(Health) 8 - Florida Laws And Rules Pertinent To Insurance

Chief Financial Officer The Chief Financial Officer oversees the Bureau of Unclaimed Property.

offering different terms of coverage for different policyowners having the same risk classification Providing different terms of coverage for different policyowners in the same risk classification would be an example of unfair discrimination.

is a company that was formed under the laws of another state In Florida, a foreign insurance company is a company that is formed under the laws of a state other than Florida.

Suitability form Every agent soliciting Medicare Supplements must provide a suitability form.

Twenty Written notice of a claim must be given to the insurer within 20 days.

24 A newly licensed agent must complete 24 hours of continuing education every 2 years.

domestic A domestic insurance company is domiciled and incorporated under the laws of the state in which its home office is located.

At the moment of birth A Group Health policy is required to provide coverage for a newborn child at the moment of birth.

Insurance A Multiple Employer Welfare Arrangement (MEWA) provides insurance benefits.

0% Most noncontributory group health plans require 100% participation by eligible members. Under Florida law, there is no specific minimum percentage participation for employees covered by employee group health insurance.

Moody's corporate bond index Adjustable rates for life insurance policy loans in Florida are based on Moody's corporate bond index.

2 years The maximum contestability period for most life insurance policies is 2 years.

an agent making a material misrepresentation to the insured Making a material misrepresentation to an insured is considered to be an unfair trade practice.

Pay monetary restitution to the client The Department of Financial Services may order the agent to pay monetary restitution to the client.

An existing policyholder purchases an additional policy from the same insurer Florida's Replacement Rule applies to all of these situations EXCEPT "An existing policyholder purchases an additional policy from the same insurer".

Department of Financial Services; and Securities Exchange Commission Variable annuities are regulated by both the Department of Financial Services and the Securities Exchange Commission.

the policyowner The replacement of existing life insurance policies with new contracts of life insurance requires a written Comparison and Summary Statement at the policyowner's request.

Automatic Premium Loan Option An automatic premium loan is not considered a Nonforfeiture Option.

to an individual policy for a stated period of time In Florida, Group Life policies must contain a conversion privilege that allows for conversion to an individual policy for a specified period of time.

10 days In Florida, monthly-premium health insurance policies must provide a grace period of at least 10 days.

to an individual policy upon employment termination When an employee covered on a Group Life policy leaves the group, the conversion privilege gives the employee the right to convert to an individual policy upon termination of employment.

Limitation on pre-existing conditions for up to 12 months There is only a 6-month limitation on pre-existing conditions for Medicare Supplements.

A portion of the premium Families with children covered by the Florida Healthy Kids Corporation program pay only a portion of the premium.

policyowner can make the premium payment during the grace period If a policyowner does not pay the premium by the due date, the premium may be paid during the grace period.

Full-time employees after the probationary period All of these employees may be excluded from a group life plan except for "Full time employees after the probationary period".

foreign company An insurance company that is domiciled in New Jersey and licensed to conduct business in Florida is referred to in Florida as a foreign company.

date of delivery In Florida, the free-look period for life insurance contracts is 14 days from policy delivery.

alien An insurance company that is organized or chartered in a country other than the United States is defined as alien.

18 months Florida requires that newborn coverage begins "from the moment of birth" and continues for eighteen (18) months.

$25 An agent is allowed to give advertising gifts to a prospective customer, provided they do not exceed $25.

the possible tax ramifications as a result of the transaction An agent must disclose the possible tax consequences of replacing or exchanging an existing annuity or life insurance policy.

offered to all insureds in the same actuarial class Rebating is allowed in Florida if the agent rebates insureds in the same actuarial class.

Florida Replacement Rule The Florida Replacement Rule sets forth the requirements and procedures to be followed by insurance companies and producers when replacing existing life insurance contracts.

Only if the agent-in-charge is present when insurance activity occurs Multiple locations are allowed as long as the agent-in-charge is present when insurance activity occurs.

Coercion Coercion is considered an unfair trade practice under Florida law.

failing to effectuate prompt, fair, and equitable settlements of a claim Failing to effectuate prompt, fair, and equitable settlements of claims is considered to be an unfair claims practice.

Misrepresentation Making a fraudulent statement on an insurance application would be considered an act of misrepresentation.

only if the child is incapable of employment and chiefly dependent on the policyowner Coverage may be extended if the handicapped child is incapable of employment and chiefly dependent on the policyowner.

Performing insurance transactions without a license A hearing may be conducted if anyone is suspected of engaging in the business of insurance without a license.

twisting Twisting is knowingly making misleading statements that would cause an insured to lapse, assign, or terminate an insurance policy in order to switch companies.