Bill Text: FL S1422 | 2019 | Regular Session | Introduced
Bill Title: Health Plans
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-05-03 - Died on Calendar, companion bill(s) passed, see CS/CS/SB 322 (Ch. 2019-129) [S1422 Detail]
Download: Florida-2019-S1422-Introduced.html
Florida Senate - 2019 SB 1422
By Senator Gruters
23-01636-19 20191422__
1 A bill to be entitled
2 An act relating to health plans; amending s. 624.438,
3 F.S.; revising eligibility requirements for multiple
4 employer welfare arrangements; amending s. 627.6045,
5 F.S.; revising applicability of requirements relating
6 to preexisting conditions; revising the font size for
7 a certain disclosure; amending s. 627.6425, F.S.;
8 revising the definition of the term “individual health
9 insurance” relating to renewability of individual
10 coverage; creating ss. 627.6426 and 627.6525, F.S.;
11 defining the term “short-term health insurance”;
12 providing disclosure requirements for short-term
13 individual, group, blanket, and franchise health
14 insurance policies; amending s. 627.654, F.S.;
15 revising requirements for, and applicability relating
16 to, association and small employer policies; providing
17 an effective date.
18
19 Be It Enacted by the Legislature of the State of Florida:
20
21 Section 1. Paragraph (b) of subsection (1) of section
22 624.438, Florida Statutes, is amended to read:
23 624.438 General eligibility.—
24 (1) To meet the requirements for issuance of a certificate
25 of authority and to maintain a multiple-employer welfare
26 arrangement, an arrangement:
27 (b)1. Must be established by a bona fide group trade
28 association, industry association, or professional association
29 of employers as defined in 29 C.F.R. s. 2510.3-5 or
30 professionals which has a constitution or bylaws specifically
31 stating its purpose and which has been organized and maintained
32 in good faith for a continuous period of 1 year for purposes in
33 addition to other than that of obtaining or providing insurance.
34 2. Must not combine member employers from disparate trades,
35 industries, or professions as defined by the appropriate
36 licensing agencies, and must not combine member employers from
37 more than one of the employer categories defined in sub
38 subparagraphs a.-c.
39 a. A trade association consists of member employers who are
40 in the same trade as recognized by the appropriate licensing
41 agency.
42 b. An industry association consists of member employers who
43 are in the same major group code, as defined by the Standard
44 Industrial Classification Manual issued by the federal Office of
45 Management and Budget, unless restricted by sub-subparagraph a.
46 or sub-subparagraph c.
47 c. A professional association consists of member employers
48 who are of the same profession as recognized by the appropriate
49 licensing agency.
50
51 The requirements of this paragraph subparagraph do not apply to
52 an arrangement licensed before prior to April 1, 1995,
53 regardless of the nature of its business. However, an
54 arrangement exempt from the requirements of this paragraph
55 subparagraph may not expand the nature of its business beyond
56 that set forth in the articles of incorporation of its
57 sponsoring association as of April 1, 1995, except as authorized
58 in this paragraph subparagraph.
59 Section 2. Subsection (3) of section 627.6045, Florida
60 Statutes, is amended to read:
61 627.6045 Preexisting condition.—A health insurance policy
62 must comply with the following:
63 (3) This section does not apply to short-term, nonrenewable
64 health insurance policies of no more than a 6-month policy term,
65 provided that it is clearly disclosed to the applicant in the
66 advertising and application, in 14-point 10-point contrasting
67 type, that “This policy does not meet the definition of
68 qualifying previous coverage or qualifying existing coverage as
69 defined in s. 627.6699. As a result, if purchased in lieu of a
70 conversion policy or other group coverage, you may have to meet
71 a preexisting condition requirement when renewing or purchasing
72 other coverage.”
73 Section 3. Subsection (1) of section 627.6425, Florida
74 Statutes, is amended to read:
75 627.6425 Renewability of individual coverage.—
76 (1) Except as otherwise provided in this section, an
77 insurer that provides individual health insurance coverage to an
78 individual shall renew or continue in force such coverage at the
79 option of the individual. For the purpose of this section, the
80 term “individual health insurance” means health insurance
81 coverage, as described in s. 624.603, offered to an individual
82 in this state, including certificates of coverage offered to
83 individuals in this state as part of a group policy issued to an
84 association outside this state, but the term does not include
85 short-term limited duration insurance or excepted benefits
86 specified in s. 627.6513(1)-(14).
87 Section 4. Section 627.6426, Florida Statutes, is created
88 to read:
89 627.6426 Short-term health insurance.—
90 (1) For purposes of this part, the term “short-term health
91 insurance” means health insurance coverage provided by an issuer
92 with an expiration date specified in the contract which is less
93 than 12 months after the original effective date of the contract
94 and, taking into account renewals or extensions, has a duration
95 not to exceed 36 months in total.
96 (2) All contracts for short-term health insurance entered
97 into by an issuer and an individual seeking coverage shall
98 include the following disclosure:
99
100 “This coverage is not required to comply with certain federal
101 market requirements for health insurance, principally those
102 contained in the Patient Protection and Affordable Care Act. Be
103 sure to check your policy carefully to make sure you are aware
104 of any exclusions or limitations regarding coverage of
105 preexisting conditions or health benefits (such as
106 hospitalization, emergency services, maternity care, preventive
107 care, prescription drugs, and mental health and substance use
108 disorder services). Your policy might also have lifetime and/or
109 annual dollar limits on health benefits. If this coverage
110 expires or you lose eligibility for this coverage, you might
111 have to wait until an open enrollment period to get other health
112 insurance coverage.”
113 Section 5. Section 627.6525, Florida Statutes, is created
114 to read:
115 627.6525 Short-term health insurance.—
116 (1) For purposes of this part, the term “short-term health
117 insurance” means a group, blanket, or franchise policy of health
118 insurance coverage provided by an issuer with an expiration date
119 specified in the contract which is less than 12 months after the
120 original effective date of the contract and, taking into account
121 renewals or extensions, has a duration not to exceed 36 months
122 in total.
123 (2) All contracts for short-term health insurance entered
124 into by an issuer and a party seeking coverage shall include the
125 following disclosure:
126
127 “This coverage is not required to comply with certain federal
128 market requirements for health insurance, principally those
129 contained in the Patient Protection and Affordable Care Act. Be
130 sure to check your policy carefully to make sure you are aware
131 of any exclusions or limitations regarding coverage of
132 preexisting conditions or health benefits (such as
133 hospitalization, emergency services, maternity care, preventive
134 care, prescription drugs, and mental health and substance use
135 disorder services). Your policy might also have lifetime and/or
136 annual dollar limits on health benefits. If this coverage
137 expires or you lose eligibility for this coverage, you might
138 have to wait until an open enrollment period to get other health
139 insurance coverage.”
140 Section 6. Subsection (1) of section 627.654, Florida
141 Statutes, is amended to read:
142 627.654 Labor union, association, and small employer health
143 alliance groups.—
144 (1)(a) A bona fide group or association of employers, as
145 defined in 29 C.F.R. s. 2510.3-5, or a group of individuals may
146 be insured under a policy issued to an association, including a
147 labor union, which association has a constitution and bylaws and
148 not less than 25 individual members and which has been organized
149 and has been maintained in good faith for a period of 1 year for
150 purposes in addition to other than that of obtaining insurance,
151 or to the trustees of a fund established by such an association,
152 which association or trustees shall be deemed the policyholder,
153 insuring at least 15 individual members of the association for
154 the benefit of persons other than the officers of the
155 association, the association, or trustees.
156 (b) A small employer, as defined in s. 627.6699 and
157 including the employer’s eligible employees and the spouses and
158 dependents of such employees, may be insured under a policy
159 issued to a small employer health alliance by a carrier as
160 defined in s. 627.6699. A small employer health alliance must be
161 organized as a not-for-profit corporation under chapter 617.
162 Notwithstanding any other law, if a small employer member of an
163 alliance loses eligibility to purchase health care through the
164 alliance solely because the business of the small employer
165 member expands to more than 50 and fewer than 75 eligible
166 employees, the small employer member may, at its next renewal
167 date, purchase coverage through the alliance for not more than 1
168 additional year. A small employer health alliance shall
169 establish conditions of participation in the alliance by a small
170 employer, including, but not limited to:
171 1. Assurance that the small employer is not formed for the
172 purpose of securing health benefit coverage.
173 2. Assurance that the employees of a small employer have
174 not been added for the purpose of securing health benefit
175 coverage.
176 Section 7. This act shall take effect July 1, 2019.
