Florida Senate - 2015                        COMMITTEE AMENDMENT
       Bill No. SB 968
       
       
       
       
       
       
                                Ì195386OÎ195386                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/23/2015           .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Banking and Insurance (Detert) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 1002 - 1015
    4  and insert:
    5         (1) A self-insured health benefit plan established or
    6  maintained by a small employer, as defined in s. 627.6699(3)(v),
    7  is exempt from s. 627.6699 and may use a stop-loss insurance
    8  policy issued to the employer. For purposes of this subsection,
    9  the term “stop-loss insurance policy” means an insurance policy
   10  issued to a small employer which covers the small employer’s
   11  obligation for the excess cost of medical care on an equivalent
   12  basis per employee provided under a self-insured health benefit
   13  plan.
   14         (a) A small employer stop-loss insurance policy is
   15  considered a health insurance policy and is subject to s.
   16  627.6699 if the policy has an aggregate attachment point that is
   17  lower than the greatest of:
   18         1. Two thousand dollars multiplied by the number of
   19  employees;
   20         2. One hundred twenty percent of expected claims, as
   21  determined by the stop-loss insurer in accordance with actuarial
   22  standards of practice; or
   23         3. Twenty thousand dollars.
   24         (b) Once claims under the small employer health benefit
   25  plan reach the aggregate attachment point set forth in paragraph
   26  (a), the stop-loss insurance policy authorized under this
   27  section must cover 100 percent of all claims that exceed the
   28  aggregate attachment point.
   29         (2) A self-insured health benefit plan established or
   30  maintained by an employer with 51 or more covered employees is
   31  considered health insurance if the plan’s stop-loss coverage, as
   32  defined in s. 627.6482(14), has an aggregate attachment point
   33  that is lower than the greater of:
   34         (a) One hundred ten percent of expected claims, as
   35  determined by the stop-loss insurer in accordance with actuarial
   36  standards of practice; or
   37         (b) Twenty thousand dollars.
   38         (3) Stop-loss insurance carriers shall use a consistent
   39  basis for determining the number of an employer’s covered
   40  employees. Such basis may include, but is not limited to, the
   41  average number of employees employed annually or at a uniform
   42  time.
   43  
   44  ================= T I T L E  A M E N D M E N T ================
   45  And the title is amended as follows:
   46         Delete lines 10 - 11
   47  and insert:
   48         authorizing certain health benefit plans to use a
   49         stop-loss insurance policy; defining the term “stop
   50         loss insurance policy”; providing requirements