Florida Statutes
Part IV - Health Maintenance Organization Consumer Assistance Plan (Ss. 631.811-631.828)
631.819 - Assessments.

1(1) For the purposes of providing the funds necessary to carry out the powers and duties of the plan, the board of directors shall assess the member HMOs at such time and for such amounts as the board finds necessary. Assessments shall be due not less than 30 days after written notice to the member HMOs.
(2) Assessments for funds to meet the requirements of the plan with respect to an insolvent HMO shall not be made until necessary to implement the purposes of this part. In order to carry out its duties and powers under this part, upon the insolvency of an HMO, the plan shall levy and collect assessments as follows:
(a) Each HMO, prior to receiving a certificate of authority after July 1, 1989, shall pay an assessment of $25,000 to the plan.
(b) If the funds provided under paragraph (a) are insufficient to carry out the powers and duties of the plan, the plan shall levy an assessment directly against all HMOs.
1(c) For the purposes of long-term care insurer impairment and insolvency assessments under s. 631.718(3)(b), member HMOs must be assessed in the same manner as member insurers of the Florida Life and Health Insurance Guaranty Association under part III of this chapter. Long-term care insurer impairment and insolvency assessments must be levied and collected by the plan pursuant to this part, deposited into the health insurance account established under s. 631.715, and used solely for long-term care insurer impairment or insolvency obligations. Assessments collected from member HMOs are considered part of and satisfy the obligations of the health insurance account under ss. 631.715(2)(a)1. and 631.718(3)(b).

1(3) All assessments against HMOs, including long-term care insurer impairment and insolvency assessments, must be levied as a percentage of annual earned premium revenue for non-Medicare and non-Medicaid contracts. In no event may the plan assess in any calendar year more than 0.5 percent of each HMO’s annual earned premium revenue for non-Medicare and non-Medicaid contracts.
(4) The plan may temporarily defer, in whole or in part, the assessment of a member HMO, if, in the opinion of the board, payment of the assessment would endanger the ability of the HMO to fulfill its contractual obligations.
(5) It shall be proper for any member HMO, in determining its premium rates, to consider the amount reasonably necessary to meet its assessment obligations under this part.
1(6) The plan shall issue, in a form prescribed by the office, a certificate of contribution to each member HMO paying a long-term care insurer impairment or insolvency assessment under this part for the amount of the assessment so paid. All outstanding certificates are of equal dignity and priority without reference to amounts or dates of issue. A certificate of contribution may be shown by the member HMO in its financial statement as an asset in such form and for such amount and period of time as the office approves. However, any amount offset pursuant to s. 631.828 may not be shown as an asset of the member HMO on any of its financial statements.
History.—ss. 1, 23, ch. 88-388; ss. 107, 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 9, ch. 2019-83.
1Note.—Section 12, ch. 2019-83, provides that “[s]ection 631.738, Florida Statutes, as created by this act, and the amendments made to ss. 631.713, 631.717, 631.718, 631.721, 631.818, 631.819, and 631.820, Florida Statutes, by this act apply only to long-term care insurer impairment and insolvency assessments that result from an insurer being adjudged insolvent by a court of competent jurisdiction or being determined by the office to be impaired on or after [June 7, 2019].”

Structure Florida Statutes