Florida Senate - 2023                                     SB 940
       
       
        
       By Senator Calatayud
       
       
       
       
       
       38-00715-23                                            2023940__
    1                        A bill to be entitled                      
    2         An act relating to multiple-employer welfare
    3         arrangements; amending s. 624.438, F.S.; revising
    4         eligibility requirements for a bona fide group to
    5         qualify as a multiple-employer welfare arrangement;
    6         providing an effective date.
    7          
    8  Be It Enacted by the Legislature of the State of Florida:
    9  
   10         Section 1. Paragraph (b) of subsection (1) of section
   11  624.438, Florida Statutes, is amended to read:
   12         624.438 General eligibility.—
   13         (1) To meet the requirements for issuance of a certificate
   14  of authority and to maintain a multiple-employer welfare
   15  arrangement, an arrangement:
   16         (b) Must be established by a trade association, industry
   17  association, professional association of employers or
   18  professionals, or a bona fide group that as defined in 29 C.F.R.
   19  part 2510.3-5 which has a constitution or bylaws specifically
   20  stating its purpose and which has been organized for purposes in
   21  addition to obtaining or providing insurance.
   22         1. A trade association consists of member employers who are
   23  in the same trade as recognized by the appropriate licensing
   24  agency.
   25         2. An industry association consists of member employers who
   26  are in the same major group code, as defined by the Standard
   27  Industrial Classification Manual issued by the federal Office of
   28  Management and Budget, unless restricted by subparagraph 1. or
   29  subparagraph 3.
   30         3. A professional association consists of member employers
   31  who are of the same profession as recognized by the appropriate
   32  licensing agency.
   33         4.A bona fide group that is an employee welfare benefit
   34  plan includes a group or association of employers which meets
   35  all of the following requirements:
   36         a.The primary purpose of the group or association is to
   37  offer and provide health coverage to its employer members and
   38  their employees. However, the group or association must also
   39  have at least one substantial business purpose unrelated to such
   40  primary purpose. For purposes of this sub-subparagraph, a
   41  substantial business purpose is deemed to exist if the group or
   42  association would be a viable entity in the absence of
   43  sponsoring an employee benefit plan. A substantial business
   44  purpose includes promoting common business interests of its
   45  members or the common economic interests in a given trade or
   46  employer community and is not required to be a for-profit
   47  activity.
   48         b.Each employer member of the group or association which
   49  participates in the group health plan is a person acting
   50  directly as an employer of at least one employee who is a
   51  participant covered under the plan.
   52         c.The group or association has a formal organizational
   53  structure with a governing body and has bylaws or other similar
   54  indications of formality.
   55         d.The functions and activities of the group or association
   56  are controlled by its employer members, and the group’s or
   57  association’s employer members that participate in the group
   58  health plan control the plan. Control must be present both in
   59  form and in substance.
   60         e.The employer members have a principal place of business
   61  in the same region that does not exceed the boundaries of a
   62  single state or metropolitan area, even if the metropolitan area
   63  includes more than one state.
   64         f.The group or association does not make health coverage
   65  through the group’s or association’s group health plan available
   66  to any person other than:
   67         (I)An employee of a current employer member of the group
   68  or association;
   69         (II)A former employee of a current employer member of the
   70  group or association who became eligible for coverage under the
   71  group health plan when the former employee was an employee of
   72  the employer; or
   73         (III)A beneficiary, such as a spouse or dependent child,
   74  of an individual described in sub-sub-subparagraph (I) or sub
   75  sub-subparagraph (II).
   76         g.The group or association and the health coverage offered
   77  by the group or association comply with the nondiscrimination
   78  provisions of s. 627.6699.
   79         h.The group or association is not a health insurance
   80  issuer described in s. 733(b)(2) of the Employee Retirement
   81  Income Security Act of 1974, 29 U.S.C. s. 1191b(b)(2), or owned
   82  or controlled by such a health insurance issuer or by a
   83  subsidiary or affiliate of such a health insurance issuer, other
   84  than to the extent such entities participate in the group or
   85  association in their capacity as employer members of the group
   86  or association.
   87  
   88  The requirements of this paragraph do not apply to an
   89  arrangement licensed before April 1, 1995, regardless of the
   90  nature of its business. However, an arrangement exempt from the
   91  requirements of this paragraph may not expand the nature of its
   92  business beyond that set forth in the articles of incorporation
   93  of its sponsoring association as of April 1, 1995, except as
   94  authorized in this paragraph.
   95         Section 2. This act shall take effect July 1, 2023.