30364606, 69O-197.007 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 30364606

Notice of Proposed Rule

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

OIR – Insurance Regulation

Chapter:

INSURANCE ADMINISTRATORS

Overview

RULE:

69O-197.007	Additional Qualifications for Independent Professional Examiners
69O-197.008	Data Gathering
69O-197.009	NAIC Market Regulation Handbook
69O-197.010	Market Conduct Examination Reimbursement Expenses
69O-197.012	Examination Cycles for Pharmacy Benefit Managers

PURPOSE:

To clarify the office’s approach to market conduct examinations and better allow the office to perform orderly and systematic examinations of regulated entities, the office is proposing six new rules under 69O-197. Rule 69O-197.007 provides for additional qualifications for independent examiners that the office selects. Rule 69O-197.008 provides the office’s directions for compliance with office data gathering requests during examinations. Rule 69O-197.009 adopts the NAIC Market Regulation Handbook for use in the office’s market conduct examinations. Rule 69O-197.010 provides guidelines for how the office would be reimbursed for inhouse work conducting market conduct exams. Rule 69O-197.012 provides for a hearing and fine under section 626.8828(6) when a pharmacy benefit manager refuses to provide contracts subject to section 626.8825. Rule 69O-197.012 details when examination periods for pharmacy benefit managers begin and close as well as what years fall within the scope of an examination.

SUMMARY:

To clarify the office’s approach to market conduct examinations and better allow the office to perform orderly and systematic examinations of regulated entities, the office is proposing six new rules under 69O-197.Rule 69O-197.007, F.A.C., provides for additional qualifications for independent examiners that the office selects. Rule 69O-197.008, F.A.C., provides the office’s directions for compliance with office data gathering requests during examinations. Rule 69O-197.009, F.A.C., adopts the Market Regulation Handbook for use in the office’s market conduct examinations. Rule 69O-197.010, F.A.C., provides guidelines for how the office would be reimbursed for inhouse work conducting market conduct exams. Rule 69O-197.012, F.A.C., details when examination periods for pharmacy benefit managers begin and close as well as what years fall within the scope of an examination.

RULEMAKING AUTHORITY:

624.308(1), 624.3161, 626.8828, 626.8991, FS.

LAW:

624.307(4), 624.318, 624.321, 624.3161, 626.8828, FS.

PRINT PUBLISH DATE:

12/31/2025 Vol. 51/252

COMMENTS:

From 12/31/2025 To 1/21/2026 (21 Days)

REFERENCE MATERIALS:

No reference(s).

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