater than $30 per month or

31  $360 per year must be approved by the office before the

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  charges can be used. The discount medical plan organization

 2  has the burden of proof that the charges bear a reasonable

 3  relation to the benefits received by the member.

 4         (2)  There must be a written agreement between the

 5  discount medical plan organization and the member specifying

 6  the benefits under the discount medical plan and complying

 7  with the disclosure requirements of this part.

 8         (3)  All forms used, including the written agreement

 9  pursuant to subsection (2), must first be filed with and

10  approved by the office. Every form filed shall be identified

11  by a unique form number placed in the lower left corner of

12  each form.

13         (4)  A charge or form is considered approved on the

14  60th day after its date of filing unless it has been

15  previously disapproved by the office. The office shall

16  disapprove any form that does not meet the requirements of

17  this part or that is unreasonable, discriminatory, misleading,

18  or unfair. If such filings are disapproved, the office shall

19  notify the discount medical plan organization and shall

20  specify in the notice the reasons for disapproval. The

21  discount medical plan organization has 21 days from the date

22  of receipt of notice to request a hearing before the office

23  pursuant to chapter 120.

24         Section 10.  Subsection (2) of section 636.218, Florida

25  Statutes, is amended to read:

26         636.218  Annual reports.--

27         (2)  Such reports must be on forms prescribed by the

28  commission and must include:

29         (a)  A sworn affidavit, signed by a company officer,

30  certifying that the discount medical plan organization is in

31  compliance with s. 636.220(1). Audited financial statements

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  prepared in accordance with generally accepted accounting

 2  principles certified by an independent certified public

 3  accountant, including the organization's balance sheet, income

 4  statement, and statement of changes in cash flow for the

 5  preceding year.

 6         (b)  If different from the initial application or the

 7  last annual report, a list of the names and residence

 8  addresses of all persons responsible for the conduct of the

 9  organization's affairs, together with a disclosure of the

10  extent and nature of any contracts or arrangements between

11  such persons and the discount medical plan organization,

12  including any possible conflicts of interest.

13         (c)  The number of discount medical plan members in the

14  state.

15         (d)  Such other information relating to the performance

16  of the discount medical plan organization as is reasonably

17  required by the commission or office.

18         Section 11.  Section 636.223, Florida Statutes, is

19  created to read:

20         636.223  Administrative penalty.--In lieu of suspending

21  or revoking a certificate of authority, whenever any discount

22  medical plan organization has been found to have violated any

23  provision of this part, the office may:

24         (1)  Issue and cause to be served upon the organization

25  charged with the violation a copy of such findings and an

26  order requiring such organization to cease and desist from

27  engaging in the act or practice that constitutes the

28  violation.

29         (2)  Impose a monetary penalty of not less that $100

30  for each violation, but not to exceed an aggregate penalty of

31  $50,000.

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1         Section 12.  Subsection (2) of section 636.228, Florida

 2  Statutes, is amended to read:

 3         636.228  Marketing of discount medical plans.--

 4         (2)  The discount medical plan organization shall have

 5  an executed written agreement with a marketer prior to the

 6  marketer's marketing, promoting, selling, or distributing the

 7  discount medical plan. Such agreement shall prohibit the

 8  marketer from using marketing materials, brochures, and

 9  discount cards without the approval in writing by the discount

10  medical plan organization. The discount medical plan

11  organization shall be bound by and shall be responsible and

12  financially liable for any acts of its marketers, within the

13  scope of the marketers' agency, that do not comply with the

14  provisions of this part.

15         Section 13.  Section 636.230, Florida Statutes, is

16  amended to read:

17         636.230  Bundling discount medical plans with other

18  insurance products.--When a marketer or discount medical plan

19  organization sells a discount medical plan together with any

20  other product, the fees for the discount medical plan each

21  individual product must be provided in writing to the member

22  if the fees exceed $30 and itemized.

23         Section 14.  Section 636.236, Florida Statutes, is

24  amended to read:

25         636.236  Surety bond or security deposit.--

26         (1)  Each discount medical plan organization licensed

27  pursuant to the provisions of this part must maintain in force

28  a surety bond in its own name in an amount not less than

29  $35,000 to be used at the discretion of the office to protect

30  the financial interests of members who may be adversely

31  affected by the insolvency of a discount medical plan

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  organization. The bond must be issued by an insurance company

 2  that is licensed to do business in this state.

 3         (2)(1)  In lieu of the bond specified in subsection

 4  (1), a licensed discount medical plan organization may must

 5  deposit and maintain deposited in trust with the department

 6  securities eligible for deposit under s. 625.52, having at all

 7  times a value of not less than $35,000, for use by the office

 8  in protecting plan members. If a licensed discount medical

 9  plan organization substitutes its deposited securities under

10  this subsection with a surety bond authorized in subsection

11  (1), such deposited securities shall be returned to the

12  discount medical plan organization no later than 45 days

13  following the effective date of the surety bond.

14         (3)(2)  No judgment creditor or other claimant of a

15  discount medical plan organization, other than the office or

16  department, shall have the right to levy upon any of the

17  assets or securities held in this state as a deposit under

18  subsections subsection (1) and (2).

19         Section 15.  Section 636.238, Florida Statutes, is

20  amended to read:

21         636.238  Penalties for violation of this part.--

22         (1)  Except as provided in subsection (2), a person who

23  willfully violates any provision of this part commits a

24  misdemeanor of the second degree, punishable as provided in s.

25  775.082 or s. 775.083.

26         (2)  A person who operates as or aids and abets another

27  operating as a discount medical plan organization in violation

28  of s. 636.204(1) commits a felony punishable as provided for

29  in s. 624.401(4)(b), as if the unlicensed discount medical

30  plan organization were an unauthorized insurer, and the fees,

31  dues, charges, or other consideration collected from the

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    Florida Senate - 2005                                  SB 2214
    37-1168A-05                                        See HB 1081




 1  members by the unlicensed discount medical plan organization

 2  or marketer were insurance premium.

 3         (3)  A person who collects fees for purported

 4  membership in a discount medical plan but purposefully fails

 5  to provide the promised benefits commits a theft, punishable

 6  as provided in s. 812.014.

 7         Section 16.  Section 636.242, Florida Statutes, is

 8  repealed.

 9         Section 17.  This act shall take effect upon becoming a

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