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Part I - Prepaid Limited Health Service Organizations (Ss. 636.002-636.067)
636.002 - Short title. - History.—s. 1, ch. 93-148.
636.003 - Definitions. - (1) “Capitation” means the fixed amount paid by a prepaid...
636.004 - Applicability of other laws. - History.—s. 3, ch. 93-148.
636.005 - Incorporation required; exceptions. - (1) On or after October 1, 1993, any entity that...
636.006 - Insurance business not authorized. - History.—s. 5, ch. 93-148; s. 1524, ch. 2003-261.
636.007 - Certificate of authority required. - History.—s. 6, ch. 93-148; s. 1525, ch. 2003-261.
636.008 - Application for certificate of authority. - (1) A copy of the applicant’s basic organizational document, including...
636.009 - Issuance of certificate of authority; denial. - (1) Following receipt of an application filed pursuant to s....
636.012 - Continued eligibility for certificate of authority. - History.—s. 9, ch. 93-148.
636.0145 - Certain entities contracting with Medicaid. - History.—s. 4, ch. 97-65; s. 130, ch. 2004-5; s. 26,...
636.015 - Language used in contracts and advertisements; translations. - (1)(a) All contracts or forms must be printed in English....
636.0155 - Disclosures required in contracts and marketing materials. - History.—s. 1, ch. 97-65.
636.016 - Prepaid limited health service contracts. - (1) Any entity issued a certificate of authority and otherwise...
636.017 - Rates and charges. - (1) The rates charged by any prepaid limited health service...
636.018 - Changes in rates and benefits; material modifications; addition of limited health services. - (1)(a) No prepaid limited health services contract, certificate of coverage,...
636.019 - Additional contract contents. - (1) Necessary because of the manner in which the organization...
636.0201 - Genetic information restrictions. - History.—s. 4, ch. 97-182.
636.022 - Restrictions upon expulsion or refusal to issue or renew contract. - History.—s. 17, ch. 93-148.
636.023 - Charter; bylaw provisions. - History.—s. 18, ch. 93-148.
636.024 - Execution of contracts. - (1) Every prepaid limited health services contract must be executed...
636.025 - Validity of noncomplying contracts. - (1) Any prepaid limited health services contract rider, endorsement, attachment,...
636.026 - Construction of contracts. - History.—s. 21, ch. 93-148.
636.027 - Delivery of contract. - History.—s. 22, ch. 93-148.
636.028 - Notice of cancellation of contract. - (1) The subscriber’s behavior is disruptive, unruly, abusive, unlawful, fraudulent,...
636.029 - Construction and relationship with other laws. - (1) No other provision of the insurance code applies to...
636.032 - Acceptable payments. - History.—s. 25, ch. 93-148.
636.033 - Certain words prohibited in name of organization. - (1) No entity certificated as a prepaid limited health service...
636.034 - Extension of benefits. - History.—s. 27, ch. 93-148.
636.035 - Provider arrangements. - (1) Whenever a contract exists between a prepaid limited health...
636.036 - Administrative, provider, and management contracts. - (1) The office may require a prepaid limited health service...
636.037 - Contract providers. - History.—s. 30, ch. 93-148; s. 1535, ch. 2003-261.
636.038 - Complaint system; annual report. - (1) Every prepaid limited health service organization must establish and...
636.039 - Examination by the office. - History.—s. 32, ch. 93-148; s. 160, ch. 98-166; s. 221,...
636.042 - Assets, liabilities, and investments. - History.—s. 33, ch. 93-148.
636.043 - Annual, quarterly, and miscellaneous reports. - (1) Each prepaid limited health service organization must file with...
636.044 - Agent licensing. - (1) With respect to a prepaid limited health services contract,...
636.045 - Minimum surplus requirements. - (1) Each prepaid limited health service organization must at all...
636.046 - Insolvency protection. - (1) Except as required in subsection (2), each prepaid limited...
636.047 - Officers’ and employees’ fidelity bond. - (1) A prepaid limited health service organization must maintain in...
636.048 - Suspension or revocation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension. - (1) The office may suspend the authority of a prepaid...
636.049 - Administrative penalty in lieu of suspension or revocation. - (1) Issue and cause to be served upon the organization,...
636.052 - Civil remedy. - History.—s. 41, ch. 93-148; s. 263, ch. 99-8; s. 1544,...
636.053 - Injunction. - (1) A prepaid limited health service organization is being operated...
636.054 - Payment of judgment by prepaid limited health service organization. - History.—s. 43, ch. 93-148.
636.055 - Levy upon deposit limited. - History.—s. 44, ch. 93-148; s. 1546, ch. 2003-261.
636.056 - Rehabilitation, conservation, liquidation, or reorganization; exclusive methods of remedy. - (1) A delinquency proceeding under part I of chapter 631...
636.057 - Fees. - (1) For filing an application for a certificate of authority...
636.058 - Investigative power of department and office. - History.—s. 47, ch. 93-148; s. 1549, ch. 2003-261.
636.059 - Unfair methods of competition, unfair or deceptive acts or practices defined. - History.—s. 48, ch. 93-148.
636.062 - Appeals from the office or department. - History.—s. 49, ch. 93-148; s. 1550, ch. 2003-261.
636.063 - Civil liability. - History.—s. 50, ch. 93-148; s. 1551, ch. 2003-261.
636.064 - Confidentiality. - (1) Any information pertaining to the diagnosis, treatment, or health...
636.065 - Acquisitions. - History.—s. 52, ch. 93-148.
636.066 - Taxes imposed. - (1) The premiums, contributions, and assessments received by prepaid limited...
636.067 - Rules. - History.—s. 54, ch. 93-148; s. 213, ch. 98-200; s. 1553,...
Part II - Discount Plan Organizations (Ss. 636.202-636.244)
636.202 - Definitions. - (1) “Discount plan” means a business arrangement or contract in...
636.204 - License required. - (1) Before doing business in this state as a discount...
636.205 - Issuance of license; denial. - (1) Following receipt of an application filed pursuant to s....
636.206 - Examinations and investigations. - (1) The office may examine or investigate the business and...
636.207 - Applicability of part. - History.—s. 5, ch. 2005-232; s. 18, ch. 2017-112.
636.208 - Fees; charges; reimbursement. - (1) A discount plan organization may charge a periodic charge...
636.210 - Prohibited activities of a discount plan organization. - (1) A discount plan organization may not: (a) Use in...
636.212 - Disclosures. - (1) A disclosure must include: (a) That the plan is...
636.214 - Provider agreements. - (1) All providers offering medical services to members under a...
636.216 - Written agreement. - History.—s. 31, ch. 2004-297; s. 10, ch. 2005-232; s. 9,...
636.218 - Annual reports. - (1) Each discount plan organization shall file with the office,...
636.220 - Minimum capital requirements. - (1) Each discount plan organization shall at all times maintain...
636.222 - Suspension or revocation of license; suspension of enrollment of new members; terms of suspension. - (1) The office may suspend the authority of a discount...
636.223 - Administrative penalty. - (1) Issue and cause to be served upon the organization...
636.224 - Notice of change of name or address of discount plan organization. - History.—s. 31, ch. 2004-297; s. 24, ch. 2017-112.
636.226 - Provider name listing. - History.—s. 31, ch. 2004-297; s. 25, ch. 2017-112.
636.228 - Marketing of discount plans. - (1) All advertisements, marketing materials, brochures, and discount cards used...
636.230 - Bundling discount plans with other products. - History.—s. 31, ch. 2004-297; s. 14, ch. 2005-232; s. 11,...
636.232 - Rules. - History.—s. 31, ch. 2004-297; s. 12, ch. 2017-112.
636.234 - Service of process on a discount plan organization. - History.—s. 31, ch. 2004-297; s. 26, ch. 2017-112.
636.236 - Surety bond or security deposit. - (1) Each discount plan organization licensed pursuant to this part...
636.238 - Penalties for violation of this part. - (1) Except as provided in subsection (2), a person who...
636.240 - Injunctions. - (1) In addition to the penalties and other enforcement provisions...
636.244 - Unlicensed discount plan organizations. - History.—s. 31, ch. 2004-297; s. 30, ch. 2017-112.