(1) Each health insurer, prepaid limited health services organization, and health maintenance organization shall submit, no later than April 1 of each year, to the office information concerning health and accident insurance coverage and medical plans being marketed and currently in force in this state. The required information shall be described by market segment, to include, but not be limited to:
(a) Issuing, servicing company, and entity contact information.
(b) Information on all health and accident insurance policies and prepaid limited health service organizations and health maintenance organization contracts in force and issued in the previous year. Such information shall include, but not be limited to, direct premiums earned, direct losses incurred, number of policies, number of certificates, number of covered lives, and the average number of days taken to pay claims.
The commission may establish rules governing the submission of information described in this section, including the use of uniform formats and electronic data transmission.
(2)(a) Every insurer transacting health insurance in this state shall report annually to the office, not later than April 1, information relating to any measure the insurer has implemented or proposes to implement during the next calendar year for the purpose of containing health insurance costs or cost increases. The reports shall identify each measure and the forms to which the measure is applied, shall provide an explanation as to how the measure is used, and shall provide an estimate of the cost effect of the measure.
(b) The commission shall promulgate forms to be used by insurers in reporting information pursuant to this subsection and shall utilize such forms to analyze the effects of health care cost containment programs used by health insurers in this state.
(c) The office shall analyze the data reported under this subsection and shall annually make available to the department which shall provide to the public a summary of its findings as to the types of cost containment measures reported and the estimated effect of these measures.
History.—ss. 28, 31, ch. 84-35; ss. 8, 10, ch. 84-235; s. 36, ch. 88-166; s. 36, ch. 88-394; s. 114, ch. 92-318; s. 1233, ch. 2003-261; s. 27, ch. 2004-297.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part XVII - Insurer Reporting (Ss. 627.911-627.919)
627.9122 - Officers’ and directors’ liability claims; reports by insurers.
627.9126 - Reports by liability insurers.
627.913 - Reports by products liability insurers.
627.914 - Reports of information by workers’ compensation insurers required.
627.915 - Insurer experience reporting.
627.917 - Uniform risk classification reporting system for motor vehicle insurance.
627.9175 - Reports of information on health and accident insurance.