Florida Regulations 69O-149.054: Forms Incorporated by Reference
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(1) The following forms are hereby adopted and incorporated by reference:
(a) Form OIR-B2-570 (12/03) “”General Information on Self-Funded Health Benefit Plans””;
(b) Form OIR-B2-571 (12/03) “”New Plan Operating Projections for Self-Funded Health Benefit Plans””;
(c) Form OIR-B2-572 (12/03) “”Annual Report of Self-Funded Health Benefit Plans””;
(d) Form OIR-B2-573 (12/03) “”Operating Projections for Self-Funded Health Benefit Plans””;
(e) Form OIR-B2-574 (12/03) “”General Information and Surplus Statement for Self-Funded Health Benefit Plans””;
(2) The above forms are hereby adopted and incorporated by reference.
(3) All forms are available and may be printed from the Office website: “”http://www.floir.com/iportal.””
Rulemaking Authority Florida Statutes § 112.08(6). Law Implemented Florida Statutes § 112.08. History-New 5-18-04.
(b) Form OIR-B2-571 (12/03) “”New Plan Operating Projections for Self-Funded Health Benefit Plans””;
(c) Form OIR-B2-572 (12/03) “”Annual Report of Self-Funded Health Benefit Plans””;
(d) Form OIR-B2-573 (12/03) “”Operating Projections for Self-Funded Health Benefit Plans””;
(e) Form OIR-B2-574 (12/03) “”General Information and Surplus Statement for Self-Funded Health Benefit Plans””;
(2) The above forms are hereby adopted and incorporated by reference.
(3) All forms are available and may be printed from the Office website: “”http://www.floir.com/iportal.””
Rulemaking Authority Florida Statutes § 112.08(6). Law Implemented Florida Statutes § 112.08. History-New 5-18-04.