Florida Senate - 2026                                    SB 1354
       
       
        
       By Senator Garcia
       
       
       
       
       
       36-01414A-26                                          20261354__
    1                        A bill to be entitled                      
    2         An act relating to small employer health insurance;
    3         amending s. 627.6699, F.S.; deleting and revising
    4         definitions; deleting provisions relating to the
    5         creation of the Florida Small Employer Health
    6         Reinsurance Program; amending ss. 627.642, 627.6475,
    7         627.657, and 627.66997, F.S.; conforming cross
    8         references; providing an effective date.
    9          
   10  Be It Enacted by the Legislature of the State of Florida:
   11  
   12         Section 1. Paragraphs (b), (p), (q), and (s) of subsection
   13  (3), paragraph (d) of subsection (9), paragraphs (b) and (c) of
   14  subsection (10), and subsection (11) of section 627.6699,
   15  Florida Statutes, are amended to read:
   16         627.6699 Employee Health Care Access Act.—
   17         (3) DEFINITIONS.—As used in this section, the term:
   18         (b) “Board” means the board of directors of the program.
   19         (p) “Plan of operation” means the plan of operation of the
   20  program, including articles, bylaws, and operating rules,
   21  adopted by the board under subsection (11).
   22         (q) “Program” means the Florida Small Employer Carrier
   23  Reinsurance Program created under subsection (11).
   24         (p)(s) “Reinsuring carrier” means a small employer carrier
   25  that elects to comply with reinsurance the requirements set
   26  forth in subsection (11).
   27         (9) SMALL EMPLOYER CARRIER’S ELECTION TO BECOME A RISK
   28  ASSUMING CARRIER OR A REINSURING CARRIER.—
   29         (d) A small employer carrier that elects to cease
   30  participating as a reinsuring carrier and to become a risk
   31  assuming carrier is prohibited from reinsuring or continuing to
   32  reinsure any small employer health benefits plan under
   33  subsection (11) as soon as the carrier becomes a risk-assuming
   34  carrier and must pay a prorated assessment based upon business
   35  issued as a reinsuring carrier for any portion of the year that
   36  the business was reinsured. A small employer carrier that elects
   37  to cease participating as a risk-assuming carrier and to become
   38  a reinsuring carrier is permitted to reinsure small employer
   39  health benefit plans under the terms set forth in subsection
   40  (11) and must pay a prorated assessment based upon business
   41  issued as a reinsuring carrier for any portion of the year that
   42  the business was reinsured.
   43         (10) ELECTION PROCESS TO BECOME A RISK-ASSUMING CARRIER.—
   44         (b) In determining whether to approve an application by a
   45  small employer carrier to become a risk-assuming carrier, the
   46  office shall consider:
   47         1. The carrier’s financial ability to support the
   48  assumption of the risk of small employer groups.
   49         2. The carrier’s history of rating and underwriting small
   50  employer groups.
   51         3. The carrier’s commitment to market fairly to all small
   52  employers in the state or its service area, as applicable.
   53         4. The carrier’s ability to assume and manage the risk of
   54  enrolling small employer groups without the protection of the
   55  reinsurance program provided in subsection (11).
   56         (c) A small employer carrier that becomes a risk-assuming
   57  carrier pursuant to this subsection is not subject to
   58  reinsurance the assessment provisions of subsection (11).
   59         (11) SMALL EMPLOYER HEALTH REINSURANCE PROGRAM.—
   60         (a) There is created a nonprofit entity to be known as the
   61  “Florida Small Employer Health Reinsurance Program.”
   62         (b)1. The program shall operate subject to the supervision
   63  and control of the board.
   64         2. Effective upon this act becoming a law, the board shall
   65  consist of the director of the office or his or her designee,
   66  who shall serve as the chairperson, and 13 additional members
   67  who are representatives of carriers and insurance agents and are
   68  appointed by the director of the office and serve as follows:
   69         a. Five members shall be representatives of health insurers
   70  licensed under chapter 624 or chapter 641. Two members shall be
   71  agents who are actively engaged in the sale of health insurance.
   72  Four members shall be employers or representatives of employers.
   73  One member shall be a person covered under an individual health
   74  insurance policy issued by a licensed insurer in this state. One
   75  member shall represent the Agency for Health Care Administration
   76  and shall be recommended by the Secretary of Health Care
   77  Administration.
   78         b. A member appointed under this subparagraph shall serve a
   79  term of 4 years and shall continue in office until the member’s
   80  successor takes office, except that, in order to provide for
   81  staggered terms, the director of the office shall designate two
   82  of the initial appointees under this subparagraph to serve terms
   83  of 2 years and shall designate three of the initial appointees
   84  under this subparagraph to serve terms of 3 years.
   85         3. The director of the office may remove a member for
   86  cause.
   87         4. Vacancies on the board shall be filled in the same
   88  manner as the original appointment for the unexpired portion of
   89  the term.
   90         (c)1. The board shall submit to the office a plan of
   91  operation to assure the fair, reasonable, and equitable
   92  administration of the program. The board may at any time submit
   93  to the office any amendments to the plan that the board finds to
   94  be necessary or suitable.
   95         2. The office shall, after notice and hearing, approve the
   96  plan of operation if it determines that the plan submitted by
   97  the board is suitable to assure the fair, reasonable, and
   98  equitable administration of the program and provides for the
   99  sharing of program gains and losses equitably and
  100  proportionately in accordance with paragraph (j).
  101         3. The plan of operation, or any amendment thereto, becomes
  102  effective upon written approval of the office.
  103         (d) The plan of operation must, among other things:
  104         1. Establish procedures for handling and accounting for
  105  program assets and moneys and for an annual fiscal reporting to
  106  the office.
  107         2. Establish procedures for selecting an administering
  108  carrier and set forth the powers and duties of the administering
  109  carrier.
  110         3. Establish procedures for reinsuring risks.
  111         4. Establish procedures for collecting assessments from
  112  participating carriers to provide for claims reinsured by the
  113  program and for administrative expenses, other than amounts
  114  payable to the administrative carrier, incurred or estimated to
  115  be incurred during the period for which the assessment is made.
  116         5. Provide for any additional matters at the discretion of
  117  the board.
  118         (e) The board shall recommend to the office market conduct
  119  requirements and other requirements for carriers and agents,
  120  including requirements relating to:
  121         1. Registration by each carrier with the office of its
  122  intention to be a small employer carrier under this section;
  123         2. Publication by the office of a list of all small
  124  employer carriers, including a requirement applicable to agents
  125  and carriers that a health benefit plan may not be sold by a
  126  carrier that is not identified as a small employer carrier;
  127         3. The availability of a broadly publicized, toll-free
  128  telephone number for access by small employers to information
  129  concerning this section;
  130         4. Periodic reports by carriers and agents concerning
  131  health benefit plans issued; and
  132         5. Methods concerning periodic demonstration by small
  133  employer carriers and agents that they are marketing or issuing
  134  health benefit plans to small employers.
  135         (f) The program has the general powers and authority
  136  granted under the laws of this state to insurance companies and
  137  health maintenance organizations licensed to transact business,
  138  except the power to issue health benefit plans directly to
  139  groups or individuals. In addition thereto, the program has
  140  specific authority to:
  141         1. Enter into contracts as necessary or proper to carry out
  142  the provisions and purposes of this act, including the authority
  143  to enter into contracts with similar programs of other states
  144  for the joint performance of common functions or with persons or
  145  other organizations for the performance of administrative
  146  functions.
  147         2. Sue or be sued, including taking any legal action
  148  necessary or proper for recovering any assessments and penalties
  149  for, on behalf of, or against the program or any carrier.
  150         3. Take any legal action necessary to avoid the payment of
  151  improper claims against the program.
  152         4. Issue reinsurance policies, in accordance with the
  153  requirements of this act.
  154         5. Establish rules, conditions, and procedures for
  155  reinsurance risks under the program participation.
  156         6. Establish actuarial functions as appropriate for the
  157  operation of the program.
  158         7. Assess participating carriers in accordance with
  159  paragraph (j), and make advance interim assessments as may be
  160  reasonable and necessary for organizational and interim
  161  operating expenses. Interim assessments shall be credited as
  162  offsets against any regular assessments due following the close
  163  of the calendar year.
  164         8. Appoint appropriate legal, actuarial, and other
  165  committees as necessary to provide technical assistance in the
  166  operation of the program, and in any other function within the
  167  authority of the program.
  168         9. Borrow money to effect the purposes of the program. Any
  169  notes or other evidences of indebtedness of the program which
  170  are not in default constitute legal investments for carriers and
  171  may be carried as admitted assets.
  172         10. To the extent necessary, increase the $5,000 deductible
  173  reinsurance requirement to adjust for the effects of inflation.
  174         (g) A reinsuring carrier may reinsure with the program
  175  coverage of an eligible employee of a small employer, or any
  176  dependent of such an employee, subject to each of the following
  177  provisions:
  178         1. Except in the case of a late enrollee, a reinsuring
  179  carrier may reinsure an eligible employee or dependent within 60
  180  days after the commencement of the coverage of the small
  181  employer. A newly employed eligible employee or dependent of a
  182  small employer may be reinsured within 60 days after the
  183  commencement of his or her coverage.
  184         2. A small employer carrier may reinsure an entire employer
  185  group within 60 days after the commencement of the group’s
  186  coverage under the plan.
  187         3. The program may not reimburse a participating carrier
  188  with respect to the claims of a reinsured employee or dependent
  189  until the carrier has paid incurred claims of at least $5,000 in
  190  a calendar year for benefits covered by the program. In
  191  addition, the reinsuring carrier shall be responsible for 10
  192  percent of the next $50,000 and 5 percent of the next $100,000
  193  of incurred claims during a calendar year and the program shall
  194  reinsure the remainder.
  195         4. The board annually shall adjust the initial level of
  196  claims and the maximum limit to be retained by the carrier to
  197  reflect increases in costs and utilization within the standard
  198  market for health benefit plans within the state. The adjustment
  199  shall not be less than the annual change in the medical
  200  component of the “Consumer Price Index for All Urban Consumers”
  201  of the Bureau of Labor Statistics of the Department of Labor,
  202  unless the board proposes and the office approves a lower
  203  adjustment factor.
  204         5. A small employer carrier may terminate reinsurance for
  205  all reinsured employees or dependents on any plan anniversary.
  206         6. The premium rate charged for reinsurance by the program
  207  to a health maintenance organization that is approved by the
  208  Secretary of Health and Human Services as a federally qualified
  209  health maintenance organization pursuant to 42 U.S.C. s.
  210  300e(c)(2)(A) and that, as such, is subject to requirements that
  211  limit the amount of risk that may be ceded to the program, which
  212  requirements are more restrictive than subparagraph 3., shall be
  213  reduced by an amount equal to that portion of the risk, if any,
  214  which exceeds the amount set forth in subparagraph 3. which may
  215  not be ceded to the program.
  216         7. The board may consider adjustments to the premium rates
  217  charged for reinsurance by the program for carriers that use
  218  effective cost containment measures, including high-cost case
  219  management, as defined by the board.
  220         8. A reinsuring carrier shall apply its case-management and
  221  claims-handling techniques, including, but not limited to,
  222  utilization review, individual case management, preferred
  223  provider provisions, other managed care provisions or methods of
  224  operation, consistently with both reinsured business and
  225  nonreinsured business.
  226         (h)1. The board, as part of the plan of operation, shall
  227  establish a methodology for determining premium rates to be
  228  charged by the program for reinsuring small employers and
  229  individuals pursuant to this section. The methodology shall
  230  include a system for classification of small employers that
  231  reflects the types of case characteristics commonly used by
  232  small employer carriers in the state. The methodology shall
  233  provide for the development of basic reinsurance premium rates,
  234  which shall be multiplied by the factors set for them in this
  235  paragraph to determine the premium rates for the program. The
  236  basic reinsurance premium rates shall be established by the
  237  board, subject to the approval of the office. The premium rates
  238  set by the board may vary by geographical area, as determined
  239  under this section, to reflect differences in cost. The
  240  multiplying factors must be established as follows:
  241         a. The entire group may be reinsured for a rate that is 1.5
  242  times the rate established by the board.
  243         b. An eligible employee or dependent may be reinsured for a
  244  rate that is 5 times the rate established by the board.
  245         2. The board periodically shall review the methodology
  246  established, including the system of classification and any
  247  rating factors, to assure that it reasonably reflects the claims
  248  experience of the program. The board may propose changes to the
  249  rates which shall be subject to the approval of the office.
  250         (i) If a health benefit plan for a small employer issued in
  251  accordance with this subsection is entirely or partially
  252  reinsured with the program, the premium charged to the small
  253  employer for any rating period for the coverage issued must be
  254  consistent with the requirements relating to premium rates set
  255  forth in this section.
  256         (j)1. Before July 1 of each calendar year, the board shall
  257  determine and report to the office the program net loss for the
  258  previous year, including administrative expenses for that year,
  259  and the incurred losses for the year, taking into account
  260  investment income and other appropriate gains and losses.
  261         2. Any net loss for the year shall be recouped by
  262  assessment of the carriers, as follows:
  263         a. The operating losses of the program shall be assessed in
  264  the following order subject to the specified limitations. The
  265  first tier of assessments shall be made against reinsuring
  266  carriers in an amount which shall not exceed 5 percent of each
  267  reinsuring carrier’s premiums from health benefit plans covering
  268  small employers. If such assessments have been collected and
  269  additional moneys are needed, the board shall make a second tier
  270  of assessments in an amount which shall not exceed 0.5 percent
  271  of each carrier’s health benefit plan premiums. Except as
  272  provided in paragraph (m), risk-assuming carriers are exempt
  273  from all assessments authorized pursuant to this section. The
  274  amount paid by a reinsuring carrier for the first tier of
  275  assessments shall be credited against any additional assessments
  276  made.
  277         b. The board shall equitably assess carriers for operating
  278  losses of the plan based on market share. The board shall
  279  annually assess each carrier a portion of the operating losses
  280  of the plan. The first tier of assessments shall be determined
  281  by multiplying the operating losses by a fraction, the numerator
  282  of which equals the reinsuring carrier’s earned premium
  283  pertaining to direct writings of small employer health benefit
  284  plans in the state during the calendar year for which the
  285  assessment is levied, and the denominator of which equals the
  286  total of all such premiums earned by reinsuring carriers in the
  287  state during that calendar year. The second tier of assessments
  288  shall be based on the premiums that all carriers, except risk
  289  assuming carriers, earned on all health benefit plans written in
  290  this state. The board may levy interim assessments against
  291  carriers to ensure the financial ability of the plan to cover
  292  claims expenses and administrative expenses paid or estimated to
  293  be paid in the operation of the plan for the calendar year prior
  294  to the association’s anticipated receipt of annual assessments
  295  for that calendar year. Any interim assessment is due and
  296  payable within 30 days after receipt by a carrier of the interim
  297  assessment notice. Interim assessment payments shall be credited
  298  against the carrier’s annual assessment. Health benefit plan
  299  premiums and benefits paid by a carrier that are less than an
  300  amount determined by the board to justify the cost of collection
  301  may not be considered for purposes of determining assessments.
  302         c. Subject to the approval of the office, the board shall
  303  make an adjustment to the assessment formula for reinsuring
  304  carriers that are approved as federally qualified health
  305  maintenance organizations by the Secretary of Health and Human
  306  Services pursuant to 42 U.S.C. s. 300e(c)(2)(A) to the extent,
  307  if any, that restrictions are placed on them that are not
  308  imposed on other small employer carriers.
  309         3. Before July 1 of each year, the board shall determine
  310  and file with the office an estimate of the assessments needed
  311  to fund the losses incurred by the program in the previous
  312  calendar year.
  313         4. If the board determines that the assessments needed to
  314  fund the losses incurred by the program in the previous calendar
  315  year will exceed the amount specified in subparagraph 2., the
  316  board shall evaluate the operation of the program and report its
  317  findings, including any recommendations for changes to the plan
  318  of operation, to the office within 180 days following the end of
  319  the calendar year in which the losses were incurred. The
  320  evaluation shall include an estimate of future assessments, the
  321  administrative costs of the program, the appropriateness of the
  322  premiums charged and the level of carrier retention under the
  323  program, and the costs of coverage for small employers. If the
  324  board fails to file a report with the office within 180 days
  325  following the end of the applicable calendar year, the office
  326  may evaluate the operations of the program and implement such
  327  amendments to the plan of operation the office deems necessary
  328  to reduce future losses and assessments.
  329         5. If assessments exceed the amount of the actual losses
  330  and administrative expenses of the program, the excess shall be
  331  held as interest and used by the board to offset future losses
  332  or to reduce program premiums. As used in this paragraph, the
  333  term “future losses” includes reserves for incurred but not
  334  reported claims.
  335         6. Each carrier’s proportion of the assessment shall be
  336  determined annually by the board, based on annual statements and
  337  other reports considered necessary by the board and filed by the
  338  carriers with the board.
  339         7. Provision shall be made in the plan of operation for the
  340  imposition of an interest penalty for late payment of an
  341  assessment.
  342         8. A carrier may seek, from the office, a deferment, in
  343  whole or in part, from any assessment made by the board. The
  344  office may defer, in whole or in part, the assessment of a
  345  carrier if, in the opinion of the office, the payment of the
  346  assessment would place the carrier in a financially impaired
  347  condition. If an assessment against a carrier is deferred, in
  348  whole or in part, the amount by which the assessment is deferred
  349  may be assessed against the other carriers in a manner
  350  consistent with the basis for assessment set forth in this
  351  section. The carrier receiving such deferment remains liable to
  352  the program for the amount deferred and is prohibited from
  353  reinsuring any individuals or groups in the program if it fails
  354  to pay assessments.
  355         (k) Neither the participation in the program as reinsuring
  356  carriers, the establishment of rates, forms, or procedures, nor
  357  any other joint or collective action required by this act, may
  358  be the basis of any legal action, criminal or civil liability,
  359  or penalty against the program or any of its carriers either
  360  jointly or separately.
  361         (l) The board shall monitor compliance with this section,
  362  including the market conduct of small employer carriers, and
  363  shall report to the office any unfair trade practices and
  364  misleading or unfair conduct by a small employer carrier that
  365  has been reported to the board by agents, consumers, or any
  366  other person. The office shall investigate all reports and, upon
  367  a finding of noncompliance with this section or of unfair or
  368  misleading practices, shall take action against the small
  369  employer carrier as permitted under the insurance code or
  370  chapter 641. The board is not given investigatory or regulatory
  371  powers, but must forward all reports of cases or abuse or
  372  misrepresentation to the office.
  373         (m) Notwithstanding paragraph (j), the administrative
  374  expenses of the program shall be recouped by assessment of risk
  375  assuming carriers and reinsuring carriers and such amounts shall
  376  not be considered part of the operating losses of the plan for
  377  the purposes of this paragraph. Each carrier’s portion of such
  378  administrative expenses shall be determined by multiplying the
  379  total of such administrative expenses by a fraction, the
  380  numerator of which equals the carrier’s earned premium
  381  pertaining to direct writing of small employer health benefit
  382  plans in the state during the calendar year for which the
  383  assessment is levied, and the denominator of which equals the
  384  total of such premiums earned by all carriers in the state
  385  during such calendar year.
  386         (n) The board shall advise the office, the Agency for
  387  Health Care Administration, the department, other executive
  388  departments, and the Legislature on health insurance issues.
  389  Specifically, the board shall:
  390         1. Provide a forum for stakeholders, consisting of
  391  insurers, employers, agents, consumers, and regulators, in the
  392  private health insurance market in this state.
  393         2. Review and recommend strategies to improve the
  394  functioning of the health insurance markets in this state with a
  395  specific focus on market stability, access, and pricing.
  396         3. Make recommendations to the office for legislation
  397  addressing health insurance market issues and provide comments
  398  on health insurance legislation proposed by the office.
  399         4. Meet at least three times each year. One meeting shall
  400  be held to hear reports and to secure public comment on the
  401  health insurance market, to develop any legislation needed to
  402  address health insurance market issues, and to provide comments
  403  on health insurance legislation proposed by the office.
  404         5. Issue a report to the office on the state of the health
  405  insurance market by September 1 each year. The report shall
  406  include recommendations for changes in the health insurance
  407  market, results from implementation of previous recommendations,
  408  and information on health insurance markets.
  409         Section 2. Subsection (3) of section 627.642, Florida
  410  Statutes, is amended to read:
  411         627.642 Outline of coverage.—
  412         (3) In addition to the outline of coverage, a policy as
  413  specified in s. 627.6699(3)(j) s. 627.6699(3)(k) must be
  414  accompanied by an identification card that contains, at a
  415  minimum:
  416         (a) The name of the organization issuing the policy or the
  417  name of the organization administering the policy, whichever
  418  applies.
  419         (b) The name of the contract holder.
  420         (c) The type of plan only if the plan is filed in the
  421  state, an indication that the plan is self-funded, or the name
  422  of the network.
  423         (d) The member identification number, contract number, and
  424  policy or group number, if applicable.
  425         (e) A contact phone number or electronic address for
  426  authorizations and admission certifications.
  427         (f) A phone number or electronic address whereby the
  428  covered person or hospital, physician, or other person rendering
  429  services covered by the policy may obtain benefits verification
  430  and information in order to estimate patient financial
  431  responsibility, in compliance with privacy rules under the
  432  Health Insurance Portability and Accountability Act.
  433         (g) The national plan identifier, in accordance with the
  434  compliance date set forth by the federal Department of Health
  435  and Human Services.
  436  
  437  The identification card must present the information in a
  438  readily identifiable manner or, alternatively, the information
  439  may be embedded on the card and available through magnetic
  440  stripe or smart card. The information may also be provided
  441  through other electronic technology.
  442         Section 3. Paragraph (a) of subsection (2), paragraphs (a),
  443  (e), and (g) of subsection (7), and paragraph (a) of subsection
  444  (8) of section 627.6475, Florida Statutes, are amended to read:
  445         627.6475 Individual reinsurance pool.—
  446         (2) DEFINITIONS.—As used in this section:
  447         (a) “Board,” “Carrier,” and “health benefit plan” have the
  448  same meaning ascribed in s. 627.6699(3).
  449         (7) INDIVIDUAL HEALTH REINSURANCE PROGRAM.—
  450         (a) The individual health reinsurance program shall operate
  451  subject to the supervision and control of the board of the small
  452  employer health reinsurance program established pursuant to s.
  453  627.6699(11). The board shall establish a separate, segregated
  454  account for eligible individuals reinsured pursuant to this
  455  section, which account may not be commingled with the small
  456  employer health reinsurance account.
  457         (e)1. Before March 1 of each calendar year, the board shall
  458  determine and report to the office the program net loss in the
  459  individual account for the previous year, including
  460  administrative expenses for that year and the incurred losses
  461  for that year, taking into account investment income and other
  462  appropriate gains and losses.
  463         2. Any net loss in the individual account for the year
  464  shall be recouped by assessing the carriers as follows:
  465         a. The operating losses of the program shall be assessed in
  466  the following order subject to the specified limitations. The
  467  first tier of assessments shall be made against reinsuring
  468  carriers in an amount that may not exceed 5 percent of each
  469  reinsuring carrier’s premiums for individual health insurance.
  470  If such assessments have been collected and additional moneys
  471  are needed, the board shall make a second tier of assessments in
  472  an amount that may not exceed 0.5 percent of each carrier’s
  473  health benefit plan premiums.
  474         b. Except as provided in paragraph (f), risk-assuming
  475  carriers are exempt from all assessments authorized pursuant to
  476  this section. The amount paid by a reinsuring carrier for the
  477  first tier of assessments shall be credited against any
  478  additional assessments made.
  479         c. The board shall equitably assess reinsuring carriers for
  480  operating losses of the individual account based on market
  481  share. The board shall annually assess each carrier a portion of
  482  the operating losses of the individual account. The first tier
  483  of assessments shall be determined by multiplying the operating
  484  losses by a fraction, the numerator of which equals the
  485  reinsuring carrier’s earned premium pertaining to direct
  486  writings of individual health insurance in the state during the
  487  calendar year for which the assessment is levied, and the
  488  denominator of which equals the total of all such premiums
  489  earned by reinsuring carriers in the state during that calendar
  490  year. The second tier of assessments shall be based on the
  491  premiums that all carriers, except risk-assuming carriers,
  492  earned on all health benefit plans written in this state. The
  493  board may levy interim assessments against reinsuring carriers
  494  to ensure the financial ability of the plan to cover claims
  495  expenses and administrative expenses paid or estimated to be
  496  paid in the operation of the plan for the calendar year prior to
  497  the association’s anticipated receipt of annual assessments for
  498  that calendar year. Any interim assessment is due and payable
  499  within 30 days after receipt by a carrier of the interim
  500  assessment notice. Interim assessment payments shall be credited
  501  against the carrier’s annual assessment. Health benefit plan
  502  premiums and benefits paid by a carrier that are less than an
  503  amount determined by the board to justify the cost of collection
  504  may not be considered for purposes of determining assessments.
  505         d. Subject to the approval of the office, the board shall
  506  adjust the assessment formula for reinsuring carriers that are
  507  approved as federally qualified health maintenance organizations
  508  by the Secretary of Health and Human Services pursuant to 42
  509  U.S.C. s. 300e(c)(2)(A) to the extent, if any, that restrictions
  510  are placed on them which are not imposed on other carriers.
  511         3. Before March 1 of each year, the board shall determine
  512  and file with the office an estimate of the assessments needed
  513  to fund the losses incurred by the program in the individual
  514  account for the previous calendar year.
  515         4. If the board determines that the assessments needed to
  516  fund the losses incurred by the program in the individual
  517  account for the previous calendar year will exceed the amount
  518  specified in subparagraph 2., the board shall evaluate the
  519  operation of the program and report its findings and
  520  recommendations to the office in the format established in s.
  521  627.6699(11) for the comparable report for the small employer
  522  reinsurance program.
  523         (g) Except as otherwise provided in this section, the board
  524  and the office shall have all powers, duties, and
  525  responsibilities with respect to carriers that issue and
  526  reinsure individual health insurance, as specified for the board
  527  and the office in s. 627.6699(11) with respect to small employer
  528  carriers, including, but not limited to, the provisions of s.
  529  627.6699(11) relating to:
  530         1. Use of assessments that exceed the amount of actual
  531  losses and expenses.
  532         2. The annual determination of each carrier’s proportion of
  533  the assessment.
  534         3. Interest for late payment of assessments.
  535         4. Authority for the office to approve deferment of an
  536  assessment against a carrier.
  537         5. Limited immunity from legal actions or carriers.
  538         6. Development of standards for compensation to be paid to
  539  agents. Such standards shall be limited to those specifically
  540  enumerated in s. 627.6699(11)(d) s. 627.6699(12)(d).
  541         7. Monitoring compliance by carriers with this section.
  542         (8) STANDARDS TO ASSURE FAIR MARKETING.—
  543         (a) Each health insurance issuer that offers individual
  544  health insurance shall actively market coverage to eligible
  545  individuals in the state. The provisions of s. 627.6699(11) s.
  546  627.6699(12) that apply to small employer carriers that market
  547  policies to small employers shall also apply to health insurance
  548  issuers that offer individual health insurance with respect to
  549  marketing policies to individuals.
  550         Section 4. Subsection (2) of section 627.657, Florida
  551  Statutes, is amended to read:
  552         627.657 Provisions of group health insurance policies.—
  553         (2) The medical policy as specified in s. 627.6699(3)(j) s.
  554  627.6699(3)(k) must be accompanied by an identification card
  555  that contains, at a minimum:
  556         (a) The name of the organization issuing the policy or name
  557  of the organization administering the policy, whichever applies.
  558         (b) The name of the certificateholder.
  559         (c) The type of plan only if the plan is filed in the
  560  state, an indication that the plan is self-funded, or the name
  561  of the network.
  562         (d) The member identification number, contract number, and
  563  policy or group number, if applicable.
  564         (e) A contact phone number or electronic address for
  565  authorizations and admission certifications.
  566         (f) A phone number or electronic address whereby the
  567  covered person or hospital, physician, or other person rendering
  568  services covered by the policy may obtain benefits verification
  569  and information in order to estimate patient financial
  570  responsibility, in compliance with privacy rules under the
  571  Health Insurance Portability and Accountability Act.
  572         (g) The national plan identifier, in accordance with the
  573  compliance date set forth by the federal Department of Health
  574  and Human Services.
  575  
  576  The identification card must present the information in a
  577  readily identifiable manner or, alternatively, the information
  578  may be embedded on the card and available through magnetic
  579  stripe or smart card. The information may also be provided
  580  through other electronic technology.
  581         Section 5. Subsection (1) of section 627.66997, Florida
  582  Statutes, is amended to read:
  583         627.66997 Stop-loss insurance.—
  584         (1) A self-insured health benefit plan established or
  585  maintained by a small employer, as defined in s. 627.6699(3)(s)
  586  s. 627.6699(3)(v), is exempt from s. 627.6699 and may use a
  587  stop-loss insurance policy issued to the employer. For purposes
  588  of this subsection, the term “stop-loss insurance policy” means
  589  an insurance policy issued to a small employer which covers the
  590  small employer’s obligation for the excess cost of medical care
  591  on an equivalent basis per employee provided under a self
  592  insured health benefit plan.
  593         (a) A small employer stop-loss insurance policy is
  594  considered a health insurance policy and is subject to s.
  595  627.6699 if the policy has an aggregate attachment point that is
  596  lower than the greatest of:
  597         1. Two thousand dollars multiplied by the number of
  598  employees;
  599         2. One hundred twenty percent of expected claims, as
  600  determined by the stop-loss insurer in accordance with actuarial
  601  standards of practice; or
  602         3. Twenty thousand dollars.
  603         (b) Once claims under the small employer health benefit
  604  plan reach the aggregate attachment point set forth in paragraph
  605  (a), the stop-loss insurance policy authorized under this
  606  section must cover 100 percent of all claims that exceed the
  607  aggregate attachment point.
  608         Section 6. This act shall take effect July 1, 2026.