Florida § 627.446 Advanced explanation of benefits

Florida Statutes

§ 627.446 — Advanced explanation of benefits

Florida § 627.446

TitleXXXVII

Ch. 627INSURANCE RATES AND CONTRACTS

This text of Florida § 627.446 (Advanced explanation of benefits) is published on Counsel Stack Legal Research, covering Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Fla. Stat. § 627.446 (2026).

Text

(1)As used in this section, the term “health insurer” means a health insurer issuing individual or group coverage or a health maintenance organization issuing coverage through an individual or a group contract.

(2)Each health insurer shall prepare an advanced explanation of benefits upon receiving a patient estimate from a facility pursuant to s. 395.301(1). The health insurer must provide the advanced explanation of benefits to the insured no later than 1 business day after receiving the patient estimate from the facility or, in the case of a service scheduled at least 10 business days in advance, no later than 3 business days after receiving such estimate. The health insurer must provide an advanced explanation of benefits to the insured no later than 3 business days after the date on

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(1) As used in this section, the term “health insurer” means a health insurer issuing individual or group coverage or a health maintenance organization issuing coverage through an individual or a group contract.

(2) Each health insurer shall prepare an advanced explanation of benefits upon receiving a patient estimate from a facility pursuant to s. 395.301(1). The health insurer must provide the advanced explanation of benefits to the insured no later than 1 business day after receiving the patient estimate from the facility or, in the case of a service scheduled at least 10 business days in advance, no later than 3 business days after receiving such estimate. The health insurer must provide an advanced explanation of benefits to the insured no later than 3 business days after the date on which the health insurer receives a request from the insured.

(3) At a minimum, the advanced explanation of benefits must include detailed coverage and cost-sharing information pursuant to the No Surprises Act, Title I of Division BB of the Consolidated Appropriations Act, 2021, Pub. L. No. 116-260.