Bill Amendment: FL S0322 | 2019 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Health Plans
Status: 2019-06-26 - Chapter No. 2019-129 [S0322 Detail]
Download: Florida-2019-S0322-Senate_Committee_Amendment_863736.html
Bill Title: Health Plans
Status: 2019-06-26 - Chapter No. 2019-129 [S0322 Detail]
Download: Florida-2019-S0322-Senate_Committee_Amendment_863736.html
Florida Senate - 2019 COMMITTEE AMENDMENT Bill No. SB 322 Ì863736AÎ863736 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Banking and Insurance (Simpson) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 627.6046, Florida Statutes, is created 6 to read: 7 627.6046 Limit on preexisting conditions.— 8 (1) As used in this section, the term: 9 (a) “Operative date” means the date on which either of the 10 following occurs with respect to the Patient Protection and 11 Affordable Care Act, Pub. L. No. 111-148, as amended by the 12 Health Care and Education Reconciliation Act of 2010, Pub. L. 13 No. 111-152 (PPACA): 14 1. A federal law is enacted which expressly repeals PPACA; 15 or 16 2. PPACA is invalidated by the United States Supreme Court. 17 (b) “Preexisting medical condition” means a condition that 18 was present before the effective date of coverage under a 19 policy, whether or not any medical advice, diagnosis, care, or 20 treatment was recommended or received before the effective date 21 of coverage. The term includes a condition identified as a 22 result of a preenrollment questionnaire or physical examination 23 given to the individual, or review of medical records relating 24 to the preenrollment period. 25 (2)(a) Not later than 30 days after the operative date, and 26 notwithstanding s. 627.6045 or any other law to the contrary, 27 every insurer issuing, delivering, or issuing for delivery 28 individual health insurance policies in this state shall make at 29 least one comprehensive major medical health insurance policy 30 available to all residents of this state, and such insurer may 31 not exclude, limit, deny, or delay coverage under such policy 32 due to one or more preexisting medical conditions. 33 (b) An insurer may not limit or exclude benefits under such 34 policy, including a denial of coverage applicable to an 35 individual as a result of information relating to an 36 individual’s health status before the individual’s effective 37 date of coverage, or if coverage is denied, the date of the 38 denial. 39 (3) The comprehensive major medical health insurance policy 40 that the insurer is required to offer under this section must be 41 a policy that had been actively marketed in this state by the 42 insurer as of the operative date and that was also actively 43 marketed in this state during the year immediately preceding the 44 operative date. 45 (4) This section does not apply to an insurer that issues 46 only limited benefit, disability income, specified disease, 47 Medicare supplement, or hospital indemnity policies in this 48 state. 49 Section 2. Section 627.65612, Florida Statutes, is created 50 to read: 51 627.65612 Limit on preexisting conditions.— 52 (1) As used in this section, the terms “operative date” and 53 “preexisting medical condition” have the same meanings as 54 provided in s. 627.6046. 55 (2)(a) Not later than 30 days after the operative date, and 56 notwithstanding s. 627.6561 or any other law to the contrary, 57 every insurer issuing, delivering, or issuing for delivery group 58 health insurance policies in this state shall make at least one 59 comprehensive major medical health insurance policy available to 60 all residents of this state, and such insurer may not exclude, 61 limit, deny, or delay coverage under such policy due to one or 62 more preexisting medical conditions. 63 (b) An insurer may not limit or exclude benefits under such 64 policy, including a denial of coverage applicable to an 65 individual as a result of information relating to an 66 individual’s health status before the individual’s effective 67 date of coverage, or if coverage is denied, the date of the 68 denial. 69 (4) This section does not apply to an insurer issuing only 70 limited benefit, disability income, specified disease, Medicare 71 supplement, or hospital indemnity policies in this state. 72 Section 3. Subsection (45) is added to section 641.31, 73 Florida Statutes, to read: 74 641.31 Health maintenance contracts.— 75 (45)(a) As used in this subsection, the terms “operative 76 date” and “preexisting medical condition” have the same meanings 77 as provided in s. 627.6046. 78 (b) Not later than 30 days after the operative date, and 79 notwithstanding s. 641.31071 or any other law to the contrary, 80 every health maintenance organization issuing, delivering, or 81 issuing for delivery individual or group contracts in this state 82 shall make at least one comprehensive major medical health 83 maintenance contract available to all residents of this state, 84 and such health maintenance organization may not exclude, limit, 85 deny, or delay coverage under such contract due to one or more 86 preexisting medical conditions. A health maintenance 87 organization may not limit or exclude benefits under such 88 contract, including a denial of coverage applicable to an 89 individual as a result of information relating to an 90 individual’s health status before the individual’s effective 91 date of coverage, or if coverage is denied, the date of the 92 denial. 93 (c) The comprehensive major medical health maintenance 94 contract the health maintenance organization is required to 95 offer under this section must be a contract that had been 96 actively marketed in this state by the health maintenance 97 organization as of the operative date and that was also actively 98 marketed in this state during the year immediately preceding the 99 operative date. 100 Section 4. This act shall take effect July 1, 2019. 101 102 ================= T I T L E A M E N D M E N T ================ 103 And the title is amended as follows: 104 Delete everything before the enacting clause 105 and insert: 106 A bill to be entitled 107 An act relating to preexisting conditions; creating 108 ss. 627.6046 and 627.65612, F.S.; defining the terms 109 “operative date” and “preexisting medical condition” 110 with respect to individual and group health insurance 111 policies, respectively; requiring insurers, contingent 112 upon the occurrence of either of two specified events, 113 to make at least one comprehensive major medical 114 health insurance policy available to all residents of 115 this state within a specified timeframe; prohibiting 116 such insurers from excluding, limiting, denying, or 117 delaying coverage under such policies due to 118 preexisting medical conditions; prohibiting certain 119 actions; requiring such policies to have been actively 120 marketed on a specified date and during a certain 121 timeframe before that date; providing applicability; 122 amending s. 641.31, F.S.; defining the terms 123 “operative date” and “preexisting medical condition” 124 with respect to health maintenance contracts; 125 requiring health maintenance organizations, contingent 126 upon the occurrence of either of two specified events, 127 to make at least one comprehensive major medical 128 health maintenance contract available to all residents 129 of this state within a specified timeframe; 130 prohibiting such health maintenance organizations from 131 excluding, limiting, denying, or delaying coverage 132 under such contracts due to preexisting medical 133 conditions; prohibiting certain actions; requiring 134 such contracts to have been actively marketed on a 135 specified date and during a certain timeframe before 136 that date; providing an effective date.