(1)(a) A health maintenance organization shall not pay any dividend or distribute cash or other property to stockholders except out of that part of its available and accumulated surplus funds which is derived from realized net operating profits on its business and net realized capital gains.
(b) Unless prior written approval is obtained from the office, a health maintenance organization may not pay or declare any dividend or distribute cash or other property to or on behalf of any stockholder if, immediately before or after such distribution, the health maintenance organization’s available and accumulated surplus funds, which are derived from realized net operating profits on its business and net realized gains, are or would be less than zero.
(c) A health maintenance organization may make dividend payments or distributions to stockholders without the prior written approval of the office when:
1. The dividend is equal to or less than the greater of:
a. Ten percent of the health maintenance organization’s accumulated surplus funds which are derived from realized net operating profits on its business and net realized capital gains as of the immediate preceding calendar year; or
b. The health maintenance organization’s entire net operating profit and realized net capital gains derived during the immediately preceding calendar year.
2. The health maintenance organization will have surplus equal to or exceeding 115 percent of the minimum required statutory surplus after the dividend or distribution is made.
3. The health maintenance organization has filed a notice with the office at least 30 days prior to the dividend payment or distribution, or such shorter period of time as approved by the office on a case-by-case basis.
4. The notice includes a certification by an officer of the health maintenance organization attesting that after payment of the dividend or distribution the health maintenance organization will have at least 115 percent of required statutory surplus.
5. The health maintenance organization has negative retained earnings, statutory surplus in excess of $50 million, and statutory surplus greater than or equal to 150 percent of its required statutory surplus before and after the dividend distribution is made based upon the health maintenance organization’s most recently filed annual financial statement.
(2) The office shall not approve a dividend or distribution in excess of the maximum amount allowed in subsection (1) unless it determines that the distribution or dividend would not jeopardize the financial condition of the health maintenance organization, considering:
(a) The liquidity, quality, and diversification of the health maintenance organization’s assets and the effect on its ability to meet its obligations.
(b) Any reduction of investment portfolio and investment income.
(c) History of capital contributions.
(d) Prior dividend distributions of the health maintenance organization.
(e) Whether the dividend is only a pass-through dividend from a subsidiary of the health maintenance organization.
(3) Any director of a health maintenance organization who knowingly votes for or concurs in declaration or payment of a dividend to stockholders when such declaration is in violation of this section is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083, and shall be jointly and severally liable, together with other such directors likewise voting for or concurring, for any loss thereby sustained by creditors of the health maintenance organization to the extent of such dividend.
(4) Any stockholder receiving such an illegal dividend shall be liable in the amount thereof to the health maintenance organization.
(5) The office may revoke or suspend the certificate of authority of a health maintenance organization which has declared or paid such an illegal dividend.
History.—ss. 19, 24, ch. 88-388; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429; s. 9, ch. 2002-247; s. 1588, ch. 2003-261.
Structure Florida Statutes
Chapter 641 - Health Care Service Programs
Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)
641.18 - Declaration of legislative intent, findings, and purposes.
641.183 - Statutory accounting procedures; transition provisions.
641.185 - Health maintenance organization subscriber protections.
641.201 - Applicability of other laws.
641.2011 - Insurance holding companies.
641.2015 - Incorporation required.
641.2017 - Insurance business not authorized.
641.2018 - Limited coverage for home health care authorized.
641.20185 - High-deductible contracts for medical savings accounts.
641.2019 - Provider service network certificate of authority.
641.21 - Application for certificate.
641.217 - Minority recruitment and retention plans required.
641.22 - Issuance of certificate of authority.
641.221 - Continued eligibility for certificate of authority.
641.225 - Surplus requirements.
641.227 - Rehabilitation Administrative Expense Fund.
641.228 - Florida Health Maintenance Organization Consumer Assistance Plan.
641.234 - Administrative, provider, and management contracts.
641.2342 - Contract providers.
641.25 - Administrative penalty in lieu of suspension or revocation.
641.255 - Acquisition, merger, or consolidation.
641.26 - Annual and quarterly reports.
641.261 - Other reporting requirements.
641.27 - Examination by the department.
641.282 - Payment of judgment by health maintenance organization.
641.285 - Insolvency protection.
641.286 - Levy upon deposit limited.
641.30 - Construction and relationship to other laws.
641.3005 - Application of ch. 85-177.
641.3007 - HIV infection and AIDS for contract purposes.
641.305 - Language used in contracts and advertisements; translations.
641.309 - Standards for marketing to persons eligible for Medicare.
641.31 - Health maintenance contracts.
641.3101 - Additional contract contents.
641.3102 - Restrictions upon expulsion or refusal to issue or renew contract.
641.3103 - Charter, bylaw provisions.
641.3104 - Execution of contracts.
641.3105 - Validity of noncomplying contracts.
641.3106 - Construction of contracts.
641.3107 - Delivery of contract; definitions.
641.31071 - Preexisting conditions.
641.31072 - Special enrollment periods.
641.31074 - Guaranteed renewability of coverage.
641.31075 - Advanced practice registered nurse services.
641.31076 - Shared savings incentive program.
641.31077 - Coverage for organ transplants.
641.3108 - Notice of cancellation of contract.
641.31085 - Disclosures to subscribers; coverage of behavioral health care services.
641.31094 - Nondiscrimination of coverage for certain surgical procedures involving bones or joints.
641.31095 - Coverage for mammograms.
641.31096 - Requirements with respect to breast cancer and routine followup care.
641.31097 - Decreasing inappropriate utilization of emergency care.
641.31098 - Coverage for individuals with developmental disabilities.
641.31099 - Restrictions on use of state and federal funds for state exchanges.
641.3111 - Extension of benefits.
641.314 - Pharmacy benefit manager contracts.
641.3154 - Organization liability; provider billing prohibited.
641.3155 - Prompt payment of claims.
641.3156 - Treatment authorization; payment of claims.
641.316 - Fiscal intermediary services.
641.33 - Certain words prohibited in name of organization.
641.35 - Assets, liabilities, and investments.
641.36 - Adoption of rules; penalty for violation.
641.37 - Prohibited activities; penalties.
641.38 - Operational health maintenance organizations; issuance of certificate.
641.385 - Order to discontinue certain advertising.
641.386 - Agent licensing and appointment required; exceptions.
641.3901 - Unfair methods of competition and unfair or deceptive acts or practices prohibited.
641.3903 - Unfair methods of competition and unfair or deceptive acts or practices defined.
641.3905 - General powers and duties of the department and office.
641.3909 - Cease and desist and penalty orders.
641.3911 - Appeals from the department or office.
641.3913 - Penalty for violation of cease and desist orders.
641.3915 - Health maintenance organization anti-fraud plans and investigative units.
641.3921 - Conversion on termination of eligibility.