House Bill 1415

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    Florida House of Representatives - 1999                HB 1415

        By Representatives Roberts, Lawson, Turnbull, Goode,
    Henriquez, Peaden and Ritchie





  1                      A bill to be entitled

  2         An act relating to the state group insurance

  3         program; amending s. 110.123, F.S.; requiring

  4         the state group insurance plan to provide an

  5         enrollee continued access to a treating health

  6         care provider who loses provider status under

  7         the program; providing limitations; providing

  8         applicability; providing an effective date.

  9

10  Be It Enacted by the Legislature of the State of Florida:

11

12         Section 1.  Paragraph (h) of subsection (3) of section

13  110.123, Florida Statutes, 1998 Supplement, is amended to

14  read:

15         110.123  State group insurance program.--

16         (3)  STATE GROUP INSURANCE PROGRAM.--

17         (h)1.  A person eligible to participate in the state

18  group health insurance plan may be authorized by rules adopted

19  by the division, in lieu of participating in the state group

20  health insurance plan, to exercise an option to elect

21  membership in a health maintenance organization plan which is

22  under contract with the state in accordance with criteria

23  established by this section and by said rules.  The offer of

24  optional membership in a health maintenance organization plan

25  permitted by this paragraph may be limited or conditioned by

26  rule as may be necessary to meet the requirements of state and

27  federal laws.

28         2.  The division shall contract with health maintenance

29  organizations to participate in the state group insurance

30  program through a request for proposal based upon a premium

31  and a minimum benefit package as follows:

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  1         a.  A minimum benefit package to be provided by a

  2  participating HMO shall include: physician services; inpatient

  3  and outpatient hospital services; emergency medical services,

  4  including out-of-area emergency coverage; diagnostic

  5  laboratory and diagnostic and therapeutic radiologic services;

  6  mental health, alcohol, and chemical dependency treatment

  7  services meeting the minimum requirements of state and federal

  8  law; skilled nursing facilities and services; prescription

  9  drugs; and other benefits as may be required by the division.

10  Additional services may be provided subject to the contract

11  between the division and the HMO.

12         b.  A uniform schedule for deductibles and copayments

13  may be established for all participating HMOs.

14         c.  Based upon the minimum benefit package and

15  copayments and deductibles contained in sub-subparagraphs a.

16  and b., the division shall issue a request for proposal for

17  all HMOs which are interested in participating in the state

18  group insurance program.  Upon receipt of all proposals, the

19  division may, as it deems appropriate, enter into contract

20  negotiations with HMOs submitting bids. As part of the request

21  for proposal process, the division may require detailed

22  financial data from each HMO which participates in the bidding

23  process for the purpose of determining the financial stability

24  of the HMO.

25         d.  In determining which HMOs to contract with, the

26  division shall, at a minimum, consider:  each proposed

27  contractor's previous experience and expertise in providing

28  prepaid health benefits; each proposed contractor's historical

29  experience in enrolling and providing health care services to

30  participants in the state group insurance program; the cost of

31  the premiums; the plan's ability to adequately provide service

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  1  coverage and administrative support services as determined by

  2  the division; plan benefits in addition to the minimum benefit

  3  package; accessibility to providers; and the financial

  4  solvency of the plan. Nothing shall preclude the division from

  5  negotiating regional or statewide contracts with health

  6  maintenance organization plans when this is cost-effective and

  7  when the division determines the plan has the best overall

  8  benefit package for the service areas involved.  However, no

  9  HMO shall be eligible for a contract if the HMO's retiree

10  Medicare premium exceeds the retiree rate as set by the

11  division for the state group health insurance plan.

12         e.  The division may limit the number of HMOs that it

13  contracts with in each service area based on the nature of the

14  bids the division receives, the number of state employees in

15  the service area, and any unique geographical characteristics

16  of the service area. The division shall establish by rule

17  service areas throughout the state.

18         f.  All persons participating in the state group

19  insurance program who are required to contribute towards a

20  total state group health premium shall be subject to the same

21  dollar contribution regardless of whether the enrollee enrolls

22  in the state group health insurance plan or in an HMO plan.

23         3.  The division is authorized to negotiate and to

24  contract with specialty psychiatric hospitals for mental

25  health benefits, on a regional basis, for alcohol, drug abuse,

26  and mental and nervous disorders. The division may establish,

27  subject to the approval of the Legislature pursuant to

28  subsection (5), any such regional plan upon completion of an

29  actuarial study to determine any impact on plan benefits and

30  premiums.

31

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  1         4.  In addition to contracting pursuant to subparagraph

  2  2., the division shall enter into contract with any HMO to

  3  participate in the state group insurance program which:

  4         a.  Serves greater than 5,000 recipients on a prepaid

  5  basis under the Medicaid program;

  6         b.  Does not currently meet the 25 percent

  7  non-Medicare/non-Medicaid enrollment composition requirement

  8  established by the Department of Health and Human Services

  9  excluding participants enrolled in the state group insurance

10  program;

11         c.  Meets the minimum benefit package and copayments

12  and deductibles contained in sub-subparagraphs 2.a. and b.;

13         d.  Is willing to participate in the state group

14  insurance program at a cost of premiums that is not greater

15  than 95 percent of the cost of HMO premiums accepted by the

16  division in each service area; and

17         e.  Meets the minimum surplus requirements of s.

18  641.225.

19

20  The division is authorized to contract with HMOs that meet the

21  requirements of sub-subparagraphs a. through d. prior to the

22  open enrollment period for state employees.  The division is

23  not required to renew the contract with the HMOs as set forth

24  in this paragraph more than twice. Thereafter, the HMOs shall

25  be eligible to participate in the state group insurance

26  program only through the request for proposal process

27  described in subparagraph 2.

28         5.  All enrollees in the state group health insurance

29  plan or any health maintenance organization plan shall have

30  the option of changing to any other health plan which is

31  offered by the state within any open enrollment period

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  1  designated by the division. Open enrollment shall be held at

  2  least once each calendar year.

  3         6.  When a treating health care provider under the

  4  state group insurance program or any health maintenance

  5  organization loses his or her network provider status for any

  6  reason other than for cause, the state group insurance plan

  7  shall allow any enrollee in the state group health insurance

  8  plan or any health maintenance organization plan for whom the

  9  terminated provider was a treating provider to continue care

10  with the terminated treating provider through completion of

11  treatment of a condition for which the enrollee was receiving

12  care at the time of termination, until the enrollee selects

13  another treating provider, or until the next open enrollment

14  period designated by the division, whichever occurs first, but

15  no longer than 1 year after termination of the treating

16  provider.  The state group health insurance plan shall allow

17  an enrollee who is in the third trimester of pregnancy to

18  continue care with a terminated treating provider until

19  completion of postpartum care. For care continued under this

20  subparagraph, the program and the provider shall continue to

21  be bound by the terms of the terminated contract for such

22  continued care.  This subparagraph shall not apply to treating

23  health care providers who have been terminated by the program

24  for cause.

25         7.6.  Any HMO participating in the state group

26  insurance program shall, upon the request of the division,

27  submit to the division standardized data for the purpose of

28  comparison of the appropriateness, quality, and efficiency of

29  care provided by the HMO. Such standardized data shall

30  include:  membership profiles; inpatient and outpatient

31  utilization by age and sex, type of service, provider type,

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  1  and facility; and emergency care experience. Requirements and

  2  timetables for submission of such standardized data and such

  3  other data as the division deems necessary to evaluate the

  4  performance of participating HMOs shall be adopted by rule.

  5         8.7.  The division shall, after consultation with

  6  representatives from each of the unions representing state and

  7  university employees, establish a comprehensive package of

  8  insurance benefits including, but not limited to, supplemental

  9  health and life coverage, dental care, long-term care, and

10  vision care to allow state employees the option to choose the

11  benefit plans which best suit their individual needs.

12         a.  Based upon a desired benefit package, the division

13  shall issue a request for proposal for health insurance

14  providers interested in participating in the state group

15  insurance program, and the division shall issue a request for

16  proposal for insurance providers interested in participating

17  in the non-health-related components of the state group

18  insurance program.  Upon receipt of all proposals, the

19  division may enter into contract negotiations with insurance

20  providers submitting bids or negotiate a specially designed

21  benefit package. Insurance providers offering or providing

22  supplemental coverage as of May 30, 1991, which qualify for

23  pretax benefit treatment pursuant to s. 125 of the Internal

24  Revenue Code of 1986, with 5,500 or more state employees

25  currently enrolled may be included by the division in the

26  supplemental insurance benefit plan established by the

27  division without participating in a request for proposal,

28  submitting bids, negotiating contracts, or negotiating a

29  specially designed benefit package.  These contracts shall

30  provide state employees with the most cost-effective and

31  comprehensive coverage available; however, no state or agency

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  1  funds shall be contributed toward the cost of any part of the

  2  premium of such supplemental benefit plans.

  3         b.  Pursuant to the applicable provisions of s.

  4  110.161, and s. 125 of the Internal Revenue Code of 1986, the

  5  division shall enroll in the pretax benefit program those

  6  state employees who voluntarily elect coverage in any of the

  7  supplemental insurance benefit plans as provided by

  8  sub-subparagraph a.

  9         c.  Nothing herein contained shall be construed to

10  prohibit insurance providers from continuing to provide or

11  offer supplemental benefit coverage to state employees as

12  provided under existing agency plans.

13         Section 2.  This act shall take effect upon becoming a

14  law.

15

16            *****************************************

17                          HOUSE SUMMARY

18
      Requires the state group insurance plan to provide an
19    enrollee continued access to a treating health care
      provider who loses provider status under the program, for
20    any reason other than for cause, through completion of
      treatment of a condition for which the enrollee was
21    receiving care at the time of loss of provider status,
      until the enrollee selects another treating provider, or
22    until the next open enrollment period, whichever occurs
      first. Provides a 1-year limit on such continued access.
23    Allows an enrollee who is in the third trimester of
      pregnancy to continue care with a terminated treating
24    provider until completion of postpartum care. Provides
      limitations.
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