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

Ch.641 HEALTH CARE SERVICE PROGRAMS F.S.1983
the ownership, control, or management of the organization
is under the control of any person whose business
operations are or have been marked by business
practices or conduct that is to the detriment of the
public, stockholders, investors, or creditors; by the
improper manipulation of assets or of accounts; or by
bad faith.
(10) The entity has a blanket fidelity bond in the
amount of $25,000, issued by a licensed insurance
carrier in this state, that will reimburse the entity in
the event that anyone handling the funds of the entity
either misappropriates or absconds with such
funds. All employees handling such funds shall be
covered by the blanket fidelity bond. An agent licensed
under the provisions of the Florida Insurance
Code may either directly or indirectly represent the
health maintenance organization in the solicitation,
negotiation, effectuation, procurement, receipt, delivery,
or forwarding of any health maintenance organization
subscriber's contract or collect or forward any
consideration paid by the subscriber to the health
maintenance organization; and such agent shall not
be required to post the bond required by this subsection.
(11) The entity has filed with the department,
and obtained approval from the department of, all
reinsurance contracts as provided in s. 641.285.
Hi.tory.-s. 6, ch. 72-264; s. 3, ch. 76-168; s. I, ch. 77-457; ss. 2, 3, ch. 81-318;
ss. 783, 804, 809(1st), ch. 82-243; s. 3, ch. 83-198.
'Note.-Expires Octoher 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.
cf.- s. 768.41 Internal risk management program; establishment required.
641.225 Surplus requirements.-
(1) Each health maintenance organization licensed
before October 1, 1983, must have by December
31, 1985, a minimum surplus of $100,000. After
December 31, 1985, each health maintenance organization
must have a minimum surplus as follows:
(a) As of December 31, 1986, $150,000.
(b) As of December 31, 1987, $200,000.
(c) As of December 31, 1988, $250,000.
(2) In lieu of having a minimum surplus, there
may exist for a health maintenance organization a
written guarantee of the type and subject to the same
provisions as outlined in s. 641.22.
Hi.tory.-s. 4, ch. 83-198.
'641.23 Revocation of certificate of authority.-The
department may revoke any certificate issued
to a health maintenance organization, or order
compliance within 60 days, if it finds that any of the
following conditions exists:
(1) The organization is not operating in compliance
with this part;
(2) The organization is in substantial violation of
its health maintenance contracts, as certified by the
Department of Health and Rehabilitative Services;
(3) The organization is unable to fulfill its obligations
under outstanding health maintenance contracts
entered into with its subscribers, as certified
by the Department of Health and Rehabilitative Services;
(4) The plan is no longer actuarially sound or the
organization does not have the minimum surplus as
required by this part;
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(5) The existing contract rates are excessive, inadequate,
or unfairly discriminatory;
(6) The organization has advertised, merchandised,
or attempted to merchandise its services in
such a manner as to misrepresent its services or capacity
for service or has engaged in deceptive, misleading,
or unfair practices with respect to advertising
or merchandising; or
(7) The organization is insolvent.
Hi.tory.-s. 7, ch. 72-264; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318;
ss. 764, 804, 809(lst), ch. 82-243; s. 5, ch. 83-198.
'N ote.-Expires Octoher 1, 1991, pursuant to s. 809(lot), ch. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
'641.24 Denial and revocation proceedings;
Department of Health and Rehabilitative Services
participation.-The Department of Health
and Rehabilitative Services shall participate in any
proceedings for denial or revocation of a certificate.
In connection with any decision regarding denial or
revocation of a certificate, the recommendations and
findings of the Department of Health and Rehabilitative
Services with respect to matters relating to the
quality and nature of health care services being provided
shall be conclusive and binding upon the department.
Bi.tory.-s. 8, ch. 72-264; s. 3, ch. 76-168; s. 1, ch. 77-457; s. 21, ch. 78-95; ss.
2, 3, ch. 81-318; ss. 785, 804, 809(1st), ch. 82-243.
'Note.-Expires October 1, 1991, pursuant to s. 809(lst), ch. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
1641.25 Administrative penalty in lieu of
revocation.-The department may, in lieu of revocation,
levy an administrative penalty in an amount
not less than $100 or more than $10,000.
Hi.tory.-s. 9, ch. 72-264; s. 3, ch. 76-168; s. 1, ch. 77-457; s. 21, ch. 78-95; ss.
2, 3, ch. 81-318; ss. 786, 804, 809(1st), ch. 82-243; s. 6, ch. 83-198.
'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.
1641.255 Transfer of ownership.-Each
health maintenance organization which desires to
transfer ownership of more than 10 percent of the
stock or ownership interest in the health maintenance
organization shall submit to the department an
application for approval of the new stockholder or
owner. The application shall contain the name and
address of the applicant or applicants and such other
information as required by the department. The application
shall be filed with the department no later
than 60 days prior to the effective date of the transfer
of ownership.
Bi.tory.- ss. 787, 809(1st), ch. 82-243.
'Note.-Expires Octoher 1, 1991, pursuant to s. 809(1st), ch. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
1641.26 Annual report.-
(1) Every health maintenance organization shall,
annually on or before April 1, or within 3 months of
the end of the fiscal year for a health maintenance organization
operating under a valid certificate of authority
as of the effective date of this section, or within
such extension of time therefor as the department,
for good cause, may grant, on forms prescribed by the
department, file a report with the department, verified
by the oath of two executive officers of the organization,
or, if not a corporation, of two persons who
are principal managing directors of the affairs of the
organization, showing its condition on the last day of