Florida Statutes
Part VI - Health Insurance Policies (Ss. 627.601-627.64995)
627.6402 - Insurance rebates for healthy lifestyles.


(1) Any rate, rating schedule, or rating manual for an individual health insurance policy filed with the office may provide for an appropriate rebate of premiums paid in the last year when the individual covered by such plan is enrolled in and maintains participation in any health wellness, maintenance, or improvement program approved by the health plan. The rebate may be based on premiums paid in the last calendar year or the last policy year. The individual must provide evidence of demonstrative maintenance or improvement of the individual’s health status as determined by assessments of agreed-upon health status indicators between the individual and the health insurer, including, but not limited to, reduction in weight, body mass index, and smoking cessation. Any rebate provided by the health insurer is presumed to be appropriate unless credible data demonstrates otherwise, or unless such rebate program requires the insured to incur costs to qualify for the rebate which equal or exceed the value of the rebate, but in no event shall the rebate exceed 10 percent of paid premiums.
(2) The premium rebate authorized by this section shall be effective for an insured on an annual basis, unless the individual fails to maintain or improve his or her health status while participating in an approved wellness program, or credible evidence demonstrates that the individual is not participating in the approved wellness program.
History.—s. 33, ch. 2004-297; s. 5, ch. 2005-231.

Structure Florida Statutes

Florida Statutes

Title XXXVII - Insurance

Chapter 627 - Insurance Rates and Contracts

Part VI - Health Insurance Policies (Ss. 627.601-627.64995)

627.601 - Scope of this part.

627.6011 - Mandated coverages.

627.602 - Scope, format of policy.

627.603 - Death benefits.

627.604 - Nonresident insured.

627.6041 - Children with disabilities; continuation of coverage.

627.6043 - Notification of cancellation, nonrenewal, or change in rates.

627.6044 - Use of a specific methodology for payment of claims.

627.6045 - Preexisting condition.

627.6046 - Limit on preexisting conditions.

627.605 - Required provisions; captions, omissions, substitutions.

627.6056 - Coverage for ambulatory surgical center service.

627.606 - Entire contract; changes.

627.607 - Time limit on certain defenses.

627.608 - Grace period.

627.609 - Reinstatement.

627.610 - Notice of claim.

627.611 - Claim forms.

627.612 - Proof of loss.

627.613 - Time of payment of claims.

627.6131 - Payment of claims.

627.614 - Payment of claims.

627.6141 - Denial of claims.

627.615 - Physical examination, autopsy.

627.616 - Legal actions.

627.617 - Change of beneficiary.

627.618 - Optional policy provisions.

627.619 - Change of occupation.

627.620 - Misstatement of age or sex.

627.621 - Other insurance with this insurer.

627.622 - Insurance with other insurers.

627.623 - Insurance with other insurers; other benefits.

627.624 - Relation of earnings to insurance.

627.625 - Unpaid premiums.

627.6265 - Cancellation or nonrenewal prohibited.

627.627 - Conformity with statutes.

627.628 - Illegal occupation.

627.629 - Intoxicants and narcotics.

627.630 - Order of certain provisions.

627.631 - Third-party ownership.

627.632 - Requirements of other jurisdictions.

627.633 - Other policy provisions.

627.634 - Age limit.

627.635 - Excess insurance.

627.636 - Industrial health insurance.

627.637 - Construction of noncomplying contracts.

627.638 - Direct payment for hospital, medical services.

627.6385 - Disclosures to policyholders; calculations of cost sharing.

627.6387 - Shared savings incentive program.

627.639 - Application signed by agent.

627.640 - Filing of classifications and rates.

627.6401 - Refunds for persons age 64.

627.6402 - Insurance rebates for healthy lifestyles.

627.64025 - Advanced practice registered nurse services.

627.6403 - Payment of acupuncture benefits to certified acupuncturists.

627.6405 - Decreasing inappropriate utilization of emergency care.

627.6406 - Maternity care.

627.6407 - Massage.

627.6408 - Diabetes treatment services.

627.6409 - Coverage for osteoporosis screening, diagnosis, treatment, and management.

627.641 - Coverage for newborn children.

627.6415 - Coverage for natural-born, adopted, and foster children; children in insured’s custodial care.

627.6416 - Coverage for child health supervision services.

627.6417 - Coverage for surgical procedures and devices incident to mastectomy.

627.64171 - Coverage for length of stay and outpatient postsurgical care.

627.64172 - Requirements with respect to breast cancer and routine followup care.

627.6418 - Coverage for mammograms.

627.6419 - Requirements with respect to breast cancer.

627.64193 - Required coverage for cleft lip and cleft palate.

627.64194 - Coverage requirements for services provided by nonparticipating providers; payment collection limitations.

627.64195 - Requirements for opioid coverage.

627.64196 - Medication synchronization.

627.64197 - Coverage for organ transplants.

627.642 - Outline of coverage.

627.6425 - Renewability of individual coverage.

627.6426 - Short-term health insurance.

627.643 - Uniform minimum standards.

627.644 - Discrimination against handicapped prohibited.

627.645 - Denial of health insurance claims restricted.

627.646 - Conversion on termination of eligibility.

627.647 - Standard health claim form.

627.6471 - Contracts for reduced rates of payment; limitations; coinsurance and deductibles.

627.6472 - Exclusive provider organizations.

627.64725 - Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

627.6473 - Combined preferred provider and exclusive provider policies.

627.64731 - Leasing, renting, or granting access to a participating provider.

627.6474 - Provider contracts.

627.64741 - Pharmacy benefit manager contracts.

627.6475 - Individual reinsurance pool.

627.6487 - Guaranteed availability of individual health insurance coverage to eligible individuals.

627.64995 - Restrictions on use of state and federal funds for state exchanges.