Florida Statutes 636.210 – Prohibited activities of a discount plan organization
Current as of: 2023 | Check for updates
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(1) A discount plan organization may not:
(a) Use in its advertisements, marketing material, brochures, and discount cards the term “insurance” except as otherwise provided in this part or as a disclaimer of any relationship between discount plan organization benefits and insurance;
Terms Used In Florida Statutes 636.210
- Discount plan: means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Florida Statutes 636.202
- Discount plan organization: means an entity that, in exchange for fees, dues, charges, or other consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Florida Statutes 636.202
- Medical services: means any care, service, or treatment of illness or dysfunction of, or injury to, the human body, including, but not limited to, physician care, inpatient care, hospital surgical services, emergency services, ambulance services, dental care services, vision care services, mental health services, substance abuse services, chiropractic services, podiatric care services, laboratory services, and medical equipment and supplies. See Florida Statutes 636.202
- Member: means any person who pays fees, dues, charges, or other consideration for the right to receive the purported benefits of a discount plan. See Florida Statutes 636.202
- person: includes individuals, children, firms, associations, joint adventures, partnerships, estates, trusts, business trusts, syndicates, fiduciaries, corporations, and all other groups or combinations. See Florida Statutes 1.01
- Provider: means any person or institution that is contracted, directly or indirectly, with a discount plan organization to provide medical services to members. See Florida Statutes 636.202
(b) Use in its advertisements, marketing material, brochures, and discount cards the terms “health plan,” “coverage,” “copay,” “copayments,” “preexisting conditions,” “guaranteed issue,” “premium,” “PPO,” “preferred provider organization,” or other terms in a manner that could reasonably mislead a person into believing the discount plan was health insurance;
(c) Have restrictions on free access to plan providers, including, but not limited to, waiting periods and notification periods; or
(d) Pay providers any fees for medical services.
(2) A discount plan organization may not collect or accept money from a member for payment to a provider for specific medical services furnished or to be furnished to the member unless the organization has an active certificate of authority from the office to act as an administrator.