Bill Text: FL S0430 | 2017 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Discount Plan Organizations
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-04-26 - Laid on Table, companion bill(s) passed, see CS/HB 577 (Ch. 2017-112) [S0430 Detail]
Download: Florida-2017-S0430-Comm_Sub.html
Bill Title: Discount Plan Organizations
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-04-26 - Laid on Table, companion bill(s) passed, see CS/HB 577 (Ch. 2017-112) [S0430 Detail]
Download: Florida-2017-S0430-Comm_Sub.html
Florida Senate - 2017 CS for SB 430 By the Committee on Banking and Insurance; and Senators Bean and Flores 597-02139-17 2017430c1 1 A bill to be entitled 2 An act relating to discount plan organizations; 3 revising the titles of ch. 636, F.S., and part II of 4 ch. 636, F.S.; amending s. 636.202, F.S.; revising 5 definitions; amending s. 636.204, F.S.; conforming 6 provisions to changes made by the act; requiring 7 third-party entities that contract with providers to 8 administer or provide platforms for discount plans to 9 be licensed as discount plan organizations; amending 10 s. 636.206, F.S.; conforming provisions to changes 11 made by the act; requiring discount plan organizations 12 to maintain, for a specified timeframe, certain 13 records in a form accessible to the Office of 14 Insurance Regulation during an examination or 15 investigation; amending s. 636.208, F.S.; conforming 16 provisions to changes made by the act; specifying 17 periodic charge reimbursement and other requirements 18 for discount plan organizations following membership 19 cancellation requests; amending s. 636.212, F.S.; 20 requiring discount plan organizations and marketers to 21 provide specified disclosures to prospective members 22 before enrollment; authorizing discount plan 23 organizations and marketers to make other disclosures; 24 requiring prospective members to acknowledge 25 acceptance of disclosures before enrollment; 26 specifying requirements for disclosures made in 27 writing or by electronic means; revising requirements 28 for disclosures made by telephone; amending s. 29 636.214, F.S.; making a technical change; conforming 30 provisions to changes made by the act; amending s. 31 636.216, F.S.; deleting provisions relating to charge 32 and form filings; conforming a provision to changes 33 made by the act; amending s. 636.228, F.S.; conforming 34 provisions to changes made by the act; authorizing a 35 discount plan organization to delegate functions to 36 its marketers; providing that the discount plan 37 organization is bound by acts of its marketers within 38 the scope of the delegation; amending s. 636.230, 39 F.S.; conforming provisions to changes made by the 40 act; authorizing a marketer or discount plan 41 organization to commingle certain products on a single 42 page of certain documents; deleting a requirement for 43 discount medical plan fees to be provided in writing 44 under certain circumstances; amending s. 636.232, 45 F.S.; conforming a provision to changes made by the 46 act; deleting rulemaking authority of the Financial 47 Services Commission as to the establishment of certain 48 standards; amending ss. 408.9091, 408.910, 627.64731, 49 636.003, 636.205, 636.207, 636.210, 636.218, 636.220, 50 636.222, 636.223, 636.224, 636.226, 636.234, 636.236, 51 636.238, 636.240, and 636.244, F.S.; conforming 52 provisions to changes made by the act; providing an 53 effective date. 54 55 Be It Enacted by the Legislature of the State of Florida: 56 57 Section 1. Chapter 636, Florida Statutes, entitled “Prepaid 58 Limited Health Service Organizations and Discount Medical Plan 59 Organizations,” is retitled “Prepaid Limited Health Service 60 Organizations and Discount Plan Organizations.” 61 Section 2. Part II of chapter 636, Florida Statutes, 62 entitled “Discount Medical Plan Organizations,” is retitled 63 “Discount Plan Organizations.” 64 Section 3. Section 636.202, Florida Statutes, is amended to 65 read: 66 636.202 Definitions.—As used in this part, the term: 67 (1) “Discountmedicalplan” means a business arrangement or 68 contract in which a person, in exchange for fees, dues, charges, 69 or other consideration, provides access for plan members to 70 providers of medical services and the right to receive medical 71 services from those providers at a discount. The term“discount72medical plan”does not include any product regulated under 73 chapter 627, chapter 641, or part I of this chapter;, orany 74 medical services provided through a telecommunications medium 75 that does not offer a discount to the plan member for those 76 medical services; or any plan that does not charge a fee to plan 77 members. Until June 30, 2018, a discount plan may also be 78 referred to as a discount medical plan. 79 (2) “Discountmedicalplan organization” means an entity 80 thatwhich, in exchange for fees, dues, charges, or other 81 consideration, provides access for plan members to providers of 82 medical services and the right to receive medical services from 83 those providers at a discount. Until June 30, 2018, a discount 84 plan organization may also be referred to as a discount medical 85 plan organization. 86 (3) “Marketer” means a person or entity thatwhichmarkets, 87 promotes, sells, or distributes a discountmedicalplan, 88 including a private label entity thatwhichplaces its name on 89 and markets or distributes a discountmedicalplan but does not 90 operate a discountmedicalplan. 91 (4) “Medical services” means any care, service, or 92 treatment of illness or dysfunction of, or injury to, the human 93 body, including, but not limited to, physician care, inpatient 94 care, hospital surgical services, emergency services, ambulance 95 services, dental care services, vision care services, mental 96 health services, substance abuse services, chiropractic 97 services, podiatric care services, laboratory services, and 98 medical equipment and supplies. The term does not include 99 pharmaceutical supplies or prescriptions. 100 (5) “Member” means any person who pays fees, dues, charges, 101 or other consideration for the right to receive the purported 102 benefits of a discountmedicalplan. 103 (6) “Provider” means any person or institution thatwhich104 is contracted, directly or indirectly, with a discountmedical105 plan organization to provide medical services to members. 106 (7) “Provider network” means an entity thatwhich107 negotiates on behalf of more than one provider with a discount 108medicalplan organization to provide medical services to 109 members. 110 Section 4. Subsections (1), (2), (4), and (6) of section 111 636.204, Florida Statutes, are amended to read: 112 636.204 License required.— 113 (1) Before doing business in this state as a discount 114medicalplan organization, an entity must be a corporation, a 115 limited liability company, or a limited partnership, 116 incorporated, organized, formed, or registered under the laws of 117 this state or authorized to transact business in this state in 118 accordance with chapter 605, part I of chapter 607, chapter 617, 119 chapter 620, or chapter 865, and must be licensed by the office 120 as a discountmedicalplan organization or be licensed by the 121 office pursuant to chapter 624, part I of this chapter, or 122 chapter 641. 123 (2) An application for a license to operate as a discount 124medicalplan organization must be filed with the office on a 125 form prescribed by the commission. Such application must be 126 sworn to by an officer or authorized representative of the 127 applicant and be accompanied by the following, if applicable: 128 (a) A copy of the applicant’s articles of incorporation or 129 other organizing documents, including all amendments. 130 (b) A copy of the applicant’s bylaws. 131 (c) A list of the names, addresses, official positions, and 132 biographical information of the individuals who are responsible 133 for conducting the applicant’s affairs, including, but not 134 limited to, all members of the board of directors, board of 135 trustees, executive committee, or other governing board or 136 committee, the officers, contracted management company 137 personnel, and any person or entity owning or having the right 138 to acquire 10 percent or more of the voting securities of the 139 applicant. Such listing must fully disclose the extent and 140 nature of any contracts or arrangements between any individual 141 who is responsible for conducting the applicant’s affairs and 142 the discountmedicalplan organization, including any possible 143 conflicts of interest. 144 (d) A complete biographical statement,on forms prescribed 145 by the commission, an independent investigation report, and a 146 set of fingerprints, as provided in chapter 624, with respect to 147 each individual identified under paragraph (c). 148 (e) A statement generally describing the applicant, its 149 facilities and personnel, and the medical services to be 150 offered. 151 (f) A copy of the form of all contracts made or to be made 152 between the applicant and any providers or provider networks 153 regarding the provision of medical services to members. 154 (g) A copy of the form of any contract made or arrangement 155 to be made between the applicant and any person listed in 156 paragraph (c). 157 (h) A copy of the form of any contract made or to be made 158 between the applicant and any person, corporation, partnership, 159 or other entity for the performance on the applicant’s behalf of 160 any function, including, but not limited to, marketing, 161 administration, enrollment, investment management, and 162 subcontracting for the provision of health services to members. 163 (i) A copy of the applicant’s most recent financial 164 statements audited by an independent certified public 165 accountant. An applicant that is a subsidiary of a parent entity 166 that is publicly traded and that prepares audited financial 167 statements reflecting the consolidated operations of the parent 168 entity and the subsidiary may petition the office to accept, in 169 lieu of the audited financial statement of the applicant, the 170 audited financial statement of the parent entity and a written 171 guaranty by the parent entity that the minimum capital 172 requirements of the applicant required by this part will be met 173 by the parent entity. 174 (j) A description of the proposed method of marketing. 175 (k) A description of the subscriber complaint procedures to 176 be established and maintained. 177 (l) The fee for issuance of a license. 178 (m) Such other information as the commission or office may 179 reasonably require to make the determinations required by this 180 part. 181 (4) BeforePrior tolicensure by the office, each discount 182medicalplan organization must establish an Internet website so 183 as to conform to the requirements of s. 636.226. 184 (6) This part does not requireNothing in this part185requiresa provider who provides discounts to his or her own 186 patients to obtain and maintain a license as a discountmedical187 plan organization. If a provider contracts with a third-party 188 entity to administer or provide a platform for a discount plan, 189 the third-party entity must be licensed as a discount plan 190 organization. 191 Section 5. Section 636.206, Florida Statutes, is amended to 192 read: 193 636.206 Examinations and investigations.— 194 (1) The office may examine or investigate the business and 195 affairs of any discountmedicalplan organization. The office 196 may order any discountmedicalplan organization or applicant to 197 produce any records, books, files, advertising and solicitation 198 materials, or other information and may take statements under 199 oath to determine whether the discountmedicalplan organization 200 or applicant is in violation of the law or is acting contrary to 201 the public interest. The expenses incurred in conducting any 202 examination or investigation must be paid by the discount 203medicalplan organization or applicant. Examinations and 204 investigations must be conducted as provided in chapter 624. For 205 the duration of the agreement and for 5 years thereafter, every 206 discount plan organization shall maintain, in a form accessible 207 to the office during an examination or investigation, an 208 accurate record of each member, the membership materials 209 provided to the member, the discount plan issued to the member, 210 and the charges billed and paid by the member. 211 (2) Failure by the discountmedicalplan organization to 212 pay the expenses incurred under subsection (1) is grounds for 213 denial or revocation. 214 Section 6. Section 636.208, Florida Statutes, is amended to 215 read: 216 636.208 Fees; charges; reimbursement.— 217 (1) A discountmedicalplan organization may charge a 218 periodic charge as well as a reasonable one-time processing fee 219 for a discountmedicalplan. 220 (2)(a) If the member cancels his or her membership in the 221 discountmedicalplan organization within the first 30 days 222 after the effective date of enrollment in the plan, the member 223 shall receive a reimbursement of all periodic charges upon 224 return of the discount card to the discountmedicalplan 225 organization. 226 (b) If the member cancels his or her membership in the 227 discount plan organization consistent with the open enrollment 228 rules established by an employer or association for a plan 229 having an open enrollment period, the member shall receive a pro 230 rata reimbursement of all periodic charges upon return of the 231 discount card to the discount plan organization. 232 (c) Except for plans enrolled under paragraph (b), if the 233 member requests in writing the cancellation of his or her 234 membership in the discount plan organization after the first 30 235 days allowed in paragraph (a), the discount plan organization: 236 1. Must make the cancellation effective no later than 30 237 days after receiving the member’s cancellation request; 238 2. May not make future charges to the member after the 239 cancellation has taken effect; and 240 3. Must provide the member a pro rata reimbursement of 241 periodic charges for all months after the effective date of the 242 cancellation. 243 (3) If the discountmedicalplan organization cancels a 244 membership for any reason other than nonpayment of fees by the 245 member, the discountmedicalplan organization mustshallmake a 246 pro rata reimbursement of all periodic charges to the member. 247 (4) In addition to the reimbursement of periodic charges 248 for the reasons stated in subsections (2) and (3), a discount 249medicalplan organization shall also reimburse the member for 250 any portion of a one-time processing fee that exceeds $30 per 251 year. 252 Section 7. Section 636.212, Florida Statutes, is amended to 253 read: 254 636.212 Disclosures.—A discount plan organization or 255 marketer shall provide disclosures to a prospective member 256 before his or her enrollment. A discount plan organization or 257 marketer may make disclosures in addition to those described in 258 this part. Before enrollment, a prospective member must 259 acknowledge he or she has accepted the disclosuresThe following260disclosures must be made in writing to any prospective member261and must be on the first page of any advertisements, marketing262materials, or brochures relating to a discount medical plan.The263disclosures must be printed in not less than 12-point type:264 (1) The disclosures must include: 265 (a) That the plan is not insurance. 266 (b)(2)That the plan provides discounts at certain health 267 care providers for medical services. 268 (c)(3)That the plan does not make payments directly to the 269 providers of medical services. 270 (d)(4)That the plan member is obligated to pay for all 271 health care services but will receive a discount from those 272 health care providers who have contracted with the discount plan 273 organization. 274 (e)(5)The name and address of the licensed discount 275medicalplan organization. 276 (2) Written disclosures must include the disclosures in 277 subsection (1) on the first page of any advertisement, marketing 278 material, or brochure relating to a discount plan. The first 279 page is the page that first includes the information describing 280 benefits. The disclosures must be printed in not less than 12 281 point type. 282 (3) Disclosures provided by electronic means must include 283 the disclosures in subsection (1) on any advertisement, 284 marketing material, or brochure relating to a discount plan. The 285 disclosures must be viewable in a readable font size and color. 286 (4) Disclosures made by telephone must include the 287 disclosures in subsection (1), and a written disclosure in 288 accordance with subsection (2) must also be provided with the 289 initial materials sent to the prospective or new member. 290 291If the initial contract is made by telephone, the disclosures292required by this section shall be made orally and provided in293the initial written materials that describe the benefits under294the discount medical plan provided to the prospective or new295member.296 Section 8. Section 636.214, Florida Statutes, is amended to 297 read: 298 636.214 Provider agreements.— 299 (1) All providers offering medical services to members 300 under a discountmedicalplan must provide such services 301 pursuant to a written agreement. The agreement may be entered 302 into directly by the provider or by a provider network to which 303 the provider belongs. 304 (2) A provider agreement between a discountmedicalplan 305 organization and a provider must provide the following: 306 (a) A list of the services and products to be provided at a 307 discount. 308 (b) The amount or amounts of the discounts or, 309 alternatively, a fee schedule which reflects the provider’s 310 discounted rates. 311 (c) A statement that the provider will not charge members 312 more than the discounted rates. 313 (3) A provider agreement between a discountmedicalplan 314 organization and a provider network mustshallrequire that the 315 provider network have written agreements with its providers 316 which: 317 (a) Contain the terms described in subsection (2). 318 (b) Authorize the provider network to contract with the 319 discountmedicalplan organization on behalf of the provider. 320 (c) Require the network to maintain an up-to-date list of 321 its contracted providers and to provide that list on a monthly 322 basis to the discountmedicalplan organization. 323 (4) The discountmedicalplan organization shall maintain a 324 copy of each active provider agreement into which it has 325 entered. 326 Section 9. Section 636.216, Florida Statutes, is amended to 327 read: 328 636.216 Written agreementCharge orform filings.— 329(1)All charges to members must be filed with the office330and any charge to members greater than $30 per month or $360 per331year must be approved by the office before the charges can be332used. The discount medical plan organization has the burden of333proof that the charges bear a reasonable relation to the334benefits received by the member.335(2)There must be a written agreement between the discount 336medicalplan organization and the member specifying the benefits 337 under the discountmedicalplan and complying with the 338 disclosure requirements of this part. 339(3)All forms used, includingthe written agreement340pursuant to subsection (2), must first be filed with and341approved by the office. Every form filed shall be identified by342a unique form number placed in the lower left corner of each343form.344(4) A charge or form is considered approved on the 60th day345after its date of filing unless it has been previously346disapproved by the office. The office shall disapprove any form347that does not meet the requirements of this part or that is348unreasonable, discriminatory, misleading, or unfair. If such349filings are disapproved, the office shall notify the discount350medical plan organization and shall specify in the notice the351reasons for disapproval.352 Section 10. Section 636.228, Florida Statutes, is amended 353 to read: 354 636.228 Marketing of discountmedicalplans.— 355 (1) All advertisements, marketing materials, brochures, and 356 discount cards used by marketers must be approved in writingfor357such useby the discountmedicalplan organization. 358 (2) The discountmedicalplan organization mustshallhave 359 an executed written agreement with a marketer beforeprior to360 the marketer’s marketing, promoting, selling, or distributing 361 the discountmedicalplan. Such agreement mustshallprohibit 362 the marketer from using marketing materials, brochures, and 363 discount cards without the approval in writing by the discount 364medicalplan organization. The discountmedicalplan 365 organization may delegate functions to its marketers but shall 366 be bound by any acts of its marketers, within the scope of the 367 delegation, whichmarketers’ agency, thatdo not comply withthe368provisions ofthis part. 369 Section 11. Section 636.230, Florida Statutes, is amended 370 to read: 371 636.230 Bundling discountmedicalplans with other 372 products.—A marketer or discount plan organization selling a 373 discount plan with medical services and other services may 374 commingle those products on a single page of forms, 375 advertisements, marketing materials, or brochuresWhen a376marketer or discount medical plan organization sells a discount377medical plan together with any other product, the fees for the378discount medical plan must be provided in writing to the member379if the fees exceed $30. 380 Section 12. Section 636.232, Florida Statutes, is amended 381 to read: 382 636.232 Rules.—The commission may adopt rules to administer 383 this part, including rules for the licensing of discountmedical384 plan organizations,;establishing standards for evaluating385forms, advertisements, marketing materials, brochures, and386discount cards;providing for the collection of data,;relating 387 to disclosures to plan members,;and defining terms used in this 388 part. 389 Section 13. Paragraph (b) of subsection (5) of section 390 408.9091, Florida Statutes, is amended to read: 391 408.9091 Cover Florida Health Care Access Program.— 392 (5) PLAN PROPOSALS.—The agency and the office shall 393 announce, no later than July 1, 2008, an invitation to negotiate 394 for Cover Florida plan entities to design a Cover Florida plan 395 proposal in which benefits and premiums are specified. 396 (b) The agency and the office may announce an invitation to 397 negotiate for the design of Cover Florida Plus products to 398 companies that offer supplemental insurance, discountmedical399 plan organizations licensed under part II of chapter 636, or 400 prepaid health clinics licensed under part II of chapter 641. 401 Section 14. Paragraph (d) of subsection (2) and paragraph 402 (d) of subsection (4) of section 408.910, Florida Statutes, are 403 amended to read: 404 408.910 Florida Health Choices Program.— 405 (2) DEFINITIONS.—As used in this section, the term: 406 (d) “Insurer” means an entity licensed under chapter 624 407 which offers an individual health insurance policy or a group 408 health insurance policy, a preferred provider organization as 409 defined in s. 627.6471, an exclusive provider organization as 410 defined in s. 627.6472,ora health maintenance organization 411 licensed under part I of chapter 641, or a prepaid limited 412 health service organization or discountmedicalplan 413 organization licensed under chapter 636. 414 (4) ELIGIBILITY AND PARTICIPATION.—Participation in the 415 program is voluntary and shall be available to employers, 416 individuals, vendors, and health insurance agents as specified 417 in this subsection. 418 (d) All eligible vendors who choose to participate and the 419 products and services that the vendors are permitted to sell are 420 as follows: 421 1. Insurers licensed under chapter 624 may sell health 422 insurance policies, limited benefit policies, other risk-bearing 423 coverage, and other products or services. 424 2. Health maintenance organizations licensed under part I 425 of chapter 641 may sell health maintenance contracts, limited 426 benefit policies, other risk-bearing products, and other 427 products or services. 428 3. Prepaid limited health service organizations may sell 429 products and services as authorized under part I of chapter 636, 430 and discountmedicalplan organizations may sell products and 431 services as authorized under part II of chapter 636. 432 4. Prepaid health clinic service providers licensed under 433 part II of chapter 641 may sell prepaid service contracts and 434 other arrangements for a specified amount and type of health 435 services or treatments. 436 5. Health care providers, including hospitals and other 437 licensed health facilities, health care clinics, licensed health 438 professionals, pharmacies, and other licensed health care 439 providers, may sell service contracts and arrangements for a 440 specified amount and type of health services or treatments. 441 6. Provider organizations, including service networks, 442 group practices, professional associations, and other 443 incorporated organizations of providers, may sell service 444 contracts and arrangements for a specified amount and type of 445 health services or treatments. 446 7. Corporate entities providing specific health services in 447 accordance with applicable state law may sell service contracts 448 and arrangements for a specified amount and type of health 449 services or treatments. 450 451 A vendor described in subparagraphs 3.-7. may not sell products 452 that provide risk-bearing coverage unless that vendor is 453 authorized under a certificate of authority issued by the Office 454 of Insurance Regulation and is authorized to provide coverage in 455 the relevant geographic area. Otherwise eligible vendors may be 456 excluded from participating in the program for deceptive or 457 predatory practices, financial insolvency, or failure to comply 458 with the terms of the participation agreement or other standards 459 set by the corporation. 460 Section 15. Subsection (11) of section 627.64731, Florida 461 Statutes, is amended to read: 462 627.64731 Leasing, renting, or granting access to a 463 participating provider.— 464 (11) This section does not apply to a contract between a 465 contracting entity and a discountmedicalplan organization 466 licensed or exempt under part II of chapter 636. 467 Section 16. Paragraph (c) of subsection (7) of section 468 636.003, Florida Statutes, is amended to read: 469 636.003 Definitions.—As used in this act, the term: 470 (7) “Prepaid limited health service organization” means any 471 person, corporation, partnership, or any other entity which, in 472 return for a prepayment, undertakes to provide or arrange for, 473 or provide access to, the provision of a limited health service 474 to enrollees through an exclusive panel of providers. Prepaid 475 limited health service organization does not include: 476 (c) Any person who is licensed pursuant to part II as a 477 discountmedicalplan organization. 478 Section 17. Paragraphs (c) and (d) of subsection (1) of 479 section 636.205, Florida Statutes, are amended to read: 480 636.205 Issuance of license; denial.— 481 (1) Following receipt of an application filed pursuant to 482 s. 636.204, the office shall review the application and notify 483 the applicant of any deficiencies contained therein. The office 484 shall issue a license to an applicant who has filed a completed 485 application pursuant to s. 636.204 upon payment of the fees 486 specified in s. 636.204 and upon the office being satisfied that 487 the following conditions are met: 488 (c) The ownership, control, and management of the entity 489 are competent and trustworthy and possess managerial experience 490 that would make the proposed operation beneficial to the 491 subscribers. The office mayshallnot grant or continue to grant 492 authority to transact the business of a discountmedicalplan 493 organization in this state at any time during which the office 494 has good reason to believe that the ownership, control, or 495 management of the organization includes any person whose 496 business operations are or have been marked by business 497 practices or conduct that is detrimental to the public, 498 stockholders, investors, or creditors. 499 (d) The discountmedicalplan organization has a complaint 500 procedure that will facilitate the resolution of subscriber 501 grievances and that includes both formal and informal steps 502 available within the organization. 503 Section 18. Section 636.207, Florida Statutes, is amended 504 to read: 505 636.207 Applicability of part.—Except as otherwise provided 506 in this part, discountmedicalplan organizations are governed 507 bythe provisions ofthis part and are exempt from the Florida 508 Insurance Code unless specifically referenced. 509 Section 19. Section 636.210, Florida Statutes, is amended 510 to read: 511 636.210 Prohibited activities of a discountmedicalplan 512 organization.— 513 (1) A discountmedicalplan organization may not: 514 (a) Use in its advertisements, marketing material, 515 brochures, and discount cards the term “insurance” except as 516 otherwise provided in this part or as a disclaimer of any 517 relationship between discountmedicalplan organization benefits 518 and insurance; 519 (b) Use in its advertisements, marketing material, 520 brochures, and discount cards the terms “health plan,” 521 “coverage,” “copay,” “copayments,” “preexisting conditions,” 522 “guaranteed issue,” “premium,” “PPO,” “preferred provider 523 organization,” or other terms in a manner that could reasonably 524 mislead a person into believing the discountmedicalplan was 525 health insurance; 526 (c) Have restrictions on free access to plan providers, 527 including, but not limited to, waiting periods and notification 528 periods; or 529 (d) Pay providers any fees for medical services. 530 (2) A discountmedicalplan organization may not collect or 531 accept money from a member for payment to a provider for 532 specific medical services furnished or to be furnished to the 533 member unless the organization has an active certificate of 534 authority from the office to act as an administrator. 535 Section 20. Subsection (1), paragraphs (b), (c), and (d) of 536 subsection (2), and subsection (3) of section 636.218, Florida 537 Statutes, are amended to read: 538 636.218 Annual reports.— 539 (1) Each discountmedicalplan organization shallmustfile 540 with the office, within 3 months after the end of each fiscal 541 year, an annual report. 542 (2) Such reports must be on forms prescribed by the 543 commission and must include: 544 (b) If different from the initial application or the last 545 annual report, a list of the names and residence addresses of 546 all persons responsible for the conduct of the organization’s 547 affairs, together with a disclosure of the extent and nature of 548 any contracts or arrangements between such persons and the 549 discountmedicalplan organization, including any possible 550 conflicts of interest. 551 (c) The number of discountmedicalplan members in the 552 state. 553 (d) Such other information relating to the performance of 554 the discountmedicalplan organization as is reasonably required 555 by the commission or office. 556 (3) Every discountmedicalplan organization thatwhich557 fails to file an annual report in the form and within the time 558 required by this section shall forfeit up to $500 for each day 559 for the first 10 days during which the neglect continues and 560 shall forfeit up to $1,000 for each day after the first 10 days 561 during which the neglect continues; and, upon notice by the 562 office to that effect, the organization’s authority to enroll 563 new members or to do business in this state ceases while such 564 default continues. The office shall deposit all sums collected 565 by the office under this section to the credit of the Insurance 566 Regulatory Trust Fund. The office may not collect more than 567 $50,000 for each report. 568 Section 21. Section 636.220, Florida Statutes, is amended 569 to read: 570 636.220 Minimum capital requirements.— 571 (1) Each discountmedicalplan organization shallmustat 572 all times maintain a net worth of at least $150,000. 573 (2) The office may not issue a license unless the discount 574medicalplan organization has a net worth of at least $150,000. 575 Section 22. Section 636.222, Florida Statutes, is amended 576 to read: 577 636.222 Suspension or revocation of license; suspension of 578 enrollment of new members; terms of suspension.— 579 (1) The office may suspend the authority of a discount 580medicalplan organization to enroll new members, revoke any 581 license issued to a discountmedicalplan organization, or order 582 compliance if the office finds that any of the following 583 conditions exist: 584 (a) The organization is not operating in compliance with 585 this part. 586 (b) The organization does not have the minimum net worth as 587 required by this part. 588 (c) The organization has advertised, merchandised, or 589 attempted to merchandise its services in such a manner as to 590 misrepresent its services or capacity for service or has engaged 591 in deceptive, misleading, or unfair practices with respect to 592 advertising or merchandising. 593 (d) The organization is not fulfilling its obligations as a 594medicaldiscountmedicalplan organization. 595 (e) The continued operation of the organization would be 596 hazardous to its members. 597 (2) If the office has cause to believe that grounds for the 598 suspension or revocation of a license exist, the office must 599shallnotify the discountmedicalplan organization in writing 600 specifically stating the grounds for suspension or revocation 601 and shall pursue a hearing on the matter in accordance withthe602provisions ofchapter 120. 603 (3) When the license of a discountmedicalplan 604 organization is surrendered or revoked, such organization must 605 proceed, immediately following the effective date of the order 606 of revocation, to wind up its affairs transacted under the 607 license. The organization may not engage in any further 608 advertising, solicitation, collecting of fees, or renewal of 609 contracts. 610 (4) The office shall, in its order suspending the authority 611 of a discountmedicalplan organization to enroll new members, 612 specify the period during which the suspension is to be in 613 effect and the conditions, if any, which must be met by the 614 discountmedicalplan organization beforeprior toreinstatement 615 of its license to enroll new members. The order of suspension is 616 subject to rescission or modification by further order of the 617 office beforeprior tothe expiration of the suspension period. 618 Reinstatement may not be made unless requested by the discount 619medicalplan organization; however, the office may not grant 620 reinstatement if it finds that the circumstances for which the 621 suspension occurred still exist or are likely to recur. 622 Section 23. Section 636.223, Florida Statutes, is amended 623 to read: 624 636.223 Administrative penalty.—In lieu of suspending or 625 revoking a certificate of authority whenever any discount 626medicalplan organization has been found to have violated any 627 provision of this part, the office may: 628 (1) Issue and cause to be served upon the organization 629 charged with the violation a copy of such findings and an order 630 requiring such organization to cease and desist from engaging in 631 the act or practice that constitutes the violation. 632 (2) Impose a monetary penalty of not less than $100 for 633 each violation, but not to exceed an aggregate penalty of 634 $75,000. 635 Section 24. Section 636.224, Florida Statutes, is amended 636 to read: 637 636.224 Notice of change of name or address of discount 638medicalplan organization.—Each discountmedicalplan 639 organization must provide the office at least 30 days’ advance 640 notice of any change in the discountmedicalplan organization’s 641 name, address, principal business address, or mailing address. 642 Section 25. Section 636.226, Florida Statutes, is amended 643 to read: 644 636.226 Provider name listing.—Each discountmedicalplan 645 organization must maintain on an Internet website an up-to-date 646 list of the names and addresses of the providers with which it 647 has contracted, on an Internet website page, the address of 648 which mustshallbe prominently displayed on all its 649 advertisements, marketing materials, brochures, and discount 650 cards. This section applies to those providers with whom the 651 discountmedicalplan organization has contracted directly, as 652 well as those who are members of a provider network with which 653 the discountmedicalplan organization has contracted. 654 Section 26. Section 636.234, Florida Statutes, is amended 655 to read: 656 636.234 Service of process on a discountmedicalplan 657 organization.—Sections 624.422 and 624.423 apply to a discount 658medicalplan organization as if the discountmedicalplan 659 organization were an insurer. 660 Section 27. Section 636.236, Florida Statutes, is amended 661 to read: 662 636.236 Surety bond or security deposit.— 663 (1) Each discountmedicalplan organization licensed 664 pursuant tothe provisions ofthis part shallmustmaintain in 665 force a surety bond in its own name in an amount not less than 666 $35,000 to be used at the discretion of the office to protect 667 the financial interests of members who may be adversely affected 668 by the insolvency of a discountmedicalplan organization. The 669 bond must be issued by an insurance company that is licensed to 670 do business in this state. 671 (2) In lieu of the bond specified in subsection (1), a 672 licensed discountmedicalplan organization may deposit and 673 maintain deposited in trust with the department securities 674 eligible for deposit under s. 625.52 having at all times a value 675 of not less than $35,000. If a licensed discountmedicalplan 676 organization substitutes its deposited securities under this 677 subsection with a surety bond authorized in subsection (1), such 678 deposited securities mustshallbe returned to the discount 679medicalplan organization no later than 45 days following the 680 effective date of the surety bond. 681 (3) ANojudgment creditor or other claimant of a discount 682medicalplan organization, other than the office or department, 683 does notshallhave the right to levy upon any of the assets or 684 securities held in this state as a deposit under subsections (1) 685 and (2). 686 Section 28. Subsections (2) and (3) of section 636.238, 687 Florida Statutes, are amended to read: 688 636.238 Penalties for violation of this part.— 689 (2) A person who operates as or willfully aids and abets 690 another operating as a discountmedicalplan organization in 691 violation of s. 636.204(1) commits a felony punishable as 692 provided for in s. 624.401(4)(b), as if the unlicensed discount 693medicalplan organization were an unauthorized insurer, and the 694 fees, dues, charges, or other consideration collected from the 695 members by the unlicensed discountmedicalplan organization or 696 marketer were insurance premium. 697 (3) A person who collects fees for purported membership in 698 a discountmedicalplan but purposefully fails to provide the 699 promised benefits commits a theft, punishable as provided in s. 700 812.014. 701 Section 29. Subsection (1) of section 636.240, Florida 702 Statutes, is amended to read: 703 636.240 Injunctions.— 704 (1) In addition to the penalties and other enforcement 705 provisions of this part, the office may seek both temporary and 706 permanent injunctive relief when: 707 (a) A discountmedicalplan is being operated by any person 708 or entity that is not licensed pursuant to this part. 709 (b) Any person, entity, or discountmedicalplan 710 organization has engaged in any activity prohibited by this part 711 or any rule adopted pursuant to this part. 712 Section 30. Section 636.244, Florida Statutes, is amended 713 to read: 714 636.244 Unlicensed discountmedicalplan organizations. 715 SectionsThe provisions of ss.626.901-626.912 apply to the 716 activities of an unlicensed discountmedicalplan organization 717 as if the unlicensed discountmedicalplan organization were an 718 unauthorized insurer. 719 Section 31. This act shall take effect upon becoming a law.