AB114-ASA1,17,1514 (c) The commissioner may not expand upon the reporting requirement under
15this subsection, except that the commissioner may effectuate this subsection.

AB114-ASA1,17,2017 CHAPTER 633
18 EMPLOYEE BENEFIT PLAN
19 ADMINISTRATORS AND, PRINCIPALS ,
20 and Pharmacy benefit managers

AB114-ASA1,17,2522 633.01 (1) (intro.) “Administrator" means a person who directly or indirectly
23solicits or collects premiums or charges or otherwise effects coverage or adjusts or
24settles claims for a an employee benefit plan, but does not include the following
25persons if they perform these acts under the circumstances specified for each:

1(c) A creditor on behalf of its debtor, if to obtain payment, reimbursement or
2other method of satisfaction from a an employee benefit plan for any part of a debt
3owed to the creditor by the debtor.

AB114-ASA1,18,55 633.01 (2r) “Enrollee” has the meaning given in s. 632.861 (1) (b).

AB114-ASA1,18,87 633.01 (3) “Insured employee" means an employee who is a resident of this
8state and who is covered under a an employee benefit plan.

AB114-ASA1,18,1611 633.01 (2g) “Plan Employee benefit plan" means an insured or wholly or
12partially self-insured employee benefit plan which by means of direct payment,
13reimbursement or other arrangement provides to one or more employees who are
14residents of this state benefits or services that include, but are not limited to, benefits
15for medical, surgical or hospital care, benefits in the event of sickness, accident,
16disability or death, or benefits in the event of unemployment or retirement.

AB114-ASA1,18,1918 633.01 (4g) “Pharmacy benefit manager” has the meaning given in s. 632.865
19(1) (c).

AB114-ASA1,18,2221 633.01 (4r) “Prescription drug benefit” has the meaning given in s. 632.865 (1)
22(e).

AB114-ASA1,18,2524 633.01 (5) “Principal" means a person, including an insurer, that uses the
25services of an administrator to provide a an employee benefit plan.

AB114-ASA1,19,22 633.01 (6) “Self-insured health plan" has the meaning given in s. 632.85 (1) (c).

AB114-ASA1,19,8 4633.04 Written agreement required. (intro.) An administrator may not
5administer a an employee benefit plan in the absence of a written agreement
6between the administrator and a principal. The administrator and principal shall
7each retain a copy of the written agreement for the duration of the agreement and
8for 5 years thereafter. The written agreement shall contain the following terms:

AB114-ASA1,19,16 10633.05 Payment to administrator. If a principal is an insurer, payment to
11the administrator of a premium or charge by or on behalf of an insured employee is
12payment to the insurer, but payment of a return premium or claim by the insurer to
13the administrator is not payment to an insured employee until the payment is
14received by the insured employee. This section does not limit any right of the insurer
15against the administrator for failure to make payments to the insurer or an insured
16employee.

AB114-ASA1,19,22 18633.06 Examination and inspection of books and records. (1) The
19commissioner may examine, audit or accept an audit of the books and records of an
20administrator or pharmacy benefit manager as provided for examination of licensees
21under s. 601.43 (1), (3), (4) and (5), to be conducted as provided in s. 601.44, and with
22costs to be paid as provided in s. 601.45.

AB114-ASA1,20,2 23(2) A principal that uses an administrator may inspect the books and records
24of the administrator, subject to any restrictions set forth in ss. 146.81 to 146.835 and

1in the written agreement required under s. 633.04, for the purpose of enabling the
2principal to fulfill its contractual obligations to insureds insured employees.

AB114-ASA1,20,6 4633.07 Approval of advertising. An administrator may not use any
5advertising for a an employee benefit plan underwritten by an insurer unless the
6insurer approves the advertising in advance.