Senate Bill sb2264
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Florida Senate - 2003 SB 2264
By Senator Atwater
25-823A-03
1 A bill to be entitled
2 An act relating to health insurance; amending
3 s. 627.6515, F.S.; amending conditions that
4 must be met to exempt from part VII of ch. 627,
5 F.S., a group health insurance policy issued or
6 delivered outside this state under which a
7 resident of this state is provided coverage;
8 providing rulemaking authority; providing an
9 effective date.
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11 Be It Enacted by the Legislature of the State of Florida:
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13 Section 1. Subsection (2) of section 627.6515, Florida
14 Statutes, is amended, and subsection (9) is added to that
15 section, to read:
16 627.6515 Out-of-state groups.--
17 (2) Except as provided in this part, this part does
18 not apply to a group health insurance policy issued or
19 delivered outside this state under which a resident of this
20 state is provided coverage if:
21 (a) The policy is issued to an employee group the
22 composition of which is substantially as described in s.
23 627.653; a labor union group or association group the
24 composition of which is substantially as described in s.
25 627.654; an additional group the composition of which is
26 substantially as described in s. 627.656; a group insured
27 under a blanket health policy when the composition of the
28 group is substantially in compliance with s. 627.659; a group
29 insured under a franchise health policy when the composition
30 of the group is substantially in compliance with s. 627.663;
31 an association group to cover persons associated in any other
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Florida Senate - 2003 SB 2264
25-823A-03
1 common group, which common group is formed primarily for
2 purposes other than providing insurance; a group that is
3 established primarily for the purpose of providing group
4 insurance, provided the benefits are reasonable in relation to
5 the premiums charged thereunder and the issuance of the group
6 policy has resulted, or will result, in economies of
7 administration; or a group of insurance agents of an insurer,
8 which insurer is the policyholder;
9 (b) Certificates evidencing coverage under the policy
10 are issued to residents of this state and contain in
11 contrasting color and not less than 10-point type the
12 following statement: "The benefits of the policy providing
13 your coverage are governed primarily by the law of a state
14 other than Florida"; and
15 (c) The policy provides the benefits specified in ss.
16 627.419, 627.6574, 627.6575, 627.6579, 627.6612, 627.66121,
17 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and
18 627.66911, and, regardless of what type of group described in
19 this subsection the policy is issued to, the policy complies
20 with the antidiscrimination provisions set forth in s.
21 627.65625, regarding rating and eligibility for enrollment and
22 for any benefit under the policy, and with s. 627.6571; and.
23 (d) The policy is not issued to a group that directly
24 or indirectly uses any factor related to health status in
25 determining eligibility for initial or continued membership in
26 the group or initial or continued eligibility of any group
27 member to participate in any aspect of the group insurance
28 program. This paragraph does not apply to policies that
29 provide coverage only to employers for the benefit of their
30 employees.
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Florida Senate - 2003 SB 2264
25-823A-03
1 (9) The Office of Insurance Regulation shall adopt
2 rules necessary to administer this section.
3 Section 2. This act shall take effect July 1, 2003.
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5 *****************************************
6 SENATE SUMMARY
7 Amends the list of conditions that must be met to exempt
from pt. VII of ch. 627, F.S., a group health insurance
8 policy issued or delivered outside this state under which
a resident of this state is provided coverage. Provides
9 rulemaking authority to the Office of Insurance
Regulation.
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