Senate Bill 0800

CODING: Words stricken are deletions; words underlined are additions.



    Florida Senate - 1999                                   SB 800

    By Senators Thomas, Childers and Mitchell





    3-722-99                                                See HB

  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 with continued access to a treating

  6         health care provider who loses provider status

  7         under the program; providing limitations;

  8         providing applicability; providing an effective

  9         date.

10

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

12

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

14  110.123, Florida Statutes, 1998 Supplement, is amended to

15  read:

16         110.123  State group insurance program.--

17         (3)  STATE GROUP INSURANCE PROGRAM.--

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

19  group health insurance plan may be authorized by rules adopted

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

21  health insurance plan, to exercise an option to elect

22  membership in a health maintenance organization plan which is

23  under contract with the state in accordance with criteria

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

25  optional membership in a health maintenance organization plan

26  permitted by this paragraph may be limited or conditioned by

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

28  federal laws.

29         2.  The division shall contract with health maintenance

30  organizations to participate in the state group insurance

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




  1  program through a request for proposal based upon a premium

  2  and a minimum benefit package as follows:

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

  4  participating HMO shall include: physician services; inpatient

  5  and outpatient hospital services; emergency medical services,

  6  including out-of-area emergency coverage; diagnostic

  7  laboratory and diagnostic and therapeutic radiologic services;

  8  mental health, alcohol, and chemical dependency treatment

  9  services meeting the minimum requirements of state and federal

10  law; skilled nursing facilities and services; prescription

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

12  Additional services may be provided subject to the contract

13  between the division and the HMO.

14         b.  A uniform schedule for deductibles and copayments

15  may be established for all participating HMOs.

16         c.  Based upon the minimum benefit package and

17  copayments and deductibles contained in sub-subparagraphs a.

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

19  all HMOs which are interested in participating in the state

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

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

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

23  for proposal process, the division may require detailed

24  financial data from each HMO which participates in the bidding

25  process for the purpose of determining the financial stability

26  of the HMO.

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

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

29  contractor's previous experience and expertise in providing

30  prepaid health benefits; each proposed contractor's historical

31  experience in enrolling and providing health care services to

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




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

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

  3  coverage and administrative support services as determined by

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

  5  package; accessibility to providers; and the financial

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

  7  negotiating regional or statewide contracts with health

  8  maintenance organization plans when this is cost-effective and

  9  when the division determines the plan has the best overall

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

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

12  Medicare premium exceeds the retiree rate as set by the

13  division for the state group health insurance plan.

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

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

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

17  the service area, and any unique geographical characteristics

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

19  service areas throughout the state.

20         f.  All persons participating in the state group

21  insurance program who are required to contribute towards a

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

23  dollar contribution regardless of whether the enrollee enrolls

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

25         3.  The division is authorized to negotiate and to

26  contract with specialty psychiatric hospitals for mental

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

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

29  subject to the approval of the Legislature pursuant to

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

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




  1  actuarial study to determine any impact on plan benefits and

  2  premiums.

  3         4.  In addition to contracting pursuant to subparagraph

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

  5  participate in the state group insurance program which:

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

  7  basis under the Medicaid program;

  8         b.  Does not currently meet the 25 percent

  9  non-Medicare/non-Medicaid enrollment composition requirement

10  established by the Department of Health and Human Services

11  excluding participants enrolled in the state group insurance

12  program;

13         c.  Meets the minimum benefit package and copayments

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

15         d.  Is willing to participate in the state group

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

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

18  division in each service area; and

19         e.  Meets the minimum surplus requirements of s.

20  641.225.

21

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

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

24  open enrollment period for state employees.  The division is

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

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

27  be eligible to participate in the state group insurance

28  program only through the request for proposal process

29  described in subparagraph 2.

30         5.  All enrollees in the state group health insurance

31  plan or any health maintenance organization plan shall have

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




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

  2  offered by the state within any open enrollment period

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

  4  least once each calendar year.

  5         6.  When a treating health care provider under the

  6  state group insurance program or any health maintenance

  7  organization loses his or her network provider status for any

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

  9  shall allow any enrollee in the state group health insurance

10  plan or any health maintenance organization plan for whom the

11  terminated provider was a treating provider to continue care

12  with the terminated treating provider through completion of

13  treatment of a condition for which the enrollee was receiving

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

15  another treating provider or until the next open enrollment

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

17  no longer than 1 year after termination of the treating

18  provider.  The state group health insurance plan shall allow

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

20  continue care with a terminated treating provider until

21  completion of postpartum care. For care continued under this

22  subparagraph, the program and the provider shall continue to

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

24  continued care.  This subparagraph shall not apply to treating

25  health care providers who have been terminated by the program

26  for cause.

27         7.6.  Any HMO participating in the state group

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

29  submit to the division standardized data for the purpose of

30  comparison of the appropriateness, quality, and efficiency of

31  care provided by the HMO. Such standardized data shall

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




  1  include:  membership profiles; inpatient and outpatient

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

  3  and facility; and emergency care experience. Requirements and

  4  timetables for submission of such standardized data and such

  5  other data as the division deems necessary to evaluate the

  6  performance of participating HMOs shall be adopted by rule.

  7         8.7.  The division shall, after consultation with

  8  representatives from each of the unions representing state and

  9  university employees, establish a comprehensive package of

10  insurance benefits including, but not limited to, supplemental

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

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

13  benefit plans which best suit their individual needs.

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

15  shall issue a request for proposal for health insurance

16  providers interested in participating in the state group

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

18  proposal for insurance providers interested in participating

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

20  insurance program.  Upon receipt of all proposals, the

21  division may enter into contract negotiations with insurance

22  providers submitting bids or negotiate a specially designed

23  benefit package. Insurance providers offering or providing

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

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

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

27  currently enrolled may be included by the division in the

28  supplemental insurance benefit plan established by the

29  division without participating in a request for proposal,

30  submitting bids, negotiating contracts, or negotiating a

31  specially designed benefit package.  These contracts shall

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    Florida Senate - 1999                                   SB 800
    3-722-99                                                See HB




  1  provide state employees with the most cost-effective and

  2  comprehensive coverage available; however, no state or agency

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

  4  premium of such supplemental benefit plans.

  5         b.  Pursuant to the applicable provisions of s.

  6  110.161, and s. 125 of the Internal Revenue Code of 1986, the

  7  division shall enroll in the pretax benefit program those

  8  state employees who voluntarily elect coverage in any of the

  9  supplemental insurance benefit plans as provided by

10  sub-subparagraph a.

11         c.  Nothing herein contained shall be construed to

12  prohibit insurance providers from continuing to provide or

13  offer supplemental benefit coverage to state employees as

14  provided under existing agency plans.

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

16  law.

17

18            *****************************************

19                       LEGISLATIVE SUMMARY

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