Fla. Stat. 627.602
Scope, format of policy


(1)

Each health insurance policy delivered or issued for delivery to any person in this state must comply with all applicable provisions of this code and all of the following requirements:The monetary and other considerations shall be expressed in the policy.The time when the insurance takes effect and terminates shall be expressed in the policy.The policy may purport to insure only one person, except that upon the application of an adult member of a family, who is deemed to be the policyholder, a policy may insure, either originally or by subsequent amendment, any eligible members of that family, including husband, wife, any children or any person dependent upon the policyholder. If an insurer offers coverage for dependent children of the policyholder, such policy must comply with the provisions of s. 627.6562.The style, arrangement, and overall appearance of the policy may not give any undue prominence to any portion of the text. Every printed portion of the text of the policy and of any endorsements or attached papers shall be plainly printed in lightfaced type of a style in general use, the size of which is uniform and is not less than 10 points with a lowercase, unspaced alphabet length of not less than 120 points. As used in this paragraph, “text” includes all printed matter except the name and address of the insurer, the name or title of the policy, the brief description of the coverage provided, if any, and captions and subcaptions.The exceptions and reductions of indemnity shall be set forth in the policy and, other than those contained in ss. 627.606-627.629, shall be printed, at the insurer’s option, either included with the benefit provisions to which they apply, or under an appropriate caption such as “Exceptions,” or “Exceptions and Reductions.” However, if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies.Each form, including outlines of coverage, applications, riders, and endorsements, shall be identified by a form identification number in the lower left-hand corner of the first page of the form.The policy may not contain any provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless the portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates, statement of classification of risks, or short-rate table filed with the office.Section 641.312 and the provisions of the Employee Retirement Income Security Act of 1974, as implemented by 29 C.F.R. s. 2560.503-1, relating to internal grievances. This paragraph does not apply to the types of benefits or coverages provided under s. 627.6513(1)-(14) issued in any market.

(a)

The monetary and other considerations shall be expressed in the policy.

(b)

The time when the insurance takes effect and terminates shall be expressed in the policy.

(c)

The policy may purport to insure only one person, except that upon the application of an adult member of a family, who is deemed to be the policyholder, a policy may insure, either originally or by subsequent amendment, any eligible members of that family, including husband, wife, any children or any person dependent upon the policyholder. If an insurer offers coverage for dependent children of the policyholder, such policy must comply with the provisions of s. 627.6562.

(d)

The style, arrangement, and overall appearance of the policy may not give any undue prominence to any portion of the text. Every printed portion of the text of the policy and of any endorsements or attached papers shall be plainly printed in lightfaced type of a style in general use, the size of which is uniform and is not less than 10 points with a lowercase, unspaced alphabet length of not less than 120 points. As used in this paragraph, “text” includes all printed matter except the name and address of the insurer, the name or title of the policy, the brief description of the coverage provided, if any, and captions and subcaptions.

(e)

The exceptions and reductions of indemnity shall be set forth in the policy and, other than those contained in ss. 627.606-627.629, shall be printed, at the insurer’s option, either included with the benefit provisions to which they apply, or under an appropriate caption such as “Exceptions,” or “Exceptions and Reductions.” However, if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies.

(f)

Each form, including outlines of coverage, applications, riders, and endorsements, shall be identified by a form identification number in the lower left-hand corner of the first page of the form.

(g)

The policy may not contain any provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless the portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates, statement of classification of risks, or short-rate table filed with the office.

(h)

Section 641.312 and the provisions of the Employee Retirement Income Security Act of 1974, as implemented by 29 C.F.R. s. 2560.503-1, relating to internal grievances. This paragraph does not apply to the types of benefits or coverages provided under s. 627.6513(1)-(14) issued in any market.

(2)

The office may require any health insurance policy or certificate containing a provision commonly known as a “deductible provision” to have printed or stamped on such policy or certificate: “This policy or certificate contains a deductible provision.”; or appropriate words of similar import approved by the office. The statement shall appear on the first page of the policy or certificate in at least 18-point type and may be printed or stamped either as an overprint or by means of a rubber stamp impression.

Source: Section 627.602 — Scope, format of policy, https://www.­flsenate.­gov/Laws/Statutes/2024/0627.­602 (accessed Aug. 7, 2025).

627.601
Scope of this part
627.602
Scope, format of policy
627.603
Death benefits
627.604
Nonresident insured
627.605
Required provisions
627.606
Entire contract
627.607
Time limit on certain defenses
627.608
Grace period
627.609
Reinstatement
627.610
Notice of claim
627.611
Claim forms
627.612
Proof of loss
627.613
Time of payment of claims
627.614
Payment of claims
627.615
Physical examination, autopsy
627.616
Legal actions
627.617
Change of beneficiary
627.618
Optional policy provisions
627.619
Change of occupation
627.620
Misstatement of age or sex
627.621
Other insurance with this insurer
627.622
Insurance with other insurers
627.623
Insurance with other insurers
627.624
Relation of earnings to insurance
627.625
Unpaid premiums
627.627
Conformity with statutes
627.628
Illegal occupation
627.629
Intoxicants and narcotics
627.630
Order of certain provisions
627.631
Third-party ownership
627.632
Requirements of other jurisdictions
627.633
Other policy provisions
627.634
Age limit
627.635
Excess insurance
627.636
Industrial health insurance
627.637
Construction of noncomplying contracts
627.638
Direct payment for hospital, medical services
627.639
Application signed by agent
627.640
Filing of classifications and rates
627.641
Coverage for newborn children
627.642
Outline of coverage
627.643
Uniform minimum standards
627.644
Discrimination against handicapped prohibited
627.645
Denial of health insurance claims restricted
627.646
Conversion on termination of eligibility
627.647
Standard health claim form
627.6011
Mandated coverages
627.6041
Children with disabilities
627.6043
Notification of cancellation, nonrenewal, or change in rates
627.6044
Use of a specific methodology for payment of claims
627.6045
Preexisting condition
627.6046
Limit on preexisting conditions
627.6056
Coverage for ambulatory surgical center service
627.6131
Payment of claims
627.6141
Denial of claims
627.6265
Cancellation or nonrenewal prohibited
627.6385
Disclosures to policyholders
627.6387
Shared savings incentive program
627.6401
Refunds for persons age 64
627.6402
Insurance rebates for healthy lifestyles
627.6403
Payment of acupuncture benefits to certified acupuncturists
627.6405
Decreasing inappropriate utilization of emergency care
627.6406
Maternity care
627.6407
Massage
627.6408
Diabetes treatment services
627.6409
Coverage for osteoporosis screening, diagnosis, treatment, and management
627.6415
Coverage for natural-born, adopted, and foster children
627.6416
Coverage for child health supervision services
627.6417
Coverage for surgical procedures and devices incident to mastectomy
627.6418
Coverage for mammograms
627.6419
Requirements with respect to breast cancer
627.6425
Renewability of individual coverage
627.6426
Short-term health insurance
627.6471
Contracts for reduced rates of payment
627.6472
Exclusive provider organizations
627.6473
Combined preferred provider and exclusive provider policies
627.6474
Provider contracts
627.6475
Individual reinsurance pool
627.6487
Guaranteed availability of individual health insurance coverage to eligible individuals
627.64025
Advanced practice registered nurse services
627.64171
Coverage for length of stay and outpatient postsurgical care
627.64172
Requirements with respect to breast cancer and routine followup care
627.64193
Required coverage for cleft lip and cleft palate
627.64194
Coverage requirements for services provided by nonparticipating providers
627.64195
Requirements for opioid coverage
627.64196
Medication synchronization
627.64197
Coverage for organ transplants
627.64725
Health maintenance organization or exclusive provider organization
627.64731
Leasing, renting, or granting access to a participating provider
627.64741
Pharmacy benefit manager contracts
627.64995
Restrictions on use of state and federal funds for state exchanges

Current through Fall 2025

§ 627.602. Scope, format of policy's source at flsenate​.gov