CS/HB 885

1	A bill to be entitled
2	An act relating to insurance; amending s. 626.9541, F.S.;
3	prohibiting construction to prevent a Medicare supplement
4	insurer from granting a premium credit to insureds under
5	certain circumstances; creating s. 627.4605, F.S.;
6	specifying nonapplication of a required notice to a
7	current insurer of a policy replacement under certain
8	circumstances; amending s. 627.464, F.S.; providing a
9	limitation on the resale of certain annuities to third
10	parties; amending s. 627.552, F.S.; prohibiting the
11	creating or permitting of certain classes of employees for
12	group health insurance policy purposes; preserving an
13	employer's authority to require certain plan participation
14	as a condition of employment; amending s. 627.5575, F.S.;
15	revising the limitation on the amount of insurance for
16	spouses of dependent children of employees of members
17	under a group life insurance policy; creating s. 627.6011,
18	F.S.; excluding certain mandatory health benefits from
19	coverage in certain insurance policies or other
20	supplemental or limited benefit policies; providing a
21	definition; amending s. 627.6741, F.S.; specifying absence
22	of a prohibition against certain Medicare supplement
23	policy insurers from entering into agreements through a
24	network with certain facilities; specifying absence of a
25	requirement to file certain contracts with the Office of
26	Insurance Regulation; amending s. 627.6745, F.S.;
27	requiring certain insurers to factor certain deductibles
28	and premium credits into loss-ratio calculation and policy
29	premiums; amending s. 627.9403, F.S.; revising application
30	of provisions to certain policies of insurance; providing
31	a definition; amending s. 634.282, F.S.; revising
32	provisions relating to refunds of excess premiums or
33	charges; providing a declaration of state public policy
34	protecting persons from government intrusion relating to
35	securing health insurance coverage without penalty;
36	prohibiting state residents from being required to obtain
37	or maintain a policy of individual health insurance
38	coverage; specifying absence of liability for penalty or
39	fine for failing to obtain or maintain health insurance
40	coverage; authorizing the Attorney General to initiate and
41	pursue litigation in federal or state court or
42	administrative forum on behalf of certain persons under
43	certain circumstances; providing an effective date.
44
45	Be It Enacted by the Legislature of the State of Florida:
46
47	Section 1.  Subsection (3) is added to section 626.9541,
48	Florida Statutes, to read:
49	626.9541  Unfair methods of competition and unfair or
50	deceptive acts or practices defined.-
51	(3)  INPATIENT FACILITY NETWORK.-This section may not be
52	construed to prohibit a Medicare supplement insurer from
53	granting a premium credit to insureds for using an in-network
54	inpatient facility.
55	Section 2.  Section 627.4605, Florida Statutes, is created
56	to read:
57	627.4605  Replacement notice.-A notice to a current insurer
58	of a replacement of a current life insurance policy is not
59	required in a transaction involving:
60	(1)  An application to the current insurer that issued the
61	current policy or contract when a contractual change or
62	conversion privilege is being exercised;
63	(2)  A current policy or contract is being replaced by the
64	same insurer pursuant to a program filed with and approved by
65	the office; or
66	(3)  A term conversion privilege is being exercised among
67	corporate affiliates.
68	Section 3.  Subsection (3) is added to section 627.464,
69	Florida Statutes, to read:
70	627.464  Annuity contracts, pure endowment contracts;
71	standard provisions.-
72	(3)  An annuity purchased, dedicated, or otherwise allocated
73	as part of a settlement to satisfy the requirements of 42 U.S.C. s.
74	1395y(b)(2) may not be sold to, or commuted by or for, a third
75	party unconnected to the settlement.
76	Section 4.  Paragraph (a) of subsection (1) of section
77	627.552, Florida Statutes, is amended to read:
78	627.552  Employee groups.-Subject to all of the
79	requirements of this section, the lives of a group of individual
80	employees of an employer may be insured, for the benefit of
81	persons other than the employer, under a policy issued to the
82	employer or to the trustees of a fund established by an
83	employer, which employer or board of trustees is deemed to be
84	the policyholder.
85	(1)(a)  The employees eligible for insurance under the
86	policy shall be all of the employees of the employer, or all of
87	any class or classes of employees determined by conditions
88	pertaining to their employment; however, a class of employees
89	may not be created or permitted that consists solely of
90	employees covered under the employer's group health plan. This
91	section does not prohibit an employer from requiring
92	participation in its group health plan as a condition of
93	employment.
94
95	This section does not affect the provisions of ss. 112.08-
96	112.14.
97	Section 5.  Subsection (3) of section 627.5575, Florida
98	Statutes, is amended to read:
99	627.5575  Group life insurance for dependents.-Except for a
100	policy issued under s. 627.553, a group life insurance policy
101	may be extended to insure the employees or members against loss
102	due to the deaths of their spouses and dependent children or any
103	class or classes thereof, subject to the following:
104	(3)  The amounts of insurance for any covered spouse or
105	dependent child under the policy may not exceed 50 percent of
106	the amount of insurance for which the employee or member is
107	insured.
108	Section 6.  Section 627.6011, Florida Statutes, is created
109	to read:
110	627.6011  Mandated coverages exclusion.-Mandatory health
111	benefits that must be covered by an insurer or health maintenance
112	organization in any group or individual medical plans regulated by
113	this chapter are not required to be covered in specified-accident,
114	specified-disease, hospital indemnity, limited benefit, disability
115	income, Medicare supplement, or long-term care insurance policies,
116	or other supplemental or limited benefit policies as described in
117	s. 627.6561(5)(b)-(d). For purposes of this section, the term
118	"mandatory health benefits" means those benefits set forth in ss.
119	627.6401-627.64193, s. 627.65626, ss. 627.65735-627.6579, ss.
120	627.6612-627.6619, and ss. 627.668-627.66911, and any cross-
121	references to such sections, or any other mandatory treatment or
122	health coverages or benefits enacted after January 1, 2010.
123	Section 7.  Subsection (6) is added to section 627.6741,
124	Florida Statutes, to read:
125	627.6741  Issuance, cancellation, nonrenewal, and
126	replacement.-
127	(6)  An insurer offering a Medicare supplement policy under
128	this part is not prohibited from entering into an agreement
129	through a network with inpatient facilities that agree to waive
130	the Medicare Part A deductible in whole or in part. An insurer
131	is not required to file a copy of the network agreement with,
132	and such network agreements are not subject to approval of, the
133	office.
134	Section 8.  Subsection (8) is added to section 627.6745,
135	Florida Statutes, to read:
136	627.6745  Loss ratio standards; public rate hearings.-
137	(8)  For an insurer that enters into a network agreement
138	pursuant to s. 627.6741(6), the waiver of the Medicare Part A
139	deductible and premium credit shall be factored into the
140	insurer's loss-ratio calculation and policy premium.
141	Section 9.  Section 627.9403, Florida Statutes, is amended
142	to read:
143	627.9403  Scope.-The provisions of this part shall apply to
144	long-term care insurance policies delivered or issued for
145	delivery in this state, and to policies delivered or issued for
146	delivery outside this state to the extent provided in s.
147	627.9406, by an insurer, a fraternal benefit society as defined
148	in s. 632.601, a health maintenance organization as defined in
149	s. 641.19, a prepaid health clinic as defined in s. 641.402, or
150	a multiple-employer welfare arrangement as defined in s.
151	624.437. A policy which is advertised, marketed, or offered as a
152	long-term care policy and as a Medicare supplement policy shall
153	meet the requirements of this part and the requirements of ss.
154	627.671-627.675 and, to the extent of a conflict, be subject to
155	the requirement that is more favorable to the policyholder or
156	certificateholder. Except as provided with respect to the
157	definition of the term "guaranteed renewable" in this section,
158	the provisions of this part shall not apply to a continuing care
159	contract issued pursuant to chapter 651 and shall not apply to
160	guaranteed renewable policies issued prior to October 1, 1988.
161	With respect to all policies of insurance covered under this part
162	whenever issued, the term "guaranteed renewable" means the insured
163	has the right to continue the policy in force by the timely payment
164	of premiums and the insurer has no unilateral right to make any
165	change in any provision of the policy while the insurance is in force
166	and cannot decline to renew the policy, except that rates may be
167	revised by the insurer on a class basis. The continuation or renewal
168	of a guaranteed renewable policy of insurance by the timely payment
169	of required premiums does not constitute making or issuing a new
170	policy of insurance for any purpose, including, but not limited to,
171	for purposes of incorporating into the policy changes in the rules
172	or provisions of law governing insurance policies. Any limited
173	benefit policy that limits coverage to care in a nursing home or
174	to one or more lower levels of care required or authorized to be
175	provided by this part or by commission rule is a type of long-
176	term care insurance policy that must meet all requirements of
177	this part that apply to long-term care insurance policies,
178	except ss. 627.9407(3)(c), (9), (10)(f), and (12) and
179	627.94073(2).
180	Section 10.  Paragraph (b) of subsection (13) of section
181	634.282, Florida Statutes, is amended to read:
182	634.282  Unfair methods of competition and unfair or
183	deceptive acts or practices defined.-The following methods,
184	acts, or practices are defined as unfair methods of competition
185	and unfair or deceptive acts or practices:
186	(13)  ILLEGAL DEALINGS IN PREMIUMS; EXCESS OR REDUCED
187	CHARGES FOR MOTOR VEHICLE SERVICE AGREEMENTS.-
188	(b)  Knowingly collecting as a premium or charge for a
189	motor vehicle service agreement any sum in excess of or less
190	than the premium or charge applicable to such motor vehicle
191	service agreement, in accordance with the applicable
192	classifications and rates as filed with the office, and as
193	specified in the motor vehicle service agreement. However, a
194	violation of this paragraph does not occur if excess premiums or
195	charges are refunded to the service agreement holder within 45 days
196	after receipt of the agreement by the service agreement company or if
197	the licensed sales representative's commission is reduced by the
198	amount of any premium undercharge.
199
200	No provision of this section shall be deemed to prohibit a
201	service agreement company or a licensed insurer from giving to
202	service agreement holders, prospective service agreement
203	holders, and others for the purpose of advertising, any article
204	of merchandise having a value of not more than $25.
205	Section 11.  (1)  It is hereby declared that the public
206	policy of this state, consistent with our constitutionally
207	recognized and inalienable rights of liberty, is that every
208	person within this state is and shall be free from governmental
209	intrusion in choosing or declining to choose any mode of
210	securing health insurance coverage without penalty or threat of
211	penalty.
212	(2)  A resident of this state, regardless of whether he or
213	she has or is eligible for health insurance coverage under any
214	policy or program provided by or through his or her employer, or
215	a plan sponsored by the state or the Federal Government, may not
216	be required to obtain or maintain a policy of individual health
217	insurance coverage. A person in this state is not liable for any
218	penalty or fine for failing to obtain or maintain health
219	insurance coverage.
220	(3)  The Attorney General may initiate and shall have
221	standing to pursue litigation in any federal or state court or
222	any administrative forum on behalf of one or more persons within
223	the state whose constitutional rights may be subject to
224	infringement by an act of Congress, or the implementation of a
225	federal legislative program, that relates to or has any impact
226	upon the rights or interests of persons as described in this
227	section.
228	Section 12.  This act shall take effect upon becoming a
229	law.

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