7040374, 69O-149.003 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 7040374

Notice of Development of Rulemaking

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

OIR – Insurance Regulation

Chapter:

FILING OF FORMS AND RATES FOR LIFE/HEALTH INSURANCE

Overview

RULE:

69O-149.003	Rate Filing Procedures
69O-149.005	Reasonableness of Benefits in Relation to Premiums
69O-149.007	Annual Rate Certification (ARC) Filing Procedures

PURPOSE:

To provide more pooling of cancer forms and to make a few clarifications to existing provisions.

SUBJECT:

Florida law requires rates for health insurance to be reasonable in relation to the benefits. Section 627.410(6)(b), F.S., provides that the Commission may establish by rule procedures to the used in ascertaining the reasonableness of filed rates. These rules provide guidelines for insurers so they can be assured the rates they charge comply with this mandate. There are three amendments to the rules. The first, in Rule 69O-149.003, F.A.C., establishes rules for pooling of cancer claims. The second, in Rule 69O-149.005, F.A.C., prohibits an insurer knowingly pricing an individual rate to be charged to an insured to be excessive. The third tightens up the requirements for rate certifications, to make sure that when an insurer annually states its rates meet Florida law, that statement is true. The rule does this by setting forth the steps an insurer must take to rectify the problem if the Office determines a rate certification was inaccurate. Pursuant to the rule, knowingly filing a false rate certification constitutes an unfair and deceptive trade practice in violation of Section 626.9541(1)(e), F.S.

RULEMAKING AUTHORITY:

624.424, 627.410 FS.

LAW:

627.9175 FS.

PRINT PUBLISH DATE:

4/24/2009 Vol. 35/16

RELATED STATUTES
AND LAWS:

624.424, 627.410 FS., 627.9175 FS.

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://www.flrules.org/gateway/ruleno.asp?id=69O-149.003&PDate=4/24/2009&Section=1

REFERENCE MATERIALS:

No reference(s).

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