Florida Senate - 2019                                     SB 418
       By Senator Simpson
       10-00477A-19                                           2019418__
    1                        A bill to be entitled                      
    2         An act relating to essential health benefits under
    3         health insurance policies and contracts; creating s.
    4         627.6054, F.S.; defining the term “PPACA”; specifying
    5         conditions under which health insurers and health
    6         maintenance organizations may comply with requirements
    7         under the federal Patient Protection and Affordable
    8         Care Act to provide essential health benefits;
    9         providing construction; providing an effective date.
   11         WHEREAS, the Legislature recognizes that the federal
   12  Patient Protection and Affordable Care Act requires that all
   13  persons in the individual and small group health insurance
   14  markets have access to 10 categories of essential health
   15  benefits as set forth in 42 U.S.C. s. 18022(b), and
   16         WHEREAS, each state is granted discretion to determine the
   17  specific benefits in each category deemed essential to the
   18  state, NOW, THEREFORE,
   20  Be It Enacted by the Legislature of the State of Florida:
   22         Section 1. Section 627.6054, Florida Statutes, is created
   23  to read:
   24         627.6054 Essential health benefits.—
   25         (1) As used in this section, the term “PPACA” has the same
   26  meaning as in s. 627.402.
   27         (2) A health insurer or health maintenance organization
   28  issuing or delivering an individual or a group health insurance
   29  policy or contract in this state:
   30         (a) Must include at least one service or coverage under
   31  each of the 10 essential health benefits categories under 42
   32  U.S.C. s. 18022(b) which are required under PPACA;
   33         (b) May fulfill the requirement in paragraph (a) by
   34  selecting one or more services or coverages for each of the
   35  required categories from the list of essential health benefits
   36  required by any single state or multiple states; and
   37         (c) May comply with paragraphs (a) and (b) by selecting one
   38  or more services or coverages from any one or more of the
   39  required categories of essential health benefits from one state
   40  or multiple states.
   41         (3) This section specifically authorizes an insurer or
   42  health maintenance organization to comply with this section by
   43  including any combination of services or coverages required by
   44  any one or a combination of states to provide the 10 categories
   45  of essential health benefits required under PPACA in a policy or
   46  contract issued in this state.
   47         Section 2. This act shall take effect July 1, 2019.