Florida Senate - 2007                        SENATOR AMENDMENT
    Bill No. HB 7087, 2nd Eng.
                        Barcode 244664
                            CHAMBER ACTION
              Senate                               House
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 3         Floor: WD/2R            .                    
       05/03/2007 12:55 PM         .                    
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11  Senator Wise moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On line 53,
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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
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    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