(1) With respect to a prepaid limited health services contract, a person may not, unless licensed and appointed as a health insurance agent in accordance with the applicable provisions of the insurance code:
(a) Solicit contracts or procure applications; or
(b) Engage or hold herself or himself out as engaging in the business of analyzing or abstracting prepaid limited health services contracts or of counseling or advising or giving opinions to persons relative to such contracts other than as a consulting actuary advising a prepaid limited health service organization or as a salaried bona fide full-time employee so counseling and advising her or his employer relative to coverage for the employer and her or his employees.
(2) All qualifications, disciplinary provisions, licensing and appointment procedures, fees, and related matters contained in the insurance code which apply to the appointment of health insurance agents by insurers also apply to prepaid limited health service organizations and to persons appointed by prepaid limited health service organizations as their agents.
(3) Examination, licensure, or appointment is not required of any regular salaried officer or employee of a prepaid limited health service organization who devotes substantially all of her or his services to activities other than the solicitation of prepaid limited health service organization contracts from the public and who receives no commission or other compensation directly dependent upon the solicitation of such contracts.
(4) As used in this section, the term “salaried” refers to basic remuneration and does not include commissions, bonuses, or any other compensatory measures.
(5) A person registered as a seller of travel under s. 559.928 is not required to be licensed under this section in order to sell prepaid limited health service contracts that cover the cost of transportation provided by an air ambulance service licensed pursuant to s. 401.251. The prepaid limited health service contract for such coverage is, however, subject to all applicable provisions of this chapter.
History.—s. 35, ch. 93-148; s. 488, ch. 97-102; s. 2, ch. 2006-173.
Structure Florida Statutes
Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations
Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)
636.004 - Applicability of other laws.
636.005 - Incorporation required; exceptions.
636.006 - Insurance business not authorized.
636.007 - Certificate of authority required.
636.008 - Application for certificate of authority.
636.009 - Issuance of certificate of authority; denial.
636.012 - Continued eligibility for certificate of authority.
636.0145 - Certain entities contracting with Medicaid.
636.015 - Language used in contracts and advertisements; translations.
636.0155 - Disclosures required in contracts and marketing materials.
636.016 - Prepaid limited health service contracts.
636.019 - Additional contract contents.
636.0201 - Genetic information restrictions.
636.022 - Restrictions upon expulsion or refusal to issue or renew contract.
636.023 - Charter; bylaw provisions.
636.024 - Execution of contracts.
636.025 - Validity of noncomplying contracts.
636.026 - Construction of contracts.
636.027 - Delivery of contract.
636.028 - Notice of cancellation of contract.
636.029 - Construction and relationship with other laws.
636.032 - Acceptable payments.
636.033 - Certain words prohibited in name of organization.
636.034 - Extension of benefits.
636.035 - Provider arrangements.
636.036 - Administrative, provider, and management contracts.
636.038 - Complaint system; annual report.
636.039 - Examination by the office.
636.042 - Assets, liabilities, and investments.
636.043 - Annual, quarterly, and miscellaneous reports.
636.045 - Minimum surplus requirements.
636.046 - Insolvency protection.
636.047 - Officers’ and employees’ fidelity bond.
636.049 - Administrative penalty in lieu of suspension or revocation.
636.054 - Payment of judgment by prepaid limited health service organization.
636.055 - Levy upon deposit limited.
636.056 - Rehabilitation, conservation, liquidation, or reorganization; exclusive methods of remedy.
636.058 - Investigative power of department and office.
636.059 - Unfair methods of competition, unfair or deceptive acts or practices defined.