(1) Except as otherwise provided by law, a group health insurance policy or certificate insuring more than one individual delivered or issued for delivery in this state must be delivered or issued for delivery to one of the groups provided for in ss. 627.653-627.656. A plan of self-insurance providing health coverage benefits to residents of this state must comply with s. 627.419 and the applicable provisions of this part relating to the rights of individuals to specified benefits and coverages.
(2) Subsection (1) does not apply to health insurance policies or plans of self-insurance:
(a) Insuring or providing benefits only to individuals related by blood, marriage, or legal adoption.
(b) Insuring or providing benefits only to individuals who have a common interest through ownership of a business enterprise, or a substantial legal interest or equity in the business enterprise, and who are actively engaged in the management of the business enterprise.
(c) Insuring or providing benefits only to individuals otherwise having an insurable interest in each other’s lives.
(d) Issued as blanket insurance pursuant to s. 627.659.
(3) A nongovernmental self-insurance plan for health benefits may not be contributory by participants.
(4) This section does not apply to any plan which is established or maintained by an individual employer in accordance with the Employee Retirement Income Security Act of 1974, Pub. L. No. 93-406, or to a multiple-employer welfare arrangement as defined in s. 624.437(1), except that a multiple-employer welfare arrangement shall comply with ss. 627.419, 627.657, 627.6575, 627.6578, 627.6579, 627.6612, 627.66121, 627.66122, 627.6615, 627.6616, and 627.662(7). This subsection does not allow an authorized insurer to issue a group health insurance policy or certificate which does not comply with this part.
History.—s. 584, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 4, 10, ch. 80-341; ss. 2, 3, ch. 81-318; ss. 498, 500, 523, 809(2nd), ch. 82-243; ss. 62, 79, ch. 82-386; s. 6, ch. 83-203; s. 1, ch. 83-213; s. 17, ch. 83-288; s. 1, ch. 84-50; s. 4, ch. 86-122; s. 1, ch. 90-255; ss. 61, 114, ch. 92-318; s. 26, ch. 95-211; s. 5, ch. 97-48; s. 82, ch. 2000-154; s. 6, ch. 2002-389.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)
627.651 - Group contracts and plans of self-insurance must meet group requirements.
627.6512 - Exemption of certain group health insurance policies.
627.6515 - Out-of-state groups.
627.652 - Group health insurance; definitions.
627.6525 - Short-term health insurance.
627.654 - Labor union, association, and small employer health alliance groups.
627.6551 - Teacher and student groups.
627.6561 - Preexisting conditions.
627.65612 - Limit on preexisting conditions.
627.65615 - Special enrollment periods.
627.6562 - Dependent coverage.
627.65626 - Insurance rebates for healthy lifestyles.
627.6563 - Full-time employment defined.
627.657 - Provisions of group health insurance policies.
627.6571 - Guaranteed renewability of coverage.
627.6572 - Pharmacy benefit manager contracts.
627.65735 - Nondiscrimination of coverage for surgical procedures.
627.65736 - Coverage for organ transplants.
627.65745 - Diabetes treatment services.
627.6575 - Coverage for newborn children.
627.65755 - Dental procedures; anesthesia and hospitalization coverage.
627.6579 - Coverage for child health supervision services.
627.658 - Use of dividends, refunds, rate reductions, commissions, service fees; premium rates.
627.659 - Blanket health insurance; eligible groups.
627.660 - Conditions and provisions of blanket health insurance policies.
627.661 - School accident insurance claims; policy service.
627.6612 - Coverage for surgical procedures and devices incident to mastectomy.
627.66121 - Coverage for length of stay and outpatient postsurgical care.
627.66122 - Requirements with respect to breast cancer and routine followup care.
627.6613 - Coverage for mammograms.
627.6615 - Children with disabilities; continuation of coverage under group policy.
627.6616 - Coverage for ambulatory surgical center service.
627.6617 - Coverage for home health care services.
627.6618 - Payment of acupuncture benefits to certified acupuncturists.
627.662 - Other provisions applicable.
627.6621 - Advanced practice registered nurse services.
627.663 - Franchise health insurance.
627.664 - Assignment of incidents of ownership in group, blanket, or franchise health policies.
627.6645 - Notification of cancellation, expiration, nonrenewal, or change in rates.
627.6646 - Cancellation or nonrenewal prohibited.
627.6648 - Shared savings incentive program.
627.667 - Extension of benefits.
627.6675 - Conversion on termination of eligibility.
627.668 - Optional coverage for mental and nervous disorders required; exception.
627.6686 - Coverage for individuals with autism spectrum disorder required; exception.
627.669 - Optional coverage required for substance abuse impaired persons; exception.
627.6691 - Coverage for osteoporosis screening, diagnosis, treatment, and management.
627.66911 - Required coverage for cleft lip and cleft palate.
627.6692 - Florida Health Insurance Coverage Continuation Act.
627.6699 - Employee Health Care Access Act.
627.66996 - Restrictions on use of state and federal funds for state exchanges.