Applicant must submit a check for $25,000 made payable to “Florida HMO
Consumer Assistance Plan” to cover the special assessment required by Section
641.228(1), Florida Statutes. Mail the check to:
Thomas A. Range, Plan Manager
Akerman LLP
201 E. Park Ave, Suite 300
Tallahassee, FL 32301
(850) 425-1628
Submit copies of the transmittal letter to the Plan Manager and the check with your
application filing.