Florida Senate - 2013                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 966
       
       
       
       
       
       
                                Barcode 153962                          
       
                              LEGISLATIVE ACTION                        
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       Senator Hukill moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 3603 and 3604
    4  insert:
    5         Section 80. Paragraph (d) of subsection (12) of section
    6  627.6699, Florida Statutes, is amended to read:
    7         627.6699 Employee Health Care Access Act.—
    8         (12) STANDARD, BASIC, HIGH DEDUCTIBLE, AND LIMITED HEALTH
    9  BENEFIT PLANS.—
   10         (d)1. Upon offering coverage under a standard health
   11  benefit plan, a basic health benefit plan, or a limited benefit
   12  policy or contract for a any small employer group, the small
   13  employer carrier shall provide such employer group with a
   14  written statement that contains, at a minimum:
   15         a. An explanation of those mandated benefits and providers
   16  that are not covered by the policy or contract;
   17         b. An explanation of the managed care and cost control
   18  features of the policy or contract, along with all appropriate
   19  mailing addresses and telephone numbers to be used by insureds
   20  in seeking information or authorization; and
   21         c. An explanation of the primary and preventive care
   22  features of the policy or contract.
   23  
   24  Such disclosure statement must be presented in a clear and
   25  understandable form and format and must be separate from the
   26  policy or certificate or evidence of coverage provided to the
   27  employer group.
   28         2. Before a small employer carrier issues a standard health
   29  benefit plan, a basic health benefit plan, or a limited benefit
   30  policy or contract, the carrier it must obtain from the
   31  prospective policyholder a signed written statement in which the
   32  prospective policyholder:
   33         a. Certifies as to eligibility for coverage under the
   34  standard health benefit plan, basic health benefit plan, or
   35  limited benefit policy or contract;
   36         b. Acknowledges the limited nature of the coverage and an
   37  understanding of the managed care and cost control features of
   38  the policy or contract;
   39         c. Acknowledges that if misrepresentations are made
   40  regarding eligibility for coverage under a standard health
   41  benefit plan, a basic health benefit plan, or a limited benefit
   42  policy or contract, the person making such misrepresentations
   43  forfeits coverage provided by the policy or contract; and
   44         d. If a limited plan is requested, acknowledges that the
   45  prospective policyholder had been offered, at the time of
   46  application for the insurance policy or contract, the
   47  opportunity to purchase any health benefit plan offered by the
   48  carrier and that the prospective policyholder had rejected that
   49  coverage.
   50  
   51  A copy of such written statement must shall be provided to the
   52  prospective policyholder by no later than at the time of
   53  delivery of the policy or contract, and the original of such
   54  written statement must shall be retained in the files of the
   55  small employer carrier for the period of time that the policy or
   56  contract remains in effect or for 5 years, whichever period is
   57  longer.
   58         3. Any material statement made by an applicant for coverage
   59  under a health benefit plan which falsely certifies as to the
   60  applicant’s eligibility for coverage serves as the basis for
   61  terminating coverage under the policy or contract.
   62         4. Each marketing communication that is intended to be used
   63  in the marketing of a health benefit plan in this state must be
   64  submitted for review by the office prior to use and must contain
   65  the disclosures stated in this subsection.
   66         Section 81. Subsection (2) of section 627.9407, Florida
   67  Statutes, is amended to read:
   68         627.9407 Disclosure, advertising, and performance standards
   69  for long-term care insurance.—
   70         (2) ADVERTISING.—The commission shall adopt rules
   71  establishing setting forth standards for the advertising,
   72  marketing, and sale of long-term care insurance policies in
   73  order to protect applicants from unfair or deceptive sales or
   74  enrollment practices. An insurer shall file with the office any
   75  long-term care insurance advertising material intended for use
   76  in this state and may immediately begin using such material upon
   77  filing, subject to subsequent disapproval by the office.
   78  Following receipt of a notice of disapproval or a withdrawal of
   79  approval, the insurer must immediately cease use of the
   80  disapproved material at least 30 days before the date of use of
   81  the advertisement in this state. Within 30 days after the date
   82  of receipt of the advertising material, the office shall review
   83  the material and shall disapprove any advertisement if, in the
   84  opinion of the office, such advertisement violates any of the
   85  provisions of this part or of part IX of chapter 626 or any rule
   86  of the commission. The office may also disapprove an
   87  advertisement at any time and enter an immediate order requiring
   88  that the use of the advertisement be discontinued if it
   89  determines that the advertisement violates any of the provisions
   90  of this part, or of part IX of chapter 626, or any rule of the
   91  commission.
   92  
   93  ================= T I T L E  A M E N D M E N T ================
   94         And the title is amended as follows:
   95         Delete line 351
   96  and insert:
   97         the state; amending ss. 627.6699 and 627.9407, F.S.;
   98         authorizing a health insurer to immediately begin
   99         using long-term care insurance advertising material
  100         under certain circumstances; amending ss. 627.645,
  101         627.668, 627.669,