Exams / Florida Health Insurance License / Fla. Stat. §641.185
Fla. Stat. §641.185 — what it says, and how the exam tests it
This section is cited by 4 of our practice questions and is tested on 2 exams including the Florida Health Insurance License.
The text
641.185 Health maintenance organization subscriber protections. — (1) With respect to the provisions of this part and part III, the principles expressed in the following statements serve as standards to be followed by the commission, the office, the department, and the Agency for Health Care Administration in exercising their powers and duties, in exercising administrative discretion, in administrative interpretations of the law, in enforcing its provisions, and in adopting rules: (a) A health maintenance organization shall ensure that the health care services provided to its subscribers shall be rendered under reasonable standards of quality of care which are at a minimum consistent with the prevailing standards of medical practice in the community pursuant to ss. 641.495(1) and 641.51. (b) A health maintenance organization subscriber should receive quality health care from a broad panel of providers, including referrals, preventive care pursuant to s. 641.402(1), emergency screening and services pursuant to ss. 641.31(12) and 641.513, and second opinions pursuant to s. 641.51. (c) A health maintenance organization subscriber should receive assurance that the health maintenance organization has been independently accredited by a national review organization pursuant to s. 641.512, and is financially secure as determined by the state pursuant to ss. 641.221, 641.225, and 641.228. (d) A health maintenance organization subscriber should receive continuity of health care, even after the provider is no longer with the health maintenance organization pursuant to s. 641.51(8). (e) A health maintenance organization subscriber should receive timely, concise information regarding the health maintenance organization’s reimbursement to providers and services pursuant to ss. 641.31 and 641.31015 and should receive prompt payment from the organization pursuant to s. 641.3155. (f) A health maintenance organization subscriber should receive the flexibility to transfer to another Florida health maintenance organization, regardless of health status, pursuant to ss. 641.228, 641.3104, 641.3107, 641.3111, 641.3921, and 641.3922. (g) A health maintenance organization subscriber should be eligible for coverage without discrimination against individual participants and beneficiaries of group plans based on health status pursuant to s. 641.31073. (h) A health maintenance…
Public record. Read the full, current section at the official source: www.leg.state.fl.us
How it comes up on the exam
Practice questions written from this section — answers and explanations are in the drill.
- Under Florida law, a health maintenance organization that issues a group health contract must provide coverage for preexisting conditions pursuant to which statute?
drill Florida Statutes, Rules and Regulations Pertinent to Health Insurance → - Under Florida law, a health maintenance organization subscriber must be given written notice at least how far in advance of a rate change?
drill Florida Statutes, Rules and Regulations Pertinent to Health Insurance → - Under Florida's HMO subscriber protection standards, a subscriber should receive continuity of health care even after what event occurs?
drill Florida Statutes, Rules and Regulations Pertinent to Health Insurance →