Florida Statutes 641.3107 – Delivery of contract; definitions
Current as of: 2023 | Check for updates
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(1) A health maintenance contract, certificate of coverage, endorsements and riders, or member handbook shall be mailed, delivered, or otherwise provided to the subscriber or, in the case of a group health maintenance contract, to the employer or other person who will hold the contract on behalf of the subscriber group, as provided in s. 627.421.
(2) As used in s. 627.421, the term:
(a) “Insurance policies and endorsements,” “policy and endorsements,” “policy,” and “policy form and endorsement form” includes the health maintenance contract, endorsement and riders, certificate of coverage, or member handbook.
Terms Used In Florida Statutes 641.3107
- Contract: A legal written agreement that becomes binding when signed.
- Health maintenance contract: means any contract entered into by a health maintenance organization with a subscriber or group of subscribers to provide coverage for comprehensive health care services in exchange for a prepaid per capita or prepaid aggregate fixed sum. See Florida Statutes 641.19
- Health maintenance organization: means any organization authorized under this part which:(a) Provides, through arrangements with other persons, emergency care, inpatient hospital services, physician care including care provided by physicians licensed under chapters 458, 459, 460, and 461, ambulatory diagnostic treatment, and preventive health care services. See Florida Statutes 641.19
- 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
- Subscriber: means an entity or individual who has contracted, or on whose behalf a contract has been entered into, with a health maintenance organization for health care coverage or other persons who also receive health care coverage as a result of the contract. See Florida Statutes 641.19
(b) “Insured” includes a subscriber or, in the case of a group health maintenance contract, the employer or other person who will hold the contract on behalf of the subscriber group.(c) “Insurer” includes a health maintenance organization.
(3) If the health maintenance organization elects to post health maintenance contracts on its Internet website in lieu of mailing or delivery to subscribers or the person who will hold the contract on behalf of a subscriber group, the health maintenance organization must comply with the requirements of s. 627.421(4). This section does not apply to the delivery of those contracts specified in s. 641.31(13).