Bill Text: FL H0021 | 2011 | Regular Session | Introduced


Bill Title: Health Insurance

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2011-01-10 - Withdrawn prior to introduction -HJ 9 [H0021 Detail]

Download: Florida-2011-H0021-Introduced.html
HB 21

1
A bill to be entitled
2An act relating to health insurance; creating ss.
3627.6404, 627.6572, and 641.31093, F.S.; requiring all
4antiretroviral agents to be included on health plan
5formularies; prohibiting access-limiting procedures used
6to restrict antiretroviral agents prescribed to treat a
7person with HIV; amending s. 627.6515, F.S.; including
8reference to such requirements on policies issued by out-
9of-state groups; providing an effective date.
10
11Be It Enacted by the Legislature of the State of Florida:
12
13     Section 1.  Section 627.6404, Florida Statutes, is created
14to read:
15     627.6404  HIV treatment.-Antiretroviral agents prescribed
16to treat a person with HIV must be included on a health plan
17formulary and may not be restricted through a requirement for
18prior authorization, step therapy, or other limitation that
19limits access to any antiretroviral agent.
20     Section 2.  Section 627.6572, Florida Statutes, is created
21to read:
22     627.6572  HIV treatment.-Antiretroviral agents prescribed
23to treat a person with HIV must be included on a health plan
24formulary and may not be restricted through a requirement for
25prior authorization, step therapy, or other limitation that
26limits access to any antiretroviral agent.
27     Section 3.  Section 641.31093, Florida Statutes, is created
28to read:
29     641.31093  HIV treatment.-Antiretroviral agents prescribed
30to treat a person with HIV must be included on a health plan
31formulary and may not be restricted through a requirement for
32prior authorization, step therapy, or other limitation that
33limits access to any antiretroviral agent.
34     Section 4.  Subsection (2) of section 627.6515, Florida
35Statutes, is amended to read:
36     627.6515  Out-of-state groups.-
37     (2)  Except as otherwise provided in this part, this part
38does not apply to a group health insurance policy issued or
39delivered outside this state under which a resident of this
40state is provided coverage if:
41     (a)  The policy is issued to an employee group the
42composition of which is substantially as described in s.
43627.653; a labor union group or association group the
44composition of which is substantially as described in s.
45627.654; an additional group the composition of which is
46substantially as described in s. 627.656; a group insured under
47a blanket health policy when the composition of the group is
48substantially in compliance with s. 627.659; a group insured
49under a franchise health policy when the composition of the
50group is substantially in compliance with s. 627.663; an
51association group to cover persons associated in any other
52common group, which common group is formed primarily for
53purposes other than providing insurance; a group that is
54established primarily for the purpose of providing group
55insurance, provided the benefits are reasonable in relation to
56the premiums charged thereunder and the issuance of the group
57policy has resulted, or will result, in economies of
58administration; or a group of insurance agents of an insurer,
59which insurer is the policyholder.;
60     (b)  Certificates evidencing coverage under the policy are
61issued to residents of this state and contain in contrasting
62color and not less than 10-point type the following statement:
63"The benefits of the policy providing your coverage are governed
64primarily by the law of a state other than Florida".; and
65     (c)  The policy provides the benefits specified in ss.
66627.419, 627.6572, 627.6574, 627.6575, 627.6579, 627.6612,
67627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and
68627.66911.
69     (d)  Applications for certificates of coverage offered to
70residents of this state must contain, in contrasting color and
71not less than 12-point type, the following statement on the same
72page as the applicant's signature:
73
74"This policy is primarily governed by the laws of ...insert
75state where the master policy if filed.... As a result, all of
76the rating laws applicable to policies filed in this state do
77not apply to this coverage, which may result in increases in
78your premium at renewal that would not be permissible under a
79Florida-approved policy. Any purchase of individual health
80insurance should be considered carefully, as future medical
81conditions may make it impossible to qualify for another
82individual health policy. For information concerning individual
83health coverage under a Florida-approved policy, consult your
84agent or the Florida Department of Financial Services."
85
86This paragraph applies only to group certificates providing
87health insurance coverage which require individualized
88underwriting to determine coverage eligibility for an individual
89or premium rates to be charged to an individual except for the
90following:
91     1.  Policies issued to provide coverage to groups of
92persons all of whom are in the same or functionally related
93licensed professions, and providing coverage only to such
94licensed professionals, their employees, or their dependents;
95     2.  Policies providing coverage to small employers as
96defined by s. 627.6699. Such policies shall be subject to, and
97governed by, the provisions of s. 627.6699;
98     3.  Policies issued to a bona fide association, as defined
99by s. 627.6571(5), provided that there is a person or board
100acting as a fiduciary for the benefit of the members, and such
101association is not owned, controlled by, or otherwise associated
102with the insurance company; or
103     4.  Any accidental death, accidental death and
104dismemberment, accident-only, vision-only, dental-only, hospital
105indemnity-only, hospital accident-only, cancer, specified
106disease, Medicare supplement, products that supplement Medicare,
107long-term care, or disability income insurance, or similar
108supplemental plans provided under a separate policy,
109certificate, or contract of insurance, which cannot duplicate
110coverage under an underlying health plan, coinsurance, or
111deductibles or coverage issued as a supplement to workers'
112compensation or similar insurance, or automobile medical-payment
113insurance.
114     Section 5.  This act shall take effect July 1, 2011.


CODING: Words stricken are deletions; words underlined are additions.
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