State RegulationsFL specificDifficulty 3/5
A Florida consumer wants a health plan that treats every licensed provider the same, with no network tier reducing reimbursement and no referral requirements, and she will handle claims paperwork herself. Which plan type fits?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under Chapter 627, Florida Statutes, and the plan-type distinctions Florida agents must know, only the traditional indemnity plan reimburses every licensed provider on the same fee-for-service basis, with no network tiers and no referral or gatekeeper mechanics. The HMO centers care in its network with referrals, the PPO lowers benefits outside its contracted network, and the EPO generally excludes non-network care entirely, so none of them delivers the uniform, network-free treatment the consumer wants.
Why the other options are wrong
- A) An HMO builds benefits around its contracted network and a primary care referral system, the opposite of unrestricted access.
- B) A PPO reimburses out-of-network providers at reduced benefits, so providers are not treated the same.
- C) An EPO generally provides no out-of-network coverage at all except emergencies, which fails the consumer's requirement.
Memory hook
No tiers, no gates, any doctor = indemnity.