Senate Bill sb2264

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    Florida Senate - 2003                                  SB 2264

    By Senator Atwater





    25-823A-03

  1                      A bill to be entitled

  2         An act relating to health insurance; amending

  3         s. 627.6515, F.S.; amending conditions that

  4         must be met to exempt from part VII of ch. 627,

  5         F.S., a group health insurance policy issued or

  6         delivered outside this state under which a

  7         resident of this state is provided coverage;

  8         providing rulemaking authority; providing an

  9         effective date.

10  

11  Be It Enacted by the Legislature of the State of Florida:

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13         Section 1.  Subsection (2) of section 627.6515, Florida

14  Statutes, is amended, and subsection (9) is added to that

15  section, to read:

16         627.6515  Out-of-state groups.--

17         (2)  Except as provided in this part, this part does

18  not apply to a group health insurance policy issued or

19  delivered outside this state under which a resident of this

20  state is provided coverage if:

21         (a)  The policy is issued to an employee group the

22  composition of which is substantially as described in s.

23  627.653; a labor union group or association group the

24  composition of which is substantially as described in s.

25  627.654; an additional group the composition of which is

26  substantially as described in s. 627.656; a group insured

27  under a blanket health policy when the composition of the

28  group is substantially in compliance with s. 627.659; a group

29  insured under a franchise health policy when the composition

30  of the group is substantially in compliance with s. 627.663;

31  an association group to cover persons associated in any other

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    Florida Senate - 2003                                  SB 2264
    25-823A-03




 1  common group, which common group is formed primarily for

 2  purposes other than providing insurance; a group that is

 3  established primarily for the purpose of providing group

 4  insurance, provided the benefits are reasonable in relation to

 5  the premiums charged thereunder and the issuance of the group

 6  policy has resulted, or will result, in economies of

 7  administration; or a group of insurance agents of an insurer,

 8  which insurer is the policyholder;

 9         (b)  Certificates evidencing coverage under the policy

10  are issued to residents of this state and contain in

11  contrasting color and not less than 10-point type the

12  following statement:  "The benefits of the policy providing

13  your coverage are governed primarily by the law of a state

14  other than Florida"; and

15         (c)  The policy provides the benefits specified in ss.

16  627.419, 627.6574, 627.6575, 627.6579, 627.6612, 627.66121,

17  627.66122, 627.6613, 627.667, 627.6675, 627.6691, and

18  627.66911, and, regardless of what type of group described in

19  this subsection the policy is issued to, the policy complies

20  with the antidiscrimination provisions set forth in s.

21  627.65625, regarding rating and eligibility for enrollment and

22  for any benefit under the policy, and with s. 627.6571; and.

23         (d)  The policy is not issued to a group that directly

24  or indirectly uses any factor related to health status in

25  determining eligibility for initial or continued membership in

26  the group or initial or continued eligibility of any group

27  member to participate in any aspect of the group insurance

28  program. This paragraph does not apply to policies that

29  provide coverage only to employers for the benefit of their

30  employees.

31  

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    Florida Senate - 2003                                  SB 2264
    25-823A-03




 1         (9)  The Office of Insurance Regulation shall adopt

 2  rules necessary to administer this section.

 3         Section 2.  This act shall take effect July 1, 2003.

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 5            *****************************************

 6                          SENATE SUMMARY

 7    Amends the list of conditions that must be met to exempt
      from pt. VII of ch. 627, F.S., a group health insurance
 8    policy issued or delivered outside this state under which
      a resident of this state is provided coverage. Provides
 9    rulemaking authority to the Office of Insurance
      Regulation.
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