ENROLLED
       2013 Legislature                    CS for SB 648, 1st Engrossed
       
       
       
       
       
       
                                                              2013648er
    1  
    2         An act relating to health insurance marketing
    3         materials; amending ss. 627.6699 and 627.9407, F.S.;
    4         authorizing a health insurer to immediately begin
    5         using long-term care insurance advertising material
    6         under certain circumstances; providing that rules
    7         adopted by the Financial Services Commission to
    8         establish the format for the notice of the estimated
    9         premium impact of the federal Patient Protection and
   10         Affordable Care Act pursuant to specified legislation
   11         are not subject to s. 120.541(3), F.S., relating to
   12         the adverse impact or regulatory costs of a rule;
   13         providing an effective date.
   14  
   15  Be It Enacted by the Legislature of the State of Florida:
   16  
   17         Section 1. Paragraph (d) of subsection (12) of section
   18  627.6699, Florida Statutes, is amended to read:
   19         627.6699 Employee Health Care Access Act.—
   20         (12) STANDARD, BASIC, HIGH DEDUCTIBLE, AND LIMITED HEALTH
   21  BENEFIT PLANS.—
   22         (d)1. Upon offering coverage under a standard health
   23  benefit plan, a basic health benefit plan, or a limited benefit
   24  policy or contract for a any small employer group, the small
   25  employer carrier shall provide such employer group with a
   26  written statement that contains, at a minimum:
   27         a. An explanation of those mandated benefits and providers
   28  that are not covered by the policy or contract;
   29         b. An explanation of the managed care and cost control
   30  features of the policy or contract, along with all appropriate
   31  mailing addresses and telephone numbers to be used by insureds
   32  in seeking information or authorization; and
   33         c. An explanation of the primary and preventive care
   34  features of the policy or contract.
   35  
   36  Such disclosure statement must be presented in a clear and
   37  understandable form and format and must be separate from the
   38  policy or certificate or evidence of coverage provided to the
   39  employer group.
   40         2. Before a small employer carrier issues a standard health
   41  benefit plan, a basic health benefit plan, or a limited benefit
   42  policy or contract, the carrier it must obtain from the
   43  prospective policyholder a signed written statement in which the
   44  prospective policyholder:
   45         a. Certifies as to eligibility for coverage under the
   46  standard health benefit plan, basic health benefit plan, or
   47  limited benefit policy or contract;
   48         b. Acknowledges the limited nature of the coverage and an
   49  understanding of the managed care and cost control features of
   50  the policy or contract;
   51         c. Acknowledges that if misrepresentations are made
   52  regarding eligibility for coverage under a standard health
   53  benefit plan, a basic health benefit plan, or a limited benefit
   54  policy or contract, the person making such misrepresentations
   55  forfeits coverage provided by the policy or contract; and
   56         d. If a limited plan is requested, acknowledges that the
   57  prospective policyholder had been offered, at the time of
   58  application for the insurance policy or contract, the
   59  opportunity to purchase any health benefit plan offered by the
   60  carrier and that the prospective policyholder had rejected that
   61  coverage.
   62  
   63  A copy of such written statement must shall be provided to the
   64  prospective policyholder by no later than at the time of
   65  delivery of the policy or contract, and the original of such
   66  written statement must shall be retained in the files of the
   67  small employer carrier for the period of time that the policy or
   68  contract remains in effect or for 5 years, whichever period is
   69  longer.
   70         3. Any material statement made by an applicant for coverage
   71  under a health benefit plan which falsely certifies as to the
   72  applicant’s eligibility for coverage serves as the basis for
   73  terminating coverage under the policy or contract.
   74         4. Each marketing communication that is intended to be used
   75  in the marketing of a health benefit plan in this state must be
   76  submitted for review by the office prior to use and must contain
   77  the disclosures stated in this subsection.
   78         Section 2. Subsection (2) of section 627.9407, Florida
   79  Statutes, is amended to read:
   80         627.9407 Disclosure, advertising, and performance standards
   81  for long-term care insurance.—
   82         (2) ADVERTISING.—The commission shall adopt rules
   83  establishing setting forth standards for the advertising,
   84  marketing, and sale of long-term care insurance policies in
   85  order to protect applicants from unfair or deceptive sales or
   86  enrollment practices. An insurer shall file with the office any
   87  long-term care insurance advertising material intended for use
   88  in this state and may immediately begin using such material upon
   89  filing, subject to subsequent disapproval by the office.
   90  Following receipt of a notice of disapproval or a withdrawal of
   91  approval, the insurer must immediately cease use of the
   92  disapproved material at least 30 days before the date of use of
   93  the advertisement in this state. Within 30 days after the date
   94  of receipt of the advertising material, the office shall review
   95  the material and shall disapprove any advertisement if, in the
   96  opinion of the office, such advertisement violates any of the
   97  provisions of this part or of part IX of chapter 626 or any rule
   98  of the commission. The office may also disapprove an
   99  advertisement at any time and enter an immediate order requiring
  100  that the use of the advertisement be discontinued if it
  101  determines that the advertisement violates any of the provisions
  102  of this part, or of part IX of chapter 626, or any rule of the
  103  commission.
  104         Section 3. The rules adopted by the Financial Services
  105  Commission to establish the format for the notice of the
  106  estimated premium impact of the federal Patient Protection and
  107  Affordable Care Act pursuant to s. 627.410, Florida Statutes, as
  108  amended by Senate Bill 1842, House Bill 7155, or similar
  109  legislation adopted in the same legislative session or an
  110  extension thereof, are not subject to s. 120.541(3), Florida
  111  Statutes.
  112         Section 4. This act shall take effect July 1, 2013.