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OIR Issues Memorandum on Guaranteed Availability of Health Insurance

OIR Issues Memorandum on Guaranteed Availability of Health Insurance

The Office of Insurance Regulation (OIR) has issued informational memorandum OIR-11-01 to life and health insurers and health maintenance organizations licensed in Florida.  The stated purpose of the memorandum is to inform insurers of the requirements of Section 627.6487, Florida Statutes, relating to the guaranteed availability of health insurance.

The memorandum states that eligible individuals who seek to enroll in individual health insurance coverage may do so without regard to pre-existing conditions if the individuals (i) have 18 months of creditable coverage as defined in Section 627.6561, Florida Statutes, (ii) most recently had coverage under a group health plan, government plan, or church plan, or health insurance coverage offered in connection with any such plan, and (iii) most recently had coverage under an individual plan and were terminated by the insurer or HMO due to insolvency or withdrawing from all health coverage in Florida.  Coverage issued under the Cover Florida program qualifies as creditable coverage for purposes of the guaranteed availability provision.