Senate Bill sb1008

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    Florida Senate - 2002                                  SB 1008

    By Senator Peaden





    1-856-02

  1                      A bill to be entitled

  2         An act relating to health flex plans; providing

  3         legislative findings and intent; defining

  4         terms; providing for a pilot program for health

  5         flex plans for certain uninsured persons;

  6         providing criteria for approval of health flex

  7         plans; delineating the responsibilities of the

  8         Agency for Health Care Administration and the

  9         Department of Insurance; exempting approved

10         health flex plans from certain regulatory

11         requirements; providing criteria for

12         eligibility to enroll in a health flex plan;

13         requiring health flex plan entities to maintain

14         certain records; providing requirements for

15         denial, nonrenewal, or cancellation of

16         coverage; specifying that coverage under an

17         approved health flex plan is not an

18         entitlement; requiring an evaluation and

19         report; providing for expiration; providing an

20         effective date.

21

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

23

24         Section 1.  Health flex plans.--

25         (1)  INTENT.--The Legislature finds that a significant

26  proportion of the residents of this state are unable to obtain

27  affordable health insurance coverage. Therefore, it is the

28  intent of the Legislature to expand the availability of health

29  care options for low-income uninsured state residents by

30  encouraging health insurers, health maintenance organizations,

31  health care provider-sponsored organizations, local

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    Florida Senate - 2002                                  SB 1008
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  1  governments, health care districts, or other public or private

  2  community-based organizations to develop alternative

  3  approaches to traditional health insurance which emphasize

  4  coverage for basic and preventive health care services. To the

  5  maximum extent possible, these options should be coordinated

  6  with existing governmental or community-based health services

  7  programs in a manner that is consistent with the objectives

  8  and requirements of such programs.

  9         (2)  DEFINITIONS.--As used in this section, the term:

10         (a)  "Agency" means the Agency for Health Care

11  Administration.

12         (b)  "Department" means the Department of Insurance.

13         (c)  "Enrollee" means an individual who has been

14  determined to be eligible for and is receiving health care

15  coverage under a health flex plan approved under this section.

16         (d)  "Health care coverage" or "health flex plan

17  coverage" means health care services that are covered as

18  benefits under an approved health flex plan or that are

19  otherwise provided, either directly or through arrangements

20  with other persons, via health flex plan health care services

21  on a prepaid per-capita basis or on a prepaid aggregate

22  fixed-sum basis.

23         (e)  "Health flex plan" means a health plan approved

24  under subsection (3) which guarantees payment for specified

25  health care coverage provided to the enrollee.

26         (f)  "Health flex plan entity" means a health insurer,

27  health maintenance organization, health care

28  provider-sponsored organization, local government, health care

29  district, or other public or private community-based

30  organization that develops and implements an approved health

31  flex plan and is responsible for administering the health flex

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    Florida Senate - 2002                                  SB 1008
    1-856-02




  1  plan and paying all claims for health flex plan coverage by

  2  enrollees of the health flex plan.

  3         (3)  PILOT PROGRAM.--The agency and the department

  4  shall each approve or disapprove health flex plans that

  5  provide health care coverage for eligible participants in the

  6  three areas of the state which the agency designates as having

  7  the highest number of uninsured persons, as determined by the

  8  Florida Health Insurance Study. A health flex plan may limit

  9  or exclude benefits otherwise required by law for insurers

10  offering coverage in this state, may cap the total amount of

11  claims paid per year per enrollee, may limit the number of

12  enrollees, or may take any combination of those actions.

13         (a)  The agency shall develop guidelines for the review

14  of applications for health flex plans and shall disapprove or

15  withdraw approval of plans that do not meet or no longer meet

16  minimum standards for quality of care and access to care.

17         (b)  The department shall develop guidelines for the

18  review of health flex plan applications and shall disapprove

19  or shall withdraw approval of plans that:

20         1.  Contain any ambiguous, inconsistent, or misleading

21  provisions or any exceptions or conditions that deceptively

22  affect or limit the benefits purported to be assumed in the

23  general coverage provided by the health flex plan;

24         2.  Provide benefits that are unreasonable in relation

25  to the premium charged or contain provisions that are unfair

26  or inequitable or contrary to the public policy of this state,

27  that encourage misrepresentation, or that result in unfair

28  discrimination in sales practices; or

29         3.  Cannot demonstrate that the health flex plan is

30  financially sound and that the applicant is able to underwrite

31  or finance the health care coverage provided.

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    Florida Senate - 2002                                  SB 1008
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  1         (c)  The agency and the department may adopt rules as

  2  needed to implement this section.

  3         (4)  LICENSE NOT REQUIRED.--Neither the licensing

  4  requirements of the Florida Insurance Code nor chapter 641,

  5  Florida Statutes, relating to health maintenance

  6  organizations, is applicable to a health flex plan approved

  7  under this section, unless expressly made applicable. However,

  8  for the purpose of prohibiting unfair trade practices, health

  9  flex plans are considered to be insurance subject to the

10  applicable provisions of part IX of chapter 626, Florida

11  Statutes, except as otherwise provided in this section.

12         (5)  ELIGIBILITY.--Eligibility to enroll in an approved

13  health flex plan is limited to residents of this state who:

14         (a)  Are 64 years of age or younger;

15         (b)  Have a family income equal to or less than 200

16  percent of the federal poverty level;

17         (c)  Are not covered by a private insurance policy and

18  are not eligible for coverage through a public health

19  insurance program, such as Medicare or Medicaid, or another

20  public health care program, such as KidCare, and have not been

21  covered at any time during the past 6 months; and

22         (d)  Have applied for health care coverage through an

23  approved health flex plan and have agreed to make any payments

24  required for participation, including periodic payments or

25  payments due at the time health care services are provided.

26         (6)  RECORDS.--Each health flex plan shall maintain

27  enrollment data and reasonable records of its losses,

28  expenses, and claims experience and shall make those records

29  reasonably available to enable the department to monitor and

30  determine the financial viability of the health flex plan, as

31  necessary. Provider networks and total enrollment by area

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    Florida Senate - 2002                                  SB 1008
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  1  shall be reported to the agency biannually to enable the

  2  agency to monitor access to care.

  3         (7)  NOTICE.--The denial of coverage by a health flex

  4  plan, or the nonrenewal or cancellation of coverage, must be

  5  accompanied by the specific reasons for denial, nonrenewal, or

  6  cancellation. Notice of nonrenewal or cancellation must be

  7  provided at least 45 days in advance of the nonrenewal or

  8  cancellation, except that 10 days' written notice must be

  9  given for cancellation due to nonpayment of premiums. If the

10  health flex plan fails to give the required notice, the health

11  flex plan coverage must remain in effect until notice is

12  appropriately given.

13         (8)  NONENTITLEMENT.--Coverage under an approved health

14  flex plan is not an entitlement, and a cause of action does

15  not arise against the state, a local government entity, or any

16  other political subdivision of this state, or against the

17  agency, for failure to make coverage available to eligible

18  persons under this section.

19         (9)  PROGRAM EVALUATION.--The agency and the department

20  shall evaluate the pilot program and its effect on the

21  entities that seek approval as health flex plans, the number

22  of enrollees, the scope of health care coverage offered under

23  a health flex plan, and an assessment of the health flex plans

24  and their potential applicability in other settings and shall,

25  by January 1, 2004, jointly submit a report to the Governor,

26  the President of the Senate, and the Speaker of the House of

27  Representatives.

28         (10)  EXPIRATION.--This section expires July 1, 2004.

29         Section 2.  This act shall take effect July 1, 2002.

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    Florida Senate - 2002                                  SB 1008
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  2                          SENATE SUMMARY

  3    Provides for a pilot program for health flex plans for
      certain uninsured persons. Provides legislative findings
  4    and intent and defines terms. Provides criteria for
      approval of health flex plans. Delineates the
  5    responsibilities of the Agency for Health Care
      Administration and the Department of Insurance. Exempts
  6    approved health flex plans from certain regulatory
      requirements. Provides criteria for eligibility to enroll
  7    in a health flex plan. Requires health flex plan entities
      to maintain certain records. Provides requirements for
  8    denial, nonrenewal, or cancellation of coverage.
      Specifies that coverage under an approved health flex
  9    plan is not an entitlement or a basis for legal action.
      Requires an evaluation of the pilot program and a report
10    to the Governor and to legislative leaders.

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