ENROLLED
       2013 Legislature                   CS for SB 1844, 1st Engrossed
       
       
       
       
       
       
                                                             20131844er
    1  
    2         An act relating to the Florida Health Choices Program;
    3         amending s. 408.910, F.S.; revising eligibility
    4         requirements for the Florida Health Choices Program;
    5         revising the enrollment period for the initial
    6         selection of products and services for individual
    7         participants in the program; providing that the
    8         Florida Insurance Code is not applicable in certain
    9         circumstances; providing an appropriation; providing
   10         an effective date.
   11  
   12  Be It Enacted by the Legislature of the State of Florida:
   13  
   14         Section 1. Paragraphs (a), (b), (e), and (f) of subsection
   15  (4) and paragraph (b) of subsection (7) of section 408.910,
   16  Florida Statutes, are amended, and paragraph (c) is added to
   17  subsection (10) of that section, to read:
   18         408.910 Florida Health Choices Program.—
   19         (4) ELIGIBILITY AND PARTICIPATION.—Participation in the
   20  program is voluntary and shall be available to employers,
   21  individuals, vendors, and health insurance agents as specified
   22  in this subsection.
   23         (a) Employers eligible to enroll in the program include
   24  those employers:
   25         1. Employers that meet criteria established by the
   26  corporation and elect to make their employees eligible through
   27  the program.
   28         2. Fiscally constrained counties described in s. 218.67.
   29         3. Municipalities having populations of fewer than 50,000
   30  residents.
   31         4. School districts in fiscally constrained counties.
   32         5. Statutory rural hospitals.
   33         (b) Individuals eligible to participate in the program
   34  include:
   35         1. Individual employees of enrolled employers.
   36         2. Other individuals that meet criteria established by the
   37  corporation State employees not eligible for state employee
   38  health benefits.
   39         3. State retirees.
   40         4. Medicaid participants who opt out.
   41         (e) Eligible individuals may participate in the program
   42  voluntarily continue participation in the program regardless of
   43  subsequent changes in job status or Medicaid eligibility.
   44  Individuals who join the program may participate by complying
   45  with the procedures established by the corporation. These
   46  procedures must include, but are not limited to:
   47         1. Submission of required information.
   48         2. Authorization for payroll deduction.
   49         3. Compliance with federal tax requirements.
   50         4. Arrangements for payment in the event of job changes.
   51         5. Selection of products and services.
   52         (f) Vendors who choose to participate in the program may
   53  enroll by complying with the procedures established by the
   54  corporation. These procedures may include, but are not limited
   55  to:
   56         1. Submission of required information, including a complete
   57  description of the coverage, services, provider network, payment
   58  restrictions, and other requirements of each product offered
   59  through the program.
   60         2. Execution of an agreement to comply with requirements
   61  established by the corporation.
   62         3. Execution of an agreement that prohibits refusal to sell
   63  any offered non-risk-bearing product or service to a participant
   64  who elects to buy it.
   65         4. Establishment of product prices based on applicable
   66  criteria age, gender, and location of the individual
   67  participant, which may include medical underwriting.
   68         5. Arrangements for receiving payment for enrolled
   69  participants.
   70         6. Participation in ongoing reporting processes established
   71  by the corporation.
   72         7. Compliance with grievance procedures established by the
   73  corporation.
   74         (7) THE MARKETPLACE PROCESS.—The program shall provide a
   75  single, centralized market for purchase of health insurance,
   76  health maintenance contracts, and other health products and
   77  services. Purchases may be made by participating individuals
   78  over the Internet or through the services of a participating
   79  health insurance agent. Information about each product and
   80  service available through the program shall be made available
   81  through printed material and an interactive Internet website. A
   82  participant needing personal assistance to select products and
   83  services shall be referred to a participating agent in his or
   84  her area.
   85         (b) Initial selection of products and services must be made
   86  by an individual participant within the applicable open
   87  enrollment period 60 days after the date the individual’s
   88  employer qualified for participation. An individual who fails to
   89  enroll in products and services by the end of this period is
   90  limited to participation in flexible spending account services
   91  until the next annual enrollment period.
   92         (10) EXEMPTIONS.—
   93         (c) Any standard forms, website design, or marketing
   94  communication developed by the corporation and used by the
   95  corporation, or any vendor that meets the requirements of s.
   96  408.910(4)(f) is not subject to the Florida Insurance Code, as
   97  established in s. 624.01.
   98         Section 2. For the 2013-2014 fiscal year, the sum of
   99  $900,000 in nonrecurring general revenue is appropriated to the
  100  Agency for Health Care Administration to fund the general
  101  administration and operations of the Florida Health Choices
  102  Program.
  103         Section 3. This act shall take effect July 1, 2013.