Florida Senate - 2017                                    SB 1582
       By Senator Bradley
       5-00827B-17                                           20171582__
    1                        A bill to be entitled                      
    2         An act relating to workers’ compensation insurance;
    3         amending s. 440.02, F.S.; redefining the term
    4         “specificity”; amending s. 440.102, F.S.; conforming a
    5         cross-reference; amending s. 440.105, F.S.; deleting a
    6         prohibition against receiving certain fees,
    7         consideration, or gratuities under certain
    8         circumstances; amending s. 440.13, F.S.; defining the
    9         term “business day”; specifying certain timeframes in
   10         terms of business days, rather than days; requiring
   11         carriers to authorize or decline, rather than respond
   12         to, certain requests for authorization within a
   13         specified time; revising construction; revising a
   14         specified interval for certain notices furnished by
   15         treating physicians to employers or carriers; amending
   16         s. 440.15, F.S.; revising the maximum period of
   17         specified temporary disability benefits; amending s.
   18         440.192, F.S.; revising conditions under which the
   19         Office of the Judges of Compensation Claims must
   20         dismiss petitions for benefits; revising requirements
   21         for such petitions; revising construction relating to
   22         dismissals of petitions or portions thereof; requiring
   23         judges of compensation claims to enter orders on
   24         certain motions to dismiss within specified
   25         timeframes; amending s. 440.34, F.S.; requiring judges
   26         of compensation claims to consider specified factors
   27         in increasing or decreasing attorney fees; specifying
   28         a basis for a maximum hourly rate for attorney fees;
   29         deleting a provision authorizing such judges to
   30         approve alternative attorney fees under certain
   31         circumstances; conforming cross-references; amending
   32         s. 624.482, F.S.; conforming a provision to changes
   33         made by the act; amending s. 627.041, F.S.; redefining
   34         terms; amending s. 627.0612, F.S.; adding prospective
   35         loss costs to a list of reviewable matters in certain
   36         proceedings by appellate courts; amending s. 627.062,
   37         F.S.; requiring insurers and rating organizations to
   38         establish and use prospective loss costs for a
   39         specified purpose; requiring copies of prospective
   40         loss costs to be filed with the Office of Insurance
   41         Regulation; amending s. 627.072, F.S.; deleting a
   42         specified methodology that may be used by the office
   43         in rate determinations; amending s. 627.091, F.S.;
   44         defining terms; requiring insurers writing workers’
   45         compensation and employer’s liability insurances to
   46         independently and individually file their proposed
   47         final rates; specifying requirements for such filings;
   48         deleting a requirement that such filings contain
   49         certain information; revising requirements for
   50         supporting information required to be furnished to the
   51         office under certain circumstances; deleting a
   52         specified method for insurers to satisfy filing
   53         obligations; specifying requirements for a licensed
   54         rating organization that elects to develop and file
   55         certain reference filings and certain other
   56         information; authorizing insurers to use supplementary
   57         rating information approved by the office; revising
   58         applicability of public meetings and records
   59         requirements to certain meetings of recognized rating
   60         organization committees; amending s. 627.093, F.S.;
   61         revising applicability of public meetings and records
   62         requirements to prospective loss cost filings or
   63         appeals; amending s. 627.101, F.S.; conforming a
   64         provision to changes made by the act; amending s.
   65         627.211, F.S.; deleting provisions relating to
   66         deviations; revising requirements for the office’s
   67         annual report to the Legislature relating to the
   68         workers’ compensation insurance market; creating s.
   69         627.2151, F.S.; defining the term “defense and cost
   70         containment expenses” or “DCCE”; requiring insurer
   71         groups or insurers writing workers’ compensation
   72         insurance to file specified schedules with the office
   73         at specified intervals; providing construction
   74         relating to excessive DCCE; requiring the office to
   75         order returns of excess amounts of DCCE, subject to
   76         certain hearing requirements; providing requirements
   77         for, and an exception from, the return of excessive
   78         DCCE amounts; providing construction; amending s.
   79         627.291, F.S.; providing applicability of certain
   80         disclosure and hearing requirements for rating
   81         organizations filing prospective loss costs; amending
   82         s. 627.318, F.S.; providing applicability of certain
   83         recordkeeping requirements for rating organizations or
   84         insurers filing or using prospective loss costs,
   85         respectively; amending s. 627.361, F.S.; providing
   86         applicability of a prohibition against false or
   87         misleading information relating to prospective loss
   88         costs; amending s. 627.371, F.S.; providing
   89         applicability of certain hearing procedures and
   90         requirements relating to the application, making, or
   91         use of prospective loss costs; providing an effective
   92         date.
   94  Be It Enacted by the Legislature of the State of Florida:
   96         Section 1. Subsection (40) of section 440.02, Florida
   97  Statutes, is amended to read:
   98         440.02 Definitions.—When used in this chapter, unless the
   99  context clearly requires otherwise, the following terms shall
  100  have the following meanings:
  101         (40) “Specificity” means information on the petition for
  102  benefits sufficient to put the employer or carrier on notice of
  103  the exact statutory classification and outstanding time period
  104  for each requested benefit, the specific amount of each
  105  requested benefit, the calculation used for computing the
  106  requested benefit, of benefits being requested and includes a
  107  detailed explanation of any benefits received that should be
  108  increased, decreased, changed, or otherwise modified. If the
  109  petition is for medical benefits, the information must shall
  110  include specific details as to why such benefits are being
  111  requested, why such benefits are medically necessary, and why
  112  current treatment, if any, is not sufficient. Any petition
  113  requesting alternate or other medical care, including, but not
  114  limited to, petitions requesting psychiatric or psychological
  115  treatment, must specifically identify the physician, as defined
  116  in s. 440.13(1), who is recommending such treatment. A copy of a
  117  report from such physician making the recommendation for
  118  alternate or other medical care must shall also be attached to
  119  the petition. A judge of compensation claims may shall not order
  120  such treatment if a physician is not recommending such
  121  treatment.
  122         Section 2. Paragraph (p) of subsection (5) of section
  123  440.102, Florida Statutes, is amended to read:
  124         440.102 Drug-free workplace program requirements.—The
  125  following provisions apply to a drug-free workplace program
  126  implemented pursuant to law or to rules adopted by the Agency
  127  for Health Care Administration:
  128         (5) PROCEDURES AND EMPLOYEE PROTECTION.—All specimen
  129  collection and testing for drugs under this section shall be
  130  performed in accordance with the following procedures:
  131         (p) All authorized remedial treatment, care, and attendance
  132  provided by a health care provider to an injured employee before
  133  medical and indemnity benefits are denied under this section
  134  must be paid for by the carrier or self-insurer. However, the
  135  carrier or self-insurer must have given reasonable notice to all
  136  affected health care providers that payment for treatment, care,
  137  and attendance provided to the employee after a future date
  138  certain will be denied. A health care provider, as defined in s.
  139  440.13(1) s. 440.13(1)(g), that refuses, without good cause, to
  140  continue treatment, care, and attendance before the provider
  141  receives notice of benefit denial commits a misdemeanor of the
  142  second degree, punishable as provided in s. 775.082 or s.
  143  775.083.
  144         Section 3. Paragraph (c) of subsection (3) of section
  145  440.105, Florida Statutes, is amended to read:
  146         440.105 Prohibited activities; reports; penalties;
  147  limitations.—
  148         (3) Whoever violates any provision of this subsection
  149  commits a misdemeanor of the first degree, punishable as
  150  provided in s. 775.082 or s. 775.083.
  151         (c) It is unlawful for any attorney or other person, in his
  152  or her individual capacity or in his or her capacity as a public
  153  or private employee, or for any firm, corporation, partnership,
  154  or association to receive any fee or other consideration or any
  155  gratuity from a person on account of services rendered for a
  156  person in connection with any proceedings arising under this
  157  chapter, unless such fee, consideration, or gratuity is approved
  158  by a judge of compensation claims or by the Deputy Chief Judge
  159  of Compensation Claims.
  160         Section 4. Present paragraphs (c) through (s) of subsection
  161  (1) of section 440.13, Florida Statutes, are redesignated as
  162  paragraphs (d) through (t), respectively, and a new paragraph
  163  (c) is added to that subsection, and paragraph (f) of subsection
  164  (2), paragraphs (d) and (i) of subsection (3), paragraph (a) of
  165  subsection (4), paragraphs (a) and (c) of subsection (5), and
  166  paragraphs (c) and (d) of subsection (9) of that section are
  167  amended, to read:
  168         440.13 Medical services and supplies; penalty for
  169  violations; limitations.—
  170         (1) DEFINITIONS.—As used in this section, the term:
  171         (c)“Business day” means Monday through Friday, excluding
  172  the following holidays: New Year’s Day, Birthday of Dr. Martin
  173  Luther King, Jr., Memorial Day, Independence Day, Labor Day,
  174  Veterans’ Day, Thanksgiving Day and the Friday after
  175  Thanksgiving, and Christmas Day. If any of the holidays falls on
  176  Saturday or Sunday, the term does not include the day on Monday
  177  through Friday on which the holiday is observed.
  179         (f) Upon the written request of the employee, the carrier
  180  shall give the employee the opportunity for one change of
  181  physician during the course of treatment for any one accident.
  182  Upon the granting of a change of physician, the originally
  183  authorized physician in the same specialty as the changed
  184  physician shall become deauthorized upon written notification by
  185  the employer or carrier. The carrier shall authorize an
  186  alternative physician who shall not be professionally affiliated
  187  with the previous physician within 5 business days after receipt
  188  of the request. If the carrier fails to provide a change of
  189  physician as requested by the employee, the employee may select
  190  the physician and such physician shall be considered authorized
  191  if the treatment being provided is compensable and medically
  192  necessary.
  194  Failure of the carrier to timely comply with this subsection
  195  shall be a violation of this chapter and the carrier shall be
  196  subject to penalties as provided for in s. 440.525.
  198         (d) A carrier must respond, by telephone or in writing,
  199  must authorize or decline to a request for authorization from an
  200  authorized health care provider by the close of the third
  201  business day after receipt of the request. A carrier authorizes
  202  the request if it who fails to respond to a written request for
  203  authorization for referral for medical treatment by the close of
  204  the third business day after receipt of the request consents to
  205  the medical necessity for such treatment. All such requests must
  206  be made to the carrier. Notice to the carrier does not include
  207  notice to the employer.
  208         (i) Notwithstanding paragraph (d), a claim for specialist
  209  consultations, surgical operations, physiotherapeutic or
  210  occupational therapy procedures, X-ray examinations, or special
  211  diagnostic laboratory tests that cost more than $1,000 and other
  212  specialty services that the department identifies by rule is not
  213  valid and reimbursable unless the services have been expressly
  214  authorized by the carrier, unless the carrier has failed to
  215  respond within 10 business days to a written request for
  216  authorization, or unless emergency care is required. The insurer
  217  shall authorize such consultation or procedure unless the health
  218  care provider or facility is not authorized, unless such
  219  treatment is not in accordance with practice parameters and
  220  protocols of treatment established in this chapter, or unless a
  221  judge of compensation claims has determined that the
  222  consultation or procedure is not medically necessary, not in
  223  accordance with the practice parameters and protocols of
  224  treatment established in this chapter, or otherwise not
  225  compensable under this chapter. Authorization of a treatment
  226  plan does not constitute express authorization for purposes of
  227  this section, except to the extent the carrier provides
  228  otherwise in its authorization procedures. This paragraph does
  229  not limit the carrier’s obligation to identify and disallow
  230  overutilization or billing errors.
  233         (a) Any health care provider providing necessary remedial
  234  treatment, care, or attendance to any injured worker shall
  235  submit treatment reports to the carrier in a format prescribed
  236  by the department. A claim for medical or surgical treatment is
  237  not valid or enforceable against such employer or employee,
  238  unless, by the close of the third business day following the
  239  first treatment, the physician providing the treatment furnishes
  240  to the employer or carrier a preliminary notice of the injury
  241  and treatment in a format prescribed by the department and,
  242  within 15 business days thereafter, furnishes to the employer or
  243  carrier a complete report, and subsequent thereto furnishes
  244  progress reports, if requested by the employer or insurance
  245  carrier, at intervals of not less than 15 business days 3 weeks
  246  apart or at less frequent intervals if requested in a format
  247  prescribed by the department.
  249         (a) In any dispute concerning overutilization, medical
  250  benefits, compensability, or disability under this chapter, the
  251  carrier or the employee may select an independent medical
  252  examiner. If the parties agree, the examiner may be a health
  253  care provider treating or providing other care to the employee.
  254  An independent medical examiner may not render an opinion
  255  outside his or her area of expertise, as demonstrated by
  256  licensure and applicable practice parameters. The employer and
  257  employee shall be entitled to only one independent medical
  258  examination per accident and not one independent medical
  259  examination per medical specialty. The party requesting and
  260  selecting the independent medical examination shall be
  261  responsible for all expenses associated with said examination,
  262  including, but not limited to, medically necessary diagnostic
  263  testing performed and physician or medical care provider fees
  264  for the evaluation. The party selecting the independent medical
  265  examination shall identify the choice of the independent medical
  266  examiner to all other parties within 15 business days after the
  267  date the independent medical examination is to take place.
  268  Failure to timely provide such notification shall preclude the
  269  requesting party from submitting the findings of such
  270  independent medical examiner in a proceeding before a judge of
  271  compensation claims. The independent medical examiner may not
  272  provide followup care if such recommendation for care is found
  273  to be medically necessary. If the employee prevails in a medical
  274  dispute as determined in an order by a judge of compensation
  275  claims or if benefits are paid or treatment provided after the
  276  employee has obtained an independent medical examination based
  277  upon the examiner’s findings, the costs of such examination
  278  shall be paid by the employer or carrier.
  279         (c) The carrier may, at its election, contact the claimant
  280  directly to schedule a reasonable time for an independent
  281  medical examination. The carrier must confirm the scheduling
  282  agreement in writing with the claimant and the claimant’s
  283  counsel, if any, at least 7 business days before the date upon
  284  which the independent medical examination is scheduled to occur.
  285  An attorney representing a claimant is not authorized to
  286  schedule the self-insured employer’s or carrier’s independent
  287  medical evaluations under this subsection. Neither the self
  288  insured employer nor the carrier shall be responsible for
  289  scheduling any independent medical examination other than an
  290  employer or carrier independent medical examination.
  291         (9) EXPERT MEDICAL ADVISORS.—
  292         (c) If there is disagreement in the opinions of the health
  293  care providers, if two health care providers disagree on medical
  294  evidence supporting the employee’s complaints or the need for
  295  additional medical treatment, or if two health care providers
  296  disagree that the employee is able to return to work, the
  297  department may, and the judge of compensation claims shall, upon
  298  his or her own motion or within 15 business days after receipt
  299  of a written request by either the injured employee, the
  300  employer, or the carrier, order the injured employee to be
  301  evaluated by an expert medical advisor. The injured employee and
  302  the employer or carrier may agree on the health care provider to
  303  serve as an expert medical advisor. If the parties do not agree,
  304  the judge of compensation claims shall select an expert medical
  305  advisor from the department’s list of certified expert medical
  306  advisors. If a certified medical advisor within the relevant
  307  medical specialty is unavailable, the judge of compensation
  308  claims shall appoint any otherwise qualified health care
  309  provider to serve as an expert medical advisor without obtaining
  310  the department’s certification. The opinion of the expert
  311  medical advisor is presumed to be correct unless there is clear
  312  and convincing evidence to the contrary as determined by the
  313  judge of compensation claims. The expert medical advisor
  314  appointed to conduct the evaluation shall have free and complete
  315  access to the medical records of the employee. An employee who
  316  fails to report to and cooperate with such evaluation forfeits
  317  entitlement to compensation during the period of failure to
  318  report or cooperate.
  319         (d) The expert medical advisor must complete his or her
  320  evaluation and issue his or her report to the department or to
  321  the judge of compensation claims within 15 business days after
  322  receipt of all medical records. The expert medical advisor must
  323  furnish a copy of the report to the carrier and to the employee.
  324         Section 5. Paragraph (a) of subsection (2) and paragraph
  325  (e) of subsection (4) of section 440.15, Florida Statutes, are
  326  amended to read:
  327         440.15 Compensation for disability.—Compensation for
  328  disability shall be paid to the employee, subject to the limits
  329  provided in s. 440.12(2), as follows:
  331         (a) Subject to subsection (7), in case of disability total
  332  in character but temporary in quality, 66 2/3 or 66.67 percent
  333  of the average weekly wages shall be paid to the employee during
  334  the continuance thereof, not to exceed 260 104 weeks except as
  335  provided in this subsection, s. 440.12(1), and s. 440.14(3).
  336  Once the employee reaches the maximum number of weeks allowed,
  337  or the employee reaches the date of maximum medical improvement,
  338  whichever occurs earlier, temporary disability benefits shall
  339  cease and the injured worker’s permanent impairment shall be
  340  determined.
  342         (e) Such benefits shall be paid during the continuance of
  343  such disability, not to exceed a period of 260 104 weeks, as
  344  provided by this subsection and subsection (2). Once the injured
  345  employee reaches the maximum number of weeks, temporary
  346  disability benefits cease and the injured worker’s permanent
  347  impairment must be determined. If the employee is terminated
  348  from postinjury employment based on the employee’s misconduct,
  349  temporary partial disability benefits are not payable as
  350  provided for in this section. The department shall by rule
  351  specify forms and procedures governing the method and time for
  352  payment of temporary disability benefits for dates of accidents
  353  before January 1, 1994, and for dates of accidents on or after
  354  January 1, 1994.
  355         Section 6. Subsections (2) and (5) of section 440.192,
  356  Florida Statutes, are amended to read:
  357         440.192 Procedure for resolving benefit disputes.—
  358         (2) Upon receipt, the Office of the Judges of Compensation
  359  Claims shall review each petition and shall dismiss each
  360  petition or any portion of such a petition that does not on its
  361  face meet the requirements of this section and the definition of
  362  specificity under s. 440.02, and specifically identify or
  363  itemize the following:
  364         (a) The name, address, and telephone number, and social
  365  security number of the employee.
  366         (b) The name, address, and telephone number of the
  367  employer.
  368         (c) A detailed description of the injury and cause of the
  369  injury, including the Florida county or, if outside of Florida,
  370  the state location of the occurrence and the date or dates of
  371  the accident.
  372         (d) A detailed description of the employee’s job, work
  373  responsibilities, and work the employee was performing when the
  374  injury occurred.
  375         (e) The specific time period for which compensation and the
  376  specific classification of compensation were not timely
  377  provided.
  378         (f) The specific date of maximum medical improvement,
  379  character of disability, and specific statement of all benefits
  380  or compensation that the employee is seeking. A claim for
  381  permanent benefits must include the specific date of maximum
  382  medical improvement and the specific date that such permanent
  383  benefits are claimed to begin.
  384         (g) All specific travel costs to which the employee
  385  believes she or he is entitled, including dates of travel and
  386  purpose of travel, means of transportation, and mileage and
  387  including the date the request for mileage was filed with the
  388  carrier and a copy of the request filed with the carrier.
  389         (h) A specific listing of all medical charges alleged
  390  unpaid, including the name and address of the medical provider,
  391  the amounts due, and the specific dates of treatment.
  392         (i) The type or nature of treatment care or attendance
  393  sought and the justification for such treatment. If the employee
  394  is under the care of a physician for an injury identified under
  395  paragraph (c), a copy of the physician’s request, authorization,
  396  or recommendation for treatment, care, or attendance must
  397  accompany the petition.
  398         (j) The specific amount of compensation claimed to be
  399  accurate and the methodology claimed to accurately calculate the
  400  average weekly wage, if the average weekly wage calculated by
  401  the employer or carrier is disputed. If the petition does not
  402  include a claim under this paragraph, the average weekly wage
  403  and corresponding compensation calculated by the employer or
  404  carrier are presumed to be accurate.
  405         (k)(j)A specific explanation of any other disputed issue
  406  that a judge of compensation claims will be called to rule upon.
  408  The dismissal of any petition or portion of such a petition
  409  under this subsection section is without prejudice and does not
  410  require a hearing.
  411         (5)(a) All motions to dismiss must state with particularity
  412  the basis for the motion. The judge of compensation claims shall
  413  enter an order upon such motions without hearing, unless good
  414  cause for hearing is shown. Dismissal of any petition or portion
  415  of a petition under this subsection is without prejudice.
  416         (b) Upon motion that a petition or portion of a petition be
  417  dismissed for lack of specificity, the judge of compensation
  418  claims shall enter an order on the motion, unless stipulated in
  419  writing by the parties, within 10 days after the motion is filed
  420  or, if good cause for hearing is shown, within 20 days after
  421  hearing on the motion. When any petition or portion of a
  422  petition is dismissed for lack of specificity under this
  423  subsection, the claimant must be allowed 20 days after the date
  424  of the order of dismissal in which to file an amended petition.
  425  Any grounds for dismissal for lack of specificity under this
  426  section which are not asserted within 30 days after receipt of
  427  the petition for benefits are thereby waived.
  428         Section 7. Section 440.34, Florida Statutes, is amended to
  429  read:
  430         440.34 Attorney Attorney’s fees; costs.—
  431         (1)(a) A fee, gratuity, or other consideration may not be
  432  paid for a claimant in connection with any proceedings arising
  433  under this chapter, unless approved by the judge of compensation
  434  claims or court having jurisdiction over such proceedings. Any
  435  attorney fees attorney’s fee approved by a judge of compensation
  436  claims for benefits secured on behalf of a claimant must equal
  437  to 20 percent of the first $5,000 of the amount of the benefits
  438  secured, 15 percent of the next $5,000 of the amount of the
  439  benefits secured, 10 percent of the remaining amount of the
  440  benefits secured to be provided during the first 10 years after
  441  the date the claim is filed, and 5 percent of the benefits
  442  secured after 10 years.
  443         (b) However, the judge of compensation claims shall
  444  consider the following factors in each case and may increase or
  445  decrease the attorney fees, based on a maximum hourly rate of
  446  $250 per hour, if in his or her judgment he or she expressly
  447  finds that the circumstances of the particular case warrant such
  448  action:
  449         1. The time and labor required, the novelty and difficulty
  450  of the questions involved, and the skill requisite to perform
  451  the legal service properly.
  452         2. The fee customarily charged in the locality for similar
  453  legal services.
  454         3. The amount involved in the controversy and the benefits
  455  resulting to the claimant.
  456         4. The time limitation imposed by the claimant or the
  457  circumstances.
  458         5. The experience, reputation, and ability of the attorney
  459  or attorneys performing services.
  460         6. The contingency or certainty of a fee.
  461         (c) The judge of compensation claims shall not approve a
  462  compensation order, a joint stipulation for lump-sum settlement,
  463  a stipulation or agreement between a claimant and his or her
  464  attorney, or any other agreement related to benefits under this
  465  chapter which provides for attorney fees an attorney’s fee in
  466  excess of the amount permitted by this section. The judge of
  467  compensation claims is not required to approve any retainer
  468  agreement between the claimant and his or her attorney. The
  469  retainer agreement as to fees and costs may not be for
  470  compensation in excess of the amount allowed under this
  471  subsection or subsection (7).
  472         (2) In awarding a claimant’s attorney fees attorney’s fee,
  473  the judge of compensation claims shall consider only those
  474  benefits secured by the attorney. An attorney is not entitled to
  475  attorney attorney’s fees for representation in any issue that
  476  was ripe, due, and owing and that reasonably could have been
  477  addressed, but was not addressed, during the pendency of other
  478  issues for the same injury. The amount, statutory basis, and
  479  type of benefits obtained through legal representation shall be
  480  listed on all attorney attorney’s fees awarded by the judge of
  481  compensation claims. For purposes of this section, the term
  482  “benefits secured” does not include future medical benefits to
  483  be provided on any date more than 5 years after the date the
  484  claim is filed. In the event an offer to settle an issue pending
  485  before a judge of compensation claims, including attorney
  486  attorney’s fees as provided for in this section, is communicated
  487  in writing to the claimant or the claimant’s attorney at least
  488  30 days prior to the trial date on such issue, for purposes of
  489  calculating the amount of attorney attorney’s fees to be taxed
  490  against the employer or carrier, the term “benefits secured”
  491  shall be deemed to include only that amount awarded to the
  492  claimant above the amount specified in the offer to settle. If
  493  multiple issues are pending before the judge of compensation
  494  claims, said offer of settlement shall address each issue
  495  pending and shall state explicitly whether or not the offer on
  496  each issue is severable. The written offer shall also
  497  unequivocally state whether or not it includes medical witness
  498  fees and expenses and all other costs associated with the claim.
  499         (3) If any party should prevail in any proceedings before a
  500  judge of compensation claims or court, there shall be taxed
  501  against the nonprevailing party the reasonable costs of such
  502  proceedings, not to include attorney attorney’s fees. A claimant
  503  is responsible for the payment of her or his own attorney
  504  attorney’s fees, except that a claimant is entitled to recover
  505  attorney fees an attorney’s fee in an amount equal to the amount
  506  provided for in subsection (1) or subsection (7) from a carrier
  507  or employer:
  508         (a) Against whom she or he successfully asserts a petition
  509  for medical benefits only, if the claimant has not filed or is
  510  not entitled to file at such time a claim for disability,
  511  permanent impairment, wage-loss, or death benefits, arising out
  512  of the same accident;
  513         (b) In any case in which the employer or carrier files a
  514  response to petition denying benefits with the Office of the
  515  Judges of Compensation Claims and the injured person has
  516  employed an attorney in the successful prosecution of the
  517  petition;
  518         (c) In a proceeding in which a carrier or employer denies
  519  that an accident occurred for which compensation benefits are
  520  payable, and the claimant prevails on the issue of
  521  compensability; or
  522         (d) In cases where the claimant successfully prevails in
  523  proceedings filed under s. 440.24 or s. 440.28.
  525  Regardless of the date benefits were initially requested,
  526  attorney attorney’s fees shall not attach under this subsection
  527  until 30 days after the date the carrier or employer, if self
  528  insured, receives the petition.
  529         (4) In such cases in which the claimant is responsible for
  530  the payment of her or his own attorney attorney’s fees, such
  531  fees are a lien upon compensation payable to the claimant,
  532  notwithstanding s. 440.22.
  533         (5) If any proceedings are had for review of any claim,
  534  award, or compensation order before any court, the court may
  535  award the injured employee or dependent attorney fees an
  536  attorney’s fee to be paid by the employer or carrier, in its
  537  discretion, which shall be paid as the court may direct.
  538         (6) A judge of compensation claims may not enter an order
  539  approving the contents of a retainer agreement that permits
  540  placing any portion of the employee’s compensation into an
  541  escrow account until benefits have been secured.
  542         (7) If an attorney’s fee is owed under paragraph (3)(a),
  543  the judge of compensation claims may approve an alternative
  544  attorney’s fee not to exceed $1,500 only once per accident,
  545  based on a maximum hourly rate of $150 per hour, if the judge of
  546  compensation claims expressly finds that the attorney’s fee
  547  amount provided for in subsection (1), based on benefits
  548  secured, fails to fairly compensate the attorney for disputed
  549  medical-only claims as provided in paragraph (3)(a) and the
  550  circumstances of the particular case warrant such action.
  551         Section 8. Subsection (10) of section 624.482, Florida
  552  Statutes, is amended to read:
  553         624.482 Making and use of rates.—
  554         (10) Any self-insurance fund that writes workers’
  555  compensation insurance and employer’s liability insurance is
  556  subject to, and shall make all rate filings for workers’
  557  compensation insurance and employer’s liability insurance in
  558  accordance with, ss. 627.091, 627.101, 627.111, 627.141,
  559  627.151, 627.171, and 627.191, and 627.211.
  560         Section 9. Subsections (3), (4), and (6) of section
  561  627.041, Florida Statutes, are amended to read:
  562         627.041 Definitions.—As used in this part:
  563         (3) “Rating organization” means every person, other than an
  564  authorized insurer, whether located within or outside this
  565  state, who has as his or her object or purpose the making of
  566  prospective loss costs, rates, rating plans, or rating systems.
  567  Two or more authorized insurers that act in concert for the
  568  purpose of making prospective loss costs, rates, rating plans,
  569  or rating systems, and that do not operate within the specific
  570  authorizations contained in ss. 627.311, 627.314(2), (4), and
  571  627.351, shall be deemed to be a rating organization. No single
  572  insurer shall be deemed to be a rating organization.
  573         (4) “Advisory organization” means every group, association,
  574  or other organization of insurers, whether located within or
  575  outside this state, which prepares policy forms or makes
  576  underwriting rules incident to but not including the making of
  577  prospective loss costs, rates, rating plans, or rating systems
  578  or which collects and furnishes to authorized insurers or rating
  579  organizations loss or expense statistics or other statistical
  580  information and data and acts in an advisory, as distinguished
  581  from a ratemaking, capacity.
  582         (6) “Subscriber” means an insurer which is furnished at its
  583  request:
  584         (a) With prospective loss costs, rates, and rating manuals
  585  by a rating organization of which it is not a member; or
  586         (b) With advisory services by an advisory organization of
  587  which it is not a member.
  588         Section 10. Subsection (1) of section 627.0612, Florida
  589  Statutes, is amended to read:
  590         627.0612 Administrative proceedings in rating
  591  determinations.—
  592         (1) In any proceeding to determine whether prospective loss
  593  costs, rates, rating plans, or other matters governed by this
  594  part comply with the law, the appellate court shall set aside a
  595  final order of the office if the office has violated s.
  596  120.57(1)(k) by substituting its findings of fact for findings
  597  of an administrative law judge which were supported by competent
  598  substantial evidence.
  599         Section 11. Paragraph (a) of subsection (2) of section
  600  627.062, Florida Statutes, is amended to read:
  601         627.062 Rate standards.—
  602         (2) As to all such classes of insurance:
  603         (a) Insurers or rating organizations shall establish and
  604  use prospective loss costs, rates, rating schedules, or rating
  605  manuals that allow the insurer a reasonable rate of return on
  606  the classes of insurance written in this state. A copy of
  607  prospective loss costs, rates, rating schedules, rating manuals,
  608  premium credits or discount schedules, and surcharge schedules,
  609  and changes thereto, must be filed with the office under one of
  610  the following procedures:
  611         1. If the filing is made at least 90 days before the
  612  proposed effective date and is not implemented during the
  613  office’s review of the filing and any proceeding and judicial
  614  review, such filing is considered a “file and use” filing. In
  615  such case, the office shall finalize its review by issuance of a
  616  notice of intent to approve or a notice of intent to disapprove
  617  within 90 days after receipt of the filing. The notice of intent
  618  to approve and the notice of intent to disapprove constitute
  619  agency action for purposes of the Administrative Procedure Act.
  620  Requests for supporting information, requests for mathematical
  621  or mechanical corrections, or notification to the insurer by the
  622  office of its preliminary findings does not toll the 90-day
  623  period during any such proceedings and subsequent judicial
  624  review. The rate shall be deemed approved if the office does not
  625  issue a notice of intent to approve or a notice of intent to
  626  disapprove within 90 days after receipt of the filing.
  627         2. If the filing is not made in accordance with
  628  subparagraph 1., such filing must be made as soon as
  629  practicable, but within 30 days after the effective date, and is
  630  considered a “use and file” filing. An insurer making a “use and
  631  file” filing is potentially subject to an order by the office to
  632  return to policyholders those portions of rates found to be
  633  excessive, as provided in paragraph (h).
  634         3. For all property insurance filings made or submitted
  635  after January 25, 2007, but before May 1, 2012, an insurer
  636  seeking a rate that is greater than the rate most recently
  637  approved by the office shall make a “file and use” filing. For
  638  purposes of this subparagraph, motor vehicle collision and
  639  comprehensive coverages are not considered property coverages.
  641  The provisions of this subsection do not apply to workers’
  642  compensation, employer’s liability insurance, and motor vehicle
  643  insurance.
  644         Section 12. Subsection (5) of section 627.072, Florida
  645  Statutes, is amended to read:
  646         627.072 Making and use of rates.—
  647         (5)(a) In the case of workers’ compensation and employer’s
  648  liability insurance, the office shall consider utilizing the
  649  following methodology in rate determinations: Premiums,
  650  expenses, and expected claim costs would be discounted to a
  651  common point of time, such as the initial point of a policy
  652  year, in the determination of rates; the cash-flow pattern of
  653  premiums, expenses, and claim costs would be determined
  654  initially by using data from 8 to 10 of the largest insurers
  655  writing workers’ compensation insurance in the state; such
  656  insurers may be selected for their statistical ability to report
  657  the data on an accident-year basis and in accordance with
  658  subparagraphs (b)1., 2., and 3., for at least 2 1/2 years; such
  659  a cash-flow pattern would be modified when necessary in
  660  accordance with the data and whenever a radical change in the
  661  payout pattern is expected in the policy year under
  662  consideration.
  663         (b) If the methodology set forth in paragraph (a) is
  664  utilized, to facilitate the determination of such a cash-flow
  665  pattern methodology:
  666         1. Each insurer shall include in its statistical reporting
  667  to the rating bureau and the office the accident year by
  668  calendar quarter data for paid-claim costs;
  669         2. Each insurer shall submit financial reports to the
  670  rating bureau and the office which shall include total incurred
  671  claim amounts and paid-claim amounts by policy year and by
  672  injury types as of December 31 of each calendar year; and
  673         3. Each insurer shall submit to the rating bureau and the
  674  office paid-premium data on an individual risk basis in which
  675  risks are to be subdivided by premium size as follows:
  677  Number of Risks in
  678   Premium Range                             Standard Premium Size
  680  ...(to be filled in by carrier)...                      $300—999
  681  ...(to be filled in by carrier)...                   1,000—4,999
  682  ...(to be filled in by carrier)...                  5,000—49,999
  683  ...(to be filled in by carrier)...                 50,000—99,999
  684  ...(to be filled in by carrier)...               100,000 or more
  685  Total:
  686         Section 13. Section 627.091, Florida Statutes, is amended
  687  to read:
  688         627.091 Rate filings; workers’ compensation and employer’s
  689  liability insurances.—
  690         (1) As used in this section, the term:
  691         (a) “Expenses” means the portion of a rate which is
  692  attributable to acquisition, field supervision, collection
  693  expenses, taxes, assessments, and general expenses.
  694         (b) “Loss cost modifier” means an adjustment to, or a
  695  deviation from, the approved prospective loss costs filed by a
  696  licensed rating organization.
  697         (c) “Loss cost multiplier” means the profit and expense
  698  factor, expressed as a single nonintegral number to be applied
  699  to the prospective loss costs other than loss adjustment
  700  expenses, which is associated with writing workers’ compensation
  701  and employer’s liability insurance and which is approved by the
  702  office in making rates for each classification of risks used by
  703  that insurer.
  704         (d) “Prospective loss costs” means the portion of a rate
  705  which reflects historical industry average aggregate losses and
  706  loss adjustment expenses projected through development to their
  707  ultimate value and through trending to a future point in time.
  708  The term does not include provisions for profit or expenses
  709  other than loss adjustment expense.
  710         (2)(1) As to workers’ compensation and employer’s liability
  711  insurances, every insurer shall file with the office every
  712  manual of classifications, rules, and rates, every rating plan,
  713  and every modification of any of the foregoing which it proposes
  714  to use. Each insurer shall independently and individually file
  715  with the office the final rates it proposes to use. An insurer
  716  may satisfy this filing requirement by adopting the office’s
  717  approved loss costs and otherwise complying with this part. Each
  718  insurer shall file data in accordance with the uniform
  719  statistical plan approved by the office. Every filing under this
  720  subsection:
  721         (a) Must state the proposed effective date and must be made
  722  at least 30 days before such proposed effective date;
  723         (b) Must indicate the character and extent of the coverage
  724  contemplated;
  725         (c) May use the approved prospective loss costs filed by a
  726  licensed rating organization in combination with the insurer’s
  727  own approved loss cost multiplier and loss cost modifier;
  728         (d) May include deductible provisions in its manual of
  729  classifications, rules, and rates. All deductibles must be in a
  730  form and manner that is consistent with the underlying purpose
  731  of chapter 440;
  732         (e) May use variable or fixed expense loads or a
  733  combination thereof, and may vary the expense, profit, or
  734  contingency provisions by class or group of classes, if the
  735  insurer files supporting data justifying such variations; and
  736         (f) May include a schedule of proposed premium discounts,
  737  credits, and surcharges. The office may not approve discounts,
  738  credits, and surcharges unless they are based on objective
  739  criteria that bear a reasonable relationship to the expected
  740  loss, expense, or profit experience of an individual
  741  policyholder or a class of policyholders Every insurer is
  742  authorized to include deductible provisions in its manual of
  743  classifications, rules, and rates. Such deductibles shall in all
  744  cases be in a form and manner which is consistent with the
  745  underlying purpose of chapter 440.
  746         (3)(2)Every such filing shall state the proposed effective
  747  date thereof, and shall indicate the character and extent of the
  748  coverage contemplated. When a prospective loss cost, loss cost
  749  multiplier, or loss cost modifier filing is not accompanied by
  750  the information upon which the insurer or rating organization
  751  supports the filing and the office does not have sufficient
  752  information to determine whether the filing meets the applicable
  753  requirements of this part, the office it shall within 15 days
  754  after the date of filing require the insurer or rating
  755  organization to furnish the information upon which it supports
  756  the filing. The information furnished in support of a filing may
  757  include:
  758         (a) The experience or judgment of the insurer or rating
  759  organization making the filing;
  760         (b) The Its interpretation of any statistical data which
  761  the insurer or rating organization making the filing it relies
  762  upon;
  763         (c) The experience of other insurers or rating
  764  organizations; or
  765         (d) Any other factors which the insurer or rating
  766  organization making the filing deems relevant.
  767         (4)(3) A filing and any supporting information are shall be
  768  open to public inspection as provided in s. 119.07(1).
  769         (4) An insurer may satisfy its obligation to make such
  770  filings by becoming a member of, or a subscriber to, a licensed
  771  rating organization which makes such filings and by authorizing
  772  the office to accept such filings in its behalf; but nothing
  773  contained in this chapter shall be construed as requiring any
  774  insurer to become a member or a subscriber to any rating
  775  organization.
  776         (5) A licensed rating organization may develop and file for
  777  approval with the office reference filings containing
  778  prospective loss costs and the underlying loss data, and other
  779  supporting statistical and actuarial information. A rating
  780  organization may not develop or file final rates or multipliers
  781  for expenses, profit, or contingencies. After a loss cost
  782  reference filing is filed with the office and is approved, the
  783  rating organization must provide its member subscribers with a
  784  copy of the approved reference filing.
  785         (6) A rating organization may file supplementary rating
  786  information that includes policywriting rules, rating plan
  787  classification codes and descriptions, experience modification
  788  plans, and rules that include factors or relativities, such as
  789  increased limits factors, classification relativities, or
  790  similar factors, but that exclude minimum premiums. An insurer
  791  may use supplementary rating information approved by the office.
  792         (7)(5) Pursuant to the provisions of s. 624.3161, the
  793  office may examine the underlying statistical data used in such
  794  filings.
  795         (8)(6) Whenever the committee of a recognized rating
  796  organization with authority to file prospective loss costs for
  797  use by insurers in determining responsibility for workers’
  798  compensation and employer’s liability insurance rates in this
  799  state meets to discuss the necessity for, or a request for,
  800  Florida rate increases or decreases in prospective loss costs in
  801  this state, the determination of prospective loss costs in this
  802  state Florida rates, the prospective loss costs rates to be
  803  requested in this state, and any other matters pertaining
  804  specifically and directly to prospective loss costs in this
  805  state such Florida rates, such meetings shall be held in this
  806  state and are shall be subject to s. 286.011. The committee of
  807  such a rating organization shall provide at least 3 weeks’ prior
  808  notice of such meetings to the office and shall provide at least
  809  14 days’ prior notice of such meetings to the public by
  810  publication in the Florida Administrative Register.
  811         Section 14. Section 627.093, Florida Statutes, is amended
  812  to read:
  813         627.093 Application of s. 286.011 to workers’ compensation
  814  and employer’s liability insurances.—Section 286.011 shall be
  815  applicable to every prospective loss cost and rate filing,
  816  approval or disapproval of filing, rating deviation from filing,
  817  or appeal from any of these regarding workers’ compensation and
  818  employer’s liability insurances.
  819         Section 15. Subsection (1) of section 627.101, Florida
  820  Statutes, is amended to read:
  821         627.101 When filing becomes effective; workers’
  822  compensation and employer’s liability insurances.—
  823         (1) The office shall review all required filings as to
  824  workers’ compensation and employer’s liability insurances as
  825  soon as reasonably possible after they have been made in order
  826  to determine whether they meet the applicable requirements of
  827  this part. If the office determines that part of a required rate
  828  filing does not meet the applicable requirements of this part,
  829  it may reject so much of the filing as does not meet these
  830  requirements, and approve the remainder of the filing.
  831         Section 16. Section 627.211, Florida Statutes, is amended
  832  to read:
  833         627.211 Annual report by the office on the workers’
  834  compensation insurance market Deviations; workers’ compensation
  835  and employer’s liability insurances.—
  836         (1) Every member or subscriber to a rating organization
  837  shall, as to workers’ compensation or employer’s liability
  838  insurance, adhere to the filings made on its behalf by such
  839  organization; except that any such insurer may make written
  840  application to the office for permission to file a uniform
  841  percentage decrease or increase to be applied to the premiums
  842  produced by the rating system so filed for a kind of insurance,
  843  for a class of insurance which is found by the office to be a
  844  proper rating unit for the application of such uniform
  845  percentage decrease or increase, or for a subdivision of
  846  workers’ compensation or employer’s liability insurance:
  847         (a) Comprised of a group of manual classifications which is
  848  treated as a separate unit for ratemaking purposes; or
  849         (b) For which separate expense provisions are included in
  850  the filings of the rating organization.
  852  Such application shall specify the basis for the modification
  853  and shall be accompanied by the data upon which the applicant
  854  relies. A copy of the application and data shall be sent
  855  simultaneously to the rating organization.
  856         (2) Every member or subscriber to a rating organization
  857  may, as to workers’ compensation and employer’s liability
  858  insurance, file a plan or plans to use deviations that vary
  859  according to factors present in each insured’s individual risk.
  860  The insurer that files for the deviations provided in this
  861  subsection shall file the qualifications for the plans,
  862  schedules of rating factors, and the maximum deviation factors
  863  which shall be subject to the approval of the office pursuant to
  864  s. 627.091. The actual deviation which shall be used for each
  865  insured that qualifies under this subsection may not exceed the
  866  maximum filed deviation under that plan and shall be based on
  867  the merits of each insured’s individual risk as determined by
  868  using schedules of rating factors which shall be applied
  869  uniformly. Insurers shall maintain statistical data in
  870  accordance with the schedule of rating factors. Such data shall
  871  be available to support the continued use of such varying
  872  deviations.
  873         (3) In considering an application for the deviation, the
  874  office shall give consideration to the applicable principles for
  875  ratemaking as set forth in ss. 627.062 and 627.072 and the
  876  financial condition of the insurer. In evaluating the financial
  877  condition of the insurer, the office may consider: (1) the
  878  insurer’s audited financial statements and whether the
  879  statements provide unqualified opinions or contain significant
  880  qualifications or “subject to” provisions; (2) any independent
  881  or other actuarial certification of loss reserves; (3) whether
  882  workers’ compensation and employer’s liability reserves are
  883  above the midpoint or best estimate of the actuary’s reserve
  884  range estimate; (4) the adequacy of the proposed rate; (5)
  885  historical experience demonstrating the profitability of the
  886  insurer; (6) the existence of excess or other reinsurance that
  887  contains a sufficiently low attachment point and maximums that
  888  provide adequate protection to the insurer; and (7) other
  889  factors considered relevant to the financial condition of the
  890  insurer by the office. The office shall approve the deviation if
  891  it finds it to be justified, it would not endanger the financial
  892  condition of the insurer, and it would not constitute predatory
  893  pricing. The office shall disapprove the deviation if it finds
  894  that the resulting premiums would be excessive, inadequate, or
  895  unfairly discriminatory, would endanger the financial condition
  896  of the insurer, or would result in predatory pricing. The
  897  insurer may not use a deviation unless the deviation is
  898  specifically approved by the office. An insurer may apply the
  899  premiums approved pursuant to s. 627.091 or its uniform
  900  deviation approved pursuant to this section to a particular
  901  insured according to underwriting guidelines filed with and
  902  approved by the office, such approval to be based on ss. 627.062
  903  and 627.072.
  904         (4) Each deviation permitted to be filed shall be effective
  905  for a period of 1 year unless terminated, extended, or modified
  906  with the approval of the office. If at any time after a
  907  deviation has been approved the office finds that the deviation
  908  no longer meets the requirements of this code, it shall notify
  909  the insurer in what respects it finds that the deviation fails
  910  to meet such requirements and specify when, within a reasonable
  911  period thereafter, the deviation shall be deemed no longer
  912  effective. The notice shall not affect any insurance contract or
  913  policy made or issued prior to the expiration of the period set
  914  forth in the notice.
  915         (5) For purposes of this section, the office, when
  916  considering the experience of any insurer, shall consider the
  917  experience of any predecessor insurer when the business and the
  918  liabilities of the predecessor insurer were assumed by the
  919  insurer pursuant to an order of the office which approves the
  920  assumption of the business and the liabilities.
  921         (6) The office shall submit an annual report to the
  922  President of the Senate and the Speaker of the House of
  923  Representatives by January 15 of each year which evaluates
  924  insurance company solvency and competition in the workers’
  925  compensation insurance market in this state. The report must
  926  contain an analysis of the availability and affordability of
  927  workers’ compensation coverage and whether the current market
  928  structure, conduct, and performance are conducive to
  929  competition, based upon economic analysis and tests. The report
  930  must also contain an analysis of each insurer’s capital compared
  931  to minimum risk-based capital. The purpose of this report is to
  932  aid the Legislature in determining whether changes to the
  933  workers’ compensation rating laws are warranted. The report must
  934  also document that the office has complied with the provisions
  935  of s. 627.096 which require the office to investigate and study
  936  all workers’ compensation insurers in the state and to study the
  937  data, statistics, schedules, or other information as it finds
  938  necessary to assist in its review of workers’ compensation rate
  939  filings.
  940         Section 17. Section 627.2151, Florida Statutes, is created
  941  to read:
  942         627.2151 Workers’ compensation excessive defense and cost
  943  containment expenses.—
  944         (1) As used in this section, the term “defense and cost
  945  containment expenses” or “DCCE” includes the following Florida
  946  expenses of an insurer group or insurer writing workers’
  947  compensation insurance:
  948         (a) Insurance company attorney fees;
  949         (b) Expert witnesses;
  950         (c) Medical examinations and autopsies;
  951         (d) Medical fee review panels;
  952         (e) Bill auditing;
  953         (f) Treatment utilization reviews;
  954         (g) Preferred provider network expenses; and
  955         (h) Vocational rehabilitation.
  956         (2) Each insurer group or insurer writing workers’
  957  compensation insurance shall file with the office a schedule of
  958  Florida defense and cost containment expenses and total Florida
  959  incurred losses for each of the 3 years before the most recent
  960  accident year. The DCCE and incurred losses must be valued as of
  961  December 31 of the first year following the latest accident year
  962  to be reported, developed to an ultimate basis, and at two 12
  963  month intervals thereafter, each developed to an ultimate basis,
  964  so that a total of three evaluations will be provided for each
  965  accident year. The first year reported shall be accident year
  966  2018, so that the reporting of 3 accident years under this
  967  evaluation will not take place until accident years 2019 and
  968  2020 have become available.
  969         (3) Excessive DCCE occurs when the Florida defense and cost
  970  containment expenses for workers’ compensation exceed 15 percent
  971  of Florida workers’ compensation incurred losses by the insurer
  972  or insurer group for the 3 most recent calendar years for which
  973  data is to be filed under this section.
  974         (4) If the insurer or insurer group realizes excessive
  975  DCCE, the office must order a return of the excess amounts after
  976  affording the insurer or insurer group an opportunity for a
  977  hearing and otherwise complying with the requirements of chapter
  978  120. Excessive DCCE amounts must be returned in all instances
  979  unless the insurer or insurer group affirmatively demonstrates
  980  to the office that the refund of the excessive DCCE amounts will
  981  render a member of the insurer group financially impaired or
  982  will render it insolvent under provisions of the Florida
  983  Insurance Code.
  984         (5) Any excess DCCE amount must be returned to
  985  policyholders in the form of a cash refund or credit toward the
  986  future purchase of insurance. The refund or credit must be made
  987  on a pro rata basis in relation to the final compilation year
  988  earned premiums to the policyholders of record of the insurer or
  989  insurer group on December 31 of the final compilation year. Cash
  990  refunds and data in required reports to the office may be
  991  rounded to the nearest dollar and must be consistently applied.
  992         (6)(a) Refunds must be completed in one of the following
  993  ways:
  994         1. A cash refund must be completed within 60 days after
  995  entry of a final order indicating that excessive DCCE has been
  996  realized.
  997         2. A credit to renewal policies must be applied to policy
  998  renewal premium notices that are forwarded to insureds more than
  999  60 calendar days after entry of a final order indicating that
 1000  excessive DCCE has been realized. If the insured thereafter
 1001  cancels a policy or otherwise allows the policy to terminate,
 1002  the insurer or insurer group must make a cash refund not later
 1003  than 60 days after coverage termination.
 1004         (b) Upon completion of the renewal credits or refunds, the
 1005  insurer or insurer group shall immediately certify having made
 1006  the refunds to the office.
 1007         (7) Any refund or renewal credit made pursuant to this
 1008  section is treated as a policyholder dividend applicable to the
 1009  year immediately succeeding the compilation period giving rise
 1010  to the refund or credit, for purposes of reporting under this
 1011  section for subsequent years.
 1012         Section 18. Section 627.291, Florida Statutes, is amended
 1013  to read:
 1014         627.291 Information to be furnished insureds; appeal by
 1015  insureds; workers’ compensation and employer’s liability
 1016  insurances.—
 1017         (1) As to workers’ compensation and employer’s liability
 1018  insurances, every rating organization filing prospective loss
 1019  costs and every insurer which makes its own rates shall, within
 1020  a reasonable time after receiving written request therefor and
 1021  upon payment of such reasonable charge as it may make, furnish
 1022  to any insured affected by a rate made by it, or to the
 1023  authorized representative of such insured, all pertinent
 1024  information as to such rate.
 1025         (2) As to workers’ compensation and employer’s liability
 1026  insurances, every rating organization filing prospective loss
 1027  costs and every insurer which makes its own rates shall provide
 1028  within this state reasonable means whereby any person aggrieved
 1029  by the application of its rating system may be heard, in person
 1030  or by his or her authorized representative, on his or her
 1031  written request to review the manner in which such rating system
 1032  has been applied in connection with the insurance afforded him
 1033  or her. If the rating organization filing prospective loss costs
 1034  or the insurer making its own rates fails to grant or rejects
 1035  such request within 30 days after it is made, the applicant may
 1036  proceed in the same manner as if his or her application had been
 1037  rejected. Any party affected by the action of such rating
 1038  organization filing prospective loss costs or insurer making its
 1039  own rates on such request may, within 30 days after written
 1040  notice of such action, appeal to the office, which may affirm or
 1041  reverse such action.
 1042         Section 19. Section 627.318, Florida Statutes, is amended
 1043  to read:
 1044         627.318 Records.—Every insurer, rating organization filing
 1045  prospective loss costs, and advisory organization and every
 1046  group, association, or other organization of insurers which
 1047  engages in joint underwriting or joint reinsurance shall
 1048  maintain reasonable records, of the type and kind reasonably
 1049  adapted to its method of operation, of its experience or the
 1050  experience of its members and of the data, statistics, or
 1051  information collected or used by it in connection with the
 1052  prospective loss costs, rates, rating plans, rating systems,
 1053  underwriting rules, policy or bond forms, surveys, or
 1054  inspections made or used by it, so that such records will be
 1055  available at all reasonable times to enable the office to
 1056  determine whether such organization, insurer, group, or
 1057  association, and, in the case of an insurer or rating
 1058  organization, every prospective loss cost, rate, rating plan,
 1059  and rating system made or used by it, complies with the
 1060  provisions of this part applicable to it. The maintenance of
 1061  such records in the office of a licensed rating organization of
 1062  which an insurer is a member or subscriber will be sufficient
 1063  compliance with this section for any such insurer maintaining
 1064  membership or subscribership in such organization, to the extent
 1065  that the insurer uses the prospective loss costs, rates, rating
 1066  plans, rating systems, or underwriting rules of such
 1067  organization. Such records shall be maintained in an office
 1068  within this state or shall be made available for examination or
 1069  inspection within this state by the department at any time upon
 1070  reasonable notice.
 1071         Section 20. Section 627.361, Florida Statutes, is amended
 1072  to read:
 1073         627.361 False or misleading information.—No person shall
 1074  willfully withhold information from or knowingly give false or
 1075  misleading information to the office, any statistical agency
 1076  designated by the office, any rating organization, or any
 1077  insurer, which will affect the prospective loss costs, rates, or
 1078  premiums chargeable under this part.
 1079         Section 21. Subsections (1) and (2) of section 627.371,
 1080  Florida Statutes, are amended to read:
 1081         627.371 Hearings.—
 1082         (1) Any person aggrieved by any rate charged, rating plan,
 1083  rating system, or underwriting rule followed or adopted by an
 1084  insurer, and any person aggrieved by any rating plan, rating
 1085  system, or underwriting rule followed or adopted by a rating
 1086  organization, may herself or himself or by her or his authorized
 1087  representative make written request of the insurer or rating
 1088  organization to review the manner in which the prospective loss
 1089  cost, rate, plan, system, or rule has been applied with respect
 1090  to insurance afforded her or him. If the request is not granted
 1091  within 30 days after it is made, the requester may treat it as
 1092  rejected. Any person aggrieved by the refusal of an insurer or
 1093  rating organization to grant the review requested, or by the
 1094  failure or refusal to grant all or part of the relief requested,
 1095  may file a written complaint with the office, specifying the
 1096  grounds relied upon. If the office has already disposed of the
 1097  issue as raised by a similar complaint or believes that probable
 1098  cause for the complaint does not exist or that the complaint is
 1099  not made in good faith, it shall so notify the complainant.
 1100  Otherwise, and if it also finds that the complaint charges a
 1101  violation of this chapter and that the complainant would be
 1102  aggrieved if the violation is proven, it shall proceed as
 1103  provided in subsection (2).
 1104         (2) If after examination of an insurer, rating
 1105  organization, advisory organization, or group, association, or
 1106  other organization of insurers which engages in joint
 1107  underwriting or joint reinsurance, upon the basis of other
 1108  information, or upon sufficient complaint as provided in
 1109  subsection (1), the office has good cause to believe that such
 1110  insurer, organization, group, or association, or any prospective
 1111  loss cost, rate, rating plan, or rating system made or used by
 1112  any such insurer or rating organization, does not comply with
 1113  the requirements and standards of this part applicable to it, it
 1114  shall, unless it has good cause to believe such noncompliance is
 1115  willful, give notice in writing to such insurer, organization,
 1116  group, or association stating therein in what manner and to what
 1117  extent noncompliance is alleged to exist and specifying therein
 1118  a reasonable time, not less than 10 days thereafter, in which
 1119  the noncompliance may be corrected, including any premium
 1120  adjustment.
 1121         Section 22. This act shall take effect July 1, 2017.