Terms Used In Florida Statutes 631.821
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Board: means the board of directors of the plan. See Florida Statutes 631.814
- HMO: means a health maintenance organization possessing a valid certificate of authority issued by the office pursuant to part I of chapter 641. See Florida Statutes 631.814
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- Plan: means the Florida Health Maintenance Organization Consumer Assistance Plan created by this part. See Florida Statutes 631.814
- Subscriber: means any resident of this state who is enrolled for benefits provided by an HMO and who makes premium payments or for whom premium payments are made. See Florida Statutes 631.814
(1) The office may suspend or revoke, after notice and hearing, the certificate of authority of a member HMO that fails to pay an assessment when due, fails to comply with the approved plan of operation of the plan, or fails either to timely comply with or to timely appeal pursuant to subsection (2) its appointment.
(2) Any action of the board of directors of the plan may be appealed to the office by any member HMO if such appeal is taken within 21 days of the action being appealed; however, the HMO must comply with such action pending exhaustion of appeal. Any appeal shall be promptly determined by the office, and final action or order of the office shall be subject to judicial review in a court of competent jurisdiction.
(3) The department may require that the plan notify the subscriber of the insolvent HMO and any other interested parties of the determination of insolvency and of their rights under this part. Such notification shall be by mail at their last known addresses, when available, but if sufficient information for notification by mail is not available, notice by publication in a newspaper of general circulation shall be sufficient.
(4) The office may revoke the designation of any servicing facility or administrator if it finds claims are being handled unsatisfactorily.