Florida Regulations 69O-149.044: Forms
Current as of: 2024 | Check for updates
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(1) The following forms are hereby adopted and incorporated by reference:
(a) OIR-B2-1117, Rev. 1/05, Florida Employee Health Care Access Act Enrollment Report.
(b) OIR-B2-1093, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Become a Risk Assuming Carrier or a Reinsuring Carrier, as Required by Florida Statutes § 627.6475(5)
(c) OIR-B2-1095, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Modify Previous Election to Become a Risk Assuming or a Reinsuring Carrier, as Required by Florida Statutes § 627.6699(9)
(d) OIR-B2-1575, Rev. 10/03, Small Employer Group Underwriting Experience Report Form.
(2)(a) Copies of forms are available and may be printed from the Office’s website: http://www.floir.com/iportal.
(b) Filings shall be submitted electronically through http://www.floir.com/iportal.
Rulemaking Authority 624.308(1), 626.9641, 627.6699(16) FS. Law Implemented 626.9541, 627.401, 627.410, 627.411, 627.6699 FS. History-New 8-4-02, Formerly 4-149.044, Amended 5-18-04, 9-15-05.
(a) OIR-B2-1117, Rev. 1/05, Florida Employee Health Care Access Act Enrollment Report.
(b) OIR-B2-1093, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Become a Risk Assuming Carrier or a Reinsuring Carrier, as Required by Florida Statutes § 627.6475(5)
(c) OIR-B2-1095, Rev. 5/02, State of Florida/Small Employer Carrier’s Application to Modify Previous Election to Become a Risk Assuming or a Reinsuring Carrier, as Required by Florida Statutes § 627.6699(9)
(d) OIR-B2-1575, Rev. 10/03, Small Employer Group Underwriting Experience Report Form.
(2)(a) Copies of forms are available and may be printed from the Office’s website: http://www.floir.com/iportal.
(b) Filings shall be submitted electronically through http://www.floir.com/iportal.
Rulemaking Authority 624.308(1), 626.9641, 627.6699(16) FS. Law Implemented 626.9541, 627.401, 627.410, 627.411, 627.6699 FS. History-New 8-4-02, Formerly 4-149.044, Amended 5-18-04, 9-15-05.