The Florida Senate

408.0014  The Florida Health Access Corporation Act.--

(1)  SHORT TITLE.--This section may be cited as the "Florida Health Access Corporation Act."

(2)  LEGISLATIVE INTENT.--The Legislature finds that there is insufficient group health insurance coverage available to employees of small businesses in Florida, that uninsured employees of small businesses represent a significant portion of the uncompensated costs of health care providers, and that uninsured individuals have impaired access to health care services and correspondingly lower health status. It is the intent of the Legislature that a nonprofit corporation, to be known as the "Florida Health Access Corporation," be organized for the purpose of pooling groups of individuals employed by small businesses, and the dependents of such employees, into larger groups in order to facilitate a program of affordable group health insurance coverage to uninsured individuals.

(3)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--

(a)  There is authorized the "Florida Health Access Corporation." The Florida Health Access Corporation shall operate in Hillsborough County and a multicounty rural site and such other counties as may be designated by the corporation.

(b)  The Florida Health Access Corporation shall:

1.  Organize employers of 24 or fewer full-time employees and facilitate the provision of group health insurance to such employers and employees and their dependents;

2.  Arrange for the collection of premiums, in an amount to be determined by the board of directors, from all insured individuals to provide for claims paid under group health insurance arrangements and for the administrative expenses incurred or estimated to be incurred during the period for which the premium is paid;

3.  Establish administrative and accounting procedures for the operation of the corporation;

4.  Establish employer and employee eligibility criteria for participation in the program;

5.  Establish participation criteria governing eligibility of insurers or any providers of health care services to participate in the program;

6.  Establish procedures under which applicants to and participants in the program may have grievances reviewed by an impartial body and reported to the board;

7.  Contract with an authorized insurer or insurance administrator to provide administrative services to the corporation if desired or when such services are deemed necessary by the board;

8.  Contract with authorized insurers or any provider of health care services for the provision of services to individuals covered through the program;

9.  Develop and implement a plan to publicize the Florida Health Access Corporation, the eligibility requirements for the program, and the procedures for enrollment in the program, and to maintain public awareness of the corporation and the program;

10.  Secure staff necessary to properly administer the corporation. Staff costs shall be funded from grant funds, state and local matching funds, administrative fees collected from employers and insurers, and other sources of funding arranged by the corporation. The board of directors is authorized to determine the number of staff necessary to administer the corporation, but shall include, at a minimum, an executive director, an assistant director, and a staff assistant; and

11.  Enter into contracts with local agencies to provide onsite marketing and enrollment services necessary to the operation of the corporation.

(c)  The corporation shall set business and employee eligibility standards which shall define a small business and further identify small businesses eligible for participation in the program. Small businesses eligible for participation shall have 24 or fewer full-time employees. Employer eligibility standards shall include a provision that the employer must attest to having offered or provided no other health insurance benefit program in the 6-month period prior to the effective date of participation in the program. The corporation shall make all necessary provisions to prevent the payment of or reimbursement for any claim or expense which may be covered under a separate health insurance or health care services plan under which an individual who participates in the program may be covered. Coverage arranged through the corporation's program is to be considered secondary to any other available coverage held by the individual participating in the program. If such an individual is also eligible for Medicare coverage, the coverage arranged by the corporation shall not pay or reimburse any individual for expenses paid by Medicare. No policy shall be arranged by the corporation which is deemed to be a Medicare supplemental policy as defined in s. 627.672.

(d)  The corporation, which shall be operated as a nonprofit private corporation organized pursuant to chapter 617, shall have all powers necessary or convenient to carry out and effectuate the purposes and provisions of this act, including, but not limited to, the power to receive and accept grants, loans, and, notwithstanding the provisions of ss. 215.42 and 215.422, advances of funds from any public or private agency, for, or in aid of, the purpose of this act, and to receive and accept contributions, from any source, of money, property, labor, or any other thing of value, to be held, used, and applied for said purposes.

(4)  BOARD OF DIRECTORS.--

(a)  The Florida Health Access Corporation shall operate subject to the supervision and approval of a seven-member board of directors, which shall consist of:

1.  Two members, one from an urban county and one from a rural county, who shall represent small businesses whose employees are eligible to participate in the Florida Health Access Corporation;

2.  One member who shall represent consumers eligible to participate in the Florida Health Access Corporation;

3.  One member who shall be a representative of a domestic health care insurer or of a private company which offers a self-insured program of health benefits to employees;

4.  One member who shall be the Director of Health Care Administration or the director's designee;

5.  One member who shall be a representative of the Florida Chamber of Commerce; and

6.  One member who shall be a representative of an employer health coalition.

(b)  The board of directors shall be appointed and may be removed by the Governor. Terms of appointment shall be for 3 years. The board shall appoint the executive director, who shall be responsible for other staff as authorized by the board.

(c)  Board members may be reimbursed from funds of the Florida Health Access Corporation for actual and necessary expenses incurred by them as members, according to state travel and per diem limitations, but may not otherwise be compensated for their services.

(d)  There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member of the board of directors, or its employees or agents, for any action taken by them in performance of their powers and duties under this act.

(5)  LICENSING, FISCAL OPERATION.--

(a)  The corporation shall not be deemed to be an insurer. The officers, directors, and employees of the corporation shall not be deemed to be agents of an insurer. Neither the corporation nor the officers, directors, or employees of the corporation shall be subject to the licensing requirements of the insurance code or the rules of the Department of Insurance. However, the Department of Insurance may require that the marketing representative utilized and compensated by the corporation be licensed as representatives of the insurers or health services providers with whom the corporation may contract.

(b)  The Florida Health Access Corporation program shall be operated in accordance with sound actuarial principles. The board shall have complete fiscal control over the corporation and shall be responsible for all corporate operations.

(c)  The Department of Insurance shall assist the program in determining that proposed premium levels will be sufficient to permit the corporation to operate in an actuarially sound manner.

(d)  The corporation may expend funds through direct reinsurance, by purchasing reinsurance, or by other means approved by the board for the program of health care services and benefits arranged through the corporation. The amount of such expenditure shall not exceed funds allocated from the Public Medical Assistance Trust Fund or other sources of funding arranged by the corporation. Notwithstanding the provisions of s. 216.301, any amount so provided, which is not annually required for such purposes, shall remain available to the corporation, to be supplemented by an annual amount equal to the amount expended in the prior year, for the purpose of meeting funding requirements in succeeding years. Any amount remaining upon the liquidation or dissolution of the corporation shall be returned to the Public Medical Assistance Trust Fund.

History.--s. 16, ch. 87-92; s. 22, ch. 90-295; s. 63, ch. 91-282; s. 10, ch. 93-129; s. 33, ch. 97-103.

Note.--Former s. 409.701.