Title: Small Group Health Insurance

Summary: Revises health benefit plan requirements relating to small employers.

Full Text:
An act relating to small group health insurance; amending s. 627.6699, F.S.; revising health benefit plan requirements relating to small employers; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Paragraph (e) of subsection (5) of section 627.6699, Florida Statutes, is amended to read: 627.6699 Employee Health Care Access Act.-(5) AVAILABILITY OF COV ERAGE.-(e) All health benefit plans issued under this section must comply with the following conditions: 1. For employers who have fewer than two employees, a late enrollee may be excluded from coverage for no longer than 16 months if he or she was no tcovered by creditable coverage continually to a date not more than days before the effective date of his or her new coverage. 2. Any requirement used by a small employer carrier in determining whether to provide coverage to a small employer group, i ncluding requirements for minimum participation of eligible employees and minimum employer contributions, must be applied uniformly among all small employer groups having the same number of eligible employees applying for coverage or receiving coverage fro mthe small employer carrier, except that HB 2016 a small employer carrier that participates in, administers, or issues health benefits pursuant to s. 381.0406 which do not include a preexisting condition exclusion may require as a condition of offering such benef its that the employer has had no health insurance coverage for its employees for a period of at least months. A small employer carrier may vary application of minimum participation requirements and minimum employer contribution requirements only by the size of the small employer group. 3. In applying minimum participation requirements with respect to a small employer, a small employer carrier shall not consider as an eligible employee employees or dependents who have qualifying existing coverage in an employer-based group insurance plan or an ERISA qualified self-insurance plan in determining whether the applicable percentage of participation is met. However, a small employer carrier may count eligible employees and dependents who have coverage under ano ther health plan that is sponsored by that employer. 4. A small employer carrier shall not increase any requirement for minimum employee participation or any requirement for minimum employer contribution applicable to a small employer at any time after the small employer has been accepted for coverage, unless the employer size has changed, in which case the small employer carrier may apply the requirements that are applicable to the new group size. 5. If a small employer carrier offers coverage to a sma ll HB 2016 employer, it must offer coverage to all the small employer's eligible employees and their dependents. A small employer carrier may not offer coverage limited to certain persons in a group or to part of a group, except with respect to late enrollees. If a small employer offers coverage to its employees, the coverage must be offered to all eligible employees. The small employer may also offer coverage to the spouses and dependents of eligible employees. 6. A small employer carrier may not modify any heal th benefit plan issued to a small employer with respect to a small employer or any eligible employee or dependent through riders, endorsements, or otherwise to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the health benefit plan. 7. An initial enrollment period of at least days must be provided. An annual-day open enrollment period must be offered to each small employer's eligible employees and their dependents. A small employer carrier must provide sp ecial enrollment periods as required by s. 627.65615. Section 2. This act shall take effect July 1, 2016.