1 | A bill to be entitled |
2 | An act relating to access to health care; amending s. |
3 | 408.909, F.S.; clarifying licensure provisions for health |
4 | flex plans; revising criteria for eligibility for |
5 | enrollment in a health flex plan; creating s. 445.015, |
6 | F.S.; establishing a small business health insurance plan |
7 | grant program; providing purposes of the grant program; |
8 | providing conditions for use of grant funds; providing |
9 | duties of the Agency for Workforce Innovation and the |
10 | Office of Insurance Regulation; requiring a report to the |
11 | Governor and Legislature; providing an appropriation; |
12 | providing an effective date. |
13 |
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14 | Be It Enacted by the Legislature of the State of Florida: |
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16 | Section 1. Subsection (5) of section 408.909, Florida |
17 | Statutes, is amended, and paragraph (d) is added to subsection |
18 | (3) of that section, to read: |
19 | 408.909 Health flex plans.-- |
20 | (3) PROGRAM.--The agency and the office shall each approve |
21 | or disapprove health flex plans that provide health care |
22 | coverage for eligible participants. A health flex plan may limit |
23 | or exclude benefits otherwise required by law for insurers |
24 | offering coverage in this state, may cap the total amount of |
25 | claims paid per year per enrollee, may limit the number of |
26 | enrollees, or may take any combination of those actions. A |
27 | health flex plan offering may include the option of a |
28 | catastrophic plan supplementing the health flex plan. |
29 | (d) In order to expedite financial determinations and |
30 | immediately qualify a large base of eligible entities to offer |
31 | health flex plans, entities licensed under chapter 624, chapter |
32 | 627, chapter 632, chapter 636, or chapter 641 and provider |
33 | service networks authorized under chapter 409 shall be deemed in |
34 | compliance with the financial requirements to offer a health |
35 | flex plan. In addition, any local government or health care |
36 | district that has the initial operating funds and taxing |
37 | authority to fulfill its obligations under the proposed health |
38 | flex plan shall be deemed in compliance with the financial |
39 | requirements to offer a health flex plan. |
40 | (5) ELIGIBILITY.--Eligibility to enroll in an approved |
41 | health flex plan is limited to residents of this state who: |
42 | (a) Are 64 years of age or younger; |
43 | (b) Have a family income equal to or less than 250 200 |
44 | percent of the federal poverty level; |
45 | (c) Are eligible under a federally approved Medicaid |
46 | demonstration waiver and reside in Palm Beach County or Miami- |
47 | Dade County; |
48 | (d) Are not covered by a private insurance policy and are |
49 | not eligible for coverage through a public health insurance |
50 | program, such as Medicare or Medicaid, unless specifically |
51 | authorized under paragraph (c), or another public health care |
52 | program, such as Kidcare, and have not been covered at any time |
53 | during the past 6 months; and |
54 | (d)(e) Have applied for health care coverage through an |
55 | approved health flex plan and have agreed to make any payments |
56 | required for participation, including periodic payments or |
57 | payments due at the time health care services are provided; and |
58 | (e) Are either: |
59 | 1. Not covered by a private insurance policy and not |
60 | eligible for coverage through a public health insurance program, |
61 | such as Medicare or Medicaid, unless specifically authorized |
62 | under paragraph (c), or another public health care program, such |
63 | as Kidcare, and have not been covered at any time during the |
64 | past 6 months; or |
65 | 2. Part of an employer group that is not covered by a |
66 | private health insurance policy and has not been covered at any |
67 | time during the past 6 months and in which at least 75 percent |
68 | of the employees have a family income equal to or less than 250 |
69 | percent of the federal poverty level. If the health flex plan |
70 | entity is a properly licensed health insurer, health plan, or |
71 | health maintenance organization, this subparagraph applies when |
72 | only 50 percent of the employees have a family income equal to |
73 | or less than 250 percent of the federal poverty level. |
74 | Section 2. Section 445.015, Florida Statutes, is created |
75 | to read: |
76 | 445.015 Small business health insurance plan grant |
77 | program.-- |
78 | (1) The agency shall establish a small business health |
79 | insurance plan grant program to award, administer, and monitor |
80 | grants to small employers and small businesses to develop and |
81 | offer cafeteria health plans that qualify under s. 125 of the |
82 | Internal Revenue Code and include options such as prepaid health |
83 | clinic services licensed under part II of chapter 641 for the |
84 | purpose of improving access to health insurance for uninsured |
85 | employees. The agency shall give priority to employer proposals |
86 | that would improve access for previously uninsured employees or |
87 | include long-term commitments to insure employees. Grant funds |
88 | shall not be used for ongoing maintenance of the plans or for |
89 | employer contributions. Health plans may identify and assist |
90 | eligible small employers and small businesses in obtaining |
91 | grants. The agency, in consultation with the Office of Insurance |
92 | Regulation, shall evaluate each project funded by a grant to |
93 | measure any increases in access to insurance and the long-term |
94 | viability of such increases. The agency shall design materials |
95 | and interactive programs to inform small employers and small |
96 | businesses about such cafeteria health plans and shall provide |
97 | training to assist small employers and small businesses in |
98 | developing such plans. Training shall include technical |
99 | assistance in establishing relationships with health plans and |
100 | individualized guidance on operational methods and |
101 | infrastructure that will best support and ensure the long-term |
102 | success of using these plans. |
103 | (2) The agency shall submit a report that documents the |
104 | specific activities undertaken during the fiscal year pursuant |
105 | to this section annually to the Governor, the President of the |
106 | Senate, and the Speaker of the House of Representatives no later |
107 | than February 1. |
108 | Section 3. The sum of $250,000 in nonrecurring revenue is |
109 | appropriated from the General Revenue Fund to the Agency for |
110 | Workforce Innovation for the 2007-2008 fiscal year to award |
111 | Small Business Health Insurance Plan Grants to eligible |
112 | businesses. |
113 | Section 4. This act shall take effect July 1, 2007. |