HB 7151

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	amending s. 627.6699, F.S.; requiring small employer
10	carriers to use a uniform employee health status form;
11	requiring the Financial Services Commission to adopt
12	rules; requiring the Office of Insurance Regulation to
13	design the form in consultation with small employer
14	carriers; specifying form requirements; providing an
15	effective date.
16
17	Be It Enacted by the Legislature of the State of Florida:
18
19	Section 1.  Paragraphs (d) and (g) of subsection (5) of
20	section 627.6692, Florida Statutes, are amended to read:
21	627.6692  Florida Health Insurance Coverage Continuation
22	Act.--
23	(5)  CONTINUATION OF COVERAGE UNDER GROUP HEALTH PLANS.--
24	(d)1.  A qualified beneficiary must give written notice to
25	the insurance carrier within 63 days after the occurrence of a
26	qualifying event. Unless otherwise specified in the notice, a
27	notice by any qualified beneficiary constitutes notice on behalf
28	of all qualified beneficiaries. The written notice must inform
29	the insurance carrier of the occurrence and type of the
30	qualifying event giving rise to the potential election by a
31	qualified beneficiary of continuation of coverage under the
32	group health plan issued by that insurance carrier, except that
33	in cases where the covered employee has been involuntarily
34	discharged, the nature of such discharge need not be disclosed.
35	The written notice must, at a minimum, identify the employer,
36	the group health plan number, the name and address of all
37	qualified beneficiaries, and such other information required by
38	the insurance carrier under the terms of the group health plan
39	or the commission by rule, to the extent that such information
40	is known by the qualified beneficiary.
41	2.  A special election period shall be provided for
42	qualified beneficiaries whose qualifying event was involuntary
43	termination of employment during the period from September 1,
44	2008, through February 16, 2009, who did not elect continuation
45	coverage when it was first offered, or who did elect
46	continuation coverage but are no longer enrolled. The carrier
47	that issued the small employer's group health plan shall provide
48	notice to individuals eligible for this special continuation
49	coverage election period informing them of this opportunity. The
50	notice must be provided by June 15, 2009.
51	a.  Individuals have 30 days after notice is provided to
52	elect continuation coverage by written notice to the insurer.
53	The written notice must, at a minimum, identify the employer,
54	the group health plan number, the name and address of all
55	qualified beneficiaries, and such other information required by
56	the insurance carrier under the terms of the group health plan
57	or the commission by rule, to the extent that such information
58	is known by the qualified beneficiary.
59	b.  Coverage shall be effective with the first period of
60	coverage on or after February 17, 2009.
61	c.  For individuals electing continuation coverage during
62	this election period, the period between the loss of coverage
63	and beginning of coverage under this election is to be
64	disregarded for purposes of determining the 63-day periods
65	referred to in s. 627.6561(6).
66	3.2.  Within 14 days after the receipt of written notice
67	under subparagraphs subparagraph 1. and 2., the insurance
68	carrier shall send each qualified beneficiary by certified mail
69	an election and premium notice form, approved by the office,
70	which form must provide for the qualified beneficiary's election
71	or nonelection of continuation of coverage under the group
72	health plan and the applicable premium amount due after the
73	election to continue coverage. This subparagraph does not
74	require separate mailing of notices to qualified beneficiaries
75	residing in the same household, but requires a separate mailing
76	for each separate household.
77	(g)  If an insurance carrier fails to comply with the
78	notice requirements of subparagraph (d)3.2. and such
79	noncompliance results in the failure of an eligible qualified
80	beneficiary to elect continuation under the group health plan,
81	the qualified beneficiary shall be deemed to have timely elected
82	continuation of coverage within the election period and shall be
83	covered under the group health plan at the expense of the
84	noncomplying insurance carrier. The liability exposure of a
85	noncomplying insurance carrier under this paragraph shall be
86	limited to that period which includes the effective date of
87	coverage pursuant to an affirmative election through the date on
88	which the qualified beneficiary receives actual notice. This
89	paragraph does not apply to the extent that the failure of the
90	insurance carrier to comply with applicable notice requirements
91	was due to noncompliance by the qualified beneficiary with
92	notice requirements applicable to the qualified beneficiary.
93	Section 2.  Paragraph (l) is added to subsection (13) of
94	section 627.6699, Florida Statutes, to read:
95	627.6699  Employee Health Care Access Act.--
96	(13)  STANDARDS TO ASSURE FAIR MARKETING.--
97	(l)1.  In order to improve the ability of small employers
98	to obtain information including premium rates for small employer
99	health benefit plans and to facilitate the application process,
100	all small employer carriers shall use a uniform employee health
101	status form. The commission shall adopt rules specifying such
102	form. The form shall be designed by the Office of Insurance
103	Regulation, in consultation with small employer carriers, to
104	permit its use as a written document and through electronic or
105	other and alternative delivery formats. The form shall include
106	the following health data elements for all persons to be covered
107	under the policy that occurred in the 2 years prior to the date
108	of completion of the form:
109	a.  Any treatment or diagnosis by any licensed medical
110	practitioner.
111	b.  Any procedure or treatment in a hospital,
112	rehabilitation program, or surgical center.
113	c.  All current medications prescribed by a licensed
114	practitioner.
115	d.  Current diagnosis of pregnancy.
116	e.  Current use of any tobacco products.
117	f.  Pending test results.
118	g.  Workers compensation injury or illness.
119	h.  Tests or treatments recommended but not completed.
120	2.  The form shall require the signature of the employee
121	completing the form. Use of a standardized form shall not
122	prevent a small employer carrier from obtaining information from
123	other sources in order to determine the appropriate premium rate
124	for a small employer.
125	Section 3.  This act shall take effect upon becoming a law.

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