The Florida Office of Insurance Regulation Amends the Application for Certificate of Authority for Health Maintenance Organizations

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Akerman LLP - Health Law Rx

Applicants for a health maintenance organization (HMO) certificate of authority (COA) in Florida must use a new application form effective January 28, 2024. After rule development by the Florida Office of Insurance Regulation, the Florida Department of Financial Services adopted amendments to Rule 69O-C1-942, F.A.C. The amendment incorporates changes to the Florida HMO COA application (Form OIR-C1-942). The prior version of the application includes the revision number “REV 5/22″ below the form number in the lower left corner of the application. The revised version will have revision number “Rev.: 07/23.”

Most of the revisions to the license application are for clarification purposes only and are not very substantive. However, there are a few clarifications about which applicants should be aware. For example:

  • Section II of the application requires the submission of the applicant’s bylaws.  In the prior version of the application, the submitted bylaws were required to be accompanied by a board resolution signed and dated by the secretary of the applicant. The new version only requires that the bylaws be certified by the applicant’s secretary.
  • Section II-5 of the revised version of the application requires that, if the applicant will use a fictitious name, it must provide documentation that it complies with the fictitious name statutory requirements (e.g., registration with the Florida Division of Corporations).

Effective January 28, if an entity submits an HMO application, it should ensure that the application has the following information in the lower left corner of the application:

OIR-C1-942

Rev.: 07/23

Rule: 69O-191.027

A copy of the current form of the application is available here. However, on or after January 28, 2024, we expect the Office of Insurance Regulation will have the new version of the application available through that link. In the meantime, the new version is available here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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