Title: State Group Health Insurance and Prescription Drug Programs

Summary: Expands eligibility for participation in state group health insurance program & prescription drug coverage program to include water management districts; requires DMS to conduct actuarial analysis to establish premiums.

Full Text:
An act relating to the state group health insurance and prescription drug programs; amending s. 110.1228, F.S.; defining the term "water management district"; authorizing a water management district to participate in the state group health insurance program and the prescription drug coverage program upon the affirmative vote of a district's governing board; establishing conditions and restrictions regarding participation; providing that monthly premium amounts be based on an actuarial analysis conducted by the Department of Management Services; requiring small counties, small municipalities, district school boards, and water management districts participating in the programs to bear the costs of the actuarial analysis; conforming provisions to changes made by the act; amending s. 373.605, F.S.; conforming a provision; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Section 110.1228, Florida Statutes, is amended to read: 110.1228 Participation by small counties, small municipalities, and district school boards,and water management HB 2018 districts located in small counties.-(1) As used in this section, the term: (a) "District school board" means a district school board located in a small county or a district school board that receives funding pursuant to s. 1011.62(7). (b) "Small municipality" means an incorporated municipality that has a population of,500 or fewer according to the most recent decennial census. (c) "Small county" means a county that has a population of 100,000 or fewer according to the most recent decennial census. (d) "Water management district" has the same meaning as in s. 373.01 9. (2) The governing body of a small county,or small municipality,or water management district or a district school board may apply for participation in the state group health insurance program authorized in s. 110.123 and the prescription drug coverag eprogram authorized by s. 110.12315 by submitting an application along with a $500 nonrefundable fee to the department. (3) Any costs or savings to the state group health insurance program or the prescription drug coverage program resulting from such pa rticipation shall be passed on to the local government and water management district participants and their employees. Such costs or savings shall be delineated based on the impact to the state, state officers and employees, and HB 2018 local government employers and their employees,and water management districts and their employees.(4) As a prerequisite to the adoption of an ordinance or resolution or the affirmative vote of a governing board, for participation in the state group health insurance program and prescription drug coverage program, a small county, small municipality, or district school board,or water management district shall issue a request for proposals to provide health insurance and prescription drug coverage. Such request for proposals shall seek coverages equivalent to those offered currently by the small county, small municipality, or district school board,or water management district and coverages equivalent to the state group health insurance program and prescription drug coverage program. Such request for proposals must provide an opportunity for the receipt of competitive proposals from all interested parties without restriction. The small county, small municipality, and district school board,and water management district shall review an dconsider all responsive proposals before prior to the adoption of any ordinance or resolution or the affirmative vote of any governing board for participation in the state group health insurance program and prescription drug coverage program. (5) If th edepartment determines that a small county, small municipality, or district school board,or water management district is eligible to enroll, the small county, HB 2018 small municipality, or district school board,or water management district must agree to the following terms and conditions: (a) The minimum enrollment or contractual period will be 79 years. (b) The small county, small municipality, or district school board,or water management district must pay to the department an initial administrative fee of not less than $2.61 per enrollee per month, or such other amount established annually to fully reimburse the department for its costs. (c) Termination of participation of a small county, small municipality, or district school board,or water management district requires written notice year before the termination date. (d) If participation is terminated, a small county, small municipality, or district school board,or water management district may not reapply for participation for a period of 92 years. (e) Small counties, small municipalities, and district school boards,and water management districts shall reimburse the state for percent of its costs, including administrative costs. (f) If a small county, small municipality, or district school board employer,or water management district fails to make the payments required by this section to fully reimburse HB 2018 the state, the Department of Revenue or the Department of Financial Services shall, upon the request of the Department of Management Services, deduct the amount owed by the employer from any funds not pledged to bond debt service satisfaction that are to be distributed by it to the small county, small municipality, or district scho ol board,or water management district.The amounts so deducted shall be transferred to the Department of Management Services for further distribution to the trust funds in accordance with this chapter. (g) The small county, small municipality, or district school board,or water management district shall furnish the department any information requested by the department which the department considers necessary to administer the state group health insurance program and the prescription drug coverage program. (h) The small county, small municipality, or district school board,or water management district shall adopt the state's eligibility rules. (i) The small county, small municipality, or district school board,or water management district may not part icipate in the state's cafeteria plan that allows for pretax treatment of premium contributions. If pretax treatment is desirable for employees of these participating employers, each employee of a participating employer shall execute a salary reduction agreement with that employer, and each participating employer HB 2018 shall establish its own cafeteria plan. (j) The small county, small municipality, or district school board,or water management district shall pay monthly premiums in amounts sufficient to cover claims costs, department administrative costs, and third-party administrative costs and provide for adequate reserves and cash flow by contributing 131 months' premiums and costs in advance of the coverage effective date. The premiums must be established by an actuarial analysis conducted by the department in which the requesting party is considered both a distinct health insurance risk pool and as part of the state group health insurance program risk pool. The actuarial analysis must be paid for by the parti cipating small county, small municipality, district school board, or water management district. (6) Sections The provisions of ss. 624.436-624.446 do not apply to the State Group Insurance Program or to this section. Section 2. Section 373.605, Flori da Statutes, is amended to read: 373.605 Group insurance for water management districts.-The governing board of a water management district may provide group insurance for its employees, and the employees of another water management district, in the same manner and with the same provisions and limitations authorized for other public employees under ss. 112.08, 112.09, 112.10, 112.11, and 112.14. Alternatively, a water management district, after an affirmative HB 2018 vote of its governing board, may participate i nthe state group health insurance program and the prescription drug coverage program under s. 110.1228. Section 3. This act shall take effect July 1, 2018.