House Bill 0083
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Florida House of Representatives - 1999 HB 83
By Representative Bloom
1 A bill to be entitled
2 An act relating to health care; creating the
3 "Contraceptive Equity Act"; creating ss.
4 627.64061 and 627.65741, F.S., and amending s.
5 641.31, F.S.; requiring certain health
6 insurance policies and health maintenance
7 contracts that cover drugs prescribed for the
8 treatment of sexual dysfunction to provide
9 coverage for any contraceptive method
10 prescribed or provided by a licensed
11 practitioner; amending ss. 627.651, 627.6515,
12 and 627.6699, F.S.; providing for application
13 to group coverage for multiple-employer welfare
14 arrangements, out-of-state groups, and small
15 employers; providing an effective date.
16
17 Be It Enacted by the Legislature of the State of Florida:
18
19 Section 1. This act may be cited as the "Contraceptive
20 Equity Act".
21 Section 2. Section 627.64061, Florida Statutes, is
22 created to read:
23 627.64061 Coverage for contraceptives.--
24 (1) Any health insurance policy that provides coverage
25 for drugs prescribed for the treatment of sexual dysfunction
26 shall also cover any contraceptive method prescribed or
27 provided by a licensed practitioner.
28 (2) Nothing in this section applies to any contract
29 with any existing or future plan which objects to such
30 coverage on the basis of religious belief. In implementing
31 this section, any plan that enters into or renews a contract
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Florida House of Representatives - 1999 HB 83
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1 under this section may not subject any individual to
2 discrimination on the basis that the individual refuses to
3 prescribe contraceptives because such activities would be
4 contrary to the individual's religious beliefs or moral
5 convictions.
6 (3) This section applies to benefits for state
7 employees under s. 110.123.
8 Section 3. Subsection (4) of section 627.651, Florida
9 Statutes, is amended to read:
10 627.651 Group contracts and plans of self-insurance
11 must meet group requirements.--
12 (4) This section does not apply to any plan which is
13 established or maintained by an individual employer in
14 accordance with the Employee Retirement Income Security Act of
15 1974, Pub. L. No. 93-406, or to a multiple-employer welfare
16 arrangement as defined in s. 624.437(1), except that a
17 multiple-employer welfare arrangement shall comply with ss.
18 627.419, 627.657, 627.65741, 627.6575, 627.6576, 627.6578,
19 627.6579, 627.6612, 627.66121, 627.66122, 627.6615, 627.6616,
20 and 627.662(6). This subsection does not allow an authorized
21 insurer to issue a group health insurance policy or
22 certificate which does not comply with this part.
23 Section 4. Paragraph (c) of subsection (2) of section
24 627.6515, Florida Statutes, 1998 Supplement, is amended to
25 read:
26 627.6515 Out-of-state groups.--
27 (2) This part does not apply to a group health
28 insurance policy issued or delivered outside this state under
29 which a resident of this state is provided coverage if:
30 (c) The policy provides the benefits specified in ss.
31 627.419, 627.6574, 627.65741, 627.6575, 627.6579, 627.6612,
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Florida House of Representatives - 1999 HB 83
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1 627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691,
2 and 627.66911.
3 Section 5. Section 627.65741, Florida Statutes, is
4 created to read:
5 627.65741 Coverage for contraceptives.--
6 (1) Any group, franchise accident, or health insurance
7 policy that provides coverage for the treatment of sexual
8 dysfunction shall also cover any contraceptive method
9 prescribed or provided by a licensed practitioner.
10 (2) Nothing in this section applies to any contract
11 with any existing or future plan which objects to such
12 coverage on the basis of religious belief. In implementing
13 this section, any plan that enters into or renews a contract
14 under this section may not subject any individual to
15 discrimination on the basis that the individual refuses to
16 prescribe contraceptives because such activities would be
17 contrary to the individual's religious beliefs or moral
18 convictions.
19 (3) This section applies to benefits for state
20 employees under s. 110.123.
21 Section 6. Paragraph (b) of subsection (12) of section
22 627.6699, Florida Statutes, 1998 Supplement, is amended to
23 read:
24 627.6699 Employee Health Care Access Act.--
25 (12) STANDARD, BASIC, AND LIMITED HEALTH BENEFIT
26 PLANS.--
27 (b)1. Each small employer carrier issuing new health
28 benefit plans shall offer to any small employer, upon request,
29 a standard health benefit plan and a basic health benefit plan
30 that meets the criteria set forth in this section.
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1 2. For purposes of this subsection, the terms
2 "standard health benefit plan" and "basic health benefit plan"
3 mean policies or contracts that a small employer carrier
4 offers to eligible small employers that contain:
5 a. An exclusion for services that are not medically
6 necessary or that are not covered preventive health services;
7 and
8 b. A procedure for preauthorization by the small
9 employer carrier, or its designees.
10 3. A small employer carrier may include the following
11 managed care provisions in the policy or contract to control
12 costs:
13 a. A preferred provider arrangement or exclusive
14 provider organization or any combination thereof, in which a
15 small employer carrier enters into a written agreement with
16 the provider to provide services at specified levels of
17 reimbursement or to provide reimbursement to specified
18 providers. Any such written agreement between a provider and a
19 small employer carrier must contain a provision under which
20 the parties agree that the insured individual or covered
21 member has no obligation to make payment for any medical
22 service rendered by the provider which is determined not to be
23 medically necessary. A carrier may use preferred provider
24 arrangements or exclusive provider arrangements to the same
25 extent as allowed in group products that are not issued to
26 small employers.
27 b. A procedure for utilization review by the small
28 employer carrier or its designees.
29
30 This subparagraph does not prohibit a small employer carrier
31 from including in its policy or contract additional managed
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1 care and cost containment provisions, subject to the approval
2 of the department, which have potential for controlling costs
3 in a manner that does not result in inequitable treatment of
4 insureds or subscribers. The carrier may use such provisions
5 to the same extent as authorized for group products that are
6 not issued to small employers.
7 4. The standard health benefit plan shall include:
8 a. Coverage for inpatient hospitalization;
9 b. Coverage for outpatient services;
10 c. Coverage for newborn children pursuant to s.
11 627.6575;
12 d. Coverage for child care supervision services
13 pursuant to s. 627.6579;
14 e. Coverage for adopted children upon placement in the
15 residence pursuant to s. 627.6578;
16 f. Coverage for mammograms pursuant to s. 627.6613;
17 g. Coverage for handicapped children pursuant to s.
18 627.6615;
19 h. Emergency or urgent care out of the geographic
20 service area; and
21 i. Coverage for services provided by a hospice
22 licensed under s. 400.602 in cases where such coverage would
23 be the most appropriate and the most cost-effective method for
24 treating a covered illness.
25 5. The standard health benefit plan and the basic
26 health benefit plan may include a schedule of benefit
27 limitations for specified services and procedures. If the
28 committee develops such a schedule of benefits limitation for
29 the standard health benefit plan or the basic health benefit
30 plan, a small employer carrier offering the plan must offer
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1 the employer an option for increasing the benefit schedule
2 amounts by 4 percent annually.
3 6. The basic health benefit plan shall include all of
4 the benefits specified in subparagraph 4.; however, the basic
5 health benefit plan shall place additional restrictions on the
6 benefits and utilization and may also impose additional cost
7 containment measures.
8 7. Sections 627.419(2), (3), and (4), 627.6574,
9 627.65741, 627.6612, 627.66121, 627.66122, 627.6616, 627.6618,
10 627.668, and 627.66911 apply to the standard health benefit
11 plan and to the basic health benefit plan. However,
12 notwithstanding said provisions, the plans may specify limits
13 on the number of authorized treatments, if such limits are
14 reasonable and do not discriminate against any type of
15 provider.
16 8. Each small employer carrier that provides for
17 inpatient and outpatient services by allopathic hospitals may
18 provide as an option of the insured similar inpatient and
19 outpatient services by hospitals accredited by the American
20 Osteopathic Association when such services are available and
21 the osteopathic hospital agrees to provide the service.
22 Section 7. Subsection (36) is added to section 641.31,
23 Florida Statutes, 1998 Supplement, to read:
24 641.31 Health maintenance contracts.--
25 (36) Any health insurance policy that provides
26 coverage for drugs prescribed for the treatment of sexual
27 dysfunction shall also cover any contraceptive method
28 prescribed or provided by a licensed practitioner.
29 (a) Nothing in this section applies to any contract
30 with any existing or future plan which objects to such
31 coverage on the basis of religious belief. In implementing
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CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 83
252-369-99
1 this section, any plan that enters into or renews a contract
2 under this section may not subject any individual to
3 discrimination on the basis that the individual refuses to
4 prescribe contraceptives because such activities would be
5 contrary to the individual's religious beliefs or moral
6 convictions.
7 (b) This section applies to benefits for state
8 employees under s. 110.123.
9 Section 8. This act shall take effect October 1, 1999.
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12 HOUSE SUMMARY
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Creates the "Contraceptive Equity Act." Requires health
14 insurance policies and health maintenance contracts that
cover drugs prescribed for the treatment of sexual
15 dysfunction to provide coverage for any contraceptive
method prescribed or provided by a licensed practitioner.
16 Provides for application to group coverage for
multiple-employer welfare arrangements, out-of-state
17 groups, and small employers. See bill for details.
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