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.
34
35 Be It Enacted by the Legislature of the State of Florida:
36
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.—
55 (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
56 REIMBURSEMENT ALLOWANCES.—
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.
76
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.