Titular de Insurance Insights
Volume 2, No. 2 - March 2013

In The Know

- Keeping you informed is what it's all about

Were You Secretly Shopped?

Twenty-one investigators from the Florida Department of Financial Services, Division of Agent and Agency Services, recently assisted in the Center for Medicare & Medicaid Services (CMS) national surveillance program to protect the citizens of Florida from the possible inappropriate marketing of Medicare Advantage and Prescription Drug Plans.

Secret shopping is the undercover surveillance of public marketing events. These events were identified from the formal sales/marketing events reported to CMS by plan sponsors through the Health Plan Management System. Shops were selected through a random sampling of events pulled from the universe of events. CMS-developed training was provided to the investigators to ensure the quality of the secret shopping initiative and consistency across shoppers. The training addressed permissible and non-permissible sales activities, targeted observation tools, and the unique aspects of different types Medicare Advantage and Medicare Part D prescription drug plans marketing violations. Department investigators participated in 75 shopping events.

In addition to determining if an agent misled consumers regarding Medicare products, investigators verified agents' licenses and determined if there were any violations of the Florida Statutes. Department investigators' attendance is not only limited to CMS marketing lectures. They may be sitting across the table from you during your sales presentation to their mother or in the audience of your next seminar.

Five Attempt Limit on License Exams

As of October 1, 2012, ss. 626.281(2), Florida Statutes changed to create a limit on the number of licensing exam attempts an individual is allowed during a given period of time. The new law established a limit of five exam attempts for the same exam type during a twelve month period. The effect of this law is the creation of a rolling time window looking back from today's date for exactly one year. All exams for a particular license attempted during that window count towards the five exam limit. Individuals who have reached the five exam limit are not permitted to sit for their next exam attempt until the one year time window only contains four exams.

Prior to October 1, 2012 there was no limit on the number of exam attempts. As a result, some individuals attempted a single exam well in excess of five times. Any of those attempts which occurred within the past one year window looking back from today are counted towards the new five exam attempt limit. Individuals in this situation should count back their five most recent exam attempts to determine the oldest of the five. Taking the date of the oldest of the five and adding one year to that date will determine the next date the individual will again be eligible to sit for the exam.

A specific example of the application of this law would be an individual taking a general lines (2-20) exam for the very first time on June 1, 2012, and failing the exam. After this first attempt, the individual sat for the exam four more times between June 2, 2012 and December 30, 2012. This individual will not be eligible to sit for the exam again until June 1, 2013.

The Department cannot waive the five exam limit for those who were unaware of the law change and unsuccessfully sat for the same exam several times. The law provides for a twelve month look back, not a look back to October 1, 2012. Therefore, exam attempts that were made before the effective date of the law change will also be counted against any exam scheduled after October 1, 2012.

Note: After three unsuccessful attempts, Bail Bond (limited surety) license exam candidates must repeat a 120-hour pre-licensing course and obtain a grade of 80 percent or higher before being eligible to attempt the exam again.

Title Insurance Agencies: New Laws on Statistical Data Gathering

Section 627.782, Florida Statutes, was revised during the 2012 Legislative Session to add that each title insurance agency licensed to do business in this state shall maintain and submit information, including revenue, loss, and expense data, to assist in the analysis of title insurance premium rates, title search costs, and the condition of the title insurance industry in this state. This information must be transmitted to the Office of Insurance Regulation (OIR) annually by March 31 of the year after the reporting year.

The implementation of this statute relies on the adoption of rules that will provide instructions for the proper submission of title-related data to the State of Florida. The OIR has been working with the title insurers, the Florida Land Title Association, and several members of the title insurance industry to create the rules required. On March 14, 2013, the OIR held a formal workshop to solicit comments from the industry and the general public.

We encourage you to review the proposed rule, data collection form, and affidavit. It is the intention of the OIR to have this rule in place in time to collect information effective January 1, 2014 from every licensed title insurance agency doing business in Florida.

Comments to the OIR may be directed to: Peter Rice at (850) 413-5249 or Peter.Rice@floir.com.

Workers' Compensation Compliance Reminder

The Florida Department of Financial Services, Division of Workers' Compensation, is responsible for ensuring that employers comply with their statutory obligations to obtain workers' compensation insurance coverage for their employees. As a part of their compliance activities, the Division has found a number of healthcare industry employers without the proper workers' compensation insurance. The Division is seeking agents' assistance in ensuring that their clients are aware of the workers' compensation requirements and are in compliance with them.

All non-construction industry employers in the State of Florida who have four or more employees must have workers' compensation insurance coverage for all of their employees.

While corporate officers are defined by law as employees, an officer of an active Florida corporation can apply for an exemption for themselves, providing that they demonstrate ownership in the business. If exempt, as approved by the Division, the corporate officer would not be included in the count of employees.

The Division of Workers' Compensation conducts routine investigations of Florida employers, including those in the medical industry, to assure that the proper insurance is in effect. Where an employer is found to be without workers' compensation insurance, a Stop-Work Order is issued. A Stop-Work Order requires the cessation of all business operations until the employer comes into compliance with the coverage requirements and pays the assessed penalty. In addition, a penalty is assessed which is equal to 1.5 times the amount the employer would have paid in premium within the preceding 3-year period or $1,000, whichever is greater.

Notice of Workers' Compensation Exemption Law Change

The Florida Legislature passed and the Governor signed into law CS/HB 941, which amended Sections 440.02(9) and 440.05, Florida Statutes.

Effective July 1, 2013, the law changes to include non-construction limited liability company (LLC) members as employees. LLC members will be included on their Workers' Compensation insurance policy; however, they may elect to be exempt by filing a Notice of Election to Be Exempt with the Division of Workers' Compensation.

To apply for a Certificate of Election to be Exempt, go to the Division of Workers' Compensation's website at www.MyFloridaCFO.com/WC and click the "Apply for an Exemption" icon.

If you have any questions, please contact the Division of Workers' Compensation at (850) 413-1609.