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The Florida Statutes

The 2003 Florida Statutes

Chapter 627
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Section 627.9175, Florida Statutes 2003

627.9175  Reports of information on health insurance.--

(1)  Each health insurer shall submit annually to the office as to policies of individual health insurance:

(a)  A summary of typical benefits, exclusions, and limitations for each type of individual policy form currently being issued in the state. The summary shall include, as appropriate:

1.  The deductible amount;

2.  The coinsurance percentage;

3.  The out-of-pocket maximum;

4.  Outpatient benefits;

5.  Inpatient benefits; and

6.  Any exclusions for preexisting conditions.

The commission shall determine other appropriate benefits, exclusions, and limitations to be reported for inclusion in the consumer's guide published pursuant to this section.

(b)  A schedule of rates for each type of individual policy form reflecting typical variations by age, sex, region of the state, or any other applicable factor which is in use and is determined to be appropriate for inclusion by the commission.

The commission shall provide by rule a uniform format for the submission of this information in order to allow for meaningful comparisons of premiums charged for comparable benefits. The office shall provide this information to the department, which shall publish annually a consumer's guide which summarizes and compares the information required to be reported under this subsection.

(2)(a)  Every insurer transacting health insurance in this state shall report annually to the office, not later than April 1, information relating to any measure the insurer has implemented or proposes to implement during the next calendar year for the purpose of containing health insurance costs or cost increases. The reports shall identify each measure and the forms to which the measure is applied, shall provide an explanation as to how the measure is used, and shall provide an estimate of the cost effect of the measure.

(b)  The commission shall promulgate forms to be used by insurers in reporting information pursuant to this subsection and shall utilize such forms to analyze the effects of health care cost containment programs used by health insurers in this state.

(c)  The office shall analyze the data reported under this subsection and shall annually make available to the department which shall provide to the public a summary of its findings as to the types of cost containment measures reported and the estimated effect of these measures.

History.--ss. 28, 31, ch. 84-35; ss. 8, 10, ch. 84-235; s. 36, ch. 88-166; s. 36, ch. 88-394; s. 114, ch. 92-318; s. 1233, ch. 2003-261.

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