Florida Senate - 2015                CS for CS for CS for SB 252
       By the Committees on Rules; Judiciary; and Banking and
       Insurance; and Senator Smith
       595-03803-15                                           2015252c3
    1                        A bill to be entitled                      
    2         An act relating to insurance; amending s. 408.909,
    3         F.S.; revising the due date for an annual report
    4         relating to health flex plans which must be submitted
    5         by the Office of Insurance Regulation and the Agency
    6         for Health Care Administration; amending s. 440.13,
    7         F.S.; revising the due date for a biennial report
    8         relating to methods to improve the workers’
    9         compensation health care delivery system which must be
   10         submitted by a certain three-member panel; amending s.
   11         624.413, F.S.; increasing the number of years that a
   12         specified examination report remains valid and may be
   13         considered for the purpose of applying for a
   14         certificate of authority; amending s. 624.425, F.S.;
   15         providing that the absence of a countersignature does
   16         not affect the validity of a policy or contract of
   17         insurance; amending s. 626.916, F.S.; revising the
   18         required conditions for the export of insurance
   19         coverage to delete a provision specifying how
   20         reasonableness shall be assessed under certain
   21         circumstances; amending s. 626.931, F.S.; deleting
   22         provisions that require surplus lines agents to file a
   23         quarterly affidavit with the Florida Surplus Lines
   24         Office; amending s.627.211, F.S.; revising the due
   25         date for an annual report relating to certain workers’
   26         compensation issues which must be submitted by the
   27         office; amending s. 627.971, F.S.; providing that the
   28         term “financial guaranty insurance” does not include
   29         guarantees of higher education loans unless written by
   30         a financial guaranty insurance corporation; amending
   31         ss. 626.932, 626.935, and 626.936, F.S.; conforming
   32         provisions to changes made by the act; providing an
   33         effective date.
   35  Be It Enacted by the Legislature of the State of Florida:
   37         Section 1. Subsection (9) of section 408.909, Florida
   38  Statutes, is amended to read:
   39         408.909 Health flex plans.—
   40         (9) PROGRAM EVALUATION.—The agency and the office shall
   41  evaluate the pilot program and its effect on the entities that
   42  seek approval as health flex plans, on the number of enrollees,
   43  and on the scope of the health care coverage offered under a
   44  health flex plan; shall provide an assessment of the health flex
   45  plans and their potential applicability in other settings; shall
   46  use health flex plans to gather more information to evaluate
   47  low-income consumer driven benefit packages; and shall, by
   48  January 15, 2016 January 1, 2005, and annually thereafter,
   49  jointly submit a report to the Governor, the President of the
   50  Senate, and the Speaker of the House of Representatives.
   51         Section 2. Paragraph (e) of subsection (12) of section
   52  440.13, Florida Statutes, is amended to read:
   53         440.13 Medical services and supplies; penalty for
   54  violations; limitations.—
   57         (e) In addition to establishing the uniform schedule of
   58  maximum reimbursement allowances, the panel shall:
   59         1. Take testimony, receive records, and collect data to
   60  evaluate the adequacy of the workers’ compensation fee schedule,
   61  nationally recognized fee schedules and alternative methods of
   62  reimbursement to health care providers and health care
   63  facilities for inpatient and outpatient treatment and care.
   64         2. Survey health care providers and health care facilities
   65  to determine the availability and accessibility of workers’
   66  compensation health care delivery systems for injured workers.
   67         3. Survey carriers to determine the estimated impact on
   68  carrier costs and workers’ compensation premium rates by
   69  implementing changes to the carrier reimbursement schedule or
   70  implementing alternative reimbursement methods.
   71         4. Submit recommendations on or before January 15, 2017
   72  January 1, 2003, and biennially thereafter, to the President of
   73  the Senate and the Speaker of the House of Representatives on
   74  methods to improve the workers’ compensation health care
   75  delivery system.
   77  The department, as requested, shall provide data to the panel,
   78  including, but not limited to, utilization trends in the
   79  workers’ compensation health care delivery system. The
   80  department shall provide the panel with an annual report
   81  regarding the resolution of medical reimbursement disputes and
   82  any actions pursuant to subsection (8). The department shall
   83  provide administrative support and service to the panel to the
   84  extent requested by the panel. For prescription medication
   85  purchased under the requirements of this subsection, a
   86  dispensing practitioner shall not possess such medication unless
   87  payment has been made by the practitioner, the practitioner’s
   88  professional practice, or the practitioner’s practice management
   89  company or employer to the supplying manufacturer, wholesaler,
   90  distributor, or drug repackager within 60 days of the dispensing
   91  practitioner taking possession of that medication.
   92         Section 3. Paragraph (f) of subsection (1) of section
   93  624.413, Florida Statutes, is amended to read:
   94         624.413 Application for certificate of authority.—
   95         (1) To apply for a certificate of authority, an insurer
   96  shall file its application therefor with the office, upon a form
   97  adopted by the commission and furnished by the office, showing
   98  its name; location of its home office and, if an alien insurer,
   99  its principal office in the United States; kinds of insurance to
  100  be transacted; state or country of domicile; and such additional
  101  information as the commission reasonably requires, together with
  102  the following documents:
  103         (f) If a foreign or alien insurer, a copy of the report of
  104  the most recent examination of the insurer certified by the
  105  public official having supervision of insurance in its state of
  106  domicile or of entry into the United States. The end of the most
  107  recent year covered by the examination must be within the 5-year
  108  3-year period preceding the date of application. In lieu of the
  109  certified examination report, the office may accept an audited
  110  certified public accountant’s report prepared on a basis
  111  consistent with the insurance laws of the insurer’s state of
  112  domicile, certified by the public official having supervision of
  113  insurance in its state of domicile or of entry into the United
  114  States.
  115         Section 4. Subsection (6) is added to section 624.425,
  116  Florida Statutes, to read:
  117         624.425 Agent countersignature required, property,
  118  casualty, surety insurance.—
  119         (6)The absence of a countersignature required under this
  120  section does not affect the validity of a policy or contract of
  121  insurance.
  122         Section 5. Paragraph (a) of subsection (1) of section
  123  626.916, Florida Statutes, is amended to read:
  124         626.916 Eligibility for export.—
  125         (1) No insurance coverage shall be eligible for export
  126  unless it meets all of the following conditions:
  127         (a) The full amount of insurance required must not be
  128  procurable, after a diligent effort has been made by the
  129  producing agent to do so, from among the insurers authorized to
  130  transact and actually writing that kind and class of insurance
  131  in this state, and the amount of insurance exported shall be
  132  only the excess over the amount so procurable from authorized
  133  insurers. Surplus lines agents must verify that a diligent
  134  effort has been made by requiring a properly documented
  135  statement of diligent effort from the retail or producing agent.
  136  However, to be in compliance with the diligent effort
  137  requirement, the surplus lines agent’s reliance must be
  138  reasonable under the particular circumstances surrounding the
  139  export of that particular risk. Reasonableness shall be assessed
  140  by taking into account factors which include, but are not
  141  limited to, a regularly conducted program of verification of the
  142  information provided by the retail or producing agent.
  143  Declinations must be documented on a risk-by-risk basis. If it
  144  is not possible to obtain the full amount of insurance required
  145  by layering the risk, it is permissible to export the full
  146  amount.
  147         Section 6. Section 626.931, Florida Statutes, is amended to
  148  read:
  149         626.931 Agent affidavit and Insurer reporting
  150  requirements.—
  151         (1) Each surplus lines agent shall on or before the 45th
  152  day following each calendar quarter file with the Florida
  153  Surplus Lines Service Office an affidavit, on forms as
  154  prescribed and furnished by the Florida Surplus Lines Service
  155  Office, stating that all surplus lines insurance transacted by
  156  him or her during such calendar quarter has been submitted to
  157  the Florida Surplus Lines Service Office as required.
  158         (2) The affidavit of the surplus lines agent shall include
  159  efforts made to place coverages with authorized insurers and the
  160  results thereof.
  161         (1)(3) Each foreign insurer accepting premiums shall, on or
  162  before the end of the month following each calendar quarter,
  163  file with the Florida Surplus Lines Service Office a verified
  164  report of all surplus lines insurance transacted by such insurer
  165  for insurance risks located in this state during such calendar
  166  quarter.
  167         (2)(4) Each alien insurer accepting premiums shall, on or
  168  before June 30 of each year, file with the Florida Surplus Lines
  169  Service Office a verified report of all surplus lines insurance
  170  transacted by such insurer for insurance risks located in this
  171  state during the preceding calendar year.
  172         (3)(5) The department may waive the filing requirements
  173  described in subsections (1) and (2) (3) and (4).
  174         (4)(6) Each insurer’s report and supporting information
  175  shall be in a computer-readable format as determined by the
  176  Florida Surplus Lines Service Office or shall be submitted on
  177  forms prescribed by the Florida Surplus Lines Service Office and
  178  shall show for each applicable agent:
  179         (a) A listing of all policies, certificates, cover notes,
  180  or other forms of confirmation of insurance coverage or any
  181  substitutions thereof or endorsements thereto and the
  182  identifying number; and
  183         (b) Any additional information required by the department
  184  or Florida Surplus Lines Service Office.
  185         Section 7. Subsection (6) of section 627.211, Florida
  186  Statutes, is amended to read
  187         627.211 Deviations; workers’ compensation and employer’s
  188  liability insurances.—
  189         (6) The office shall submit an annual report to the
  190  President of the Senate and the Speaker of the House of
  191  Representatives by January 15 1 of each year which evaluates
  192  competition in the workers’ compensation insurance market in
  193  this state. The report must contain an analysis of the
  194  availability and affordability of workers’ compensation coverage
  195  and whether the current market structure, conduct, and
  196  performance are conducive to competition, based upon economic
  197  analysis and tests. The purpose of this report is to aid the
  198  Legislature in determining whether changes to the workers’
  199  compensation rating laws are warranted. The report must also
  200  document that the office has complied with the provisions of s.
  201  627.096 which require the office to investigate and study all
  202  workers’ compensation insurers in the state and to study the
  203  data, statistics, schedules, or other information as it finds
  204  necessary to assist in its review of workers’ compensation rate
  205  filings.
  206         Section 8. Paragraph (b) of subsection (1) of section
  207  627.971, Florida Statutes, is amended to read
  208         627.971 Definitions.—As used in this part:
  209         (1)
  210         (b) However, “financial guaranty insurance” does not
  211  include:
  212         1. Insurance of a loss resulting from an event described in
  213  paragraph (a), if the loss is payable only upon the occurrence
  214  of any of the following, as specified in a surety bond,
  215  insurance policy, or indemnity contract:
  216         a. A fortuitous physical event;
  217         b. A failure of or deficiency in the operation of
  218  equipment; or
  219         c. An inability to extract or recover a natural resource;
  220         2. An individual or schedule public official bond;
  221         3. A court bond required in connection with judicial,
  222  probate, bankruptcy, or equity proceedings, including a waiver,
  223  probate, open estate, or life tenant bond;
  224         4. A bond running to a federal, state, county, municipal
  225  government, or other political subdivision, as a condition
  226  precedent to the granting of a license to engage in a particular
  227  business or of a permit to exercise a particular privilege;
  228         5. A loss security bond or utility payment indemnity bond
  229  running to a governmental unit, railroad, or charitable
  230  organization;
  231         6. A lease, purchase and sale, or concessionaire surety
  232  bond;
  233         7. Credit unemployment insurance on a debtor in connection
  234  with a specific loan or other credit transaction, to provide
  235  payments to a creditor in the event of unemployment of the
  236  debtor for the installments or other periodic payments becoming
  237  due while a debtor is unemployed;
  238         8. Credit insurance indemnifying a manufacturer, merchant,
  239  or educational institution which extends credit against loss or
  240  damage resulting from nonpayment of debts owed to her or him for
  241  goods or services provided in the normal course of her or his
  242  business;
  243         9. Guaranteed investment contracts that are issued by life
  244  insurance companies and that provide that the life insurer will
  245  make specified payments in exchange for specific premiums or
  246  contributions;
  247         10. Mortgage guaranty insurance as defined in s. 635.011(1)
  248  or s. 635.021;
  249         11. Indemnity contracts or similar guaranties, to the
  250  extent that they are not otherwise limited or proscribed by this
  251  part, in which a life insurer guarantees:
  252         a. Its obligations or indebtedness or the obligations or
  253  indebtedness of a subsidiary of which it owns more than 50
  254  percent, other than a financial guaranty insurance corporation,
  255  if:
  256         (I) For any such obligations or indebtedness that are
  257  backed by specific assets, such assets are at all times owned by
  258  the insurer or the subsidiary; and
  259         (II) For the obligations or indebtedness of the subsidiary
  260  that are not backed by specific assets of the life insurer, the
  261  guaranty terminates once the subsidiary ceases to be a
  262  subsidiary; or
  263         b. The obligations or indebtedness, including the
  264  obligation to substitute assets where appropriate, with respect
  265  to specific assets acquired by a life insurer in the course of
  266  normal investment activities and not for the purpose of resale
  267  with credit enhancement, or guarantees obligations or
  268  indebtedness acquired by its subsidiary, provided that the
  269  assets so acquired have been:
  270         (I) Acquired by a special purpose entity where the sole
  271  purpose is to acquire specific assets of the life insurer or the
  272  subsidiary and issue securities or participation certificates
  273  backed by such assets; or
  274         (II) Sold to an independent third party; or
  275         c. The obligations or indebtedness of an employee or agent
  276  of the life insurer;
  277         12. Any form of surety insurance as defined in s. 624.606;
  278         13. Guarantees of higher education loans, unless written by
  279  a financial guaranty insurance corporation; or
  280         14.13. Any other form of insurance covering risks which the
  281  office determines to be substantially similar to any of the
  282  foregoing.
  283         Section 9. Paragraph (a) of subsection (2) of section
  284  626.932, Florida Statutes, is amended to read:
  285         626.932 Surplus lines tax.—
  286         (2)(a) The surplus lines agent shall make payable to the
  287  department the tax related to each calendar quarter’s business
  288  as reported to the Florida Surplus Lines Service Office, and
  289  remit the tax to the Florida Surplus Lines Service Office on or
  290  before the 45th day following each calendar quarter at the same
  291  time as provided for the filing of the quarterly affidavit,
  292  under s. 626.931. The Florida Surplus Lines Service Office shall
  293  forward to the department the taxes and any interest collected
  294  pursuant to paragraph (b), within 10 days of receipt.
  295         Section 10. Paragraph (d) of subsection (1) of section
  296  626.935, Florida Statutes, is amended to read:
  297         626.935 Suspension, revocation, or refusal of surplus lines
  298  agent’s license.—
  299         (1) The department shall deny an application for, suspend,
  300  revoke, or refuse to renew the appointment of a surplus lines
  301  agent and all other licenses and appointments held by the
  302  licensee under this code, on any of the following grounds:
  303         (d) Failure to make and file his or her affidavit or
  304  reports when due as required by s. 626.931.
  305         Section 11. Subsection (1) of section 626.936, Florida
  306  Statutes, is amended to read:
  307         626.936 Failure to file reports or pay tax or service fee;
  308  administrative penalty.—
  309         (1) Any licensed surplus lines agent who neglects to file a
  310  report or an affidavit in the form and within the time required
  311  or provided for in the Surplus Lines Law may be fined up to $50
  312  per day for each day the neglect continues, beginning the day
  313  after the report or affidavit was due until the date the report
  314  or affidavit is received. All sums collected under this section
  315  shall be deposited into the Insurance Regulatory Trust Fund.
  316         Section 12. This act shall take effect July 1, 2015.