Fla. Stat. 641.31072
Special enrollment periods


(1)

A health maintenance organization that issues a group health insurance policy shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the contract, or a dependent of such an employee if the dependent is eligible but not enrolled for coverage under such terms, to enroll for coverage under the terms of the contract if each of the following conditions is met:The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or dependent. For the purpose of this section, the terms “group health plan” and “health insurance coverage” have the same meaning ascribed in s. 2791 of the Public Health Service Act.The employee stated in writing at such time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor or health maintenance organization, if applicable, required such a statement at such time and provided the employee with notice of such requirement and the consequences of such requirement at such time.The employee’s or dependent’s coverage described in paragraph (a):
Was under a COBRA continuation provision or continuation pursuant to s. 627.6692, and the coverage under such provision was exhausted; or
Was not under such a provision and the coverage was terminated as a result of loss of eligibility for the coverage, including legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment, or the coverage was terminated as a result of the termination of employer contributions toward such coverage.
Under the terms of the contract, the employee requests such enrollment not later than 30 days after the date of exhaustion of coverage described in subparagraph (c)1., or termination or employer contribution described in subparagraph (c)2.

(a)

The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or dependent. For the purpose of this section, the terms “group health plan” and “health insurance coverage” have the same meaning ascribed in s. 2791 of the Public Health Service Act.

(b)

The employee stated in writing at such time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor or health maintenance organization, if applicable, required such a statement at such time and provided the employee with notice of such requirement and the consequences of such requirement at such time.

(c)

The employee’s or dependent’s coverage described in paragraph (a):Was under a COBRA continuation provision or continuation pursuant to s. 627.6692, and the coverage under such provision was exhausted; orWas not under such a provision and the coverage was terminated as a result of loss of eligibility for the coverage, including legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment, or the coverage was terminated as a result of the termination of employer contributions toward such coverage.
1. Was under a COBRA continuation provision or continuation pursuant to s. 627.6692, and the coverage under such provision was exhausted; or
2. Was not under such a provision and the coverage was terminated as a result of loss of eligibility for the coverage, including legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment, or the coverage was terminated as a result of the termination of employer contributions toward such coverage.

(d)

Under the terms of the contract, the employee requests such enrollment not later than 30 days after the date of exhaustion of coverage described in subparagraph (c)1., or termination or employer contribution described in subparagraph (c)2.

(2)

For dependent beneficiaries, if:A group health maintenance organization contract makes coverage available with respect to a dependent of an individual;The individual is a participant under the contract, or has met any waiting period applicable to becoming a participant under the contract, and is eligible to be enrolled under the contract but for a failure to enroll during a previous enrollment period; andA person becomes such a dependent of the individual through marriage, birth, or adoption or placement for adoption,

the health maintenance organization shall provide for a dependent special enrollment period described in subsection (3) during which the person, or, if not otherwise enrolled, the individual, may be enrolled under the plan as a dependent of the individual, and in the case of the birth or adoption of a child, the spouse of the individual may be enrolled as a dependent of the individual if such spouse is otherwise eligible for coverage.

(a)

A group health maintenance organization contract makes coverage available with respect to a dependent of an individual;

(b)

The individual is a participant under the contract, or has met any waiting period applicable to becoming a participant under the contract, and is eligible to be enrolled under the contract but for a failure to enroll during a previous enrollment period; and

(c)

A person becomes such a dependent of the individual through marriage, birth, or adoption or placement for adoption,

(3)

A dependent special enrollment period under subsection (2) shall be a period of not less than 30 days and shall begin on the later of:The date dependent coverage is made available; orThe date of the marriage, birth, or adoption or placement for adoption described in paragraph (2)(c).

(a)

The date dependent coverage is made available; or

(b)

The date of the marriage, birth, or adoption or placement for adoption described in paragraph (2)(c).

(4)

If an individual seeks to enroll a dependent during the first 30 days of such a dependent special enrollment period, the coverage of the dependent shall become effective:In the case of marriage, not later than the first day of the first month beginning after the date the completed request for enrollment is received.In the case of a dependent’s birth, as of the date of such birth.In the case of a dependent’s adoption or placement for adoption, the date of such adoption or placement for adoption.

(a)

In the case of marriage, not later than the first day of the first month beginning after the date the completed request for enrollment is received.

(b)

In the case of a dependent’s birth, as of the date of such birth.

(c)

In the case of a dependent’s adoption or placement for adoption, the date of such adoption or placement for adoption.

Source: Section 641.31072 — Special enrollment periods, https://www.­flsenate.­gov/Laws/Statutes/2024/0641.­31072 (accessed Aug. 7, 2025).

641.17
Short title
641.18
Declaration of legislative intent, findings, and purposes
641.19
Definitions
641.21
Application for certificate
641.22
Issuance of certificate of authority
641.23
Revocation or cancellation of certificate of authority
641.25
Administrative penalty in lieu of suspension or revocation
641.26
Annual and quarterly reports
641.27
Examination by the department
641.28
Civil remedy
641.29
Fees
641.30
Construction and relationship to other laws
641.31
Health maintenance contracts
641.32
Acceptable payments
641.33
Certain words prohibited in name of organization
641.35
Assets, liabilities, and investments
641.36
Adoption of rules
641.37
Prohibited activities
641.38
Operational health maintenance organizations
641.183
Statutory accounting procedures
641.185
Health maintenance organization subscriber protections
641.201
Applicability of other laws
641.215
Conditions precedent to issuance or maintenance of certificate of authority
641.217
Minority recruitment and retention plans required
641.221
Continued eligibility for certificate of authority
641.225
Surplus requirements
641.227
Rehabilitation Administrative Expense Fund
641.228
Florida Health Maintenance Organization Consumer Assistance Plan
641.234
Administrative, provider, and management contracts
641.255
Acquisition, merger, or consolidation
641.261
Other reporting requirements
641.281
Injunction
641.282
Payment of judgment by health maintenance organization
641.284
Liquidation, rehabilitation, reorganization, and conservation
641.285
Insolvency protection
641.286
Levy upon deposit limited
641.305
Language used in contracts and advertisements
641.309
Standards for marketing to persons eligible for Medicare
641.312
Scope
641.313
Health maintenance contracts
641.314
Pharmacy benefit manager contracts
641.315
Provider contracts
641.316
Fiscal intermediary services
641.365
Dividends
641.385
Order to discontinue certain advertising
641.386
Agent licensing and appointment required
641.2011
Insurance holding companies
641.2015
Incorporation required
641.2017
Insurance business not authorized
641.2018
Limited coverage for home health care authorized
641.2019
Provider service network certificate of authority
641.2261
Application of solvency requirements to provider-sponsored organizations and Medicaid provider service networks
641.2342
Contract providers
641.3005
Application of ch. 85-177
641.3007
HIV infection and AIDS for contract purposes
641.3101
Additional contract contents
641.3102
Restrictions upon expulsion or refusal to issue or renew contract
641.3103
Charter, bylaw provisions
641.3104
Execution of contracts
641.3105
Validity of noncomplying contracts
641.3106
Construction of contracts
641.3107
Delivery of contract
641.3108
Notice of cancellation of contract
641.3111
Extension of benefits
641.3154
Organization liability
641.3155
Prompt payment of claims
641.3156
Treatment authorization
641.3901
Unfair methods of competition and unfair or deceptive acts or practices prohibited
641.3903
Unfair methods of competition and unfair or deceptive acts or practices defined
641.3905
General powers and duties of the department and office
641.3907
Defined unfair practices
641.3909
Cease and desist and penalty orders
641.3911
Appeals from the department or office
641.3913
Penalty for violation of cease and desist orders
641.3915
Health maintenance organization anti-fraud plans and investigative units
641.3917
Civil liability
641.3921
Conversion on termination of eligibility
641.3922
Conversion contracts
641.3923
Discrimination against providers prohibited
641.20185
High-deductible contracts for medical savings accounts
641.31015
Health maintenance organization or exclusive provider organization
641.31071
Preexisting conditions
641.31072
Special enrollment periods
641.31073
Prohibiting discrimination against individual participants and beneficiaries based on health status
641.31074
Guaranteed renewability of coverage
641.31075
Advanced practice registered nurse services
641.31076
Shared savings incentive program
641.31077
Coverage for organ transplants
641.31085
Disclosures to subscribers
641.31094
Nondiscrimination of coverage for certain surgical procedures involving bones or joints
641.31095
Coverage for mammograms
641.31096
Requirements with respect to breast cancer and routine followup care
641.31097
Decreasing inappropriate utilization of emergency care
641.31098
Coverage for individuals with developmental disabilities
641.31099
Restrictions on use of state and federal funds for state exchanges
641.39001
Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited

Current through Fall 2025

§ 641.31072. Spec. enrollment periods's source at flsenate​.gov