Florida Senate - 2022                                    SB 1660
       By Senator Gruters
       23-01227-22                                           20221660__
    1                        A bill to be entitled                      
    2         An act relating to dependent eligibility for state
    3         group health insurance enrollment; amending s.
    4         110.12301, F.S.; designating the Department of
    5         Management Services, rather than the Division of State
    6         Group Insurance, as the entity that contracts for
    7         dependent eligibility services in the state group
    8         insurance program; authorizing the department or the
    9         contractor providing dependent eligibility
   10         verification services to require certain information
   11         from subscribers; deleting obsolete language; revising
   12         the records retention schedule regarding documents
   13         obtained during the dependent eligibility verification
   14         process; providing an effective date.
   16  Be It Enacted by the Legislature of the State of Florida:
   18         Section 1. Subsections (1) and (2) of section 110.12301,
   19  Florida Statutes, are amended to read:
   20         110.12301 Competitive procurement of postpayment claims
   21  review services and dependent eligibility verification services;
   22  public records exemption.—
   23         (1) The Division of State Group Insurance is directed to
   24  competitively procure postpayment claims review services for the
   25  state group health insurance plans established pursuant to s.
   26  110.123. Compensation under the contract must shall be paid from
   27  amounts identified as claim overpayments that are made by or on
   28  behalf of the health plans and that are recovered by the vendor.
   29  The vendor may retain that portion of the amount recovered as
   30  provided in the contract. The contract must require the vendor
   31  to maintain all necessary documentation supporting the amounts
   32  recovered, retained, and remitted to the division.; and
   33         (2) The Department of Management Services Division of State
   34  Group Insurance is directed to competitively procure a contract
   35  for dependent eligibility verification services for the state
   36  group insurance program; however, compensation under the
   37  contract may not exceed historical claim costs for the prior 12
   38  months for the dependent populations disenrolled as a result of
   39  the contractor’s services.
   40         (a)1. By September 1, 2017, the division shall notify all
   41  subscribers regarding the eligibility rules for dependents.
   42  Through November 30, 2017, the division must hold subscribers
   43  harmless for past claims of ineligible dependents if such
   44  dependents are removed from plan membership before December 1,
   45  2017.
   46         2. Subparagraph 1. does not apply to any dependent
   47  identified as ineligible before July 1, 2017, for which the
   48  department has notified the state agency employing the
   49  associated subscriber.
   50         (b) The department or the contractor providing dependent
   51  eligibility verification services may require request the
   52  following information from subscribers:
   53         1. To prove a spouse’s eligibility:
   54         a. If married less than 12 months and the subscriber and
   55  his or her spouse have not filed a joint federal income tax
   56  return, a government-issued marriage certificate; or
   57         b. If married for 12 or more months, a transcript of the
   58  most recently filed federal income tax return.
   59         2. To prove a biological child’s or a newborn grandchild’s
   60  eligibility, a government-issued birth certificate.
   61         3. To prove an adopted child’s eligibility:
   62         a. An adoption certificate; or
   63         b. An adoption placement agreement and a petition for
   64  adoption.
   65         4. To prove a stepchild’s eligibility:
   66         a. A government-issued birth certificate for the stepchild;
   67  and
   68         b. The transcript of the subscriber’s most recently filed
   69  federal income tax return.
   70         5. Any other information necessary to verify the
   71  dependent’s eligibility for enrollment in the state group
   72  insurance program.
   73         (b)(c) If a document requested from a subscriber is not
   74  confidential or exempt from public records requirements, the
   75  division and the contractor shall disclose to all subscribers
   76  that such information submitted to verify the eligibility of
   77  dependents may be subject to disclosure and inspection under
   78  chapter 119.
   79         (c)(d) A government-issued marriage license or marriage
   80  certificate submitted for dependent eligibility verification
   81  must include the date of the marriage between the subscriber and
   82  the spouse.
   83         (d)(e) A government-issued birth certificate submitted for
   84  dependent eligibility verification must list the parents’ names.
   85         (e)(f) Foreign-born subscribers unable to obtain the
   86  necessary documentation within the specified time period of
   87  producing verification documentation may execute a signed
   88  affidavit attesting to eligibility requirements.
   89         (f)(g) Documentation submitted to verify eligibility may be
   90  an original or a photocopy of an original document. Before
   91  submitting a document, the subscriber may redact any information
   92  on a document which is not necessary to verify the eligibility
   93  of the dependent.
   94         (g)(h) All documentation obtained by the contractor to
   95  conduct the dependent eligibility verification services must be
   96  retained in accordance with the applicable records retention
   97  schedule until June 30, 2019. The department or the contractor
   98  is not required to retain such documentation after June 30,
   99  2019, and shall destroy such documentation as soon as
  100  practicable after such date.
  101         Section 2. This act shall take effect upon becoming a law.