Florida Senate - 2019                                     SB 322
       
       
        
       By Senator Simpson
       
       
       
       
       
       10-00487C-19                                           2019322__
    1                        A bill to be entitled                      
    2         An act relating to preexisting conditions; creating
    3         ss. 627.6046 and 627.65612, F.S.; defining the terms
    4         “operative date” and “preexisting medical condition”
    5         with respect to health insurance policies and group,
    6         blanket, and franchise health insurance policies;
    7         requiring insurers and health maintenance
    8         organizations, contingent upon the occurrence of
    9         either of two specified events, to make at least one
   10         comprehensive major medical health insurance policy or
   11         health maintenance contract available to all residents
   12         of this state within a specified timeframe;
   13         prohibiting such insurers or health maintenance
   14         organizations from excluding or delaying coverage
   15         under such policies or contracts due to preexisting
   16         medical conditions; requiring such policies or
   17         contracts to have been actively marketed on a
   18         specified date and during a certain timeframe before
   19         that date; providing applicability; providing an
   20         effective date.
   21          
   22  Be It Enacted by the Legislature of the State of Florida:
   23  
   24         Section 1. Section 627.6046, Florida Statutes, is created
   25  to read:
   26         627.6046 Limit on preexisting conditions.—
   27         (1) As used in this section, the term:
   28         (a) “Operative date” means the date that either of the
   29  following occurs with respect to the Patient Protection and
   30  Affordable Care Act, Pub. L. No. 111-148, as amended by the
   31  Health Care and Education Reconciliation Act of 2010, Pub. L.
   32  No. 111-152 (PPACA):
   33         1. A federal law is enacted which expressly repeals PPACA;
   34  or
   35         2. PPACA is invalidated by the United States Supreme Court.
   36         (b) “Preexisting medical condition” means:
   37         1. A condition that, during the 24-month period immediately
   38  preceding the effective date of coverage, manifested itself in
   39  such a manner as to cause an ordinarily prudent person to seek
   40  medical advice, diagnosis, care, or treatment or for which
   41  medical advice, diagnosis, care, or treatment was recommended or
   42  received; or
   43         2. A pregnancy existing on the effective date of coverage.
   44         (2) No later than 30 days after the operative date, and
   45  notwithstanding s. 627.6045 or any other law to the contrary,
   46  every insurer and health maintenance organization issuing,
   47  delivering, or issuing for delivery individual health insurance
   48  policies or health maintenance contracts in this state shall
   49  make at least one comprehensive major medical health insurance
   50  policy or health maintenance contract available to all residents
   51  of this state, and such insurer or health maintenance
   52  organization may not exclude or delay coverage under such policy
   53  or contract due to one or more preexisting medical conditions.
   54         (3) The comprehensive major medical health insurance policy
   55  or health maintenance contract that the insurer or health
   56  maintenance organization is required to offer under this section
   57  must be a policy or contract that had been actively marketed in
   58  this state by the insurer or health maintenance organization as
   59  of the operative date and that was also actively marketed in
   60  this state during the year immediately preceding the operative
   61  date.
   62         (4) This section does not apply to an insurer that issues
   63  only limited benefit, disability income, specified disease,
   64  Medicare supplement, or hospital indemnity policies in this
   65  state.
   66         Section 2. Section 627.65612, Florida Statutes, is created
   67  to read:
   68         627.65612 Limit on preexisting conditions.—
   69         (1) As used in this section, the terms “operative date” and
   70  “preexisting medical condition” have the same meanings as
   71  provided in s. 627.6046.
   72         (2) No later than 30 days after the operative date, and
   73  notwithstanding ss. 627.6561 and 641.31071 or any other law to
   74  the contrary, every insurer and health maintenance organization
   75  issuing, delivering, or issuing for delivery group health
   76  insurance policies or health maintenance contracts in this state
   77  shall make at least one comprehensive major medical health
   78  insurance policy or health maintenance contract available to all
   79  residents of this state, and such insurer or health maintenance
   80  organization may not exclude or delay coverage under such policy
   81  or contract due to one or more preexisting medical conditions.
   82         (3) The comprehensive major medical health insurance policy
   83  or health maintenance contract the insurer or health maintenance
   84  organization is required to offer under this section must be a
   85  policy or contract that had been actively marketed in this state
   86  by the insurer or health maintenance organization as of the
   87  operative date and that was also actively marketed in this state
   88  during the year immediately preceding the operative date.
   89         (4) This section does not apply to an insurer issuing only
   90  limited benefit, disability income, specified disease, Medicare
   91  supplement, or hospital indemnity policies in this state.
   92         Section 3. This act shall take effect July 1, 2019.