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Rule Chapter 69D-2, FAC has
been adopted September 15, 2006. Effective 20
days from this date insurers and Health
Maintenance Organizations (HMO) must file
updated SIU Descriptions or Anti-fraud plans
pursuant to section 626.9891, Florida Statutes.
The type of filing will be differentiated by
the insurer’s volume of Florida annual direct
written premium for calendar year 2006. Those
insurers that write $10 million or more in
annual direct written premium are subject to
Section 626.9891(1), F.S. and 69D-2.003, FAC and
those that write less than $10 million in annual
direct written premium are subject to Section
626.9891(2), F.S. and 69D-2.004, FAC.
Rule Chapter 69D-2, FAC
requires that insurers and HMOs file the updated
SIU descriptions and anti-fraud plans on the
division’s on-line, electronic database known
as
IFPR
(INSURANCE FRAUD PLAN REPORTING).
Further, the rule stipulates that insurers and
HMOs must file the updated SIU descriptions
AND/OR anti-fraud plans on FORMS specified by
the division. There are only two types of forms
available. The available forms are indicated
below. An insurer or HMO will only make one
filing, either the SIU description or anti-fraud
plan depending on their premium volume.
The insurer or HMO user
will first select the type of
form that they should file.
Form
DFS-L1-1689/SIU Description – Word –
if more than $10 million in Florida annual
direct written premium.
Form
DFS-L1-1689 (Word)
Form
DFS-L1-1689 (PDF)
Form
DFS-L1-1690/Anti-fraud plans – Word –
if less than $10 million in Florida direct
written premium
Form
DFS-L1-1690 (Word)
Form
DFS-L1-1690 (PDF)
Once the form is selected,
the user will click on the form and
“save” the form file
to your computer files. You can save it as the
form #, but it may be better to rename it after
the form has been completed. The insurer or HMO
should complete each component requirements
(Questions) on the form. After the user has
completed the correct form, the user will
return to IFPR so that
the filing can be made.
You can click
“Instructions for Filing SIU Descriptions and
Anti-fraud plans to IFPR”
for detailed instructions to make the
filing. Important note: The SIU descriptions and
anti-fraud plan form filings request
“acknowledgments”, but each insurer and HMO must
have detail descriptions of the requested
information in their unit SIU descriptions and
anti-fraud plans in the event the description
or anti-fraud plan is audited by the Office of
Insurance Regulation, Market Conduct
Examinations.
Frequently Asked Questions on Insurance Fraud
Plan Report Filing
INSURANCE FRAUD PLAN REPORT FILING – IFPR to
make filing
Rule 69D-2, F.A.C.
INSURER ANTI-FRAUD INVESTIGATIVE UNITS AND ANTI-
FRAUD PLANS
DFS INFORMATIONAL MEMORANDUM
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