Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. SB 422
       
       
       
       
       
       
                                Barcode 122406                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RS            .                                
                  03/21/2013           .                                
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       The Committee on Appropriations (Benacquisto) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 109 and 110
    4  insert:
    5         Section 4. Subsection (2) of section 627.6515, Florida
    6  Statutes, is amended to read:
    7         627.6515 Out-of-state groups.—
    8         (2) Except as otherwise provided in this part, this part
    9  does not apply to a group health insurance policy issued or
   10  delivered outside this state under which a resident of this
   11  state is provided coverage if:
   12         (a) The policy is issued to an employee group the
   13  composition of which is substantially as described in s.
   14  627.653; a labor union group or association group the
   15  composition of which is substantially as described in s.
   16  627.654; an additional group the composition of which is
   17  substantially as described in s. 627.656; a group insured under
   18  a blanket health policy when the composition of the group is
   19  substantially in compliance with s. 627.659; a group insured
   20  under a franchise health policy when the composition of the
   21  group is substantially in compliance with s. 627.663; an
   22  association group to cover persons associated in any other
   23  common group, which common group is formed primarily for
   24  purposes other than providing insurance; a group that is
   25  established primarily for the purpose of providing group
   26  insurance, provided the benefits are reasonable in relation to
   27  the premiums charged thereunder and the issuance of the group
   28  policy has resulted, or will result, in economies of
   29  administration; or a group of insurance agents of an insurer,
   30  which insurer is the policyholder;
   31         (b) Certificates evidencing coverage under the policy are
   32  issued to residents of this state and contain in contrasting
   33  color and not less than 10-point type the following statement:
   34  “The benefits of the policy providing your coverage are governed
   35  primarily by the law of a state other than Florida”; and
   36         (c) The policy provides the benefits specified in ss.
   37  627.419, 627.42391, 627.6574, 627.6575, 627.6579, 627.6612,
   38  627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and
   39  627.66911, and complies with the requirements of s. 627.66996.
   40         (d) Applications for certificates of coverage offered to
   41  residents of this state must contain, in contrasting color and
   42  not less than 12-point type, the following statement on the same
   43  page as the applicant’s signature:
   44  
   45         “This policy is primarily governed by the laws of
   46         ...insert state where the master policy if filed....
   47         As a result, all of the rating laws applicable to
   48         policies filed in this state do not apply to this
   49         coverage, which may result in increases in your
   50         premium at renewal that would not be permissible under
   51         a Florida-approved policy. Any purchase of individual
   52         health insurance should be considered carefully, as
   53         future medical conditions may make it impossible to
   54         qualify for another individual health policy. For
   55         information concerning individual health coverage
   56         under a Florida-approved policy, consult your agent or
   57         the Florida Department of Financial Services.”
   58  
   59  This paragraph applies only to group certificates providing
   60  health insurance coverage which require individualized
   61  underwriting to determine coverage eligibility for an individual
   62  or premium rates to be charged to an individual except for the
   63  following:
   64         1. Policies issued to provide coverage to groups of persons
   65  all of whom are in the same or functionally related licensed
   66  professions, and providing coverage only to such licensed
   67  professionals, their employees, or their dependents;
   68         2. Policies providing coverage to small employers as
   69  defined by s. 627.6699. Such policies shall be subject to, and
   70  governed by, the provisions of s. 627.6699;
   71         3. Policies issued to a bona fide association, as defined
   72  by s. 627.6571(5), if provided that there is a person or board
   73  acting as a fiduciary for the benefit of the members, and such
   74  association is not owned, controlled by, or otherwise associated
   75  with the insurance company; or
   76         4. Any accidental death, accidental death and
   77  dismemberment, accident-only, vision-only, dental-only, hospital
   78  indemnity-only, hospital accident-only, cancer, specified
   79  disease, Medicare supplement, products that supplement Medicare,
   80  long-term care, or disability income insurance, or similar
   81  supplemental plans provided under a separate policy,
   82  certificate, or contract of insurance, which cannot duplicate
   83  coverage under an underlying health plan, coinsurance, or
   84  deductibles or coverage issued as a supplement to workers’
   85  compensation or similar insurance, or automobile medical-payment
   86  insurance.
   87  
   88  ================= T I T L E  A M E N D M E N T ================
   89         And the title is amended as follows:
   90         Delete line 14
   91  and insert:
   92         compliance with this act; amending s. 627.6515, F.S.;
   93         adding a cross-reference to conform to changes made by
   94         the act; providing a directive to the