Department Communication

 

The Communications Director manages the Department of Communications. The Insurance Commissioner appointed Florida’s Communications Director in March 2014. According to the Insurance Commissioner, the department’s Director (aka “Commissioner”) of Communications is responsible for: “… the day-to-day activities of the communications business unit. He will serve as the key spokesperson for the OIR, and advise on overall communication strategies.” [Source: OIR Press Release]

 

The CFO and Insurance Commissioner are proponents of transparency for its citizens. Managing communications and making them public (as appropriate) enforces the transparency process. The Newsroom on the floir.com/office/newsroom.aspx website makes the Director available, provides access to OIR actions, and ensures related news is current. Citizens are invited to follow them @FLOIR_comm on Twitter© and Facebook© and sign up for the weekly newsletter Dollars & Sense.

 

 

Guaranty Association

 

Florida Insurance Guaranty Association (FIGA) is part of a non-profit, state-based, statutorily-created system that pays certain outstanding claims of insolvent insurance companies. By paying these claims, guaranty associations protect policyholders and claimants. Guaranty associations are active in every state, the District of Columbia, Puerto Rico and the Virgin Islands. 

Guaranty associations ease the burden on policyholders and claimants of the insolvent insurer by immediately stepping in to assume responsibility for most policy claims following liquidation. The coverage guaranty associations provide is fixed by the policy or state law; they do not offer a "replacement policy."

By virtue of the authority given to the guaranty associations by state law, they are able to provide two important benefits: prompt payment of covered claims and payment of the full value of covered claims up to the limits set by the policy or state law.

Specifically, when a member insurer is found to be insolvent and is ordered liquidated, a receiver takes over the insurer under court supervision and processes the assets and liabilities through liquidation. Upon liquidation, FLAHIGA automatically becomes liable for the policy obligations the liquidated insurer owed to its Florida policyholders. [Chapter 631]

 

 

Life and Health Insurance Guaranty of Payments [§631.711]

What follows applies to direct life insurance, health insurance, annuity contracts, and supplemental contracts issued by those licensed to transact insurance in Florida. Coverage is provided to: 

 

· Those who are the beneficiaries, assignees, or payees of covered persons; and

· Those who are owners of policies or contracts, and who:

o Are residents of Florida; or

o Are residents of other states, IF:

* The insurer is in Florida;

* The insurers were not licensed in the states in which the individuals reside at the time specified in a state’s guaranty association law (necessary for coverage);

* Such other states have associations similar to the association created by Florida; and

* Such persons are not eligible for coverage by those associations.

* Notwithstanding any other provisions this part applies to coverage of a person who is a payee under a structured settlement annuity, or a beneficiary if the payee is deceased, with a coverage limit of $300,000 by the association, if:

· The payee is a resident of Florida.

· The payee, the beneficiary, or the contract owner is eligible for coverage by the association of the state in which the contract owner resides.

 

Administration and Assessment [§631.715(2)(a)]

 For purposes of administration and assessment, the association maintains three accounts:

· The health insurance account;

· The life insurance account; and

· The annuity account.

Borrowing between accounts for payment of policyholder and contract holder claims and other obligations of the association is authorized at the discretion of the board of directors, provided that the amounts are restored to the appropriate accounts not less than annually.

The association is under the immediate supervision of the department and subject to the applicable provisions of the insurance laws of Florida.

 

 

Florida HMO Consumer Assistance Plan [§631.811 and §631.828]

There is a nonprofit legal entity known as the Florida HMO Consumer Assistance Plan. All HMOs must remain members of the plan as a condition of their authority to transact business in Florida. The plan performs its functions under the plan of operations established and approved under the provisions and exercise its powers through a board of directors. The plan comes under the immediate supervision of the department and is subject to the applicable laws of Florida.

 

 

INSURANCE LAW AND UPDATES

 

New Florida Law Updates

The following are summaries of new Florida laws and their effective date:

2019 UPDATES

HB 29—Active Military Members, Veterans, and Their Spouses

House Bill 29 waives the prelicensing education requirement for active military members, veterans, and their spouses who are currently in good
standing with the military or have been honorably discharged. These individuals are also exempt from license application fees if they are currently in good standing with the military or have been honorably discharged within 24 months of application.
[Sec. 626.171, 732, 7851, 8311, 8417, 927 F.S.; effective July 1, 2018]

HB483—Advertising and Promotional Gifts

This bill modifies Florida’s unfair trade practices law regarding advertising
and promotional gifts. Insurers and agents may give insureds, prospective insureds, and others merchandise, gift cards, event tickets, or other items valued at $100 or less per individual in any calendar year. For title insurance agents and agencies, a $25 limit applies. Insurers and agents may also make charitable contributions on behalf of insureds or prospective insureds of up to $100 per individual in any calendar year.
[Sec. 626.9541 F.S.; effective July 1, 2018]

 

2020 UPDATES

HB 7065 – Assignment Of Benefits Reform

Provides for substantial changes in the way insurance benefits may be assigned to third parties. Defines “assignment agreement” and establishes requirements for the execution, validity, and effect of such an agreement; Transfers certain pre-lawsuit duties under the insurance contract to the assignee and shifts the burden to the assignee to prove that any failure to carry out such duties has not limited the insurer’s ability to perform under the contract; Requires each insurer to report specified data on claims paid in the prior year under assignment agreements by Jan. 30, 2022, and each year thereafter; allows an insurer to make available a policy prohibiting assignment, in whole or in part, under certain conditions; Revises the state’s one-way attorney fee statute to incorporate an attorney fee structure in determining the fee amount awarded in suits by an assignee against an insurer; requires service providers to give an insurer and the consumer prior written notice of at least 10 business days before filing suit on a claim.  Takes Effect: July 1, 2019

2021 UPDATES

SB 292: Insurance Claims Data

Insurance Claims Data; Defining the terms “loss run statement” and “provide”; requiring authorized insurers to provide insureds a loss run statement within 15 days after receipt of the insured’s written request and provide notice to the agent of record. No fees can be charged for providing this information once, annually.

This section defines a loss runs statement as a report that contains the following information about an insurance policy:
· The policy number
· The period of coverage
· The number of claims
· The paid losses on all claims
· The date of each loss

Loss run statements do not include supporting claim file documentation such as the following:
· Copies of claim files
· Investigation reports
· Evaluation statements
· Insureds’ statements
· Documents protected by a common law or statutory privilege

The loss run statement that will be given to an insured is required to contain a claims history with the insurer that covers the past five years or the complete claims history if it is less than five years. Insurers are not required to provide loss reserve information. Effective Date: 1/1/2021

HB 1189: Genetic Information for Insurance Purposes

Now, insurers who provide health, life, and long-term care insurance, in the absence of a diagnosis of a condition related to genetic information, cannot cancel, limit, or deny coverage, or establish differentials in premium rates, based on that kind of genetic information.

Additional language was added to establish that this does not prevent a life or long-term care insurer from looking at an individual’s medical record as part of the application process. The statute also does not prohibit these kinds of insurers from considering a medical diagnosis included in a medical record, even if the diagnosis was based on the results of a genetic test.
Effective Date: July 1, 2020

HB 1409: Records of Insurers

Exempts from public records requirements certain records made or received by DFS acting as receiver pursuant to specified provisions; provides that such records comprise consumer personal financial & health information, certain underwriting files, insurer personnel & payroll records, consumer claim files, certain reports & documents submitted to OIR relating to insurer own-risk, corporate governance annual disclosures, & certain information received from NAIC or governments; provides retroactive applicability; provides for future legislative review & repeal of exemptions; provides statements of public necessity.
Effective Date: July 1, 2020

 

2022 UPDATES

HB 1209 - Department of Financial Services
The bill modifies several areas regulated by the Department of Financial Services including:

- Division of Public Assistance Fraud: establishes DPAF as a criminal justice agency.
-Changes the mandatory continuing education (CE) update course for all insurance agents, customer representatives, and insurance adjusters from a five-hour course every two years to a four-hour course every two years. This language does not change the total number of CE hours that insurance agents, customer representatives, and adjusters must obtain every two years during their compliance period. This provision is effective for compliance periods that end January 1, 2022, or later, and for any agent/customer representative with such a compliance period who has already taken the five-hour course, credit will be given for the four-hour course plus one hour of elective credit.
-Protecting Proprietary Business Information: prohibits a person from requiring an insurance agent or agency to provide the replacement cost estimator or other proprietary underwriting information as a condition to extending credit secured by real property, nor may an insurance agent or agency provide this information.

Effective Date: July 1, 2021.

Senate Bill 1598 - Agency Package - PROTECTING INSURANCE POLICYHOLDERS

-Requires an entity that is licensed or issued a certificate of authority by the Department of Financial Services (DFS) or the Florida Office of Insurance Regulation (OIR) to respond to document requests from the DFS Division of Consumer Services.
-Revises the Licensing Procedures Law's prohibition against unlicensed activity to include knowingly aiding or abetting an unlicensed person in transacting insurance or otherwise engaging in insurance activities in this state without a license. A person who does so commits a thirddegree felony.
-Authorizes DFS to suspend, revoke, or refuse to issue the license of an insurance agent, adjuster, customer representative, service representative, or managing general agent that makes a consumer's personal financial or medical information available to the public, or initiates in-person or telephone solicitation with a prospective customer
after 9 p.m. or before 8 a.m., unless the customer requests otherwise.
-Prohibits the sale of industrial life insurance policies, effective July 1, 2021.
-Expands the definition of sliding, a practice that violates the Unfair Insurance Trade Practices.
-Requires insurance agencies whose name contains the word “Medicare” or Medicaid” to delete those words from the agency name no later than June 30, 2023.
Effective Date: Upon becoming law (06/16/2021, unless otherwise noted).

Senate Bill 1120 - PUSHING BACK AGAINST UNSOLICITED TELEMARKETNG

-Requires all sales telephone calls, text messages, and direct-to-voicemail transmissions to have the receiving consumer's prior express written consent if the call will be made using an automated machine to dial the recipient's phone number or will play a recorded message upon connection with the recipient.
-Amends the Florida Telemarketing Act to prohibit telephone sellers or salespersons from calling consumers outside of the hours between 8 a.m. and 8 p.m. in the consumer's time zone and prohibits telephone sellers or salespersons from contacting consumer on the same subject matter more than three times in a 24-hour period. The bill also clarifies that calls made through an automated dialer or recorded message are subject to the same prohibitions.
Effective Date: July 1, 2021

 

UPDATES 2023

HB1099 – Living Organ Donors in Insurance Policies
Prohibits insurers of life insurance policies, industrial life policies, group life policies, credit life and credit disabilities policies, and long-term care policies from discrimination against living organ donors or prospective living organ donors, in coverage or eligibility solely on their status as a living organ donor.
Effective July 1, 2022

 

UPDATES 2024

HB1185 - Consumer Protection
Living Organ Donors in Insurance Policies
Prohibits insurers of life insurance policies, industrial life policies, group life policies, credit life and credit disabilities policies, and long-term care policies from discrimination against living organ donors or prospective living organ donors, in coverage or eligibility solely on their status as a living organ donor. Effective July 1, 2022

Annuity Investments:
CS/CS/HB1185 covers regulations related to annuity investments. The bill adopts the National Association of Insurance Commissioners (NAIC) Suitability in Annuity Transactions Model Regulation (2020), which broadens the scope of requirements for sales or recommendations of annuities. The bill places a duty on insurers and agents to act in the best interest of consumers, emphasizing care, disclosure, conflict of interest, and recordkeeping. Certain exceptions are provided, and the bill introduces training requirements for agents involved in annuity sales.

Insurance Provisions:
The bill addresses unfair trade practices by requiring agents to disclose third-party remuneration for health insurance marketing practices.

CS/CS/HB 487 - Department of Financial Services

CS/CS/HB 487 is a legislative bill aimed at revising various programs and provisions within the Florida Department of Financial Services (DFS). The bill encompasses a wide range of changes that impact different aspects of financial regulation, insurance, and related areas. This summary provides an overview of the key provisions within the bill and their implications.

Investigations and Prosecutions:

The bill amends existing provisions to empower the Division of Investigative and Forensic Services (DIFS) within the DFS to conduct investigations when there is reason to believe a violation of Florida or federal criminal law has occurred. This expansion includes the authority to initiate investigations, rather than merely conduct them. Moreover, it extends the jurisdiction of the Chief Financial Officer (CFO) and State Fire Marshal to initiate investigations. Additionally, the DFS gains the authority to refer both state and federal criminal violations for prosecution.

Anti-Fraud Reward Program:

The bill introduces changes to the Anti-Fraud Reward Program by expanding the list of insurance fraud violations for which the DFS can offer rewards of up to $25,000. The expanded list includes violations related to nursing homes, forgery, racketeering, theft, false insurance claims, money laundering, and more. Importantly, the bill eliminates the requirement for a conviction to award a reward under this program, potentially encouraging more individuals to report fraudulent activities.

Florida Family and Medical Leave Act (FMLA):

The Family and Medical Leave Act (FMLA) provides eligible employees with up to 12 weeks of unpaid leave per year for family or medical reasons. While the law doesn't mandate paid sick leave, it safeguards employees' jobs during their absence.
Employment law attorneys can assist employees in understanding and asserting their FMLA rights, particularly if an employer fails to comply with the law or discriminates against them for utilizing FMLA benefits.

 

UPDATES 2025

HB201 Emergency Refills of Insulin and Insulin-related Supplies or Equipment
Authorizes emergency refill of insulin & insulin-related supplies or equipment not to exceed three non-consecutive times per calendar year.. Effective Date: July 1, 2024

SB 892 Dental Insurance Claims
Prohibiting a contract between a health insurer and a dentist from containing certain restrictions on payment methods; prohibiting a health insurer from charging a fee to transmit a payment to a dentist through Automated Clearing House (ACH) transfer unless the dentist has consented to such fee; prohibiting a health insurer from denying claims for procedures included in a prior authorization; prohibiting a contract between a prepaid limited health service organization and a dentist from containing certain restrictions on payment methods, etc. Effective Date: 1/1/2025

House Bill 1093 "Florida Uniform Fiduciary Income and Principal Act"
CS/HB 1093 codifies FUFIPA into ch. 738, F.S., replacing FUPIA as the law governing the allocation of trust and estate receipts and disbursements between principal and interest where a Florida trust does not provide its own terms for such an allocation. FUFIPA would, in addition to modernizing trust law generally:

· Allow for total-return investing under the “modern portfolio theory.”
· Provide for the conversion of an existing trust into a unitrust.
· Provide flexibility for more individualized estate planning.
· Provide a governing law provision to reduce jurisdictional disputes.
Effective on January 1, 2025.

 

UPDATES 2026

SB 480 Nonprofit Agricultural Organization Medical Benefit Plans
Statutes Affected: 624.4032
SB 480 creates a new section of law authorizing Nonprofit Agricultural Organizations to establish medical benefit plans, effective July 1, 2025. Farm Bureaus, which are nonprofit agricultural organizations, offer medical benefit plans that are exempt from state insurance laws in several states. SB 480 allows such organizations to do so in Florida. Section 624.4032 is added to Part III Authorization of Insurers and General Requirements of Chapter 624 of the Insurance Code. Effective Date: July 1, 2025

SB 944 Insurance Overpayment Claims Submitted to Psychologists
Statutes Affected: 627.6131, 641.3155
SB 944 reduces from 30 months to 12 months the timeframe for a health insurer or health maintenance organization (HMO) to submit claims for overpayment to a licensed psychologist. The bill’s reduction in the look-back period results in licensed psychologists being subject to the same 12-month look-back period for insurer and HMO overpayments as health care providers licensed under Chapters 458 (Medical Practice), 459 (Osteopathic Medicine), 460 (Chiropractic Medicine), 461 (Podiatric Medicine), or 466 (Dentistry). Applies to claims for services addressed by SB 944 provided on or after January 1, 2026. Effective Date: Generally, July 1, 2025.

SB 1808 Refund of Overpayments Made by Patients
Statutes Affected: 408.12, 408.813, 456.0625, 456.072
SB 1808 requires health care practitioners, facilities, providers, and anyone who accepts payment from insurance for services rendered by health care practitioners, to refund any overpayment made by the patient no later than 30 days after determining that the patient made an overpayment.
Effective Date: January 1, 2026

SB 42 General Reviser’s Bill
SB 42 is a general reviser’s bill to:
delete expired or obsolete language;
correct cross-references and grammatical or typographical errors;
remove inconsistencies and redundancies from the statutes;
improve the clarity of the statutes and facilitate their correct interpretation;
confirm the restoration of provisions unintentionally omitted from republication in the acts of the Legislature during the amendatory process; and
revise statutory provisions to conform to directives of the Legislature.
Effective Date: July 1, 2025 (On the 60th day after adjournment sine die of the session of the Legislature in which enacted.)

Surplus lines: Diligent Effort requirement eliminated (CS/HB 1549)
Summary
   Even though this mostly affects property and casualty coverage, many agencies that also sell life or health insurance will feel it in their office procedures, training, and compliance forms. It changes how agencies handle documentation, customer disclosures, and marketing materials across all lines, since clients often assume “regulated by Florida” applies to every product their agent offers.

 In the past, Florida would require agents who wanted to place a client’s policy with a surplus lines carrier (an insurer not licensed by the state but allowed to do business here for hard-to-insure risks) to first make a “diligent effort.” That meant contacting several regular, state-licensed insurers - called admitted carriers - to get formal rejections and then documenting those declinations. Only after proving that no admitted insurer would write the policy could the agent move it to the surplus lines market.

  The new law removes that step. Agents no longer must collect or file evidence that they tried - and failed - to find coverage with admitted companies.
  However, the trade-off is a stronger disclosure rule for customers. The client must now sign a notice clearly stating that surplus lines policies are not approved or regulated by Florida’s insurance department, so their rates and policy forms haven’t been reviewed by the state for fairness or adequacy.

If your shop does both life/health and P&C, your advertising and onboarding scripts should reflect the new disclosure language and no longer reference a diligent effort step. (Keep surplus-lines conversations clearly separate from admitted life/health marketing.)
Effective July 1, 2025

   The bill removes the definition of “diligent effort” for surplus lines insurance. (Section 2). The bill removes all existing eligibility criteria for surplus lines exporting, including the diligent effort requirement, layering allowances, and documentation standards. It also removes the Financial Services Commission’s authority to declare classes or risks exportable by rule and eliminates exemptions for wet marine, aviation, deductible indemnity, and certain property lines. The only provisions retained and added are updates to the disclosure form required for surplus lines placements. Specifically, the bill adds that surplus lines insurers’ policy rates and forms are not approved by any Florida regulatory agency, and that if an insured signs the disclosure, they are presumed to have been informed that other coverage may be available. (Section 3).

  The bill updates cross-references and related provisions to reflect the restructuring of surplus lines statutes. It clarifies that the per-policy fee authorized for surplus lines placements with unauthorized insurers remains valid, and confirms that this fee is included in the definition of “premium” for purposes of calculating surplus lines taxes and service fees. The bill also updates the unfair insurance practices statute to reflect the renumbered provision and clarifies that charging the authorized fee does not constitute an unfair or deceptive act. Additionally, the bill updates a cross-reference in the flood insurance export statute to align with the restructured surplus lines provisions.
“Florida House of Representatives Final Bill Analysis” [1]
[1] https://flsenate.gov/Session/Bill/2025/1549/Analyses/h1549z1.IBS.PDF

 

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Chapter 3 Contents

 

 

Department Communication
Guaranty Association
Insurance Law & Updates
Pertinent Federal Law Review Pertinent to Florida Licensed Insurance Professionals

 

 

 

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