Florida Statutes 1983, Volume 3 - Florida State University College of ...

Ch.641 HEALTH CARE SERVICE PROGRAMS F.S.1983
641.01
641.02
641.03
641.04
641.05
641.06
641.08
641.12
641.13
641.14
CHAPTER 641
HEALTH CARE SERVICE PROGRAMS
PART I HEALTH CARE SERVICES PLANS (ss. 641.01-641.14)
PART II HEALTH MAINTENANCE ORGANIZATIONS (ss. 641.17-641.38)
PART I
HEALTH CARE
SERVICES PLANS
Definition and scope.
Incorporation.
Contracts.
Certificate of authority.
Amendments to charter, bylaws, contracts,
rates; approval by department.
Annual reports or statements.
Acquisition costs.
Revocation of license.
Licenses and taxes.
Regulation of employees or representatives.
1641.01 Definition and scope.-Any five or
more persons may form a corporation for the purpose
of establishing, maintaining, and operating a nonprofit
health care services plan in the state, whereby
medical, surgical, hospital, or other health care services
related to the treatment or prevention of sickness
or injury may be provided by the corporation or
by physicians, surgeons, hospitals, or other providers
of such services to members of the public who become
subscribers under a contract with the corporation.
The plan shall be governed by the provisions of
the laws of this state regarding health insurance and
health insurers; and the department shall have all
powers pertaining to such plan as it possesses as to
health insurance and health insurers, except as otherwise
provided by this chapter. Health maintenance
organizations shall organize under and be subject to
part II of this chapter.
History.-s. I, ch. 22826, 1945; s. I, ch. 25394, 1949; s. I, ch. 69·92; 88. 13, 35,
ch. 69·106; s. 24, ch. 72·264; s. 3, ch. 76·168; s. I, ch. 77-457; ss. 2, 3, ch. 81 -318;
88. 759, 777, 809(lst), ch. 82-243.
'Note.-Expires October I, 1991, pursuant to s. 809(lst), ch. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
1641.02 Incorporation.-
(1) Any health care services plan shall be incorporated
under chapter 617; and every charter or certificate
of incorporation of the plan shall be subject
to the approval of the department, and its approval
shall be endorsed thereon.
(2) The directors of every health care services
plan shall include members of the general public,
physicians contracting with the plan, and administrators
or trustees of hospitals contracting with the plan.
At least a majority of the directors of every such plan
shall be representatives of the general public and not
of the health or insurance industries.
History.-s. 2, ch. 22826, 1945; 88. 13,35, ch. 69-106; s. 3, ch. 76-168; s. I, ch.
77-457; 88. 2, 3, ch. 81-318; 88. 760, 777, 809(lst), ch. 82-243.
'Note.-Expires October I, 1991, pursuant to s. 809(lst), ch. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
764
1641.03 Contracts.-
(1) Any health care services plan may contract
with licensed physicians, hospitals, and other health
care providers to render service to, or accept payment
on behalf of, its subscribers. Such contracts and
amendments thereto shall be filed with the department.
(2) The rates charged by a health care services
plan to the subscribers for medical, surgical, hospital,
or other health care services shall at all times be subject
to the approval of the department. All rates of
payments made by a health care services plan pursuant
to the contracts provided for in subsection (1)
shall be approved by the department.
HI.tory.-s. 3, ch. 22826, 1945; 88. 13,35, ch. 69-106; s. 3, ch. 76-168; s. I, ch.
77-457; 88. 2, 3, ch. 81-318; 88. 716, 777, 809(1st), ch. 82-243.
'Note.-Expires October I, 1991, pursuant to s. 809(lst), ch. 82-243, and i8
scheduled for review pursuant to 8. 11.61 in advance of that date.
1641.04 Certificate of authority.-
(1) No health care services plan shall issue contracts
to subscribers until the department has, by
formal certificate of authority, authorized it to do so.
Application for a certificate shall be niade on forms
supplied by the department, containing such information
as it deems necessary.
(2) Each application for such certificate, as a part
thereof, sha1I be accompanied by copies of the following
documents, duly certified to by at least two of the
executive officers of the plan:
(a) Charter or certificate of incorporation, with
all amendments thereto.
(b) Bylaws with all amendments thereto.
(c) Proposed contracts between the plan and any
party for the provision of, or the payment in whole or
in part for, hQspital, medical, surgical, or other health
care services provided the subscribers.
(d) Proposed contracts to be issued to subscribers
to the plan showing the benefits to which they are entitled,
together with a table of the rates to be charged
to subscribers for each form of contract.
(e) Financial statement of the plan which shall
include the amounts of each contribution paid or
agreed to be paid to the plan for working capital, the
name or names of each contributor, and the terms of
each contribution.
(3) The department shall issue a certificate to
each applicant upon the payment of the fees provided
for in s. 624.501 and upon being satisfied as to the
following:
(a) That the applicant has been organized bona
fide for the purpose of establishing, maintaining, and
operating a nonprofit health care services plan.
(b) That each contract executed or proposed to
be executed by the applicant and the physician, hospital,
or other health care service provider obligates,
or will when executed obligate, each physician, hospi-