Florida Law and Ethics Update (5-240) 4 HR CE

This continuing education class fulfills the entire law and ethics review required for your health insurance license renewal. In addition to discussing significant recent legislative changes to the practice of insurance in Florida, the course covers all the topics and cited references in the Regulatory Resource Guide prepared for this specific license type by the Department of Financial Services (DFS).

The material covered will help students review and clarify the regulatory structure for insurance in the state, deepen their knowledge of ethical standards enforced in Florida with regard to insurance, and refresh their understanding of their responsibilities and of the professional standards to which they are held. Most importantly, the class also covers major federal and state changes enacted during the recent legislative sessions, with a focus on the law updates and changes health insurance licensees.

Some of the topics covered include the following:

• Regulatory awareness, including the various departments in Florida that administer financial services and insurance as well as jurisdiction of duties and responsibilities;
• Licensing requirements, including appointments, contact information, agency licensing, transferring, surrendering and terminating licenses, grounds for compulsory or discretionary refusal of a license, as well as suspensions and revocations for individuals and agencies;
• Florida administrative codes that govern licensing, including scope of license, the new pathway to receive a 4-40 Customer Service license, prelicense requirements, unaffiliated agents, appointments, renewal, continuation, reinstatement, or termination of appointments, CE requirements and fees;
• Contact information change requirements, insurance agency licensing, transfer of license from another state, duration of suspensions and revocations, surrender of license, fines in place of or in addition to other penalties, probation and restitution;
• Agency personnel powers, duties and limitations, customer representative's powers; agent’s or agency’s responsibility, unlicensed agency personnel, prohibition against unlicensed transaction of life/health insurance and unlawful payment or sharing of commissions;
• Other requirements, including reporting and accounting for funds, administrative actions, and unlicensed activity by a MEWA;
• Advertising, including ads supplied by an insurer;
• Bans on unfair inducements to purchase insurance, testimonials by third parties, disparaging statements or comparisons, record-keeping;
• Department communication: MyProfile, Insurance Insights, industry alerts and consumer services, and the Office of Insurance Regulation website;
• Guaranty Associations, the Florida Life and Health Insurance Guaranty Association (FLAHIGA), the goal of the association, and statutory limits for protections;
• Law updates and changes, including:
• Protection for specified adults;
• §825.103(1) – Exploitation of an Elderly Person or Disabled Adult
• CS/SB 1808: Refund of Patient Overpayments;
• SB 2514: Colorectal Cancer Screening;
• SB 892: Dental claims and credit card payments;
• SB 7018: The Health Care Innovation Council;
• SB 1550: Prescription drug pricing transparency and price increases;
• HB 201: Emergency refills of insulin and related supplies; and
• SB 1580: Protections of medical conscience.
• Changes to the Affordable Care Act including income and subsidy changes
• Ethical requirements are thoroughly discussed, and include the state’s Code of Ethics, the NAIFA ethical code, marketing and regulatory environments that require ethical actions and additional ethical guidelines for Florida licensees;
• Bill of Rights for Policyholders
• Understanding industry products and suitability of sales and services: suitability of sales to consumers and required elements and transactions that make a sale suitable for the customer;
• Unfair methods of competition and unfair and deceptive practices (parts 1-6) by insurers, agents, agencies and claims personnel, including penalties for violations and advertising restrictions;
• Understanding required premium discounts;
• Disciplinary actions and industry trends:
• Unauthorized products and entities involved in Florida commerce, duties of a licensed agent, associated penalties;
• Enforcement actions: cited cases and investigations:
• An exploration of recent violations and enforcement actions with an emphasis on how to perform within expectations and within ethical and legal guidelines;
• A case of a felony conviction involving a nonresident licensee: DFS, Division of Insurance Agent and Agency Services, Petitioner, v. Respondent Joseph Samuel Brown Jr., Case No.: 359317-26-AG;
• A case of a licensee convicted of numerous felonies: DFS, Division of Insurance Agent and Agency Services, Petitioner, v. Balmont Thompson, Respondent, Case No.: 333995-24-AG
• A 10- count charge against a licensee for repeated fraudulent actions and willful misrepresentation: DFS, Division of Insurance Agent and Agency Services, Petitioner, v. Mauro David Jesef, Respondent, Case No.: 264104-20-AG;
• Federal sanctions for fraud and false statements under 18 USC § 1033/1034: crimes by or affecting persons engaged in insurance, including potential penalties and sanctions, as well as the waiver allowing those convicted to seek reinstatement of license(s);
• The future of insurance in Florida;
• Conclusion and end of course.

During the course, there will be embedded questions to help the licensee gauge their knowledge while moving through the class, to test their knowledge as they go. There is also a final exam of 25 questions at the end of the class.

Course Format: Text

Credit Type: Ethics, Laws and Rules

Course ID(s): 139949

Approved By: Florida Department of Financial Services - Division of Insurance