Florida Senate - 2016                                     SB 910
       
       
        
       By Senator Braynon
       
       
       
       
       
       36-01261-16                                            2016910__
    1                        A bill to be entitled                      
    2         An act relating to small group health insurance;
    3         amending s. 627.6699, F.S.; revising health benefit
    4         plan requirements relating to small employers;
    5         providing an effective date.
    6          
    7  Be It Enacted by the Legislature of the State of Florida:
    8  
    9         Section 1. Paragraph (e) of subsection (5) of section
   10  627.6699, Florida Statutes, is amended to read:
   11         627.6699 Employee Health Care Access Act.—
   12         (5) AVAILABILITY OF COVERAGE.—
   13         (e) All health benefit plans issued under this section must
   14  comply with the following conditions:
   15         1. For employers who have fewer than two employees, a late
   16  enrollee may be excluded from coverage for no longer than 24
   17  months if he or she was not covered by creditable coverage
   18  continually to a date not more than 63 days before the effective
   19  date of his or her new coverage.
   20         2. Any requirement used by a small employer carrier in
   21  determining whether to provide coverage to a small employer
   22  group, including requirements for minimum participation of
   23  eligible employees and minimum employer contributions, must be
   24  applied uniformly among all small employer groups having the
   25  same number of eligible employees applying for coverage or
   26  receiving coverage from the small employer carrier, except that
   27  a small employer carrier that participates in, administers, or
   28  issues health benefits pursuant to s. 381.0406 which do not
   29  include a preexisting condition exclusion may require as a
   30  condition of offering such benefits that the employer has had no
   31  health insurance coverage for its employees for a period of at
   32  least 6 months. A small employer carrier may vary application of
   33  minimum participation requirements and minimum employer
   34  contribution requirements only by the size of the small employer
   35  group.
   36         3. In applying minimum participation requirements with
   37  respect to a small employer, a small employer carrier shall not
   38  consider as an eligible employee employees or dependents who
   39  have qualifying existing coverage in an employer-based group
   40  insurance plan or an ERISA qualified self-insurance plan in
   41  determining whether the applicable percentage of participation
   42  is met. However, a small employer carrier may count eligible
   43  employees and dependents who have coverage under another health
   44  plan that is sponsored by that employer.
   45         4. A small employer carrier shall not increase any
   46  requirement for minimum employee participation or any
   47  requirement for minimum employer contribution applicable to a
   48  small employer at any time after the small employer has been
   49  accepted for coverage, unless the employer size has changed, in
   50  which case the small employer carrier may apply the requirements
   51  that are applicable to the new group size.
   52         5. If a small employer carrier offers coverage to a small
   53  employer, it must offer coverage to all the small employer’s
   54  eligible employees and their dependents. A small employer
   55  carrier may not offer coverage limited to certain persons in a
   56  group or to part of a group, except with respect to late
   57  enrollees. If a small employer offers coverage to its employees,
   58  the coverage must be offered to all eligible employees. The
   59  small employer may also offer coverage to the spouses and
   60  dependents of eligible employees.
   61         6. A small employer carrier may not modify any health
   62  benefit plan issued to a small employer with respect to a small
   63  employer or any eligible employee or dependent through riders,
   64  endorsements, or otherwise to restrict or exclude coverage for
   65  certain diseases or medical conditions otherwise covered by the
   66  health benefit plan.
   67         7. An initial enrollment period of at least 30 days must be
   68  provided. An annual 30-day open enrollment period must be
   69  offered to each small employer’s eligible employees and their
   70  dependents. A small employer carrier must provide special
   71  enrollment periods as required by s. 627.65615.
   72         Section 2. This act shall take effect July 1, 2016.