627.651
Group contracts and plans of self-insurance must meet group requirements.
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627.651 Group contracts and plans of self-insurance must meet group requirements.—
(1) Except as otherwise provided by law, a group health insurance policy or certificate insuring more than one individual delivered or issued for delivery in this state must be delivered or issued for delivery to one of the groups provided for in ss. 627.653-627.656. A plan of self-insurance providing health coverage benefits to residents of this state must comply with s. 627.419 and the applicable provisions of this part relating to the rights of individuals to specified benefits and coverages.
(2) Subsection (1) does not apply to health insurance policies or plans of self-insurance:
(a) Insuring or providing benefits only to individuals related by blood, marriage, or legal adoption.
(b) Insuring or providing benefits only to individuals who have a common interest through ownership of a business enterprise, or a substantial legal interest or equity in the business enterprise, and who are actively engaged in the management of the business enterprise.
(c) Insuring or providing benefits only to individuals otherwise having an insurable interest in each other’s lives.
(d) Issued as blanket insurance pursuant to s. 627.659.
(3) A nongovernmental self-insurance plan for health benefits may not be contributory by participants.
(4) This section does not apply to any plan which is established or maintained by an individual employer in accordance with the Employee Retirement Income Security Act of 1974, Pub. L. No. 93-406, or to a multiple-employer welfare arrangement as defined in s. 624.437(1), except that a multiple-employer welfare arrangement shall comply with ss. 627.419, 627.657, 627.6575, 627.6578, 627.6579, 627.6612, 627.66121, 627.66122, 627.6615, 627.6616, and 627.662(7). This subsection does not allow an authorized insurer to issue a group health insurance policy or certificate which does not comply with this part.
History.—s. 584, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 4, 10, ch. 80-341; ss. 2, 3, ch. 81-318; ss. 498, 500, 523, 809(2nd), ch. 82-243; ss. 62, 79, ch. 82-386; s. 6, ch. 83-203; s. 1, ch. 83-213; s. 17, ch. 83-288; s. 1, ch. 84-50; s. 4, ch. 86-122; s. 1, ch. 90-255; ss. 61, 114, ch. 92-318; s. 26, ch. 95-211; s. 5, ch. 97-48; s. 82, ch. 2000-154; s. 6, ch. 2002-389.
Notes of Decisions
Cited in 2
cases, 1992–2014 · leading case: United Healthcare Services, Inc. v. Sanctuary Surgical Centre, Inc.
United Healthcare Services, Inc. v. Sanctuary Surgical Centre, Inc. (2014)
“§ 627.651(4), Fla. Stat. Here, the defendants maintain that the claims at issue were made under group health insurance plans governed by ERISA.”
FLORIDA AUTO. DEALERS INDUSTRY v. Small (1992)
“We note that section 627.651(5), which is placed under Part VII, while providing "[t]his section," relating to the requirements applicable to group contracts and plans of self-insurance, is inapplicable to MEWAs, nonetheless subsection (5) also states that MEWAs must comply with…”
— 627.651(4) — 1 case
United Healthcare Services, Inc. v. Sanctuary Surgical Centre, Inc. (2014)
“§ 627.651(4), Fla. Stat. Here, the defendants maintain that the claims at issue were made under group health insurance plans governed by ERISA.”
— 627.651(5) — 1 case
FLORIDA AUTO. DEALERS INDUSTRY v. Small (1992)
“We note that section 627.651(5), which is placed under Part VII, while providing "[t]his section," relating to the requirements applicable to group contracts and plans of self-insurance, is inapplicable to MEWAs, nonetheless subsection (5) also states that MEWAs must comply with…”
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