Fla. Stat. 641.31074
Guaranteed renewability of coverage

(1)

Except as otherwise provided in this section, a health maintenance organization that issues a health insurance contract must renew or continue in force such coverage at the option of the contract holder.

(2)

A health maintenance organization may nonrenew or discontinue a contract based only on one or more of the following conditions:The contract holder has failed to pay premiums or contributions in accordance with the terms of the contract or the health maintenance organization has not received timely premium payments.The contract holder has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the contract.The contract holder has failed to comply with a material provision of the plan which relates to rules for employer contributions or group participation.The health maintenance organization is ceasing to offer coverage in such a market in accordance with subsection (3).There is no longer any enrollee in connection with such plan who lives, resides, or works in the service area of the health maintenance organization or in the area in which the health maintenance organization is authorized to do business.In the case of coverage that is made available only through one or more bona fide associations as defined in s. 627.6571(5), the membership of an employer in the association, on the basis of which the coverage is provided, ceases, but only if such coverage is terminated under this paragraph uniformly without regard to any health-status-related factor that relates to any covered individuals.

(a)

The contract holder has failed to pay premiums or contributions in accordance with the terms of the contract or the health maintenance organization has not received timely premium payments.

(b)

The contract holder has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the contract.

(c)

The contract holder has failed to comply with a material provision of the plan which relates to rules for employer contributions or group participation.

(d)

The health maintenance organization is ceasing to offer coverage in such a market in accordance with subsection (3).

(e)

There is no longer any enrollee in connection with such plan who lives, resides, or works in the service area of the health maintenance organization or in the area in which the health maintenance organization is authorized to do business.

(f)

In the case of coverage that is made available only through one or more bona fide associations as defined in s. 627.6571(5), the membership of an employer in the association, on the basis of which the coverage is provided, ceases, but only if such coverage is terminated under this paragraph uniformly without regard to any health-status-related factor that relates to any covered individuals.

(3)(a)

A health maintenance organization may discontinue offering a particular contract form only if:
The health maintenance organization provides notice to each contract holder provided coverage of this form in such market, and participants and beneficiaries covered under such coverage, of such discontinuation at least 90 days prior to the date of the nonrenewal of such coverage;
The health maintenance organization offers to each contract holder provided coverage of this form in such market the option to purchase all, or in the case of the large group market, any other health insurance coverage currently being offered by the health maintenance organization in such market; and
In exercising the option to discontinue coverage of this form and in offering the option of coverage under subparagraph 2., the health maintenance organization acts uniformly without regard to the claims experience of those contract holders or any health-status-related factor that relates to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for such coverage.
In any case in which a health maintenance organization elects to discontinue offering all coverage in the individual market, the small group market, the large group market, or any combination thereof in this state, coverage may be discontinued by the insurer only if:
The health maintenance organization provides notice to the office and to each contract holder, and participants and beneficiaries covered under such coverage, of such discontinuation at least 180 days prior to the date of the nonrenewal of such coverage; and
All health insurance issued or delivered for issuance in this state in such market is discontinued and coverage under such health insurance coverage in such market is not renewed.
In the case of a discontinuation under subparagraph 1. in a market, the health maintenance organization may not provide for the issuance of any health maintenance organization contract coverage in the market in this state during the 5-year period beginning on the date of the discontinuation of the last insurance contract not renewed.

(3)(a)

A health maintenance organization may discontinue offering a particular contract form only if:The health maintenance organization provides notice to each contract holder provided coverage of this form in such market, and participants and beneficiaries covered under such coverage, of such discontinuation at least 90 days prior to the date of the nonrenewal of such coverage;The health maintenance organization offers to each contract holder provided coverage of this form in such market the option to purchase all, or in the case of the large group market, any other health insurance coverage currently being offered by the health maintenance organization in such market; andIn exercising the option to discontinue coverage of this form and in offering the option of coverage under subparagraph 2., the health maintenance organization acts uniformly without regard to the claims experience of those contract holders or any health-status-related factor that relates to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for such coverage.
1. The health maintenance organization provides notice to each contract holder provided coverage of this form in such market, and participants and beneficiaries covered under such coverage, of such discontinuation at least 90 days prior to the date of the nonrenewal of such coverage;
2. The health maintenance organization offers to each contract holder provided coverage of this form in such market the option to purchase all, or in the case of the large group market, any other health insurance coverage currently being offered by the health maintenance organization in such market; and
3. In exercising the option to discontinue coverage of this form and in offering the option of coverage under subparagraph 2., the health maintenance organization acts uniformly without regard to the claims experience of those contract holders or any health-status-related factor that relates to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for such coverage.

(b)1.

In any case in which a health maintenance organization elects to discontinue offering all coverage in the individual market, the small group market, the large group market, or any combination thereof in this state, coverage may be discontinued by the insurer only if:
The health maintenance organization provides notice to the office and to each contract holder, and participants and beneficiaries covered under such coverage, of such discontinuation at least 180 days prior to the date of the nonrenewal of such coverage; and
All health insurance issued or delivered for issuance in this state in such market is discontinued and coverage under such health insurance coverage in such market is not renewed.
In the case of a discontinuation under subparagraph 1. in a market, the health maintenance organization may not provide for the issuance of any health maintenance organization contract coverage in the market in this state during the 5-year period beginning on the date of the discontinuation of the last insurance contract not renewed.
(b)1. In any case in which a health maintenance organization elects to discontinue offering all coverage in the individual market, the small group market, the large group market, or any combination thereof in this state, coverage may be discontinued by the insurer only if:a. The health maintenance organization provides notice to the office and to each contract holder, and participants and beneficiaries covered under such coverage, of such discontinuation at least 180 days prior to the date of the nonrenewal of such coverage; andb. All health insurance issued or delivered for issuance in this state in such market is discontinued and coverage under such health insurance coverage in such market is not renewed.
a. The health maintenance organization provides notice to the office and to each contract holder, and participants and beneficiaries covered under such coverage, of such discontinuation at least 180 days prior to the date of the nonrenewal of such coverage; and
b. All health insurance issued or delivered for issuance in this state in such market is discontinued and coverage under such health insurance coverage in such market is not renewed.
2. In the case of a discontinuation under subparagraph 1. in a market, the health maintenance organization may not provide for the issuance of any health maintenance organization contract coverage in the market in this state during the 5-year period beginning on the date of the discontinuation of the last insurance contract not renewed.

(4)

At the time of coverage renewal, a health maintenance organization may modify the coverage for a product offered:In the large group market;In the small group market if, for coverage that is available in such market other than only through one or more bona fide associations, as defined in s. 627.6571(5), such modification is consistent with s. 627.6699 and effective on a uniform basis among group health plans with that product; orIn the individual market if the modification is consistent with the laws of this state and effective on a uniform basis among all individuals with that policy form.

(a)

In the large group market;

(b)

In the small group market if, for coverage that is available in such market other than only through one or more bona fide associations, as defined in s. 627.6571(5), such modification is consistent with s. 627.6699 and effective on a uniform basis among group health plans with that product; or

(c)

In the individual market if the modification is consistent with the laws of this state and effective on a uniform basis among all individuals with that policy form.

(5)

In applying this section in the case of health insurance coverage that is made available by a health maintenance organization in the small group market or large group market to employers only through one or more associations, a reference to “contract holder” is deemed, with respect to coverage provided to an employer member of the association, to include a reference to such employer.

Source: Section 641.31074 — Guaranteed renewability of coverage, https://www.­flsenate.­gov/Laws/Statutes/2024/0641.­31074 (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

§ 641.31074. Guaranteed renewability of coverage's source at flsenate​.gov