Coronavirus (COVID-19)

OIR-20-06M: Telehealth and Pharmacy Audit Guidance

April 6, 2020

In response to Governor Ron DeSantis’ Executive Orders 20-51 and 20-52 establishing COVID-19 response protocols and declaring a state of emergency in the state of Florida, OIR issued Informational Memorandum OIR-20-06M to all health insurers, and other health entities regulated by OIR, and all Pharmacy Benefit Managers registered to do business in Florida to encourage the use of technology to help combat the spread of COVID-19.

All health insurers, health maintenance organizations, and other health entities are encouraged to broaden access to care for telehealth services to help alleviate hurdles for Floridians attempting to utilize telehealth services to receive needed care.

All registered Pharmacy Benefit Managers are requested to transition to an electronic audit process in order to avoid unnecessary risk and maintain social distancing, and extended audit deadlines when possible.

Please read Informational Memorandum OIR-20-06M here.

OIR-20-05M: Workers’ Compensation Insurance

April 6, 2020

In response to Governor Ron DeSantis’ Executive Orders 20-51 and 20-52 establishing COVID-19 response protocols and declaring a state of emergency in the state of Florida, and Chief Financial Officer Patronis’ Directive 2020-05 providing workers compensation coverage for public servants on the front line of COVID-19, OIR issued Informational Memorandum OIR-20-05M to all insurers and entities authorized to write workers’ compensation insurance.

First responders, health care workers, and others that contract COVID-19 due to work-related exposure would be eligible for workers’ compensation benefits under Florida law.

OIR reminds insurers of applicable statutes regarding workers’ compensation insurance and expects workers’ compensation insurers to comply with all of the provisions of Florida’s Workers’ Compensation Law and will take appropriate action in the event of non-compliance.

Please read Informational Memorandum OIR-20-05M here.

OIR-20-04M: Leniency on Payments and Other Considerations

March 25, 2020

The OIR issued Informational Memorandum OIR-20-04M to all insurers and entities regulated by the office to provide general guidance on the treatment of policyholders as part of the state’s ongoing efforts to protect Floridians. Guidance within this memorandum includes:

Leniency on Premium Payments

Regulated entities are encouraged, when prudently possible, to be flexible with premium payments in order to avoid a lapse in coverage. Regulated entities are encouraged to only consider cancellation of policies if all possible efforts to work with consumers to continue coverage have been exhausted.

Removing Exclusions on Certain Personal Auto Exclusions

Many insureds may be temporarily utilizing their personal automobile for purposes that might otherwise be considered commercial use. Regulated entities are encouraged to consider allowing such use for insureds, provided that such use is limited to the duration of the Emergency Orders.

Underwriting and Claims Inspections

Regulated entities, agents, consumers, and employers are strongly encouraged to explore virtual options for underwriting and adjusting claims in lieu of in-person property inspections and for premium audits of employers’ records.

General Considerations

OIR has provided guidance on general considerations regulated entities can make, including electronic communications, teleworking, and utilizing electronic signatures. In addition, OIR is granting a 30-day extension for any annual statements due to be filed with OIR by a regulated entity on or before May 1, 2020, for the following regulated entities:

• Health maintenance organizations pursuant to section 641.26, Florida Statutes;

• Insurance administrators pursuant to section 626.89, Florida Statutes;

• Continuing care providers pursuant to section 651.026, Florida Statutes; and

• Multiple-employer welfare arrangements pursuant to section 624.442, Florida Statutes. 

Please read Informational Memorandum OIR-20-04M here.

OIR-20-03M: Business Continuity / Continuity of Operations Plans

March 16, 2020

Understanding recommended COVID-19 prevention and treatment measures may disrupt normal business operations, OIR issued Informational Memorandum OIR-20-03M directing all insurers and entities regulated by OIR to review and update their Business Continuity Plans and/or Continuity of Operation Plans immediately. The plans must provide a framework for the continuation of company operations, including key insurance functions such as policy issuance, premium collection, claims adjustment and payment and policyholder service. The continuity plans should also account for DOH and CDC guidance surrounding COVID-19, including executive orders issued at the state and national level.

Please read Informational Memorandum OIR-20-03M here.

OIR-20-02M: Prescription Refills

March 10, 2020

Following Governor DeSantis’ Executive Order 20-52 declaring an emergency in the state of Florida in response to the COVID-19 public health emergency, the Florida Office of Insurance Regulation (OIR) issued Informational Memorandum OIR-20-02M to all health insurers, health maintenance organizations and other health entities authorized to do business in Florida as a reminder of Florida law regarding early prescription refills.

Please read Informational Memorandum OIR-20-02M here.

OIR-20-01M: Communication and Cost-Sharing

March 6, 2020

In response to the Executive Order 20-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, the Florida Office of Insurance Regulation (OIR) is issuing this Informational Memorandum to all health insurers authorized to do business in Florida to help facilitate the state’s ongoing efforts to protect Floridians.

This memorandum directs insurers to:

• Use every channel available to them to communicate with their policyholders and share official CDC and DOH information;
• Devote resources to inform consumers of available benefits, quickly respond to inquiries, and avoid and dispel misinformation;
• Work with public health officials to do everything possible to prepare and respond; and
• Consider all practicable options to reduce the barriers of cost-sharing for testing and treatment of COVID-19.

Please read Informational Memorandum OIR-20-01M here.