(1) The purpose of this section is to improve patient care by minimizing confusion, eliminating unnecessary work, decreasing patient wait time, and improving business efficiencies.
(2) Any health insurer or health maintenance organization and all state and local government entities entering into an agreement to provide coverage for prescription drugs on an outpatient basis shall provide a benefits-identification card containing the following information:
(a) The name of the claim processor.
(b) The electronic-claims payor identification number or the issuer identification number, also referred to as the Banking Identification Number or “BIN,” assigned by the American National Standards Institute.
(c) The insured’s prescription group number.
(d) The insured’s identification number.
(e) The insured’s name.
(f) The claims submission name and address.
(g) The help desk telephone number.
(h) Any other information that the entity finds will assist in the processing of the claim.
The information required in paragraphs (a), (b), (g), and (h) must be provided on the card, unless instruction is provided on the card for ready access to such information by electronic means.
(3) The benefits-identification card must present the information in a manner readily identifiable or, alternatively, the information may be embedded in the card and available through magnetic stripe or smart card. The information may also be provided through other electronic technology.
(4) Any entity providing a health-benefits-identification card containing all of the information required by this section shall not be required to provide a separate identification card for prescription drug benefits.
(5) A benefits-identification card required under subsection (2) shall be issued no later than 60 days after any change in the information contained on the card becomes effective. An entity may issue a temporary sticker containing the new information in lieu of issuing a new card prior to the annual renewal date. Such sticker must be designed so that it can be attached to the existing card.
History.—s. 1, ch. 2002-245.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part II - The Insurance Contract (Ss. 627.401-627.444)
627.4025 - Residential coverage and hurricane coverage defined.
627.4035 - Payment of premiums; claims.
627.404 - Insurable interest; personal insurance.
627.405 - Insurable interest; property.
627.406 - Power to contract; purchase of insurance by or for minor.
627.407 - Alteration of application.
627.408 - Application as evidence.
627.4085 - Insurer name, agent name, and license identification number required on application.
627.409 - Representations in applications; warranties.
627.4091 - Specific reasons for denial, cancellation, or nonrenewal.
627.40951 - Standard personal lines residential insurance policy.
627.410 - Filing, approval of forms.
627.4101 - Credit insurance enrollment forms.
627.4102 - Informational filing of forms.
627.4105 - Life and health insurance; reduced premiums upon rigorous physical examination.
627.411 - Grounds for disapproval.
627.412 - Standard provisions, in general.
627.413 - Contents of policies, in general; identification.
627.4131 - Telephone number required.
627.4132 - Stacking of coverages prohibited.
627.4133 - Notice of cancellation, nonrenewal, or renewal premium.
627.4135 - Casualty insurance contracts subject to general provisions for insurance contracts.
627.4136 - Nonjoinder of insurers.
627.4137 - Disclosure of certain information required.
627.4138 - Wrap-up insurance policies for nonpublic construction projects.
627.414 - Additional policy contents.
627.4143 - Outline of coverage.
627.4145 - Readable language in insurance policies.
627.4147 - Medical malpractice insurance contracts.
627.4148 - Medical malpractice insurers; required offer of coverage limits.
627.41495 - Public notice of medical malpractice rate filings.
627.415 - Charter, bylaw provisions.
627.416 - Execution of policies.
627.417 - Underwriters’ and combination policies.
627.418 - Validity of noncomplying contracts.
627.419 - Construction of policies.
627.4195 - Health insurance; claims for payment of psychotherapeutic services; confidentiality.
627.4205 - Coverage identification number required.
627.4215 - Disclosures to policyholders; coverage of behavioral health care services.
627.422 - Assignment of policies or post-loss benefits.
627.423 - Payment discharges insurer.
627.4232 - Health insurance out-of-hospital benefits.
627.4233 - Total disability defined.
627.4234 - Health insurance cost containment provisions required.
627.4235 - Coordination of benefits.
627.4236 - Coverage for bone marrow transplant procedures.
627.4237 - Sickness disability or disability due to sickness.
627.4238 - Health insurer examinations.
627.4239 - Coverage for use of drugs in treatment of cancer.
627.42392 - Prior authorization.
627.42393 - Step-therapy protocol.
627.42395 - Coverage for certain prescription and nonprescription enteral formulas.
627.42396 - Reimbursement for telehealth services.
627.42397 - Coverage for air ambulance services.
627.424 - Minor may give acquittance.
627.425 - Forms for proof of loss to be furnished.
627.426 - Claims administration.
627.4265 - Payment of settlement.
627.427 - Payment of judgment by insurer; penalty for failure.
627.429 - Medical tests for HIV infection and AIDS for insurance purposes.
627.4295 - Dental procedures; anesthesia and hospitalization coverage.
627.4301 - Genetic information for insurance purposes.
627.4302 - Identification cards for processing prescription drug claims.
627.43141 - Notice of change in policy terms.
627.441 - Commercial general liability policies; coverage to contractors for completed operations.
627.442 - Insurance contracts.