Get Individual Health Coverage Policy Forms Issued/renewed In Florida

This guide provides a comprehensive and user-friendly approach to completing the Individual Health Coverage Policy Forms issued or renewed in Florida. By following the steps outlined below, users can efficiently fill out and submit these essential forms online.

Follow the steps to complete your health coverage policy form online.

1. Click 'Get Form' button to access the form and open it for completion.
2. In Section A, fill in your company name, FEIN, NAIC Co Code, state, zip code, phone number, fax number, toll-free Florida consumer information number, date filed, mailing address, city, contact person, and their email address.
3. Proceed to Section B where you need to indicate your carrier individual election status by selecting one of the options: 'Risk Assuming Carrier,' 'Reinsuring Carrier,' 'Withdrawing from the Market,' or 'Not Applicable and/or Not authorized to write health coverage in Florida.'
4. Move to Section C. Here, you must confirm if your company currently offers individual major medical and/or hospital, surgical, or medical expense products by answering 'Yes' or 'No.'
5. If you answered 'Yes' in Section C, skip to Section D. Fill out the plan name, form number(s), primary insured, dependents, largest volume producing product, and second largest volume producing product.
6. Provide descriptions of the benefits for each policy issued or in force, and total the number of primary insureds and dependents covered under these policies at the end of the reporting calendar year.
7. If actively marketing these products, continue to Section E. Note the information requested for the two actively marketed products, including the largest and next largest direct premium earned volume, and provide necessary attachments.
8. Finally, make sure to review all information for accuracy. Once completed, you can save changes, download, print, or share the form as needed.

Start filling out your Individual Health Coverage Policy Form online now to ensure timely submission.