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CS/CS/SB 1170 — Health Plan Regulatory Administration

by Appropriations Committee; Banking and Insurance Committee; and Senator Detert

This summary is provided for information only and does not represent the opinion of any Senator, Senate Officer, or Senate Office.

Prepared by: Banking and Insurance Committee (BI)

The bill revises provisions in the Insurance Code and other Florida Statutes that conflict with the federal Patient Protection and Affordable Care Act (PPACA) and provides other changes. These changes include:

  • Eliminating provisions relating to the imposition of a preexisting condition exclusion since the federal act requires guaranteed issue of coverage and prohibits preexisting condition exclusions;
  • Removing the requirement that insurers provide an outline of coverage for individual or family accident and health insurance policies since the federal act requires a summary of benefits and coverage for individual and small group coverage;
  • Eliminating provisions relating to medical loss ratios since the federal act prescribes such standards and requires rebates if certain conditions are met;
  • Eliminating the requirement for insurers to issue certificates of creditable coverage; and
  • Providing technical and conforming changes.

The bill also provides that a not for profit corporation whose membership consists entirely of local governmental units that are authorized to enter into risk management consortiums under s. 112.08, F.S., is exempt from licensure by the Office of Insurance Regulation (OIR) as a third-party administrator for self-insurance.

If approved by the Governor, these provisions take effect July 1, 2016.

Vote: Senate 38-0; House 114-0