CS/CS/HB 1401

1
A bill to be entitled
2An act relating to access to health care; amending s.
3408.909, F.S.; clarifying licensure provisions for health
4flex plans; revising criteria for eligibility for
5enrollment in a health flex plan; creating s. 445.015,
6F.S.; establishing a small business health insurance plan
7grant program; providing purposes of the grant program;
8providing conditions for use of grant funds; providing
9duties of the Agency for Workforce Innovation and the
10Office of Insurance Regulation; requiring a report to the
11Governor and Legislature; providing an appropriation;
12providing an effective date.
13
14Be It Enacted by the Legislature of the State of Florida:
15
16     Section 1.  Subsection (5) of section 408.909, Florida
17Statutes, 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
21or disapprove health flex plans that provide health care
22coverage for eligible participants. A health flex plan may limit
23or exclude benefits otherwise required by law for insurers
24offering coverage in this state, may cap the total amount of
25claims paid per year per enrollee, may limit the number of
26enrollees, or may take any combination of those actions. A
27health flex plan offering may include the option of a
28catastrophic plan supplementing the health flex plan.
29     (d)  In order to expedite financial determinations and
30immediately qualify a large base of eligible entities to offer
31health flex plans, entities licensed under chapter 624, chapter
32627, chapter 632, chapter 636, or chapter 641 and provider
33service networks authorized under chapter 409 shall be deemed in
34compliance with the financial requirements to offer a health
35flex plan. In addition, any local government or health care
36district that has the initial operating funds and taxing
37authority to fulfill its obligations under the proposed health
38flex plan shall be deemed in compliance with the financial
39requirements to offer a health flex plan.
40     (5)  ELIGIBILITY.--Eligibility to enroll in an approved
41health 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
44percent of the federal poverty level;
45     (c)  Are eligible under a federally approved Medicaid
46demonstration waiver and reside in Palm Beach County or Miami-
47Dade County;
48     (d)  Are not covered by a private insurance policy and are
49not eligible for coverage through a public health insurance
50program, such as Medicare or Medicaid, unless specifically
51authorized under paragraph (c), or another public health care
52program, such as Kidcare, and have not been covered at any time
53during the past 6 months; and
54     (d)(e)  Have applied for health care coverage through an
55approved health flex plan and have agreed to make any payments
56required for participation, including periodic payments or
57payments 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
60eligible for coverage through a public health insurance program,
61such as Medicare or Medicaid, unless specifically authorized
62under paragraph (c), or another public health care program, such
63as Kidcare, and have not been covered at any time during the
64past 6 months; or
65     2.  Part of an employer group that is not covered by a
66private health insurance policy and has not been covered at any
67time during the past 6 months and in which at least 75 percent
68of the employees have a family income equal to or less than 250
69percent of the federal poverty level. If the health flex plan
70entity is a properly licensed health insurer, health plan, or
71health maintenance organization, this subparagraph applies when
72only 50 percent of the employees have a family income equal to
73or less than 250 percent of the federal poverty level.
74     Section 2.  Section 445.015, Florida Statutes, is created
75to read:
76     445.015  Small business health insurance plan grant
77program.--
78     (1)  The agency shall establish a small business health
79insurance plan grant program to award, administer, and monitor
80grants to small employers and small businesses to develop and
81offer cafeteria health plans that qualify under s. 125 of the
82Internal Revenue Code and include options such as prepaid health
83clinic services licensed under part II of chapter 641 for the
84purpose of improving access to health insurance for uninsured
85employees. The agency shall give priority to employer proposals
86that would improve access for previously uninsured employees or
87include long-term commitments to insure employees. Grant funds
88shall not be used for ongoing maintenance of the plans or for
89employer contributions. Health plans may identify and assist
90eligible small employers and small businesses in obtaining
91grants. The agency, in consultation with the Office of Insurance
92Regulation, shall evaluate each project funded by a grant to
93measure any increases in access to insurance and the long-term
94viability of such increases. The agency shall design materials
95and interactive programs to inform small employers and small
96businesses about such cafeteria health plans and shall provide
97training to assist small employers and small businesses in
98developing such plans. Training shall include technical
99assistance in establishing relationships with health plans and
100individualized guidance on operational methods and
101infrastructure that will best support and ensure the long-term
102success of using these plans.
103     (2)  The agency shall submit a report that documents the
104specific activities undertaken during the fiscal year pursuant
105to this section annually to the Governor, the President of the
106Senate, and the Speaker of the House of Representatives no later
107than February 1.
108     Section 3.  The sum of $250,000 in nonrecurring revenue is
109appropriated from the General Revenue Fund to the Agency for
110Workforce Innovation for the 2007-2008 fiscal year to award
111Small Business Health Insurance Plan Grants to eligible
112businesses.
113     Section 4.  This act shall take effect July 1, 2007.


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