No. SB 440
Filed under Healthcare.
Florida Employee Health Choices Program; Renaming the “Florida Health Choices Program” as the “Florida Employee Health Choices Program”; revising eligibility and participation requirements for vendors under the program; revising the types of health insurance products that are available for purchase through the program; deleting exemptions from certain requirements of the Florida Insurance Code under the program, etc.
Plain English Summary
AI-GENERATEDThe Florida Health Choices Program becomes the Florida Employee Health Choices Program, shifting its purpose from serving all state residents to serving employees whose employers fund individual coverage through health reimbursement arrangements.
Only insurers and health maintenance organizations may now sell through the program, and only health insurance policies or HMO contracts; prepaid clinics, service-contract providers, and other former vendor types are cut out entirely.
Plans sold through the program lose their exemption from the Florida Insurance Code, so they must now meet the licensing and mandated-coverage rules that apply to insurance sold outside the program.
The bill also repeals the program's risk-pooling system, its price-transparency rule, its consumer disclosure form, and its 12-month enrollment lock-in, while shrinking the governing board from 15 members to 8.
AIThe program's stated purpose shifts from helping any state resident buy health coverage to serving employees whose employers give them money through an individual coverage health reimbursement arrangement to buy their own plan.
AIOnly insurers licensed under chapter 624 and health maintenance organizations licensed under part I of chapter 641 may sell through the program; prepaid clinics, direct health-service providers, and other vendor types allowed under prior law are removed entirely.
AIHealth insurance policies and HMO contracts sold through the program are no longer exempt from the Florida Insurance Code's licensing requirements or the mandated coverage rules in part VI of chapter 627 and chapter 641.
AIThe prior law's risk-pooling system, which let the corporation adjust payments to vendors based on the health risk of their enrollees, is deleted without any replacement mechanism.
AIThe requirement that vendor prices be transparent to participants, and the requirement that the corporation give consumers a disclosure form explaining plan benefits and limits, are both deleted from the program's rules.
AIThe rule locking individual participants into a selected product for at least 12 months, and limiting changes to an annual enrollment period, is deleted along with the risk-bearing-product limits tied to it.
AIThe new Florida Employee Health Choices, Inc. is governed by an eight-member board (three gubernatorial, two Senate, two House, one nonvoting Management Services designee), down from the prior 15-member board.