(1) The office may suspend or revoke, after notice and hearing, the certificate of authority of a member HMO that fails to pay an assessment when due, fails to comply with the approved plan of operation of the plan, or fails either to timely comply with or to timely appeal pursuant to subsection (2) its appointment.
(2) Any action of the board of directors of the plan may be appealed to the office by any member HMO if such appeal is taken within 21 days of the action being appealed; however, the HMO must comply with such action pending exhaustion of appeal. Any appeal shall be promptly determined by the office, and final action or order of the office shall be subject to judicial review in a court of competent jurisdiction.
(3) The department may require that the plan notify the subscriber of the insolvent HMO and any other interested parties of the determination of insolvency and of their rights under this part. Such notification shall be by mail at their last known addresses, when available, but if sufficient information for notification by mail is not available, notice by publication in a newspaper of general circulation shall be sufficient.
(4) The office may revoke the designation of any servicing facility or administrator if it finds claims are being handled unsatisfactorily.
History.—ss. 1, 23, ch. 88-388; ss. 109, 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 6, ch. 95-213; s. 1368, ch. 2003-261; s. 11, ch. 2019-83.
Structure Florida Statutes
Chapter 631 - Insurer Insolvency; Guaranty of Payment
Part IV - Health Maintenance Organization Consumer Assistance Plan (Ss. 631.811-631.828)
631.812 - Purpose; construction.
631.813 - Application of part.
631.815 - Florida Health Maintenance Organization Consumer Assistance Plan.
631.818 - Powers and duties of the plan.
631.821 - Powers and duties of the department.
631.823 - Examination of the plan; annual report.
631.826 - Extent of liability of plan.
631.827 - Prohibited advertisement.
631.828 - Assessments against member HMOs; income tax credit for assessments paid.