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

Ch.641 HEALTH CARE SERVICE PROGRAMS F.S.1983
On or before January 1 of each succeeding year, unless
inapplicable, the organization shall deposit with
the department cash, securities, or any combination
of these or other measures acceptable to the department
in an amount equal to 4 percent of the preceding
12 months' uncovered expenditures or 4 percent
of its estimated annual uncovered expenditures for
the succeeding year, whichever is greater.
(b) Unless inapplicable, an organization that is in
operation on the effective date of this section shall
make a deposit equal to 1 percent of the preceding 12
months' uncovered expenditures or $100,000, whichever
is greater, on the first day of the first calendar
year beginning 6 months or more after the effective
date of this section. In the second calendar year, if
applicable, the amount of the additional deposit shall
be equal to 2 percent of its estimated annual uncovered
expenditures. In the third calendar year, if applicable,
the additional deposit shall be equal to 3
percent of its estimated annual uncovered expenditures
for that year, and in the fourth and subsequent
years, if applicable, the additional deposit shall be
equal to 4 percent of its estimated annual uncovered
expenditures for each year. Each year's estimate, after
the first year of operation, shall reasonably reflect
the prior year's operating experience and delivery arrangements.
(2) The department may waive any of the deposit
requirements set forth in subsection (1) whenever the
department is satisfied that:
(a) The organization has sufficient surplus and
an adequate history of generating net income to assure
its financial viability for the next year;
(b) The performance and obligations of the organization
are guaranteed by an organization which has
sufficient surplus and an adequate history of generating
net income; or
(c) The assets of the organization or its contracts
with insurers (hospital or medical service corporations),
governments, or other organizations are reasonably
sufficient to assure the performance of the
obligations of the organization.
(3) When an organization has achieved a surplus,
not including land, buildings, and equipment, of at
least $1 million or has achieved a surplus, including
organization-related land, buildings, and equipment,
of at least $5 million, the annual deposit requirement
does not apply. The annual deposit requirement does
not apply to an organization if the total amount of
the accumulated deposit is equal to 25 percent of its
estimated annual uncovered expenditures for the
next calendar year, or $1,500,000, whichever is less. If
the organization has a guaranteeing organization
which has been in operation for 5 years or more and
has a surplus, not including land, buildings, and
equipment, of at least $1 million, or which has been
in operation for 10 years or more and has a surplus,
including organization-related land, buildings, and
equipment, of at least $5 million, the annual deposit
requirement does not apply; however, if the guaranteeing
organization is sponsoring more than one organization,
the surplus requirement shall be increased
by a multiple equal to the number of such organizations.
This requirement to maintain a deposit in excess
of $1 million does not apply during any time that
the guaranteeing organization maintains for each or-
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ganization it sponsors a surplus at least equal to
$1,500,000.
(4) All income from deposits shall belong to the
depositing organization and shall be paid to it as it
becomes available. A health maintenance organization
that has made a securities deposit may withdraw
that deposit, or any part thereof, after making a substitute
deposit of cash, securities, or any combination
of these or other measures of equal amount and value.
Any securities shall be approved by the department.
(5) In any year in which an annual deposit is not
required of an organization, at the request of the organization
the department shall reduce the required,
previously accumulated deposit to $100,000 for each
$250,000 of surplus in excess of the amount that allows
the organization not to make the annual deposit.
If the amount of surplus no longer supports a reduction
of its required deposit, the organization shall immediately
redeposit $100,000 for each $250,000 of reduction
in surplus, provided that its total deposit
does not exceed the maximum required under this
section.
(6) The requirements of this section do not apply
to an applying or licensed health maintenance organization
which has on file with the department contracts
of insurance or reinsurance to protect subscribers
in the event the organization is unable to meet its
obligations. Each such agreement between the organization
and an insurer shall be subject to the laws of
this state regarding reinsurance. Each such agreement
and any modifications thereto must be filed
with and approved by the department. Each such
agreement shall remain in full force and effect until
replaced or for at least 90 days following written notification
to the department by registered mail of cancellation
by either party.
History.-S8. 791, 809(18t), ch. 82-243; 8. 10, ch. 83-198.
'Note.-Expires October 1, 1991, pursuant to s. 809(18t), ch. 82-243, and is
scbeduled for review pursuant to s. 11.61 in advance of that date.
1641.29 Fees.-Every health maintenance organization
shall pay to the department the following
fees:
(1) For filing a copy of its application for a certificate
of authority or amendment thereto, a nonrefundable
fee in the amount of $150.
(2) For filing each annual report, $150.
Fees charged under this section shall be distributed
as follows: one-third to the Department of Health
and Rehabilitative Services and two-thirds to the Department
of Insurance.
History.-8. 13, ch. 72-264; 8. 3, cb. 76-168; s. 1, ch. 77-457; S8. 2, 3, cb.
81-318; ... 792, 804, 809(18t), cb. 82-243.
'Note.-Expires October 1, 1991, pursuant to s. 809(18t), cb. 82-243, and is
scheduled for review pursuant to s. 11.61 in advance of that date.
1641.30 Construction and relationship to other
laws.-
(1) Every health maintenance organization and
its agents and employees shall be subject to the provisions
of part VIII of chapter 626.
(2) Except as provided in this part, the Florida
Insurance Code does not apply to health maintenance
organizations, and health maintenance organi-