Fla. Admin. Code R. 69O-149.207

Current through Reg. 50, No. 253; December 31, 2024

Section 69O-149.207 - Health Maintenance Organization Standard Risk Rates

(1) The table below provides the standard annual risk rates for HMO plans for the Standard Benefit Plan. The 200% standard risk rate referenced in section 627.6675(3)(a), F.S., is determined by multiplying each value in the table by the factor 2.0.

(2) To determine the rate for a particular county, multiply the rate schedule below by the appropriate area factor.

(3) Standard risk rates for coverage providing benefits coordinating with or otherwise considering coverage under Medicare, parts A and B, shall be determined by multiplying the standard risk rates identified herein by .278.

STANDARD HEALTH BENEFIT PLAN
Age	Male	Female	County	Area Factor
0	$5,258.45	$5,250.04	Alachua	1.04
1	$2,968.48	$2,960.07	Baker	1.06
2-6	$2,909.90	$2,901.49	Bay	0.90
7-12	$2,822.45	$2,814.04	Bradford	1.04
13-17	$2,972.73	$2,964.33	Brevard	0.94
18	$2,549.95	$4,120.85	Broward	1.00
19	$2,570.16	$4,301.90	Calhoun	0.90
20	$2,610.13	$4,382.36	Charlotte	0.99
21	$2,630.36	$4,472.30	Citrus	0.92
22	$2,670.38	$4,539.11	Clay	1.06
23	$2,729.45	$4,663.20	Collier	0.90
24	$2,776.56	$4,759.79	Columbia	1.04
25	$2,819.35	$4,883.42	Dade	1.00
26	$2,899.75	$5,051.05	De Soto	0.90
27	$2,983.75	$5,227.91	Dixie	1.04
28	$3,047.19	$5,290.86	Duval	1.06
29	$3,150.59	$5,242.98	Escambia	1.08
30	$3,236.87	$5,247.52	Flagler	0.90
31	$3,279.13	$5,177.31	Franklin	0.90
32	$3,340.11	$5,172.07	Gadsden	0.90
33	$3,402.20	$5,136.91	Gilchrist	1.05
34	$3,444.91	$5,106.34	Glades	0.90
35	$3,532.78	$5,128.20	Gulf	0.90
36	$3,580.77	$5,108.61	Hamilton	0.90
37	$3,649.52	$5,085.24	Hardee	0.84
38	$3,748.38	$5,099.53	Hendry	0.96
39	$3,815.47	$5,111.88	Hernando	1.03
40	$3,923.62	$5,139.24	Highlands	0.84
41	$4,003.19	$5,186.08	Hillsborough	1.01
42	$4,102.20	$5,276.71	Holmes	0.90
43	$4,235.88	$5,400.47	Indian River	0.90
44	$4,359.59	$5,523.74	Jackson	0.90
45	$4,486.17	$5,621.99	Jefferson	0.90
46	$4,682.63	$5,747.05	Lafayette	0.90
47	$4,872.08	$5,874.81	Lake	0.94
48	$5,109.97	$5,986.94	Lee	1.01
49	$5,341.56	$6,117.55	Leon	0.90
50	$5,598.42	$6,278.89	Levy	1.04
51	$5,909.83	$6,447.58	Liberty	0.90
52	$6,253.14	$6,612.37	Madison	0.90
53	$6,590.04	$6,778.15	Manatee	1.06
54	$6,966.54	$6,965.19	Marion	0.97
55	$7,360.26	$7,102.09	Martin	1.02
56	$7,730.02	$7,258.77	Monroe	0.90
57	$8,099.29	$7,390.68	Nassau	1.06
58	$8,615.15	$7,721.59	Okaloosa	1.05
59	$9,149.91	$8,070.04	Okeechobee	0.94
60	$9,714.17	$8,467.78	Orange	0.94
61	$10,192.09	$8,914.29	Osceola	0.96
62	$10,667.92	$9,373.20	Palm Beach	1.06
63	$11,239.30	$9,927.57	Pasco	1.01
64	$11,819.57	$10,475.54	Pinellas	1.01
65	$14,318.73	$12,839.86	Polk	1.15
66	$14,377.66	$12,885.56	Putnam	1.01
67	$14,436.21	$12,930.98	St. Johns	1.06
68	$14,494.23	$12,975.97	St. Lucie	1.01
69	$14,551.64	$13,020.50	Santa Rosa	1.08
70	$14,608.25	$13,064.41	Sarasota	1.07
71	$14,663.96	$13,107.62	Seminole	0.97
72	$14,718.64	$13,150.03	Sumter	0.97
73	$14,772.15	$13,191.51	Suwannee	0.94
74	$14,824.35	$13,232.00	Taylor	0.90
75	$14,875.09	$13,271.34	Union	0.90
76	$14,924.27	$13,309.50	Volusia	1.00
77	$14,971.75	$13,346.31	Wakulla	0.90
78	$15,017.41	$13,381.72	Walton	1.07
79	$15,061.10	$13,415.60	Washington	0.90

Fla. Admin. Code Ann. R. 69O-149.207

Rulemaking Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS.

New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.207, Amended 5-18-04, 5-22-05, 6-1-06, 8-23-07, 10-29-08.