Florida Senate - 2010 CS for SB 2374
By the Policy and Steering Committee on Ways and Means; and
Senator Alexander
576-03802-10 20102374c1
1 A bill to be entitled
2 An act relating to the state group insurance program;
3 amending s. 110.123, F.S.; establishing the state’s
4 monthly contributions for employees who have
5 individual coverage and for employees who have family
6 coverage; requiring that the Division of State Group
7 Insurance within the Department of Management Services
8 establish a state employee health clinic pilot
9 program; requiring the division to select a vendor to
10 establish and manage at least one full-scope health
11 and wellness clinic that will provide specified
12 services to members of the State Group Health
13 Insurance Program; requiring that the vendor provide
14 the start-up costs associated with the pilot program;
15 requiring that the vendor staff and manage the clinic,
16 subvendors, and integrated services providers;
17 requiring that the pilot program commence by a
18 specified date; requiring that the Department of
19 Management Services submit an evaluation of the pilot
20 program to the Governor and the Legislature by a
21 specified date; providing that the term of the
22 contract be for only the 2011 plan year; requiring the
23 Division of State Group Insurance to contract for
24 postpayment claims review services for the State Group
25 Insurance Program; requiring that all payments made
26 under the contract be paid from overpayment amounts
27 identified and recovered by the vendor; directing the
28 Division of State Group Insurance to contract for
29 dependent eligibility verification services for the
30 State Group Insurance Program; providing a limitation
31 on compensation to the contract vendor; requiring
32 subscribers of the State Group Insurance Program to
33 provide documentation validating eligibility of
34 dependents; authorizing a grace period to document
35 eligibility; authorizing the division to seek
36 indemnification from subscribers having ineligible
37 dependents; providing an effective date.
38
39 Be It Enacted by the Legislature of the State of Florida:
40
41 Section 1. Subsection (12) of section 110.123, Florida
42 Statutes, is amended to read:
43 110.123 State group insurance program.—
44 (12) HEALTH SAVINGS ACCOUNTS.—The department is authorized
45 to establish health savings accounts for full-time and part-time
46 state employees in association with a health insurance plan
47 option authorized by the Legislature and conforming to the
48 requirements and limitations of federal provisions relating to
49 the Medicare Prescription Drug, Improvement, and Modernization
50 Act of 2003.
51 (a)1. A member participating in this health insurance plan
52 option shall be eligible to receive an employer contribution
53 into the employee’s health savings account from the State
54 Employees Health Insurance Trust Fund in an amount to be
55 determined by the Legislature. A member is not eligible for an
56 employer contribution upon termination of employment. For the
57 2010-2011 2009-2010 fiscal year, the state’s monthly
58 contribution for employees having individual coverage shall be
59 $41.66 and the monthly contribution for employees having family
60 coverage shall be $83.33.
61 2. A member participating in this health insurance plan
62 option shall be eligible to deposit the member’s own funds into
63 a health savings account.
64 (b) The monthly premiums paid by the employer for a member
65 participating in this health insurance plan option shall include
66 an amount equal to the monthly employer contribution authorized
67 by the Legislature for that fiscal year.
68 (c) The health savings accounts shall be administered in
69 accordance with the requirements and limitations of federal
70 provisions relating to the Medicare Prescription Drug,
71 Improvement, and Modernization Act of 2003.
72 Section 2. (1) The Division of State Group Insurance within
73 the Department of Management Services shall establish a state
74 employee health clinic pilot program for the 2011 plan year.
75 (2) The Division of State Group Insurance, through a
76 competitive procurement pursuant to the chapter 287, Florida
77 Statutes, shall select a vendor that shall establish and manage
78 at least one full-scope health and wellness clinic providing
79 members of the State Group Health Insurance Program access to
80 the following services:
81 (a) Primary care services, including walk-in and
82 consultative appointments for full-scope clinic services,
83 including urgent care;
84 (b) Occupational health services, including return-to-work
85 planning, new hire and emergent drug screening, and injury care;
86 (c) Immunizations, including vaccines and flu shots; and
87 (d) Wellness services, including online tools and services,
88 health risk assessment and recommendations, health mailings,
89 health fairs, wellness screenings, and on-site education.
90 (3) The vendor shall provide any start-up costs associated
91 with the pilot program and shall employ the staff and manage the
92 clinic, subvendors, and integrated services providers.
93 (4) The pilot program shall commence no later than January
94 1, 2011. By February 1, 2012, the Department of Management
95 Services shall submit an evaluation of the pilot program to the
96 Governor, the President of the Senate, and the Speaker of the
97 House of Representatives. The report must evaluate the extent to
98 which the vendor has:
99 (a) Implemented comprehensive services for state employees;
100 (b) Leveraged group purchasing power in order to enable
101 convenient access to full-scope services;
102 (c) Distributed health and wellness information and health
103 education materials; and
104 (d) Ensured consistent quality standards.
105 (5) The term of the contract shall be for only the 2011
106 plan year.
107 Section 3. The Division of State Group Insurance is
108 directed to competitively procure:
109 (1) Postpayment claims review services for the State Group
110 Insurance Program established pursuant to s. 110.123, Florida
111 Statutes; however, all payments made under the contract must be
112 paid from overpayment amounts identified and recovered by the
113 vendor. The vendor under such contract shall identify
114 overpayments made by or on behalf of the State Group Insurance
115 Program, may collect such overpaid amounts, and retain that
116 portion of the collections so designated in the contract; and
117 (2) Dependent eligibility verification services for the
118 State Group Insurance Program; however, compensation under the
119 contract may not exceed the verifiable cost avoidance resulting
120 from the successful disenrollment of unauthorized individuals.
121 Section 4. As a condition to continuing enrollment and
122 participation of dependents in the State Group Insurance Program
123 administered by the Division of State Group Insurance pursuant
124 to s. 110.123, Florida Statutes, subscribers must provide
125 documentation validating eligibility criteria. Such
126 documentation may include, but need not be limited to, marriage
127 certificates, birth certificates, court orders, notarized
128 attestations, and other documents validating eligibility
129 criteria. The Division of State Group Insurance may implement a
130 grace period of up to 6 months and may thereafter seek
131 indemnification from subscribers who have ineligible dependents.
132 Section 5. This act shall take effect July 1, 2010.