Senate Bill sb1744

    Florida Senate - 2004                                  SB 1744

    By Senator Peaden





    2-962-04

  1                      A bill to be entitled

  2         An act relating to health flex plans; amending

  3         s. 408.909, F.S.; expanding a pilot program to

  4         provide for the establishment of health flex

  5         plans statewide by the Agency for Health Care

  6         Administration and the Office of Insurance

  7         Regulation of the Financial Services

  8         Commission; authorizing the agency and the

  9         commission to adopt rules; providing an

10         effective date.

11  

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

13  

14         Section 1.  Subsection (3) of section 408.909, Florida

15  Statutes, is amended to read:

16         408.909  Health flex plans.--

17         (3)  HEALTH FLEX PILOT PROGRAM.--The agency and the

18  office shall each approve or disapprove health flex plans that

19  provide health care coverage for eligible participants who

20  reside in the three areas of the state that have the highest

21  number of uninsured persons, as identified in the Florida

22  Health Insurance Study conducted by the agency and in Indian

23  River County. A health flex plan may limit or exclude benefits

24  otherwise required by law for insurers offering coverage in

25  this state, may cap the total amount of claims paid per year

26  per enrollee, may limit the number of enrollees, or may take

27  any combination of those actions.

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

29  of applications for health flex plans and shall disapprove or

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

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

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 1744
    2-962-04




 1         (b)  The office shall develop guidelines for the review

 2  of health flex plan applications and shall disapprove or shall

 3  withdraw approval of plans that:

 4         1.  Contain any ambiguous, inconsistent, or misleading

 5  provisions or any exceptions or conditions that deceptively

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

 7  general coverage provided by the health flex plan;

 8         2.  Provide benefits that are unreasonable in relation

 9  to the premium charged or contain provisions that are unfair

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

11  that encourage misrepresentation, or that result in unfair

12  discrimination in sales practices; or

13         3.  Cannot demonstrate that the health flex plan is

14  financially sound and that the applicant is able to underwrite

15  or finance the health care coverage provided.

16         (c)  The agency and the Financial Services Commission

17  may adopt rules as needed to administer this section.

18         Section 2.  This act shall take effect upon becoming a

19  law.

20  

21            *****************************************

22                          SENATE SUMMARY

23    Provides for the statewide establishment of health flex
      plans by the Agency for Health Care Administration and
24    the Office of Insurance Regulation of the Financial
      Services Commission.
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CODING: Words stricken are deletions; words underlined are additions.