(1) Notwithstanding any other provision of law, any two or more corporations not for profit located in and organized under the laws of this state may form a self-insurance fund for the purpose of pooling and spreading liabilities of its group members in any one or combination of property or casualty risk, provided the corporation not for profit self-insurance fund that is created:
(a) Has annual normal premiums in excess of $5 million.
(b) Requires for qualification that each participating member receive at least 75 percent of its revenues from local, state, or federal governmental sources or a combination of such sources.
(c) Uses a qualified actuary to determine rates using accepted actuarial principles and annually submits to the office a certification by the actuary that the rates are actuarially sound and are not inadequate, as defined in s. 627.062.
(d) Uses a qualified actuary to establish reserves for loss and loss adjustment expenses and annually submits to the office a certification by the actuary that the loss and loss adjustment expense reserves are adequate. If the actuary determines that reserves are not adequate, the fund shall file with the office a remedial plan for increasing the reserves or otherwise addressing the financial condition of the fund, subject to a determination by the office that the fund will operate on an actuarially sound basis and the fund does not pose a significant risk of insolvency.
(e) Maintains a continuing program of excess insurance coverage and reserve evaluation to protect the financial stability of the fund in an amount and manner determined by a qualified actuary. At a minimum, this program must:
1. Purchase excess insurance from authorized insurance carriers or eligible surplus lines insurers or reinsurers.
2. Retain a per-loss occurrence that does not exceed $350,000.
(f) Submit to the office annually an audited fiscal year-end financial statement by an independent certified public accountant within 6 months after the end of the fiscal year.
(g) Have a governing body that is comprised entirely of officials from corporations not for profit that are members of the corporation not for profit self-insurance fund.
(h) Use knowledgeable persons or business entities to administer or service the fund in the areas of claims administration, claims adjusting, underwriting, risk management, loss control, policy administration, financial audit, and legal areas. Such persons must meet all applicable requirements of law for state licensure and must have at least 5 years’ experience with commercial self-insurance funds formed under s. 624.462, self-insurance funds formed under s. 624.4622, or domestic insurers.
(i) Submit to the office copies of contracts used for its members that clearly establish the liability of each member for the obligations of the fund.
(j) Annually submit to the office a certification by the governing body of the fund that, to the best of its knowledge, the requirements of this section are met.
(2) As used in this section, the term “qualified actuary” means an actuary that is a member of the Casualty Actuarial Society or the American Academy of Actuaries.
(3) A corporation not for profit self-insurance fund that meets the requirements of this section is not:
(a) An insurer for purposes of participation in or coverage by any insurance guaranty association established by chapter 631; or
(b) Subject to s. 624.4621 and is not required to file any report with the department under s. 440.38(2)(b) that is uniquely required of group self-insurer funds qualified under s. 624.4621.
(4) Premiums, contributions, and assessments received by a corporation not for profit self-insurance fund are subject to ss. 624.509(1) and (2) and 624.5092, except that the tax rate shall be 1.6 percent of the gross amount of such premiums, contributions, and assessments.
(5) A corporation not for profit self-insurance fund formed under this section, which is hereby deemed to be an association in compliance with s. 627.654, may purchase for its members, on a group basis, any one or more policies of health, accident, or hospitalization coverage, provided:
(a) Insurance policies purchased to provide coverage under this subsection are purchased only from authorized insurance companies that participate in the Florida Life and Health Insurance Guaranty Association and such policy forms have been filed with and approved by the office;
(b) The corporation not for profit self-insurance fund retains no risk related to coverage provided under this subsection;
(c) An insurance policy purchased to provide coverage under this subsection shall not be subject to the restrictions relating to the premium rates for small employer groups under chapter 627;
(d) The premiums paid for insurance policies purchased pursuant to paragraph (a) shall not count toward the $5 million requirement in paragraph (1)(a); and
(e) Any individual not-for-profit entity participating as a member of the association for the purchase of a master health, accident, or hospitalization policy by the association under this subsection may retain its individual insurance agent, and such agent shall be deemed an additional agent of record for the master policy issued to the association.
(6) If any of the requirements of subsection (1) are not met, a corporation not for profit self-insurance fund is subject to the requirements of s. 624.4621 if the fund provides only workers’ compensation coverage or is subject to the requirements of ss. 624.460-624.488 if the fund provides coverage for other property, casualty, or surety risks.
History.—s. 14, ch. 2007-1; s. 2, ch. 2012-151.
Structure Florida Statutes
Chapter 624 - Insurance Code: Administration and General Provisions
Part III - Authorization of Insurers and General Requirements (Ss. 624.401-624.491)
624.401 - Certificate of authority required.
624.402 - Exceptions, certificate of authority required.
624.4031 - Church benefit plans and church benefit board.
624.404 - General eligibility of insurers for certificate of authority.
624.4055 - Restrictions on existing private passenger automobile insurance.
624.406 - Combinations of insuring powers, one insurer.
624.407 - Surplus required; new insurers.
624.4073 - Officers and directors of insolvent insurers.
624.408 - Surplus required; current insurers.
624.4085 - Risk-based capital requirements for insurers.
624.40851 - Confidentiality of risk-based capital information.
624.4094 - Bail bond premiums.
624.4095 - Premiums written; restrictions.
624.410 - Permissible insuring combinations without additional capital funds.
624.411 - Deposit requirement; domestic insurers and foreign insurers.
624.412 - Deposit of alien insurers.
624.413 - Application for certificate of authority.
624.414 - Issuance or refusal of authority.
624.415 - Ownership of certificate of authority; return.
624.416 - Continuance, expiration, reinstatement, and amendment of certificate of authority.
624.418 - Suspension, revocation of certificate of authority for violations and special grounds.
624.421 - Duration of suspension; insurer’s obligations during suspension period; reinstatement.
624.4211 - Administrative fine in lieu of suspension or revocation.
624.4212 - Confidentiality of proprietary business and other information.
624.4213 - Trade secret documents.
624.422 - Service of process; appointment of Chief Financial Officer as process agent.
624.424 - Annual statement and other information.
624.4241 - NAIC filing requirements.
624.4243 - Reporting of premium growth.
624.4245 - Change in controlling interest of foreign or alien insurer; report required.
624.425 - Agent countersignature required, property, casualty, surety insurance.
624.426 - Exceptions to countersignature law.
624.428 - Licensed agent law, life and health insurances.
624.430 - Withdrawal of insurer or discontinuance of writing certain kinds or lines of insurance.
624.4305 - Nonrenewal of residential property insurance policies.
624.4315 - Workers’ compensation insurers; notice of significant underwriting change.
624.436 - Florida Nonprofit Multiple-Employer Welfare Arrangement Act.
624.438 - General eligibility.
624.4385 - Certain words prohibited in name of organization.
624.439 - Filing of application.
624.44 - Examination by the office.
624.441 - Insolvency protection.
624.4411 - Administrative, provider, and management contracts.
624.4414 - Employer participants’ liability.
624.4416 - Assessments by receiver.
624.4417 - Certain sales prohibited.
624.442 - Annual reports; actuarial certification; quarterly reports; penalties.
624.443 - Place of business; maintenance of records.
624.4431 - Administration; rules.
624.4432 - Assets, liabilities, and investments.
624.444 - Suspension, revocation of approval.
624.445 - Order, notice, duration, effect of suspension or revocation; administrative fine.
624.446 - Rehabilitation, dissolution.
624.447 - Certificate of insurance for contractors.
624.448 - Assets of insurers; reporting requirements.
624.449 - Insurer investment in foreign companies.
624.45 - Participation of financial institutions in reinsurance and in insurance exchanges.
624.462 - Commercial self-insurance funds.
624.4621 - Group self-insurance funds.
624.4622 - Local government self-insurance funds.
624.46223 - Notice of intent to withdraw.
624.46225 - Self-insured public utilities.
624.46226 - Public housing authorities self-insurance funds; exemption for taxation and assessments.
624.4623 - Independent Educational Institution Self-Insurance Funds.
624.4625 - Corporation not for profit self-insurance funds.
624.4626 - Electric cooperative self-insurance fund.
624.464 - Certificate of authority required; penalties.
624.466 - Application requirements for certificate of authority.
624.468 - Continuing requirements for certificate of authority.
624.4741 - Venue in assessment actions.
624.475 - Tax on premiums, contributions, and assessments.
624.476 - Impaired self-insurance funds.
624.477 - Liquidation, rehabilitation, reorganization, and conservation.
624.480 - Filing, approval, and disapproval of forms.
624.482 - Making and use of rates.
624.483 - Self-insurer members; payment of delinquent premiums and assessments.
624.484 - Registration of agent.
624.487 - Enforcement of specified insurance provisions.
624.488 - Applicability of related laws.