Florida Senate - 2016                      CS for CS for SB 1036
       
       
        
       By the Committees on Commerce and Tourism; and Banking and
       Insurance; and Senator Brandes
       
       577-03595-16                                          20161036c2
    1                        A bill to be entitled                      
    2         An act relating to automobile insurance; amending s.
    3         627.0651, F.S.; providing an exception to a provision
    4         that deems use of a single zip code as a rating
    5         territory for insurance rates to be unfairly
    6         discriminatory; requiring the Office of Insurance
    7         Regulation to ensure that rates or rate changes
    8         contained in certain rate filings are not excessive,
    9         inadequate, or unfairly discriminatory; amending s.
   10         627.311, F.S.; authorizing the Florida Automobile
   11         Joint Underwriting Association and a joint
   12         underwriting plan approved by the Office of Insurance
   13         Regulation to cancel personal lines or commercial
   14         policies within a specified time for nonpayment of
   15         premium due to certain reasons; prohibiting an insured
   16         from cancelling a policy or binder within a specified
   17         time except under certain conditions; amending s.
   18         627.7283, F.S.; authorizing an insured who cancels a
   19         policy to apply the unearned portion of any premium
   20         paid to unpaid balances of other policies with the
   21         same insurer or insurer group; amending s. 627.7295,
   22         F.S.; updating applicability language to include a
   23         reference to recurring credit card or debit card
   24         payments; authorizing an additional form of payment
   25         for certain motor vehicle insurance contract premiums;
   26         authorizing an insurer to impose a specified
   27         insufficient funds fee under certain circumstances;
   28         amending s. 627.736, F.S.; requiring that a certain
   29         standard form be approved by the office and adopted by
   30         the Financial Services Commission, rather than
   31         approved by the office or adopted by the commission;
   32         revising standards for compliance for specified
   33         billings for medical services; adding a specified
   34         entity to a list of entities that are not required to
   35         be licensed as a clinic to receive reimbursement under
   36         the Florida Motor Vehicle No-Fault Law; providing an
   37         effective date.
   38          
   39  Be It Enacted by the Legislature of the State of Florida:
   40  
   41         Section 1. Subsection (8) of section 627.0651, Florida
   42  Statutes, is amended to read:
   43         627.0651 Making and use of rates for motor vehicle
   44  insurance.—
   45         (8) Rates are not unfairly discriminatory if averaged
   46  broadly among members of a group; nor are rates unfairly
   47  discriminatory even though they are lower than rates for
   48  nonmembers of the group. However, such rates are unfairly
   49  discriminatory if they are not actuarially measurable and
   50  credible and sufficiently related to actual or expected loss and
   51  expense experience of the group so as to assure that nonmembers
   52  of the group are not unfairly discriminated against. Use of a
   53  single United States Postal Service zip code as a rating
   54  territory shall be deemed unfairly discriminatory unless filed
   55  pursuant to paragraph (1)(a) and the territory incorporates
   56  sufficient actual or expected loss and loss adjustment expense
   57  experience so as to be actuarially measurable and credible. The
   58  office shall ensure that any rate filing resulting from the use
   59  of a single zip code as a rating territory does not contain a
   60  rate or rate change that is excessive, inadequate, or unfairly
   61  discriminatory.
   62         Section 2. Paragraph (m) is added to subsection (3) of
   63  section 627.311, Florida Statutes, to read:
   64         627.311 Joint underwriters and joint reinsurers; public
   65  records and public meetings exemptions.—
   66         (3) The office may, after consultation with insurers
   67  licensed to write automobile insurance in this state, approve a
   68  joint underwriting plan for purposes of equitable apportionment
   69  or sharing among insurers of automobile liability insurance and
   70  other motor vehicle insurance, as an alternate to the plan
   71  required in s. 627.351(1). All insurers authorized to write
   72  automobile insurance in this state shall subscribe to the plan
   73  and participate therein. The plan shall be subject to continuous
   74  review by the office which may at any time disapprove the entire
   75  plan or any part thereof if it determines that conditions have
   76  changed since prior approval and that in view of the purposes of
   77  the plan changes are warranted. Any disapproval by the office
   78  shall be subject to the provisions of chapter 120. The Florida
   79  Automobile Joint Underwriting Association is created under the
   80  plan. The plan and the association:
   81         (m) May cancel personal lines or commercial policies issued
   82  by the plan within the first 60 days after the effective date of
   83  the policy or binder for nonpayment of premium if the check
   84  issued for payment of the premium is dishonored for any reason
   85  or if any other form of payment is rejected or deemed invalid.
   86  An insured may not cancel a policy or binder within the first 90
   87  days after its effective date, or within a lesser period as
   88  required by the plan, except:
   89         1. Upon total destruction of the insured motor vehicle;
   90         2. Upon transfer of ownership of the insured motor vehicle;
   91  or
   92         3. After purchase of another policy or binder covering the
   93  motor vehicle that was covered under the policy being canceled.
   94         Section 3. Section 627.7283, Florida Statutes, is amended
   95  to read:
   96         627.7283 Cancellation; return of unearned premium.—
   97         (1) If the insured cancels a policy of motor vehicle
   98  insurance, the insurer must mail or electronically transfer the
   99  unearned portion of any premium paid within 30 days after the
  100  effective date of the policy cancellation or receipt of notice
  101  or request for cancellation, whichever is later. This
  102  requirement applies to a cancellation initiated by an insured
  103  for any reason. However, the insured may apply the unearned
  104  portion of any premium paid to unpaid balances of other policies
  105  with the same insurer or insurer group.
  106         (2) If an insurer cancels a policy of motor vehicle
  107  insurance, the insurer must mail or electronically transfer the
  108  unearned premium portion of any premium within 15 days after the
  109  effective date of the policy cancellation. However, the insured
  110  may apply the unearned portion of any premium paid to unpaid
  111  balances of other policies with the same insurer or insurer
  112  group.
  113         (3) If the unearned premium is not mailed, or
  114  electronically transferred, or applied to the unpaid balance of
  115  other policies within the applicable period, the insurer must
  116  pay to the insured 8 percent interest on the amount due. If the
  117  unearned premium is not mailed or electronically transferred
  118  within 45 days after the applicable period, the insured may
  119  bring an action against the insurer pursuant to s. 624.155.
  120         (4) If the insured cancels, the insurer may retain up to 10
  121  percent of the unearned premium and must refund at least 90
  122  percent of the unearned premium. If the insurer cancels, the
  123  insurer must refund 100 percent of the unearned premium.
  124  Cancellation is without prejudice to any claim originating prior
  125  to the effective date of the cancellation. For purposes of this
  126  section, unearned premiums must be computed on a pro rata basis.
  127         (5) The insurer must refund 100 percent of the unearned
  128  premium if the insured is a servicemember, as defined in s.
  129  250.01, who cancels because he or she is called to active duty
  130  or transferred by the United States Armed Forces to a location
  131  where the insurance is not required. The insurer may require a
  132  servicemember to submit either a copy of the official military
  133  orders or a written verification signed by the servicemember’s
  134  commanding officer to support the refund authorized under this
  135  subsection. If the insurer cancels, the insurer must refund 100
  136  percent of the unearned premium. Cancellation is without
  137  prejudice to any claim originating prior to the effective date
  138  of the cancellation. For purposes of this section, unearned
  139  premiums must be computed on a pro rata basis.
  140         Section 4. Subsection (7) of section 627.7295, Florida
  141  Statutes, is amended, and a new subsection (9) is added to that
  142  section, to read:
  143         627.7295 Motor vehicle insurance contracts.—
  144         (7) A policy of private passenger motor vehicle insurance
  145  or a binder for such a policy may be initially issued in this
  146  state only if, before the effective date of such binder or
  147  policy, the insurer or agent has collected from the insured an
  148  amount equal to 2 months’ premium. An insurer, agent, or premium
  149  finance company may not, directly or indirectly, take any action
  150  resulting in the insured having paid from the insured’s own
  151  funds an amount less than the 2 months’ premium required by this
  152  subsection. This subsection applies without regard to whether
  153  the premium is financed by a premium finance company or is paid
  154  pursuant to a periodic payment plan of an insurer or an
  155  insurance agent. This subsection does not apply if an insured or
  156  member of the insured’s family is renewing or replacing a policy
  157  or a binder for such policy written by the same insurer or a
  158  member of the same insurer group. This subsection does not apply
  159  to an insurer that issues private passenger motor vehicle
  160  coverage primarily to active duty or former military personnel
  161  or their dependents. This subsection does not apply if all
  162  policy payments are paid pursuant to a payroll deduction plan,
  163  or an automatic electronic funds transfer payment plan from the
  164  policyholder, or a recurring credit card or debit card agreement
  165  with the insurer. This subsection and subsection (4) do not
  166  apply if all policy payments to an insurer are paid pursuant to
  167  an automatic electronic funds transfer payment plan from an
  168  agent, a managing general agent, or a premium finance company
  169  and if the policy includes, at a minimum, personal injury
  170  protection pursuant to ss. 627.730-627.7405; motor vehicle
  171  property damage liability pursuant to s. 627.7275; and bodily
  172  injury liability in at least the amount of $10,000 because of
  173  bodily injury to, or death of, one person in any one accident
  174  and in the amount of $20,000 because of bodily injury to, or
  175  death of, two or more persons in any one accident. This
  176  subsection and subsection (4) do not apply if an insured has had
  177  a policy in effect for at least 6 months, the insured’s agent is
  178  terminated by the insurer that issued the policy, and the
  179  insured obtains coverage on the policy’s renewal date with a new
  180  company through the terminated agent.
  181         (9)(a) In addition to the methods provided in s.
  182  627.4035(1), the premiums for motor vehicle insurance contracts
  183  issued in this state or covering risk located in this state may
  184  be paid in cash in the form of a draft or drafts.
  185         (b) If a payment of premium under this subsection by debit
  186  card, credit card, or automatic electronic funds transfer is
  187  returned or declined or cannot be processed due to insufficient
  188  funds, the insurer may impose an insufficient funds fee of up to
  189  $15 per occurrence pursuant to the policy terms.
  190         Section 5. Paragraphs (d) and (h) of subsection (5) of
  191  section 627.736, Florida Statutes, are amended to read:
  192         627.736 Required personal injury protection benefits;
  193  exclusions; priority; claims.—
  194         (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
  195         (d) All statements and bills for medical services rendered
  196  by a physician, hospital, clinic, or other person or institution
  197  shall be submitted to the insurer on a properly completed
  198  Centers for Medicare and Medicaid Services (CMS) 1500 form, UB
  199  92 forms, or any other standard form approved by the office and
  200  or adopted by the commission for purposes of this paragraph. All
  201  billings for such services rendered by providers must, to the
  202  extent applicable, comply with the CMS 1500 form instructions,
  203  the American Medical Association CPT Editorial Panel, and the
  204  Healthcare Common Procedure Coding System (HCPCS); and must
  205  follow the Physicians’ Current Procedural Terminology (CPT), the
  206  HCPCS in effect for the year in which services are rendered, and
  207  the International Classification of Diseases (ICD) adopted by
  208  the United States Department of Health and Human Services for
  209  the service year in which the services, supplies, or care is
  210  rendered as described in subparagraph (a)2. follow the
  211  Physicians’ Current Procedural Terminology (CPT) or Healthcare
  212  Correct Procedural Coding System (HCPCS), or ICD-9 in effect for
  213  the year in which services are rendered and comply with the CMS
  214  1500 form instructions, the American Medical Association CPT
  215  Editorial Panel, and the HCPCS. All providers, other than
  216  hospitals, must include on the applicable claim form the
  217  professional license number of the provider in the line or space
  218  provided for “Signature of Physician or Supplier, Including
  219  Degrees or Credentials.” In determining compliance with
  220  applicable CPT and HCPCS coding, guidance shall be provided by
  221  the Physicians’ Current Procedural Terminology (CPT) or the
  222  Healthcare Correct Procedural Coding System (HCPCS) in effect
  223  for the year in which services were rendered, the Office of the
  224  Inspector General, Physicians Compliance Guidelines, and other
  225  authoritative treatises designated by rule by the Agency for
  226  Health Care Administration. A statement of medical services may
  227  not include charges for medical services of a person or entity
  228  that performed such services without possessing the valid
  229  licenses required to perform such services. For purposes of
  230  paragraph (4)(b), an insurer is not considered to have been
  231  furnished with notice of the amount of covered loss or medical
  232  bills due unless the statements or bills comply with this
  233  paragraph and are properly completed in their entirety as to all
  234  material provisions, with all relevant information being
  235  provided therein.
  236         (h) As provided in s. 400.9905, an entity excluded from the
  237  definition of a clinic shall be deemed a clinic and must be
  238  licensed under part X of chapter 400 in order to receive
  239  reimbursement under ss. 627.730-627.7405. However, this
  240  licensing requirement does not apply to:
  241         1. An entity wholly owned by a physician licensed under
  242  chapter 458 or chapter 459, or by the physician and the spouse,
  243  parent, child, or sibling of the physician;
  244         2. An entity wholly owned by a dentist licensed under
  245  chapter 466, or by the dentist and the spouse, parent, child, or
  246  sibling of the dentist;
  247         3. An entity wholly owned by a chiropractic physician
  248  licensed under chapter 460, or by the chiropractic physician and
  249  the spouse, parent, child, or sibling of the chiropractic
  250  physician;
  251         4. A hospital or ambulatory surgical center licensed under
  252  chapter 395;
  253         5. An entity that wholly owns or is wholly owned, directly
  254  or indirectly, by a hospital or hospitals licensed under chapter
  255  395;
  256         6. An entity that is a clinical facility affiliated with an
  257  accredited medical school at which training is provided for
  258  medical students, residents, or fellows; or
  259         7. An entity that is certified under 42 C.F.R. part 485,
  260  subpart H; or
  261         8.An entity that is owned by a publicly traded
  262  corporation, either directly or indirectly through its
  263  subsidiaries, that has $250 million or more in total annual
  264  sales of health care services provided by licensed health care
  265  practitioners, if one or more of the persons responsible for the
  266  operations of the entity are health care practitioners who are
  267  licensed in this state and are responsible for supervising the
  268  business activities of the entity and the entity’s compliance
  269  with state law for purposes of this section.
  270         Section 6. This act shall take effect July 1, 2016.