Florida Senate - 2007 SENATOR AMENDMENT
Bill No. HB 7087, 2nd Eng.
Barcode 244664
CHAMBER ACTION
Senate House
.
.
1 .
.
2 .
.
3 Floor: WD/2R .
05/03/2007 12:55 PM .
4 ______________________________________________________________
5
6
7
8
9
10 ______________________________________________________________
11 Senator Wise moved the following amendment:
12
13 Senate Amendment (with title amendment)
14 On line 53,
15
16 insert:
17 Section 1. Effective July 1, 2007, subsection (5) of
18 section 408.909, Florida Statutes, is amended, and paragraph
19 (d) is added to subsection (3) of that section, to read:
20 408.909 Health flex plans.--
21 (3) PROGRAM.--The agency and the office shall each
22 approve or disapprove health flex plans that provide health
23 care coverage for eligible participants. A health flex plan
24 may limit or exclude benefits otherwise required by law for
25 insurers offering coverage in this state, may cap the total
26 amount of claims paid per year per enrollee, may limit the
27 number of enrollees, or may take any combination of those
28 actions. A health flex plan offering may include the option of
29 a catastrophic plan supplementing the health flex plan.
30 (d) In order to expedite financial determinations and
31 immediately qualify a large base of eligible entities to offer
1
3:34 PM 05/02/07 h708702e2c-05-r9j
Florida Senate - 2007 SENATOR AMENDMENT
Bill No. HB 7087, 2nd Eng.
Barcode 244664
1 health flex plans, health insurers licensed under chapters 624
2 and 627, fraternal benefit societies licensed under chapter
3 632, prepaid limited health service organizations licensed
4 under chapter 636, health maintenance organizations licensed
5 under part I of chapter 641, prepaid health clinics licensed
6 under part II of chapter 641, and hospital-owned provider
7 service networks authorized under chapter 409 shall be deemed
8 in compliance with the financial requirements to offer a
9 health flex plan. In addition, any local government or health
10 care district that has the initial operating funds and taxing
11 authority to fulfill its obligations under the proposed health
12 flex plan shall be deemed in compliance with the financial
13 requirements to offer a health flex plan.
14 (5) ELIGIBILITY.--Eligibility to enroll in an approved
15 health flex plan is limited to residents of this state who:
16 (a) Are 64 years of age or younger;
17 (b) Have a family income equal to or less than 250 200
18 percent of the federal poverty level;
19 (c) Are eligible under a federally approved Medicaid
20 demonstration waiver and reside in Palm Beach County or
21 Miami-Dade County;
22 (d) Are not covered by a private insurance policy and
23 are not eligible for coverage through a public health
24 insurance program, such as Medicare or Medicaid, unless
25 specifically authorized under paragraph (c), or another public
26 health care program, such as Kidcare, and have not been
27 covered at any time during the past 6 months; and
28 (d)(e) Have applied for health care coverage through
29 an approved health flex plan and have agreed to make any
30 payments required for participation, including periodic
31 payments or payments due at the time health care services are
2
3:34 PM 05/02/07 h708702e2c-05-r9j
Florida Senate - 2007 SENATOR AMENDMENT
Bill No. HB 7087, 2nd Eng.
Barcode 244664
1 provided; and
2 (e) Are either:
3 1. Not covered by a private insurance policy and not
4 eligible for coverage through a public health insurance
5 program, such as Medicare or Medicaid, unless specifically
6 authorized under paragraph (c), or another public health care
7 program, such as Kidcare, and have not been covered at any
8 time during the past 6 months; or
9 2. Part of an employer group that is not covered by a
10 private health insurance policy and has not been covered at
11 any time during the past 6 months and in which at least 75
12 percent of the employees have a family income equal to or less
13 than 250 percent of the federal poverty level. If the health
14 flex plan entity is a properly licensed health insurer, health
15 plan, or health maintenance organization, this subparagraph
16 applies when only 50 percent of the employees have a family
17 income equal to or less than 250 percent of the federal
18 poverty level.
19
20 (Redesignate subsequent sections.)
21
22
23 ================ T I T L E A M E N D M E N T ===============
24 And the title is amended as follows:
25 On line 2, after the semicolon,
26
27 insert:
28 amending s. 408.909, F.S.; clarifying licensure
29 provisions for health flex plans; revising
30 criteria for eligibility for enrollment in a
31 health flex plan;
3
3:34 PM 05/02/07 h708702e2c-05-r9j