Rule: 69O-149.005 Prev   Up   Next

Rule Title: Reasonableness of Benefits in Relation to Premiums
Department: DEPARTMENT OF FINANCIAL SERVICES    Add to MyFLRules Favorites
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Division: OIR – Insurance Regulation
Chapter: FILING OF FORMS AND RATES FOR LIFE/HEALTH INSURANCE

Latest version of the final adopted rule presented in Florida Administrative Code (FAC):

VIEW_RULE Effective Date: 1/17/2024
History Notes: Rulemaking Authority 624.308(1), 627.410(6)(b), (d), (e) FS. Law Implemented 626.9541(1), 627.410(6)(d), (e), 627.410(7), 627.411(1)(a), (e), 627.9175 FS. History–New 7-1-85, Formerly 4-58.05, 4-58.005, Amended 4-18-94, 11-20-02, Formerly 4-149.005, Amended 5-18-04, 11-2-06, 6-18-07, 10-1-08, 8-15-19, 1-17-24.
References in this version: No reference(s).
History of this Rule since Jan. 6, 2006
Notice /
Adopted
Section Description ID Publish
Date
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 27914774 Effective:
01/17/2024
View Text Change
69O-149.005
Reasonableness of Benefits in Relation to Premiums 27804000 11/22/2023
Vol. 49/227
View Text Proposed
69O-149.005
To clarify certain tables are also applicable to paid family leave policies. 27610776 9/29/2023
Vol. 49/190
View Text Development
69O-149.005
To clarify certain tables are also applicable to pain family leave policies. 27357121 7/24/2023
Vol. 49/142
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 22195945 Effective:
08/15/2019
View Text Public Hearing
69O-149.005
......
The Office of Insurance Regulation is amending rules related to Filing of Forms and Rates for Life/Health Insurance to allow an exemption to ....
  Wednesday, June 26, 2019, 10:00 a.m.
  116 Larson Building, 200 East Gaines Street, Tallahassee, Florida. ....
21977210 6/12/2019
Vol. 45/114
View Text Proposed
69O-149.005
......
The rules are being amended to allow an exemption to paragraph 14(b) of 69O-149.005 for certain types of plans issued by an insurer, to update the Experience on the Form requirements, and to update the actuarial certification .... 21640814 3/21/2019
Vol. 45/56
View Text Development
69O-149.005
......
The rules are being amended to allow an exemption to paragraph 14(b) of 69O-149.005 for certain types of plans issued by an insurer, to update the Experience on the Form requirements, and to update the actuarial certification .... 21418005 1/22/2019
Vol. 45/14
View Text Variances
69O-149.005
Metropolitan Life Insurance Company filed a petition for Variance from Rule 69O-149.005(14)(b), F.A.C. on August 9, 2018. The petition requests that the Office extend a variance granted on December 22, 2016, which concerns .... 21127781 11/6/2018
Vol. 44/217
View Text Variances
69O-149.005
On August 14, 2018, the Office of Insurance Regulation published notice in Volume 44, No. 158, F.A.R., of the filing of a petition for variance received from Metropolitan Life Insurance Company seeking a variance from paragraph .... 21114492 11/2/2018
Vol. 44/215
View Text Variances
69O-149.005
On August 15, 2018, the Office of Insurance Regulation published notice in Volume 44, No. 159, F.A.R. of the filing of a petition for variance received from Delta Dental Insurance Company seeking a variance from paragraph .... 20873350 9/10/2018
Vol. 44/176
View Text Variances
69O-149.005
to extend a variance. Petitioner’s Name: Metropolitan Life Insurance Company Rule No.: 69O-149.005(14)(b), F.A.C. Nature of the rule for which variance or waiver is sought: The petition requests that the Office extend .... 20804092 8/21/2018
Vol. 44/163
View Text Variances
69O-149.005
a variance. Petitioner’s Name: Delta Dental Insurance Company Rule No.: 69O-149.005(14)(b), F.A.C. Nature of the rule for which variance or waiver is sought: The petition requests that the Office grant a variance from .... 20782461 8/15/2018
Vol. 44/159
View Text Variances
69O-149.005
a variance. Petitioner’s Name: Metropolitan Life Insurance Company Rule No.: 69O-149.005(14)(b), F.A.C. Nature of the rule for which variance or waiver is sought: The petition requests that the Office grant a variance .... 20777805 8/14/2018
Vol. 44/158
View Text Variances
69O-149.005
A Notice of a filing of a Petition for Variance by Advantica Insurance Company was published on September 21, 2017 in Volume 43, No. 185. A letter withdrawing the Petition for Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) .... 19723900 11/9/2017
Vol. 43/218
View Text Variances
69O-149.005
On September 28, 2017, National Guardian Life Insurance Company withdrew its request for the Petition for Variance or Waiver from Rule 69O-149.005, F.A.C. Accordingly, this proceeding is dismissed and withdrawn from further .... 19476162 10/2/2017
Vol. 43/190
View Text Variances
69O-149.005
A Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) from Advantica Insurance Company was received by the Office of Insurance Regulation on September 21, 2017. The petition requests that the Office grant a variance .... 19441533 9/25/2017
Vol. 43/185
View Text Variances
69O-149.005
Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) from National Guardian Life Insurance Company. The petition requests that the Office grant a variance from the multiple year rate guarantee or rating cap provision .... 19307091 8/17/2017
Vol. 43/160
View Text Development
69O-149.0025
......
Amendments update statutory references, edits requirements for Stop-loss insurance and updates the applicable actuarial standards to be used in the Actuarial Memorandum. 19174395 7/12/2017
Vol. 43/134
View Text Variances
69O-149.005
On December 5, 2016, Petitioners Humana Insurance Company and CompBenefits Company filed a Petition for Variance from Rule 69O-149.005(14)(b), F.A.C. On or about January 4, 2017, the Petitioners withdrew the Petition for .... 18564168 2/3/2017
Vol. 43/23
View Text Variances
69O-149.005
Metropolitan Life Insurance Company filed a petition for Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) on July 22, 2016. The petition requested that the Office grant a variance from the multiple year rate guarantee .... 18408192 12/27/2016
Vol. 42/249
View Text Variances
69O-149.005
Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) from Humana Insurance Company and CompBenefits Company. The petition requests that the Office grant a variance from the multiple year rate guarantee or rating cap .... 18376473 12/16/2016
Vol. 42/243
View Text Variances
69O-149.005
Variance from Fla. Admin. Code Ann. r. 69O-149.005(14)(b) from Metropolitan Life Insurance Company. The petition requests that the Office grant a variance from the multiple year rate guarantee or rating cap provision that .... 17816395 7/28/2016
Vol. 42/146
View Text Workshop
69O-149.005
The rule workshop has been cancelled.
  March 1, 2013 at 10:30 a.m.
  116 Larson
12666277 2/20/2013
Vol. 39/35
View Text Development
69O-149.005
Rule 69O-149.005(14) currently permits insurers that meet certain conditions to issue multi-year rate guarantees. One such condition is that a rate guarantee cannot apply for greater than 24 months. The Office is proposing .... 12649205 2/15/2013
Vol. 39/32
View Text Development
69O-149.003
......
To provide more pooling of cancer forms and to make a few clarifications to existing provisions. 7040374 4/24/2009
Vol. 35/16
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 17395997 Effective:
10/01/2008
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 6182894 Effective:
10/01/2008
View Text Withdrawal
69O-149.003
......
Rate Filing Procedures, Reasonableness of Benefits in Relation to Premiums, Annual Rate Certification (ARC) Filing Procedures 6044378 8/29/2008
Vol. 34/35
View Text Validity
69O-149.003
......
America’s Health Insurance Plans, Inc.’s and Florida Insurance Council vs. Financial Services Commission and Office of Insurance Regulation; Case No.: 08-3297RP; Rule No.: 69O-149.003, 69O-149.005, 69O-149.007; Dismissed 5983268 8/8/2008
Vol. 34/32
View Text Validity
69O-149.003
......
America’s Health Insurance Plans, Inc.’s and Florida Insurance Council vs. Financial Services Commission and Office of Insurance Regulation; Case No.: 08-3297RP; Rule No.: 69O-149.003, 69O-149.005, 69O-149.007; Petition 5981522 8/8/2008
Vol. 34/32
View Text Public Hearing
69O-149.003
......
This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.003,.005,.007, Florida Administrative Code, published ....
  August 12, 2008 9:00 a.m.
  Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, ....
5865898 7/18/2008
Vol. 34/29
View Text Public Hearing
69O-149.0025
......
This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.0025,.005,.006, Florida Administrative Code, published ....
  August 12, 2008, 9:00 a.m.,
  Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, ....
5860757 7/18/2008
Vol. 34/29
View Text Proposed
69O-149.003
......
To provide more pooling of cancer forms and to make a few clarifications to existing provisions. 5609818 5/30/2008
Vol. 34/22
View Text Proposed
69O-149.0025
......
To answer questions on health rate filings. 5609236 5/30/2008
Vol. 34/22
View Text Withdrawal
69O-149.003
......
Rate Filing Procedures, Reasonableness of Benefits in Relation to Premiums, Annual Rate Certification (ARC) Filing Procedures 4777849 11/2/2007
Vol. 33/44
View Text Proposed
69O-149.003
......
The purpose of the rule is to establish standards for ascertaining the reasonableness of benefits in relation to premium rates. 4633707 9/21/2007
Vol. 33/38
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 4258026 Effective:
06/18/2007
View Text Development
69O-149.003
......
To provide guidelines for insurers to ensure the rates charged are reasonable. 4154333 5/18/2007
Vol. 33/20
View Text Public Hearing
69O-149.005
This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.005, Florida Administrative Code, published on December ....
  April 17, 2007 at 9:00 a.m., during a regular meeting of the ....
  Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, ....
3931718 3/30/2007
Vol. 33/13
View Text Change
69O-149.005
Reasonableness of Benefits in Relation to Premiums 3843157 3/9/2007
Vol. 33/10
View Text Proposed
69O-149.005
To implement guidelines for multiple year rate guarantees for health insurance. 3220029 12/22/2006
Vol. 32/51
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 3087721 Effective:
11/02/2006
View Text Development
69O-149.005
To implement guidelines for multiple year rate guarantees. 586867 8/11/2006
Vol. 32/32
View Text Change
69O-149.005
......
Reasonableness of Benefits in Relation to Premiums, Actuarial Memorandum, Annual Rate Certification (ARC) Filing Procedures 492486 7/14/2006
Vol. 32/28
View Text Proposed
69O-149.005
: The rule interprets, clarifies and implements the related statutes for Reasonableness of Benefits in Relation to Premiums; establishes ARC filing procedures; and requires the experience exhibit in the actuarial memorandum .... 274139 4/28/2006
Vol. 32/17
View Text Development
69O-149.005
......
To interpret, clarify and implement the related statutes for Reasonableness of Benefits in Relation to Premiums; ARC filing procedures; and to require the experience exhibit in the actuarial memorandum be in an Excel document..... 78975 2/3/2006
Vol. 32/05
View Text Final
69O-149.005
Reasonableness of Benefits in Relation to Premiums 2764129 Effective:
05/18/2004