CS for CS for CS for SB 252                      First Engrossed
    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. 627.211, F.S.; revising the due
   18         date for an annual report relating to certain workers’
   19         compensation issues which must be submitted by the
   20         office; amending s. 627.971, F.S.; providing that the
   21         term “financial guaranty insurance” does not include
   22         guarantees of higher education loans unless written by
   23         a financial guaranty insurance corporation; providing
   24         an effective date.
   26  Be It Enacted by the Legislature of the State of Florida:
   28         Section 1. Subsection (9) of section 408.909, Florida
   29  Statutes, is amended to read:
   30         408.909 Health flex plans.—
   31         (9) PROGRAM EVALUATION.—The agency and the office shall
   32  evaluate the pilot program and its effect on the entities that
   33  seek approval as health flex plans, on the number of enrollees,
   34  and on the scope of the health care coverage offered under a
   35  health flex plan; shall provide an assessment of the health flex
   36  plans and their potential applicability in other settings; shall
   37  use health flex plans to gather more information to evaluate
   38  low-income consumer driven benefit packages; and shall, by
   39  January 15, 2016 January 1, 2005, and annually thereafter,
   40  jointly submit a report to the Governor, the President of the
   41  Senate, and the Speaker of the House of Representatives.
   42         Section 2. Paragraph (e) of subsection (12) of section
   43  440.13, Florida Statutes, is amended to read:
   44         440.13 Medical services and supplies; penalty for
   45  violations; limitations.—
   48         (e) In addition to establishing the uniform schedule of
   49  maximum reimbursement allowances, the panel shall:
   50         1. Take testimony, receive records, and collect data to
   51  evaluate the adequacy of the workers’ compensation fee schedule,
   52  nationally recognized fee schedules and alternative methods of
   53  reimbursement to health care providers and health care
   54  facilities for inpatient and outpatient treatment and care.
   55         2. Survey health care providers and health care facilities
   56  to determine the availability and accessibility of workers’
   57  compensation health care delivery systems for injured workers.
   58         3. Survey carriers to determine the estimated impact on
   59  carrier costs and workers’ compensation premium rates by
   60  implementing changes to the carrier reimbursement schedule or
   61  implementing alternative reimbursement methods.
   62         4. Submit recommendations on or before January 15, 2017
   63  January 1, 2003, and biennially thereafter, to the President of
   64  the Senate and the Speaker of the House of Representatives on
   65  methods to improve the workers’ compensation health care
   66  delivery system.
   68  The department, as requested, shall provide data to the panel,
   69  including, but not limited to, utilization trends in the
   70  workers’ compensation health care delivery system. The
   71  department shall provide the panel with an annual report
   72  regarding the resolution of medical reimbursement disputes and
   73  any actions pursuant to subsection (8). The department shall
   74  provide administrative support and service to the panel to the
   75  extent requested by the panel. For prescription medication
   76  purchased under the requirements of this subsection, a
   77  dispensing practitioner shall not possess such medication unless
   78  payment has been made by the practitioner, the practitioner’s
   79  professional practice, or the practitioner’s practice management
   80  company or employer to the supplying manufacturer, wholesaler,
   81  distributor, or drug repackager within 60 days of the dispensing
   82  practitioner taking possession of that medication.
   83         Section 3. Paragraph (f) of subsection (1) of section
   84  624.413, Florida Statutes, is amended to read:
   85         624.413 Application for certificate of authority.—
   86         (1) To apply for a certificate of authority, an insurer
   87  shall file its application therefor with the office, upon a form
   88  adopted by the commission and furnished by the office, showing
   89  its name; location of its home office and, if an alien insurer,
   90  its principal office in the United States; kinds of insurance to
   91  be transacted; state or country of domicile; and such additional
   92  information as the commission reasonably requires, together with
   93  the following documents:
   94         (f) If a foreign or alien insurer, a copy of the report of
   95  the most recent examination of the insurer certified by the
   96  public official having supervision of insurance in its state of
   97  domicile or of entry into the United States. The end of the most
   98  recent year covered by the examination must be within the 5-year
   99  3-year period preceding the date of application. In lieu of the
  100  certified examination report, the office may accept an audited
  101  certified public accountant’s report prepared on a basis
  102  consistent with the insurance laws of the insurer’s state of
  103  domicile, certified by the public official having supervision of
  104  insurance in its state of domicile or of entry into the United
  105  States.
  106         Section 4. Subsection (6) is added to section 624.425,
  107  Florida Statutes, to read:
  108         624.425 Agent countersignature required, property,
  109  casualty, surety insurance.—
  110         (6)The absence of a countersignature required under this
  111  section does not affect the validity of a policy or contract of
  112  insurance.
  113         Section 5. Subsection (6) of section 627.211, Florida
  114  Statutes, is amended to read:
  115         627.211 Deviations; workers’ compensation and employer’s
  116  liability insurances.—
  117         (6) The office shall submit an annual report to the
  118  President of the Senate and the Speaker of the House of
  119  Representatives by January 15 1 of each year which evaluates
  120  competition in the workers’ compensation insurance market in
  121  this state. The report must contain an analysis of the
  122  availability and affordability of workers’ compensation coverage
  123  and whether the current market structure, conduct, and
  124  performance are conducive to competition, based upon economic
  125  analysis and tests. The purpose of this report is to aid the
  126  Legislature in determining whether changes to the workers’
  127  compensation rating laws are warranted. The report must also
  128  document that the office has complied with the provisions of s.
  129  627.096 which require the office to investigate and study all
  130  workers’ compensation insurers in the state and to study the
  131  data, statistics, schedules, or other information as it finds
  132  necessary to assist in its review of workers’ compensation rate
  133  filings.
  134         Section 6. Paragraph (b) of subsection (1) of section
  135  627.971, Florida Statutes, is amended to read:
  136         627.971 Definitions.—As used in this part:
  137         (1)
  138         (b) However, “financial guaranty insurance” does not
  139  include:
  140         1. Insurance of a loss resulting from an event described in
  141  paragraph (a), if the loss is payable only upon the occurrence
  142  of any of the following, as specified in a surety bond,
  143  insurance policy, or indemnity contract:
  144         a. A fortuitous physical event;
  145         b. A failure of or deficiency in the operation of
  146  equipment; or
  147         c. An inability to extract or recover a natural resource;
  148         2. An individual or schedule public official bond;
  149         3. A court bond required in connection with judicial,
  150  probate, bankruptcy, or equity proceedings, including a waiver,
  151  probate, open estate, or life tenant bond;
  152         4. A bond running to a federal, state, county, municipal
  153  government, or other political subdivision, as a condition
  154  precedent to the granting of a license to engage in a particular
  155  business or of a permit to exercise a particular privilege;
  156         5. A loss security bond or utility payment indemnity bond
  157  running to a governmental unit, railroad, or charitable
  158  organization;
  159         6. A lease, purchase and sale, or concessionaire surety
  160  bond;
  161         7. Credit unemployment insurance on a debtor in connection
  162  with a specific loan or other credit transaction, to provide
  163  payments to a creditor in the event of unemployment of the
  164  debtor for the installments or other periodic payments becoming
  165  due while a debtor is unemployed;
  166         8. Credit insurance indemnifying a manufacturer, merchant,
  167  or educational institution which extends credit against loss or
  168  damage resulting from nonpayment of debts owed to her or him for
  169  goods or services provided in the normal course of her or his
  170  business;
  171         9. Guaranteed investment contracts that are issued by life
  172  insurance companies and that provide that the life insurer will
  173  make specified payments in exchange for specific premiums or
  174  contributions;
  175         10. Mortgage guaranty insurance as defined in s. 635.011(1)
  176  or s. 635.021;
  177         11. Indemnity contracts or similar guaranties, to the
  178  extent that they are not otherwise limited or proscribed by this
  179  part, in which a life insurer guarantees:
  180         a. Its obligations or indebtedness or the obligations or
  181  indebtedness of a subsidiary of which it owns more than 50
  182  percent, other than a financial guaranty insurance corporation,
  183  if:
  184         (I) For any such obligations or indebtedness that are
  185  backed by specific assets, such assets are at all times owned by
  186  the insurer or the subsidiary; and
  187         (II) For the obligations or indebtedness of the subsidiary
  188  that are not backed by specific assets of the life insurer, the
  189  guaranty terminates once the subsidiary ceases to be a
  190  subsidiary; or
  191         b. The obligations or indebtedness, including the
  192  obligation to substitute assets where appropriate, with respect
  193  to specific assets acquired by a life insurer in the course of
  194  normal investment activities and not for the purpose of resale
  195  with credit enhancement, or guarantees obligations or
  196  indebtedness acquired by its subsidiary, provided that the
  197  assets so acquired have been:
  198         (I) Acquired by a special purpose entity where the sole
  199  purpose is to acquire specific assets of the life insurer or the
  200  subsidiary and issue securities or participation certificates
  201  backed by such assets; or
  202         (II) Sold to an independent third party; or
  203         c. The obligations or indebtedness of an employee or agent
  204  of the life insurer;
  205         12. Any form of surety insurance as defined in s. 624.606;
  206         13. Guarantees of higher education loans, unless written by
  207  a financial guaranty insurance corporation; or
  208         14.13. Any other form of insurance covering risks which the
  209  office determines to be substantially similar to any of the
  210  foregoing.
  211         Section 7. This act shall take effect July 1, 2015.