Florida Administrative Code
69 - DEPARTMENT OF FINANCIAL SERVICES
69O - OIR - Insurance Regulation
Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS
Section 69O-187.007 - Continuing Requirements Including Filing of Reports and Rates

Universal Citation: FL Admin Code R 69O-187.007

Current through Reg. 50, No. 187; September 24, 2024

(1) The Trustees shall have the accounts and records of the Fund audited annually or at any time as may be required by the Office, such audit to be made by Certified Public Accountants or by authorized representatives of the Office, with the Office reserving the right to prescribe a uniform accounting system to be used by the Fund in order that it may determine the solvency of the Fund. An audit prepared by other than Office personnel shall be a certified audit filed with and received by the Office in Tallahassee within ninety (90) days after the close of the fund year. All filings shall be submitted electronically to http://www.floir.com/iportal.

(2) The Trustees shall annually file a report as to financial condition, loss experience, and operational expense of the Fund on Form OIR-342 entitled "Medical Malpractice Self-Insurance Trust Fund Annual Audit." This report shall be due and must be received by the Office within ninety (90) days of the close of the fund year. Form OIR-342, rev. 2/93, is hereby adopted and incorporated by reference. Forms are available at http://www.floir.com/iportal.

(3) The Fund and its Service Agent shall be subject to Office inspection and examination of the affairs, transactions, accounts, books, records, and assets of the self-insurance trust fund or Service Agent as often as the Office deems advisable. The reasonable expense of any such examination including record reconstruction or costs of appraisals shall be borne by the Fund but for no more than one examination per year.

(4) Each Fund shall comply with Section 627.912, F.S., and Rule 69O-171.003, F.A.C., by filing Form OIR-303 entitled "Florida Medical Professional Liability Insurance Claims Report," which is incorporated by reference in Rule 69O-171.003, F.A.C., with the Office. Form OIR-303 may be obtained from the Office of Insurance Regulation, Bureau of Property and Casualty Forms and Rates, Larson Building, Tallahassee, Florida 32399-0300.

(5) The Trustees and the Service Agent shall make available to the Office at their request any or all minutes pertaining to the meetings of the Trustees. Any matter relating to individual members or individual claims may be edited to preserve the confidentiality of the member's name or claim information.

(6) The Fund shall file with the Office all changes or modifications to documents previously filed with the Office at least thirty (30) days prior to the date of implementation and all changes and modifications shall be subject to Office approval. All filings shall be submitted electronically to http://www.floir.com/iportal.

(7) The Fund shall file all rate changes with the Office at least thirty (30) days prior to use and include in such filings the expense factors underlying the proposed rates and such additional information that demonstrates that rates are adequate so as to guarantee the maintenance of sufficient reserves to cover contingent liabilities. The Office's responsibility in the review of such filings shall be as follows:

(a) At such time the Office determines the expense factors are justified, and the associated rates are adequate so as to guarantee the maintenance of sufficient reserves to cover contingent liabilities, the Fund shall be notified in writing that the expense factors are approved and the rates utilizing such expense factors are acceptable for use.

(b) The Office shall disapprove any rate if it is determined that the expense factors are not justified and reasonable or that the rates are inadequate and do not guarantee the maintenance of sufficient reserves to cover contingent liabilities. The Fund shall be notified by certified mail of this fact with an explanation of the underlying factors that led to such conclusion. The Fund shall be entitled to the rights as specified in Chapter 120, F.S. In the event the filing is deficient and the Office cannot make an initial determination, the Office shall within thirty (30) days of the receipt of such filing request in writing additional information. The Fund shall have thirty (30) days from the date of the Office's request to respond, and if such information is not received or is not sufficiently responsive, the rates shall be disapproved. The Fund shall be entitled to the rights as specified in Chapter 120, F.S.

(8) Unless otherwise indicated in these rules, all Funds shall maintain on a continuing basis and file with the Office the requirements pursuant to paragraphs 69O-187.004(2)(a), (d), (e) and (g) through (p), F.A.C. Failure to do so may result in withdrawal of the Fund's self-insurance privilege.

(9) The Trustees shall file quarterly reports as to the financial condition, loss experience and operational expense of the Fund on Form OIR-343, "Medical Malpractice Self-Insurance Trust Fund Quarterly Audit," rev. 2/93, which is hereby adopted and incorporated by reference. This report is due and must be received by the Office within sixty (60) days of the close of the fund quarter. Forms are available at http://www.floir.com/iportal.

(10) Each Fund shall comply with Sections 627.4147 and 627.4148, F.S.

Rulemaking Authority 624.308(1), 627.357(6) FS. Law Implemented 624.307(1), 624.424, 627.357, 627.4147, 627.4148 FS.

New 10-7-75, Formerly 4-39.06, Amended 5-10-89, Formerly 4-39.006, Amended 1-18-94, Formerly 4-187.007, Amended 7-30-17.

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