| 1 | A bill to be entitled |
| 2 | An act relating to small employer group health insurance; |
| 3 | amending s. 627.6692, F.S.; providing for a special |
| 4 | election period for continuation of coverage under group |
| 5 | health plans for certain qualified beneficiaries; |
| 6 | providing carrier notification requirements; providing for |
| 7 | effectiveness of such coverage; providing for disregarding |
| 8 | certain periods for which coverage is not provided; |
| 9 | providing an effective date. |
| 10 |
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| 11 | Be It Enacted by the Legislature of the State of Florida: |
| 12 |
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| 13 | Section 1. Paragraphs (d) and (g) of subsection (5) of |
| 14 | section 627.6692, Florida Statutes, are amended to read: |
| 15 | 627.6692 Florida Health Insurance Coverage Continuation |
| 16 | Act.-- |
| 17 | (5) CONTINUATION OF COVERAGE UNDER GROUP HEALTH PLANS.-- |
| 18 | (d)1. A qualified beneficiary must give written notice to |
| 19 | the insurance carrier within 63 days after the occurrence of a |
| 20 | qualifying event. Unless otherwise specified in the notice, a |
| 21 | notice by any qualified beneficiary constitutes notice on behalf |
| 22 | of all qualified beneficiaries. The written notice must inform |
| 23 | the insurance carrier of the occurrence and type of the |
| 24 | qualifying event giving rise to the potential election by a |
| 25 | qualified beneficiary of continuation of coverage under the |
| 26 | group health plan issued by that insurance carrier, except that |
| 27 | in cases where the covered employee has been involuntarily |
| 28 | discharged, the nature of such discharge need not be disclosed. |
| 29 | The written notice must, at a minimum, identify the employer, |
| 30 | the group health plan number, the name and address of all |
| 31 | qualified beneficiaries, and such other information required by |
| 32 | the insurance carrier under the terms of the group health plan |
| 33 | or the commission by rule, to the extent that such information |
| 34 | is known by the qualified beneficiary. |
| 35 | 2. A special election period shall be provided for |
| 36 | qualified beneficiaries whose qualifying event was involuntary |
| 37 | termination of employment during the period from September 1, |
| 38 | 2008, through February 16, 2009, who did not elect continuation |
| 39 | coverage when it was first offered, or who did elect |
| 40 | continuation coverage but are no longer enrolled. The carrier |
| 41 | that issued the small employer's group health plan shall provide |
| 42 | notice to individuals eligible for this special continuation |
| 43 | coverage election period informing them of this opportunity. The |
| 44 | notice must be provided by June 15, 2009. |
| 45 | a. Individuals have 30 days after notice is provided to |
| 46 | elect continuation coverage by written notice to the insurer. |
| 47 | The written notice must, at a minimum, identify the employer, |
| 48 | the group health plan number, the name and address of all |
| 49 | qualified beneficiaries, and such other information required by |
| 50 | the insurance carrier under the terms of the group health plan |
| 51 | or the commission by rule, to the extent that such information |
| 52 | is known by the qualified beneficiary. |
| 53 | b. Coverage shall be effective with the first period of |
| 54 | coverage on or after February 17, 2009. |
| 55 | c. For individuals electing continuation coverage during |
| 56 | this election period, the period between the loss of coverage |
| 57 | and beginning of coverage under this election is to be |
| 58 | disregarded for purposes of determining the 63-day periods |
| 59 | referred to in s. 627.6561(6). |
| 60 | 3.2. Within 14 days after the receipt of written notice |
| 61 | under subparagraphs subparagraph 1. and 2., the insurance |
| 62 | carrier shall send each qualified beneficiary by certified mail |
| 63 | an election and premium notice form, approved by the office, |
| 64 | which form must provide for the qualified beneficiary's election |
| 65 | or nonelection of continuation of coverage under the group |
| 66 | health plan and the applicable premium amount due after the |
| 67 | election to continue coverage. This subparagraph does not |
| 68 | require separate mailing of notices to qualified beneficiaries |
| 69 | residing in the same household, but requires a separate mailing |
| 70 | for each separate household. |
| 71 | (g) If an insurance carrier fails to comply with the |
| 72 | notice requirements of subparagraph (d)3.2. and such |
| 73 | noncompliance results in the failure of an eligible qualified |
| 74 | beneficiary to elect continuation under the group health plan, |
| 75 | the qualified beneficiary shall be deemed to have timely elected |
| 76 | continuation of coverage within the election period and shall be |
| 77 | covered under the group health plan at the expense of the |
| 78 | noncomplying insurance carrier. The liability exposure of a |
| 79 | noncomplying insurance carrier under this paragraph shall be |
| 80 | limited to that period which includes the effective date of |
| 81 | coverage pursuant to an affirmative election through the date on |
| 82 | which the qualified beneficiary receives actual notice. This |
| 83 | paragraph does not apply to the extent that the failure of the |
| 84 | insurance carrier to comply with applicable notice requirements |
| 85 | was due to noncompliance by the qualified beneficiary with |
| 86 | notice requirements applicable to the qualified beneficiary. |
| 87 | Section 2. This act shall take effect upon becoming a law. |