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Life and Health Product Review

Rate Filing Requirements

Additional Periodic Rate Filings, Certifications or Reports


Annual Rate Certification Filings


Section 627.410(7), Florida Statutes

Rule 69O-149.007,Florida Administrative Code

Universal Standardized Data Letter

Universal Standardized Data Letter Instructions

Actuarial Certification - see Rule 69O-149.007(5) Florida Administrative Code for format

Rule 69O-149.007(5), Florida Administrative Code

Small Employer Group Actuarial Certification


Section 627.6699, Florida Statutes

Rule 69O-149.038(1) (b), Florida Administrative Code

Actuarial Certification - see Rule 69O-149.038(1)(b), FAC for language

Small Employer Group Underwriting Experience Report


Section 627.6699(6)(b)5, Florida Statutes

Rule 69O-149.038(3), Florida Administrative Code

OIR-B2-1575 - Small Employer Group Underwriting experience Reporting Form

Annual Medicare Supplement Refund Calculation Report


Section 627.6745(5), Florida Statutes

Rule 69O-156.011(2), Florida Administrative Code

OIR-B2-MSR--Medicare Supplement Refund Calculation Form

OIR-B2-MSB-I -- Reporting Forms for the Calculation of Benchmark Loss Ratio since Inception (Individual)

OIR-B2-MSB-G-- Reporting Forms for the Calculation of Benchmark Loss Ratio since Inception (Group)

Self-Funded Health Benefit Plans for Local Governmental Units


Section 112.08, Florida Statutes

Rule 69O-149.051-053, Florida Administrative Code

OIR-B2-570 -- General Information for Self-funded Health Benefit Plans

OIR-B2-571 -- Specific Information on Self-funded Health Benefit Plans

OIR-B2-572 -- Annual Report of Self-funded Health Benefit Plans

OIR-B2-573 -- Operating Projects for Self-funded Health Benefit Plans

OIR-B2-574 -- Deficit Elimination Plan for Self-funded Health Benefit Plans

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Annual Credit Life/Disability Experience Report


Sections 627.676 - 627.6845, Florida Statutes

Rule 69O-163.012, Florida Administrative Code

OIR-B2-272 -- Credit Life and Disability Insurance Experience Report (A) - Obsolete

OIR-B2-273 -- Credit Insurance Experience Report Prima Facie Earned Premium (B1) - Obsolete

OIR-B2-274 -- Credit Disability Insurance Experience Report, Prima Facie Earned Premium (B2) - Obsolete

OIR-B2-275 -- Credit Life Insurance Experience, Reconciliation to State Page (C1) - Obsolete

OIR-B2-276 -- Credit Disability Insurance Report, Reconciliation to State Page (C2) - Obsolete

Long-Term Care


Rule 69O-157, Florida Administrative Code

OIR-B2-1552 -- Rescission Reporting (Appendix A) Due March 1 Annually

OIR-B2-1553 -- Claims Denial Report Form (Appendix E) Due June 30 Annually

OIR-B2-1554 -- Potential Rate Increase Disclosure Form (Appendix F)

OIR-B2-1555 -- Replacement and Lapse Reporting Form (Appendix J) due June 30 Annually

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