Florida Senate - 2019 SENATOR AMENDMENT Bill No. CS for CS for CS for SB 1180 Ì494528EÎ494528 LEGISLATIVE ACTION Senate . House . . . Floor: 1/RS/2R . 04/25/2019 05:12 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Mayfield moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 65 - 293 4 and insert: 5 this state shall provide general notification of the change in 6 the formulary to current and prospective insureds in a readily 7 accessible format on the insurer’s website and notify, 8 electronically or by first-class mail, any insured currently 9 receiving coverage for a prescription drug for which the 10 formulary change modifies coverage and the insured’s treating 11 physician, including information on the specific drugs involved. 12 (2) A health insurer shall maintain a record of any change 13 in its formulary during the policy year and, within 90 days 14 after the end of the policy year, submit an annual report to the 15 office delineating such changes. The annual report must include, 16 at a minimum: 17 (a) A list of all drugs that were removed from a formulary 18 and the reasons for the removal; 19 (b) A list of all drugs that were moved to a tier that 20 resulted in additional out-of-pocket costs to insureds; 21 (c) The number of insureds notified by the insurer of a 22 change in formulary; and 23 (d) The increased cost, by dollar amount, incurred by 24 insureds because of such change in the formulary. 25 Section 2. Paragraph (e) of subsection (5) of section 26 627.6699, Florida Statutes, is amended to read: 27 627.6699 Employee Health Care Access Act.— 28 (5) AVAILABILITY OF COVERAGE.— 29 (e) All health benefit plans issued under this section must 30 comply with the following conditions: 31 1. For employers who have fewer than two employees, a late 32 enrollee may be excluded from coverage for no longer than 24 33 months if he or she was not covered by creditable coverage 34 continually to a date not more than 63 days before the effective 35 date of his or her new coverage. 36 2. Any requirement used by a small employer carrier in 37 determining whether to provide coverage to a small employer 38 group, including requirements for minimum participation of 39 eligible employees and minimum employer contributions, must be 40 applied uniformly among all small employer groups having the 41 same number of eligible employees applying for coverage or 42 receiving coverage from the small employer carrier, except that 43 a small employer carrier that participates in, administers, or 44 issues health benefits pursuant to s. 381.0406 which do not 45 include a preexisting condition exclusion may require as a 46 condition of offering such benefits that the employer has had no 47 health insurance coverage for its employees for a period of at 48 least 6 months. A small employer carrier may vary application of 49 minimum participation requirements and minimum employer 50 contribution requirements only by the size of the small employer 51 group. 52 3. In applying minimum participation requirements with 53 respect to a small employer, a small employer carrier shall not 54 consider as an eligible employee employees or dependents who 55 have qualifying existing coverage in an employer-based group 56 insurance plan or an ERISA qualified self-insurance plan in 57 determining whether the applicable percentage of participation 58 is met. However, a small employer carrier may count eligible 59 employees and dependents who have coverage under another health 60 plan that is sponsored by that employer. 61 4. A small employer carrier shall not increase any 62 requirement for minimum employee participation or any 63 requirement for minimum employer contribution applicable to a 64 small employer at any time after the small employer has been 65 accepted for coverage, unless the employer size has changed, in 66 which case the small employer carrier may apply the requirements 67 that are applicable to the new group size. 68 5. If a small employer carrier offers coverage to a small 69 employer, it must offer coverage to all the small employer’s 70 eligible employees and their dependents. A small employer 71 carrier may not offer coverage limited to certain persons in a 72 group or to part of a group, except with respect to late 73 enrollees. 74 6. A small employer carrier may not modify any health 75 benefit plan issued to a small employer with respect to a small 76 employer or any eligible employee or dependent through riders, 77 endorsements, or otherwise to restrict or exclude coverage for 78 certain diseases or medical conditions otherwise covered by the 79 health benefit plan. 80 7. An initial enrollment period of at least 30 days must be 81 provided. An annual 30-day open enrollment period must be 82 offered to each small employer’s eligible employees and their 83 dependents. A small employer carrier must provide special 84 enrollment periods as required by s. 627.65615. 85 8. A small employer carrier shall comply with s. 627.42393 86 for any change to a prescription drug formulary. 87 Section 3. Subsection (36) of section 641.31, Florida 88 Statutes, is amended to read: 89 641.31 Health maintenance contracts.— 90 (36) Except as provided in paragraph (a), a health 91 maintenance organization may increase the copayment for any 92 benefit, or delete, amend, or limit any of the benefits to which 93 a subscriber is entitled under the group contract only, upon 94 written notice to the contract holder at least 45 days in 95 advance of the time of coverage renewal. The health maintenance 96 organization may amend the contract with the contract holder, 97 with such amendment to be effective immediately at the time of 98 coverage renewal. The written notice to the contract holder must 99shallspecifically identify any deletions, amendments, or 100 limitations to any of the benefits provided in the group 101 contract during the current contract period which will be 102 included in the group contract upon renewal. This subsection 103 does not apply to any increases in benefits. The 45-day notice 104 requirement doesshallnot apply if benefits are amended, 105 deleted, or limited at the request of the contract holder. 106 (a) At least 60 days before the effective date of any 107 change to a prescription drug formulary during a contract year, 108 the health maintenance organization shall provide general 109 notification of the change in the formulary to current and 110 prospective subscribers in a readily accessible format on the 111 health maintenance organization’s website and notify, 112 electronically or by first-class mail, any subscriber currently 113 receiving coverage for a prescription drug for which the 114 formulary change modifies coverage and the subscriber’s treating 115 physician, including information on the specific drugs involved. 116 (b) A health maintenance organization shall maintain a 117 record of any change in its formulary during the policy year 118 and, within 90 days after the end of the policy year, submit an 119 annual report to the office delineating such changes. The annual 120 report must include, at a minimum: 121 1. A list of all drugs that were removed from a formulary 122 and the reasons for the removal; 123 2. A list of all drugs that were moved to a tier that 124 resulted in additional out-of-pocket costs to subscribers; 125 3. The number of subscribers notified by the health 126 maintenance organization of a change in formulary; and 127 4. The increased cost, by dollar amount, incurred by 128 subscribers because of such change in the formulary. 129 130 ================= T I T L E A M E N D M E N T ================ 131 And the title is amended as follows: 132 Delete lines 6 - 53 133 and insert: 134 current and prospective insureds, and the insureds’ 135 treating physicians, within a certain timeframe before 136 the effective date of any change to a prescription 137 drug formulary during a policy year; requiring such 138 insurers to maintain a record of formulary changes and 139 submit a certain annual report to the Office of 140 Insurance Regulation within a certain timeframe; 141 specifying requirements for the annual report; 142 amending s. 627.6699, F.S.; requiring small employer 143 carriers to comply with certain requirements for any 144 change to a prescription drug formulary under the 145 health benefit plan; amending s. 641.31, F.S.; 146 requiring health maintenance organizations to provide 147 certain notices to current and prospective 148 subscribers, and the subscribers’ treating physicians, 149 within a certain timeframe before the effective date 150 of any change to a prescription drug formulary during 151 a contract year; requiring such health maintenance 152 organizations to maintain a record of formulary 153 changes and submit a certain annual report to the 154 office within a certain timeframe; specifying 155 requirements for the annual report; providing a 156 declaration of important state