Florida Statutes Part VII - Group, Blanket, And Franchise Health Insurance Policies (Ss. 627.651-627.66997)

• 627.651 - Group Contracts And Plans Of Self-insurance Must Meet Group Requirements.
  (1) Except as otherwise provided by law, a group health insurance policy or certificate insuring more than one individual delivered or issued for delivery in this...
• 627.6512 - Exemption Of Certain Group Health Insurance Policies.
  Sections 627.6561, 627.65615, 627.65625, and 627.6571 do not apply to:(1) Any group insurance policy in relation to its provision of excepted benefits described in s. 627.6561(5)(b).(2) Any...
• 627.6513 - Scope.
  Section 641.312 and the provisions of the Employee Retirement Income Security Act of 1974, as implemented by 29 C.F.R. s. 2560.503-1, relating to internal grievances,...
• 627.6515 - Out-of-state Groups.
  (1) Any group health insurance policy issued or delivered outside this state under which a resident of this state is provided coverage shall comply with the...
• 627.6516 - Trustee Groups.
  A group of employees of employers or members of labor unions may be insured for the benefit of persons other than the employers or unions...
• 627.652 - Group Health Insurance; Definitions.
  As used in this part:(1) Group health insurance is that form of health insurance covering groups of persons under a master group health insurance policy issued...
• 627.653 - Employee Groups.
  (1)(a) A group of individual employees of an employer, or employees and their dependents, may be insured, for the benefit of persons other than the employer,...
• 627.654 - Labor Union, Association, And Small Employer Health Alliance Groups.
  (1)(a) A group of individuals may be insured under a policy issued to an association, including a labor union, which association has a constitution and bylaws...
• 627.655 - Debtor Groups.
  A group of individual debtors of a creditor may be insured under a policy issued to a creditor under which the debtors are indemnified in...
• 627.6551 - Teacher And Student Groups.
  A group of teachers or students of an institution of learning may be insured under a policy issued by an insurer authorized under chapter 624...
• 627.656 - Additional Groups.
  (1) A group of individuals, other than the groups defined in s. 627.556, may be insured under a policy issued to any person or organization to...
• 627.6561 - Preexisting Conditions.
  (1) As used in this section, the term:(a) “Enrollment date” means, with respect to an individual covered under a group health policy, the date of enrollment of...
• 627.65615 - Special Enrollment Periods.
  (1) An insurer that issues a group health insurance policy shall permit an employee who is eligible, but not enrolled, for coverage under the terms of...
• 627.6562 - Dependent Coverage.
  (1) If an insurer offers coverage under a group, blanket, or franchise health insurance policy that insures dependent children of the policyholder or certificateholder, the policy...
• 627.65625 - Prohibiting Discrimination Against Individual Participants And Beneficiaries Based On Health Status.
  (1) Subject to subsection (2), an insurer that offers a group health insurance policy may not establish rules for eligibility, including continued eligibility, of an individual...
• 627.65626 - Insurance Rebates For Healthy Lifestyles.
  (1) Any rate, rating schedule, or rating manual for a health insurance policy that provides creditable coverage as defined in s. 627.6561(5) filed with the office...
• 627.6563 - Full-time Employment Defined.
  Upon the request of the policyholder, a group, blanket, or franchise health insurance policy issued or delivered in this state that provides coverage to an...
• 627.657 - Provisions Of Group Health Insurance Policies.
  (1) Each group health insurance policy shall contain in substance the following provisions:(a) A provision that, in the absence of fraud, all statements made by applicants or...
• 627.6571 - Guaranteed Renewability Of Coverage.
  (1) Except as otherwise provided in this section, an insurer that issues a group health insurance policy must renew or continue in force such coverage at...
• 627.65735 - Nondiscrimination Of Coverage For Surgical Procedures.
  No group, franchise, or blanket health insurance contract or policy which provides coverage on a group or individual basis for any diagnostic or surgical procedure...
• 627.6574 - Maternity Care.
  (1) Any group, blanket, or franchise policy of health insurance that provides coverage for maternity care must also cover the services of certified nurse-midwives and midwives...
• 627.65745 - Diabetes Treatment Services.
  (1) A health insurance policy or group health insurance policy sold in this state, including a health benefit plan issued pursuant to s. 627.6699, must provide...
• 627.6575 - Coverage For Newborn Children.
  (1) Any group, blanket, or franchise health insurance policy providing coverage on an expense-incurred basis that provides coverage for a family member of the certificateholder or...
• 627.65755 - Dental Procedures; Anesthesia And Hospitalization Coverage.
  For purposes of this section, dental treatment or surgery shall be considered necessary when the dental condition is likely to result in a medical condition...
• 627.6577 - Dental Care.
  (1) Any employer, group, or organization that pays or contributes to the premium of a group health insurance plan or dental service plan corporation which provides...
• 627.6578 - Coverage For Natural-born, Adopted, And Foster Children; Children In Insured’s Custodial Care.
  (1) A group, blanket, or franchise health insurance policy that provides coverage for a family member of the certificateholder or subscriber shall, as to such family...
• 627.6579 - Coverage For Child Health Supervision Services.
  (1) All group, blanket, or franchise health insurance policies providing coverage on an expense-incurred basis which provide coverage for a family member of the certificateholder or...
• 627.658 - Use Of Dividends, Refunds, Rate Reductions, Commissions, Service Fees; Premium Rates.
  (1) Section 627.569 also applies to group health insurance policies.(2) An insurer may issue a group health insurance policy at a premium rate less than the usual...
• 627.659 - Blanket Health Insurance; Eligible Groups.
  Blanket health insurance is that form of health insurance which covers special groups of individuals as enumerated in one of the following subsections:(1) Under a policy...
• 627.660 - Conditions And Provisions Of Blanket Health Insurance Policies.
  (1) An individual application shall not be required from a person covered under a blanket health insurance policy or contract, nor shall it be necessary for...
• 627.661 - School Accident Insurance Claims; Policy Service.
  An insurer issuing a school accident policy referred to in s. 627.659(3) shall maintain an office or offices in this state for the processing and...
• 627.6612 - Coverage For Surgical Procedures And Devices Incident To Mastectomy.
  (1) Any group, blanket, or franchise accident or health insurance policy that provides coverage for mastectomies must also provide coverage for prosthetic devices and breast reconstructive...
• 627.66121 - Coverage For Length Of Stay And Outpatient Postsurgical Care.
  (1) Any group, blanket, or franchise accident or health insurance policy that is issued, amended, delivered, or renewed in this state which provides coverage for breast...
• 627.66122 - Requirements With Respect To Breast Cancer And Routine Followup Care.
  Routine followup care to determine whether a breast cancer has recurred in a person who has been previously determined to be free of breast cancer...
• 627.6613 - Coverage For Mammograms.
  (1) A group, blanket, or franchise accident or health insurance policy issued, amended, delivered, or renewed in this state must provide coverage for at least the...
• 627.6615 - Children With Disabilities; Continuation Of Coverage Under Group Policy.
  (1) A group health insurance policy or health care services plan contract that is delivered or issued for delivery in this state and that provides that...
• 627.6616 - Coverage For Ambulatory Surgical Center Service.
  No group health insurance policy providing coverage on an expense-incurred basis, or group service or indemnity-type contract issued by a nonprofit corporation, or self-insured group...
• 627.6617 - Coverage For Home Health Care Services.
  (1) Any group health insurance policy providing coverage on an expense-incurred basis shall provide coverage for home health care by a home health care agency licensed...
• 627.6618 - Payment Of Acupuncture Benefits To Certified Acupuncturists.
  Any policy of group health insurance that provides coverage for acupuncture shall cover the services of an acupuncturist certified pursuant to chapter 457 under the...
• 627.6619 - Massage.
  Any policy of health insurance that provides coverage for massage shall also cover the services of persons licensed to practice massage pursuant to chapter 480,...
• 627.662 - Other Provisions Applicable.
  The following provisions apply to group health insurance, blanket health insurance, and franchise health insurance:(1) Section 627.569, relating to use of dividends, refunds, rate reductions, commissions,...
• 627.663 - Franchise Health Insurance.
  (1) “Franchise health insurance,” also known as “franchise group insurance,” is that form of health insurance issued to:(a) Two or more employees of any corporation, professional association,...
• 627.664 - Assignment Of Incidents Of Ownership In Group, Blanket, Or Franchise Health Policies.
  (1) No provision of the insurance code or any other law shall be construed to prohibit an insured under any group, blanket, or franchise health insurance...
• 627.6645 - Notification Of Cancellation, Expiration, Nonrenewal, Or Change In Rates.
  (1) Every insurer delivering or issuing for delivery a group health insurance policy under the provisions of this part shall give the policyholder at least 45...
• 627.6646 - Cancellation Or Nonrenewal Prohibited.
  Notwithstanding any other provision of law to the contrary, no insurer shall cancel or nonrenew the health insurance policy of any insured because of diagnosis...
• 627.6647 - Release Of Claims Experience.
  (1) Any insurer issuing or delivering group health insurance policies in this state must provide to a policyholder, within 21 days after a written request, information...
• 627.6651 - Replacement Or Termination Of Group, Blanket, Or Franchise Health Policy Or Contract; Liability Of Prior Insurer.
  When a purchaser of insurance terminates or replaces an existing group, blanket, or franchise health insurance policy or contract with another such policy, the prior...
• 627.666 - Liability Of Succeeding Insurer On Replacement Of Group, Blanket, Or Franchise Health Insurance Policy.
  Upon replacement of a group, blanket, or franchise health insurance policy:(1) Each person who was covered by the prior insurer must be covered by the succeeding...
• 627.667 - Extension Of Benefits.
  (1) Each group, blanket, or franchise policy or contract renewed, delivered, or issued for delivery in this state shall contain a reasonable provision for extension of...
• 627.6675 - Conversion On Termination Of Eligibility.
  Subject to all of the provisions of this section, a group policy delivered or issued for delivery in this state by an insurer or nonprofit...
• 627.668 - Optional Coverage For Mental And Nervous Disorders Required; Exception.
  (1) Every insurer, health maintenance organization, and nonprofit hospital and medical service plan corporation transacting group health insurance or providing prepaid health care in this state...
• 627.6686 - Coverage For Individuals With Autism Spectrum Disorder Required; Exception.
  (1) This section and s. 641.31098 may be cited as the “Steven A. Geller Autism Coverage Act.”(2) As used in this section, the term:(a) “Applied behavior analysis” means...
• 627.669 - Optional Coverage Required For Substance Abuse Impaired Persons; Exception.
  (1) Insurers, health maintenance organizations, and nonprofit health care services plans transacting group health insurance or providing prepaid health care in this state shall make available...
• 627.6691 - Coverage For Osteoporosis Screening, Diagnosis, Treatment, And Management.
  Any group, blanket, or franchise health insurance policy that covers a resident of this state and that is issued, amended, delivered, or renewed in this...
• 627.66911 - Required Coverage For Cleft Lip And Cleft Palate.
  A health insurance policy that covers a child under the age of 18 must provide coverage for treatment of cleft lip and cleft palate for...
• 627.6692 - Florida Health Insurance Coverage Continuation Act.
  (1) SHORT TITLE.—This section may be cited as the “Florida Health Insurance Coverage Continuation Act.”(2) PURPOSE AND INTENT.—The purpose and intent of this section is to ensure...
• 627.6698 - Attorney’s Fees.
  (1) Upon the rendition of a judgment by any of the courts of this state against an insurer and in favor of any resident of this...
• 627.6699 - Employee Health Care Access Act.
  (1) SHORT TITLE.—This section may be cited as the “Employee Health Care Access Act.”(2) PURPOSE AND INTENT.—The purpose and intent of this section is to promote the...
• 627.66996 - Restrictions On Use Of State And Federal Funds For State Exchanges.
  (1) A group, franchise, or blanket health insurance policy under which coverage is purchased in whole or in part with any state or federal funds through...
• 627.66997 - Stop-loss Insurance.
  (1) A self-insured health benefit plan established or maintained by a small employer, as defined in s. 627.6699(3)(v), is exempt from s. 627.6699 and may use...

Last modified: September 23, 2016