1. (1) An application for a person applying for a certificate of authority as a prepaid health clinic consists of the following:

   1. (a) Form OIR-C1-483, “Application for Certificate of Authority Prepaid Health Clinic,” incorporated by reference in Rule 69O-136.100, F.A.C.;
   2. (b) The biographical information package as defined in subsection 69O-136.100(3), F.A.C.; and,
   3. (c) Form OIR-C1-2221, “Management Information Form,” incorporated by reference in Rule 69O-136.100, F.A.C.
2. (2) A person applying for a certificate of authority as a prepaid health clinic shall submit forms in subsection (1) as directed by the Office electronically at https://www.floir.gov/iportal. The forms may be obtained from https://www.floir.gov/iportal.

Rulemaking Authority 641.403, 641.405(2) FS. Law Implemented 641.405, 641.406, 641.407, 641.409, 641.412, 641.42, 641.427, 641.43, 641.441 FS. History–New 5-9-85, Formerly 4-69.03, 4-69.003, 4-194.003, Amended 9-28-22, 1-4-24, Formerly 69O-194.003, Amended 3-31-25, Technical Change 2-6-26.