Senate Bill 1116
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1116
By Senator Forman
32-1346-98 See HB
1 A bill to be entitled
2 An act relating to health insurance; amending
3 s. 627.6484, F.S.; providing limitations on
4 applications for insurance under certain
5 circumstances; deleting requirements and
6 criteria for a market assistance plan; amending
7 s. 627.6486, F.S., to conform; amending s.
8 627.6492, F.S.; exempting certain insurers from
9 certain assessments under certain
10 circumstances; providing an exception;
11 providing requirements; providing an effective
12 date.
13
14 Be It Enacted by the Legislature of the State of Florida:
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16 Section 1. Section 627.6484, Florida Statutes, is
17 amended to read:
18 627.6484 Termination of enrollment; availability of
19 other coverage.--
20 (1) The association may shall accept up to 5,000
21 applications for insurance at a rate of up to 1,000
22 applications annually for a 5-year period, exclusive of
23 replacement applications only until June 30, 1991, after which
24 date no further applications may be accepted. Upon receipt of
25 an application for insurance, the association shall issue
26 coverage for an eligible applicant. Applications shall be
27 processed on a first-come, first-served basis. All
28 applications received on the same day at the same time shall
29 be processed as a group, provided, if processing the number of
30 applications in such group would exceed the 1,000 application
31 limit for a given year, such group shall be held for
1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1116
32-1346-98 See HB
1 processing until such time as processing such applications
2 would not exceed such limit. When appropriate, the
3 administrator shall forward a copy of the application to a
4 market assistance plan created by the department, which shall
5 conduct a diligent search of the private marketplace for a
6 carrier willing to accept the application.
7 (2) The department shall, after consultation with the
8 health insurers licensed in this state, adopt a market
9 assistance plan to assist in the placement of risks of Florida
10 Comprehensive Health Association applicants. All health
11 insurers and health maintenance organizations licensed in this
12 state shall participate in the plan.
13 (3) Guidelines for the use of such program shall be a
14 part of the association's plan of operation. The guidelines
15 shall describe which types of applications are to be exempt
16 from submission to the market assistance plan. An exemption
17 shall be based upon a determination that due to a specific
18 health condition an applicant is ineligible for coverage in
19 the standard market. The guidelines shall also describe how
20 the market assistance plan is to be conducted, and how the
21 periodic reviews to depopulate the association are to be
22 conducted.
23 (4) If a carrier is found through the market
24 assistance plan, the individual shall apply to that company.
25 If the individual's application is accepted, association
26 coverage shall terminate upon the effective date of the
27 coverage with the private carrier. For the purpose of
28 applying a preexisting condition limitation or exclusion, any
29 carrier accepting a risk pursuant to this section shall
30 provide coverage as if it began on the date coverage was
31 effectuated on behalf of the association, and shall be
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1116
32-1346-98 See HB
1 indemnified by the association for claims costs incurred as a
2 result of utilizing such effective date.
3 (2)(5) The association shall establish a policyholder
4 assistance program by July 1, 1991, to assist in placing
5 eligible policyholders in other coverage programs, including
6 Medicare and Medicaid.
7 Section 2. Paragraph (f) of subsection (2) of section
8 627.6486, Florida Statutes, is amended to read:
9 627.6486 Eligibility.--
10 (2)
11 (f) No person is eligible for coverage under the plan
12 unless such person has been rejected by two insurers for
13 coverage substantially similar to the plan coverage and no
14 insurer has been found through the market assistance plan
15 pursuant to s. 627.6484 that is willing to accept the
16 application. As used in this paragraph, "rejection" includes
17 an offer of coverage with a material underwriting restriction
18 or an offer of coverage at a rate greater than the association
19 plan rate.
20 Section 3. Subsection (4) is added to section
21 627.6492, Florida Statutes, to read:
22 627.6492 Participation of insurers.--
23 (4) An insurer is exempt from the assessment imposed
24 under this section for all administrative costs and losses
25 incurred by all policyholders enrolled after January 1, 1999,
26 if such insurer has assumed the risk of insurance for a
27 proportionate number of persons from the Florida Comprehensive
28 Health Association pool of new applicants equal to the
29 percentage such insurer has in relation to the total insurance
30 coverage provided by all insurers. An insurer may not be
31 exempt from the assessment imposed under this section if such
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1116
32-1346-98 See HB
1 insurer's market percentage in relation to the total insurance
2 coverage provided by all insurers is less than 2 percent.
3 Administrative costs and losses incurred by all policyholders
4 prior to January 1, 1999, shall be distributed as provided in
5 this section. Participation of insurers shall continue until
6 such time as the pool of insureds ceases to exist.
7 Section 4. This act shall take effect October 1 of the
8 year in which enacted.
9
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11 HOUSE SUMMARY
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Provides limitations on applications for insurance
13 through the Florida Comprehensive Health Association.
Deletes requirements for a market assistance plan for
14 placement of risks. Exempts insurers from assessments for
administrative costs and losses incurred by policyholders
15 under specific circumstances. See bill for details.
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