Senate Bill sb0168c1

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    Florida Senate - 2001                            CS for SB 168

    By the Committee on Banking and Insurance; and Senators
    Wasserman Schultz and Geller




    311-1559-01

  1                      A bill to be entitled

  2         An act relating to health insurance; creating

  3         ss. 627.64191, 627.65741, F.S.; requiring

  4         individual and group health insurance policies

  5         to comply with decisions of the United States

  6         Equal Employment Opportunity Commission with

  7         respect to exclusions that violate Title VII of

  8         the Civil Rights Act, as amended; requiring the

  9         Department of Insurance to make such

10         determination when approving policy forms;

11         amending ss. 627.6699, 641.31, F.S.; requiring

12         standard and basic health benefit plans issued

13         by small employer carriers and health

14         maintenance contracts to comply with decisions

15         of the United States Equal Employment

16         Opportunity Commission with respect to

17         exclusions that violate Title VII of the Civil

18         Rights Act, as amended; requiring the

19         Department of Insurance to make such

20         determination when approving policy forms;

21         providing for application; providing an

22         effective date.

23

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

25

26         Section 1.  Section 627.64191, Florida Statutes, is

27  created to read:

28         627.64191  Compliance with decisions of the United

29  States Equal Employment Opportunity Commission.--The benefits,

30  exclusions, and limitations of individual health insurance

31  policies must comply with and be consistent with the decisions

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    Florida Senate - 2001                            CS for SB 168
    311-1559-01




  1  of the United States Equal Employment Opportunity Commission

  2  which hold that the exclusion or limitation of a specific

  3  benefit violates Title VII of the Civil Rights Act of 1964, as

  4  amended by the Pregnancy Discrimination Act of 1978. The

  5  department must determine such compliance in approving form

  6  filings under ss. 627.410 and 627.411, based on decisions

  7  rendered by the United States Equal Employment Opportunity

  8  Commission before January 1, 2001.

  9         Section 2.  Section 627.65741, Florida Statutes, is

10  created to read:

11         627.65741  Compliance with decisions of the United

12  States Equal Employment Opportunity Commission.--The benefits,

13  exclusions, and limitations of group health insurance policies

14  must comply with and be consistent with the decisions of the

15  United States Equal Employment Opportunity Commission which

16  hold that the exclusion or limitation of a specific benefit

17  violates Title VII of the Civil Rights Act of 1964, as amended

18  by the Pregnancy Discrimination Act of 1978. The department

19  must determine such compliance in approving form filings under

20  ss. 627.410 and 627.411, based on decisions rendered by the

21  United States Equal Employment Opportunity Commission before

22  January 1, 2001.

23         Section 3.  Paragraph (b) of subsection (12) of section

24  627.6699, Florida Statutes, is amended to read:

25         627.6699  Employee Health Care Access Act.--

26         (12)  STANDARD, BASIC, AND LIMITED HEALTH BENEFIT

27  PLANS.--

28         (b)1.  Each small employer carrier issuing new health

29  benefit plans shall offer to any small employer, upon request,

30  a standard health benefit plan and a basic health benefit plan

31  that meets the criteria set forth in this section.

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    Florida Senate - 2001                            CS for SB 168
    311-1559-01




  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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    Florida Senate - 2001                            CS for SB 168
    311-1559-01




  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

31

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    Florida Senate - 2001                            CS for SB 168
    311-1559-01




  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 4.  Subsection (40) is added to section 641.31,

23  Florida Statutes, to read:

24         641.31  Health maintenance contracts.--

25         (40)  The benefits, exclusions, and limitations of

26  organization contracts must comply with and be consistent with

27  the decisions of the United States Equal Employment

28  Opportunity Commission which hold that the exclusion or

29  limitation of a specific benefit violates Title VII of the

30  Civil Rights Act of 1964, as amended by the Pregnancy

31  Discrimination Act of 1978. The department must determine such

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    Florida Senate - 2001                            CS for SB 168
    311-1559-01




  1  compliance in approving form filings under this section, based

  2  on decisions rendered by the United States Equal Employment

  3  Opportunity Commission before January 1, 2001.

  4         Section 5.  This act shall take effect July 1, 2001,

  5  and shall apply to policies and contracts issued or renewed on

  6  or after that date.

  7

  8          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  9                              SB 168

10

11  Replaces the provisions of the bill with the requirement that
    individual and group (including the standard and basic
12  policies that must be offered to small employers) health
    insurance policies and health maintenance organization
13  (HMO)contracts be in compliance with the decisions of the
    Equal Employment Opportunity Commission (EEOC) that hold that
14  the exclusion or limitation of a specific benefit violates
    Title VII of the Civil Rights Act of 1964, as amended by the
15  Pregnancy Discrimination Act (PDA) of 1978. The Department of
    Insurance would determine such compliance in approving policy
16  forms, based on the decisions by the EEOC rendered prior to
    January 1, 2001.
17
    This provision would require insurance policies to be in
18  compliance with a recent ruling by the EEOC which held that it
    was unlawful to exclude prescription contraceptive drugs and
19  devices from health insurance plans because such exclusion
    violated Title VII and the Pregnancy Discrimination Act (PDA).
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