1. (1) Prior to establishing a Self-Funded Health Benefit Plan, the local governmental unit shall submit the following:

   1. (a) A copy of its Plan, including a list of its offered benefits;
   2. (b) Form OIR-B2-570, “General Information on Self-Funded Health Benefit Plans”; as adopted in Rule 69O-149.054, F.A.C.;
   3. (c) Form OIR-B2-571 “New Plan Operating Projections for Self-Funded Health Benefit Plans”; as adopted in Rule 69O-149.054, F.A.C.;
   4. (d) Form OIR-B2-573, “Operating Projections for Self-Funded Health Benefit Plans”; as adopted in Rule 69O-149.054, F.A.C.; and,
   5. (e) A certification as to the actuarial soundness of the Plan prepared by an actuary who is a member of the Society of Actuaries or the American Academy of Actuaries accompanied by an explanation or basis of how the certification was made.
2. (2) The filing shall be submitted to the Office electronically through http://www.floir.com/iportal.

Rulemaking Authority 112.08(6) FS. Law Implemented 112.08(2) FS. History–New 7-9-91, Formerly 4-111.002, 4-149.052, Amended 5-18-04.