69O-154.305. Election and Premium Notice Form

(1) Within 14 days of the date that the carrier receives the notice of occurrence of a qualifying event from the qualified beneficiary the carrier must send to the employee, covered spouse and covered dependents, by certified mail, the Election and Premium Notice Form OIR-B2-1261 (REV 8/03), which is hereby adopted and incorporated by reference. Copies of the forms are available and may be printed from the Office’s website: http://www.floir.com/iportal. (2) Carriers may develop a similar form which must include the information in Form OIR-B2-1261. Any similar form must be filed and approved before use pursuant to the requirements of Section 627.410, F.S. Any filing shall be submitted to the Office electronically through http://www.floir.com/iportal.