Senate Bill sb1006er

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  2         An act relating to state employee health

  3         insurance; amending s. 110.123, F.S.; revising

  4         the terms of coverage and payment for officers

  5         and employees participating in state employee

  6         group health insurance; amending s. 110.161,

  7         F.S.; providing eligibility for state

  8         universities in the pretax benefits program;

  9         amending s. 1001.74, F.S.; providing

10         eligibility for universities in the pretax

11         benefits program; providing an effective date.

12  

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

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15         Section 1.  Paragraphs (e), (i), and (k) of subsection

16  (2), paragraphs (b), (c), (f), (g), and (h) of subsection (3),

17  paragraphs (c), (d), and (e) of subsection (4), paragraph (d)

18  of subsection (5), and paragraph (b) of subsection (8) of

19  section 110.123, Florida Statutes, are amended to read:

20         110.123  State group insurance program.--

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

22         (e)  "Health plan member" means any person

23  participating in a the state group health insurance plan or in

24  a health maintenance organization plan under the state group

25  insurance program, including enrollees and covered dependents

26  thereof.

27         (i)  "State group health insurance plan or plans" or

28  "state plan or plans" mean means the state self-insured health

29  insurance plan or plans offered to state officers and

30  employees, retired state officers and employees, and surviving

31  


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 1  spouses of deceased state officers and employees pursuant to

 2  this section.

 3         (k)  "State group insurance program" or "programs"

 4  means the package of insurance plans offered to state officers

 5  and employees, retired state officers and employees, and

 6  surviving spouses of deceased state officers and employees

 7  pursuant to this section, including the state group health

 8  insurance plan or plans, health maintenance organization

 9  plans, and other plans required or authorized by law this

10  section.

11         (3)  STATE GROUP INSURANCE PROGRAM.--

12         (b)  It is the intent of the Legislature to offer a

13  comprehensive package of health insurance and retirement

14  benefits and a personnel system for state employees which are

15  provided in a cost-efficient and prudent manner, and to allow

16  state employees the option to choose benefit plans which best

17  suit their individual needs. Therefore, the state group

18  insurance program is established which may include the state

19  group health insurance plan or plans, health maintenance

20  organization plans, group life insurance plans, group

21  accidental death and dismemberment plans, and group disability

22  insurance plans. Furthermore, the department is additionally

23  authorized to establish and provide as part of the state group

24  insurance program any other group insurance plans or coverage

25  choices that which are consistent with the provisions of this

26  section.

27         (c)  Notwithstanding any provision in this section to

28  the contrary, it is the intent of the Legislature that the

29  department shall be responsible for all aspects of the

30  purchase of health care for state employees under the state

31  group health insurance plan or plans and the health


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 1  maintenance organization plans. Responsibilities shall

 2  include, but not be limited to, the development of requests

 3  for proposals or invitations to negotiate for state employee

 4  health services, the determination of health care benefits to

 5  be provided, and the negotiation of contracts for health care

 6  and health care administrative services.  Prior to the

 7  negotiation of contracts for health care services, the

 8  Legislature intends that the department shall develop, with

 9  respect to state collective bargaining issues, the health

10  benefits and terms to be included in the state group health

11  insurance program. The department shall adopt rules necessary

12  to perform its responsibilities pursuant to this section.  It

13  is the intent of the Legislature that the department shall be

14  responsible for the contract management and day-to-day

15  management of the state employee health insurance program,

16  including, but not limited to, employee enrollment, premium

17  collection, payment to health care providers, and other

18  administrative functions related to the program.

19         (f)  Except as provided for in subparagraph (h)2., the

20  percentage of state contribution toward the cost of any plan

21  in the state group insurance program shall be uniform with

22  respect to all state employees in a state collective

23  bargaining unit units participating in the same coverage tier

24  in the same plan or any similar plan. Nothing contained within

25  this section prohibits the development of separate benefit

26  plans for officers and employees exempt from the career

27  service collective bargaining or the development of separate

28  benefit plans for each collective bargaining unit.

29         (g)  Participation by individuals in the program shall

30  be available to all state officers, full-time state employees,

31  and part-time state employees; and such participation in the


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 1  program or any plan thereof shall be voluntary. Participation

 2  in the program shall also be available to retired state

 3  officers and employees, as defined in paragraph (2)(g), who

 4  elect at the time of retirement to continue coverage under the

 5  program, but they may elect to continue all or only part of

 6  the coverage they had at the time of retirement. A surviving

 7  spouse may elect to continue coverage only under a the state

 8  group health insurance plan or a health maintenance

 9  organization plan.

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

11  group insurance program may be authorized by rules adopted by

12  the department, in lieu of participating in the state group

13  health insurance plan, to exercise an option to elect

14  membership in a health maintenance organization plan which is

15  under contract with the state in accordance with criteria

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

17  optional membership in a health maintenance organization plan

18  permitted by this paragraph may be limited or conditioned by

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

20  federal laws.

21         2.  The department shall contract with health

22  maintenance organizations seeking to participate in the state

23  group insurance program through a request for proposal or

24  other procurement process, as developed by the Department of

25  Management Services and determined to be appropriate.

26         a.  The department shall establish a schedule of

27  minimum benefits for health maintenance organization coverage,

28  and that schedule shall include: physician services; inpatient

29  and outpatient hospital services; emergency medical services,

30  including out-of-area emergency coverage; diagnostic

31  laboratory and diagnostic and therapeutic radiologic services;


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 1  mental health, alcohol, and chemical dependency treatment

 2  services meeting the minimum requirements of state and federal

 3  law; skilled nursing facilities and services; prescription

 4  drugs; age-based and gender-based wellness benefits; and other

 5  benefits as may be required by the department.  Additional

 6  services may be provided subject to the contract between the

 7  department and the HMO.

 8         b.  The department may establish uniform deductibles,

 9  copayments, coverage tiers, or coinsurance schedules for all

10  participating HMO plans.

11         c.  The department may require detailed information

12  from each health maintenance organization participating in the

13  procurement process, including information pertaining to

14  organizational status, experience in providing prepaid health

15  benefits, accessibility of services, financial stability of

16  the plan, quality of management services, accreditation

17  status, quality of medical services, network access and

18  adequacy, performance measurement, ability to meet the

19  department's reporting requirements, and the actuarial basis

20  of the proposed rates and other data determined by the

21  director to be necessary for the evaluation and selection of

22  health maintenance organization plans and negotiation of

23  appropriate rates for these plans.  Upon receipt of proposals

24  by health maintenance organization plans and the evaluation of

25  those proposals, the department may enter into negotiations

26  with all of the plans or a subset of the plans, as the

27  department determines appropriate. Nothing shall preclude the

28  department from negotiating regional or statewide contracts

29  with health maintenance organization plans when this is

30  cost-effective and when the department determines that the

31  plan offers high value to enrollees.


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 1         d.  The department may limit the number of HMOs that it

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

 3  bids the department receives, the number of state employees in

 4  the service area, or any unique geographical characteristics

 5  of the service area. The department shall establish by rule

 6  service areas throughout the state.

 7         e.  All persons participating in the state group

 8  insurance program may be who are required to contribute

 9  towards a total state group health premium that may vary

10  depending upon the plan and coverage tier selected by the

11  enrollee and the level of state contribution authorized by the

12  Legislature shall be subject to the same dollar contribution

13  regardless of whether the enrollee enrolls in the state group

14  health insurance plan or in an HMO plan.

15         3.  The department is authorized to negotiate and to

16  contract with specialty psychiatric hospitals for mental

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

18  and mental and nervous disorders. The department may

19  establish, subject to the approval of the Legislature pursuant

20  to subsection (5), any such regional plan upon completion of

21  an actuarial study to determine any impact on plan benefits

22  and premiums.

23         4.  In addition to contracting pursuant to subparagraph

24  2., the department may shall enter into contract with any HMO

25  to participate in the state group insurance program which:

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

27  basis under the Medicaid program;

28         b.  Does not currently meet the 25-percent

29  non-Medicare/non-Medicaid enrollment composition requirement

30  established by the Department of Health excluding participants

31  enrolled in the state group insurance program;


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 1         c.  Meets the minimum benefit package and copayments

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

 3         d.  Is willing to participate in the state group

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

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

 6  department in each service area; and

 7         e.  Meets the minimum surplus requirements of s.

 8  641.225.

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10  The department is authorized to contract with HMOs that meet

11  the requirements of sub-subparagraphs a.-d. prior to the open

12  enrollment period for state employees.  The department is not

13  required to renew the contract with the HMOs as set forth in

14  this paragraph more than twice. Thereafter, the HMOs shall be

15  eligible to participate in the state group insurance program

16  only through the request for proposal or invitation to

17  negotiate process described in subparagraph 2.

18         5.  All enrollees in a the state group health insurance

19  plan or any health maintenance organization plan shall have

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

21  offered by the state within any open enrollment period

22  designated by the department. Open enrollment shall be held at

23  least once each calendar year.

24         6.  When a contract between a treating provider and the

25  state-contracted health maintenance organization is terminated

26  for any reason other than for cause, each party shall allow

27  any enrollee for whom treatment was active to continue

28  coverage and care when medically necessary, through completion

29  of treatment of a condition for which the enrollee was

30  receiving care at the time of the termination, until the

31  enrollee selects another treating provider, or until the next


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 1  open enrollment period offered, whichever is longer, but no

 2  longer than 6 months after termination of the contract. Each

 3  party to the terminated contract shall allow an enrollee who

 4  has initiated a course of prenatal care, regardless of the

 5  trimester in which care was initiated, to continue care and

 6  coverage until completion of postpartum care. This does not

 7  prevent a provider from refusing to continue to provide care

 8  to an enrollee who is abusive, noncompliant, or in arrears in

 9  payments for services provided. For care continued under this

10  subparagraph, the program and the provider shall continue to

11  be bound by the terms of the terminated contract. Changes made

12  within 30 days before termination of a contract are effective

13  only if agreed to by both parties.

14         7.  Any HMO participating in the state group insurance

15  program shall submit health care utilization and cost data to

16  the department, in such form and in such manner as the

17  department shall require, as a condition of participating in

18  the program.  The department shall enter into negotiations

19  with its contracting HMOs to determine the nature and scope of

20  the data submission and the final requirements, format,

21  penalties associated with noncompliance, and timetables for

22  submission.  These determinations shall be adopted by rule.

23         8.  The department may establish and direct, with

24  respect to collective bargaining issues, a comprehensive

25  package of insurance benefits that may include supplemental

26  health and life coverage, dental care, long-term care, vision

27  care, and other benefits it determines necessary to enable

28  state employees to select from among benefit options that best

29  suit their individual and family needs.

30         a.  Based upon a desired benefit package, the

31  department shall issue a request for proposal or invitation to


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 1  negotiate for health insurance providers interested in

 2  participating in the state group insurance program, and the

 3  department shall issue a request for proposal or invitation to

 4  negotiate for insurance providers interested in participating

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

 6  insurance program. Upon receipt of all proposals, the

 7  department may enter into contract negotiations with insurance

 8  providers submitting bids or negotiate a specially designed

 9  benefit package. Insurance providers offering or providing

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

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

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

13  currently enrolled may be included by the department in the

14  supplemental insurance benefit plan established by the

15  department without participating in a request for proposal,

16  submitting bids, negotiating contracts, or negotiating a

17  specially designed benefit package. These contracts shall

18  provide state employees with the most cost-effective and

19  comprehensive coverage available; however, no state or agency

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

21  premium of such supplemental benefit plans. With respect to

22  dental coverage, the division shall include in any

23  solicitation or contract for any state group dental program

24  made after July 1, 2001, a comprehensive indemnity dental plan

25  option which offers enrollees a completely unrestricted choice

26  of dentists. If a dental plan is endorsed, or in some manner

27  recognized as the preferred product, such plan shall include a

28  comprehensive indemnity dental plan option which provides

29  enrollees with a completely unrestricted choice of dentists.

30         b.  Pursuant to the applicable provisions of s.

31  110.161, and s. 125 of the Internal Revenue Code of 1986, the


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 1  department shall enroll in the pretax benefit program those

 2  state employees who voluntarily elect coverage in any of the

 3  supplemental insurance benefit plans as provided by

 4  sub-subparagraph a.

 5         c.  Nothing herein contained shall be construed to

 6  prohibit insurance providers from continuing to provide or

 7  offer supplemental benefit coverage to state employees as

 8  provided under existing agency plans.

 9         (4)  PAYMENT OF PREMIUMS; CONTRIBUTION BY STATE;

10  LIMITATION ON ACTIONS TO PAY AND COLLECT PREMIUMS.--

11         (c)  During each policy or budget year, no state agency

12  shall contribute a greater dollar amount percentage of the

13  premium cost for its officers or employees for any plan option

14  type of coverage under the state group insurance program than

15  any other agency for similar officers and employees, nor shall

16  any greater dollar amount percentage contribution of premium

17  cost be made for employees in one state collective bargaining

18  unit than for those in any other state collective bargaining

19  unit. Nothing in this section prohibits the use of different

20  levels of state contributions for positions exempt from career

21  service.

22         (d)  The state contribution for a part-time permanent

23  state employee who elects to participate in the program shall

24  be prorated so that the amount percentage of the cost

25  contributed for the part-time permanent employee bears that

26  relation to the amount percentage of cost contributed for a

27  similar full-time employee that the part-time employee's

28  normal workday bears to a full-time employee's normal workday.

29         (e)  No state contribution for the cost of any part of

30  the premium shall be made for retirees or surviving spouses

31  for any type of coverage under the state group insurance


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 1  program. However, any state agency that employs a full-time

 2  law enforcement officer, correctional officer, or correctional

 3  probation officer who is killed or suffers catastrophic injury

 4  in the line of duty as provided in s. 112.19, or a full-time

 5  firefighter who is killed or suffers catastrophic injury in

 6  the line of duty as provided in s. 112.191, shall pay the

 7  entire premium of the state group health insurance plan

 8  selected for the employee's surviving spouse until remarried,

 9  and for each dependent child of the employee, subject to the

10  conditions and limitations set forth in s. 112.19 or s.

11  112.191, as applicable.

12         (5)  DEPARTMENT POWERS AND DUTIES.--The department is

13  responsible for the administration of the state group

14  insurance program.  The department shall initiate and

15  supervise the program as established by this section and shall

16  adopt such rules as are necessary to perform its

17  responsibilities.  To implement this program, the department

18  shall, with prior approval by the Legislature:

19         (d)  With respect to a the state group health insurance

20  plan, be authorized to require copayments with respect to all

21  providers under the plan.

22  

23  Final decisions concerning enrollment, the existence of

24  coverage, or covered benefits under the state group insurance

25  program shall not be delegated or deemed to have been

26  delegated by the department.

27         (8)  COVERAGE FOR LEGISLATIVE MEMBERS AND EMPLOYEES.--

28         (b)  Effective July 1, 1999, any legislative member who

29  terminates his or her elected service after July 1, 1999,

30  after having vested in the state retirement system, may

31  purchase coverage in a the state group health insurance plan


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 1  at the same premium cost as that for retirees and surviving

 2  spouses. Such legislators may also elect to continue coverage

 3  under the group term life insurance program prevailing for

 4  current members at the premium cost in effect for that plan.

 5         Section 2.  Subsection (2) of section 110.161, Florida

 6  Statutes, is amended to read:

 7         110.161  State employees; pretax benefits program.--

 8         (2)  As used in this section, "employee" means any

 9  individual filling an authorized and established position in

10  the executive, legislative, or judicial branch of the state,

11  including the employees of the State Board of Administration

12  and the state universities.

13         Section 3.  Subsection (19) of section 1001.74, Florida

14  Statutes, is amended to read:

15         1001.74  Powers and duties of university boards of

16  trustees.--

17         (19)  Each board of trustees shall establish the

18  personnel program for all employees of the university,

19  including the president, pursuant to the provisions of chapter

20  1012 and, in accordance with rules and guidelines of the State

21  Board of Education, including: compensation and other

22  conditions of employment, recruitment and selection,

23  nonreappointment, standards for performance and conduct,

24  evaluation, benefits and hours of work, leave policies,

25  recognition and awards, inventions and works, travel, learning

26  opportunities, exchange programs, academic freedom and

27  responsibility, promotion, assignment, demotion, transfer,

28  tenure and permanent status, ethical obligations and conflicts

29  of interest, restrictive covenants, disciplinary actions,

30  complaints, appeals and grievance procedures, and separation

31  and termination from employment. The Department of Management


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 1  Services shall retain authority over state university

 2  employees for programs established in ss. 110.123, 110.161,

 3  110.1232, 110.1234, and 110.1238 and in chapters 121, 122, and

 4  238.

 5         Section 4.  This act shall take effect July 1, 2003.

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