FL
Florida House Bill H5009

Florida 2022 Regular Session

Florida House Bill H5009 Compare Versions

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1010 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14+A bill to be entitled 1
1515 An act relating to the state group insurance program; 2
1616 amending s. 110.123, F.S.; providing and revising 3
1717 definitions; authorizing eligible former employees to 4
1818 participate in the state group insurance program; 5
1919 removing certain benefit levels for certain health 6
2020 plans; conforming provisions to changes made by the 7
21-act; conforming cross -references; amending s. 8
22-110.12303, F.S.; requiring cost savings to an enrollee 9
23-to include a specified waiver, unless prohibited under 10
24-certain tax laws; revising what may be included in 11
25-cost savings; creating s. 110.12306, F.S.; defining 12
26-the term "designated anti -fraud unit"; requiring the 13
27-Division of State Group Insurance to establish and 14
28-maintain, or contract with other entities to establish 15
29-and maintain, a designated anti -fraud unit for certain 16
30-purposes, to adopt an anti -fraud plan, and to 17
31-designate staff with certain responsibilities by a 18
32-specified date; creating s. 110.12313, F.S.; 19
33-specifying that eligible former employees may obtain 20
34-certain health insurance coverage within a specified 21
35-time after their separation from employment; providing 22
36-requirements for certain health insurance coverage 23
37-options; amending s. 110.1239, F.S.; removin g language 24
38-that certain additional appropriations are considered 25
39-ENROLLED
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21+act; conforming cross -references; creating s. 8
22+110.12306, F.S.; defining the term "designated anti -9
23+fraud unit"; requiring the Division of State Group 10
24+Insurance to establish and maintain, or contract with 11
25+other entities to establish and maintain, a designated 12
26+anti-fraud unit for certain purposes, to adopt an 13
27+anti-fraud plan, and to designate staff with certai n 14
28+responsibilities by a specified date; creating s. 15
29+110.12313, F.S.; requiring the Department of 16
30+Management Services to provide an open enrollment 17
31+period for eligible former employees for a certain 18
32+plan year for certain purposes; providing requirements 19
33+for certain health insurance coverage options; 20
34+requiring that eligible former employees enroll in the 21
35+state group insurance program within a specified time; 22
36+ratifying specified rules of the Florida 23
37+Administrative Code; providing construction; providing 24
38+effective dates. 25
39+
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4747 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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51-a state contribution, which result in an increase in 26
52-the state premium; ratifying specified rules of the 27
53-Florida Administrative Code relating to health 28
54-maintenance organization plan regions; providing 29
55-construction; providing effective dates. 30
56- 31
57-Be It Enacted by the Legislature of the State of Florida: 32
58- 33
59- Section 1. Paragraph (b) and paragraphs (c) through (p) of 34
60-subsection (2) of section 110.123, Florida Statutes, are 35
61-redesignated as parag raph (c) and paragraphs (e) through (r), 36
62-respectively, present paragraphs (b), (k), (m), and (o) of 37
63-subsection (2), paragraphs (d), (g), and (j) of subsection (3), 38
64-paragraph (e) of subsection (4), and paragraphs (c) and (d) of 39
65-subsection (13) are amended, and new paragraphs (b) and (d) are 40
66-added to subsection (2) of that section, to read: 41
67- 110.123 State group insurance program. — 42
68- (2) DEFINITIONS.—As used in ss. 110.123 -110.1239, the 43
69-term: 44
70- (b) "Eligible former employee" means a former state 45
71-officer or employee who was enrolled in the state group 46
72-insurance program for at least 6 cumulative years with an 47
73-employer or employers participating in the state group insurance 48
74-program, and who was enrolled in the state group insurance 49
75-program at the time of his or h er separation from employment and 50
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51+ 26
52+Be It Enacted by the Legislature of the State of Florida: 27
53+ 28
54+ Section 1. Paragraphs (b) through (p) of subsection (2) of 29
55+section 110.123, Florida Statutes, are redesignated as 30
56+paragraphs (c) through (q), respectively, present paragraphs 31
57+(b), (k), (m), and (o) of subsection (2), paragraphs (d), (g), 32
58+and (j) of subsection (3), paragraph (e) of subsection (4), and 33
59+paragraphs (c) and (d) of subsection (13) are amended, and a new 34
60+paragraph (b) is added to subsection (2) of that section, to 35
61+read: 36
62+ 110.123 State group insurance program. — 37
63+ (2) DEFINITIONS.—As used in ss. 110.123 -110.1239, the 38
64+term: 39
65+ (b) "Eligible former employee" means a former full -time 40
66+state employee who worked at least 6 cumulative years with a 41
67+branch or agency of state govern ment, was enrolled in the state 42
68+group insurance program at the time of his or her separation 43
69+from employment, and whose separation from employment occurred 44
70+on or after July 1, 2022. The term "eligible former employee" 45
71+does not include seasonal workers who were paid from OPS funds 46
72+during their employment, state university employees, or other 47
73+benefits-only employees. 48
74+ (c)(b) "Enrollee" means all state officers and employees, 49
75+retired state officers and employees, surviving spouses of 50
76+
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8484 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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88-whose separation from employment occurred on or after July 1, 51
89-2022. 52
90- (c)(b) "Enrollee" means all state officers and employees, 53
91-retired state officers and employees, surviving spouses of 54
92-deceased state officers and employe es, eligible former 55
93-employees, and terminated employees or individuals with 56
94-continuation coverage who are enrolled in an insurance plan 57
95-offered by the state group insurance program. The term 58
96-"enrollee" includes all state university officers and employees, 59
97-retired state university officers and employees, surviving 60
98-spouses of deceased state university officers and employees, and 61
99-terminated state university employees or individuals with 62
100-continuation coverage who are enrolled in an insurance plan 63
101-offered by the state group insurance program. 64
102- (d) "Enrollee cost-sharing liability" means the amount an 65
103-enrollee or beneficiary is responsible for paying for a covered 66
104-item or service under the terms of the state group insurance 67
105-program. The term "enrollee cost -sharing liability" includes 68
106-deductibles, coinsurance, and copayments, but does not include 69
107-premiums. 70
108- (m)(k) "State group health insurance plan or plans" or 71
109-"state plan or plans" means the state self -insured health 72
110-insurance plan or plans offered to state offic ers and employees, 73
111-retired state officers and employees, eligible former employees, 74
112-and surviving spouses of deceased state officers , and employees, 75
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88+deceased state officers a nd employees, eligible former 51
89+employees, and terminated employees or individuals with 52
90+continuation coverage who are enrolled in an insurance plan 53
91+offered by the state group insurance program. The term 54
92+"enrollee" includes all state university officers and e mployees, 55
93+retired state university officers and employees, surviving 56
94+spouses of deceased state university officers and employees, and 57
95+terminated state university employees or individuals with 58
96+continuation coverage who are enrolled in an insurance plan 59
97+offered by the state group insurance program. 60
98+ (l)(k) "State group health insurance plan or plans" or 61
99+"state plan or plans" means the state self -insured health 62
100+insurance plan or plans offered to state officers and employees, 63
101+retired state officers and employe es, eligible former employees, 64
102+and surviving spouses of deceased state officers , and employees, 65
103+and eligible former employees under pursuant to this section. 66
104+ (n)(m) "State group insurance program" or "programs" means 67
105+the package of insurance plans offere d to state officers and 68
106+employees, retired state officers and employees, eligible former 69
107+employees, and surviving spouses of deceased state officers , and 70
108+employees, and eligible former employees under pursuant to this 71
109+section, including the state group hea lth insurance plan or 72
110+plans, health maintenance organization plans, TRICARE 73
111+supplemental insurance plans, and other plans required or 74
112+authorized by law. 75
113+
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121121 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125-and eligible former employees under pursuant to this section. 76
126- (o)(m) "State group insurance program" or " programs" means 77
127-the package of insurance plans offered to state officers and 78
128-employees, retired state officers and employees, eligible former 79
129-employees, and surviving spouses of deceased state officers , and 80
130-employees, and eligible former employees under pursuant to this 81
131-section, including the state group health insurance plan or 82
132-plans, health maintenance organization plans, TRICARE 83
133-supplemental insurance plans, and other plans required or 84
134-authorized by law. 85
135- (q)(o) "Surviving spouse" means the widow or wid ower of a 86
136-deceased state officer, full -time state employee, part -time 87
137-state employee, eligible former employee, or retiree if such 88
138-widow or widower was covered as a dependent under the state 89
139-group health insurance plan, TRICARE supplemental insurance 90
140-plan, or a health maintenance organization plan established 91
141-under pursuant to this section at the time of the death of the 92
142-deceased officer, employee, eligible former employee, or 93
143-retiree. The term "surviving spouse" also means any widow or 94
144-widower who is recei ving or eligible to receive a monthly state 95
145-warrant from a state retirement system as the beneficiary of a 96
146-state officer, full-time state employee, or retiree who died 97
147-prior to July 1, 1979. For the purposes of this section, any 98
148-such widow or widower shall cease to be a surviving spouse upon 99
149-his or her remarriage. 100
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125+ (p)(o) "Surviving spouse" means the widow or widower of a 76
126+deceased state officer, full -time state employee, part-time 77
127+state employee, eligible former employee, or retiree if such 78
128+widow or widower was covered as a dependent under the state 79
129+group health insurance plan, TRICARE supplemental insurance 80
130+plan, or a health maintenance organization plan establishe d 81
131+under pursuant to this section at the time of the death of the 82
132+deceased officer, employee, eligible former employee, or 83
133+retiree. The term "surviving spouse" also means any widow or 84
134+widower who is receiving or eligible to receive a monthly state 85
135+warrant from a state retirement system as the beneficiary of a 86
136+state officer, full-time state employee, or retiree who died 87
137+prior to July 1, 1979. For the purposes of this section, any 88
138+such widow or widower shall cease to be a surviving spouse upon 89
139+his or her remarriage. 90
140+ (3) STATE GROUP INSURANCE PROGRAM. — 91
141+ (d)1. Notwithstanding chapter 287 and the authority of the 92
142+department, for the purpose of protecting the health of, and 93
143+providing medical services to, state employees and eligible 94
144+former employees participating in the state group insurance 95
145+program, the department may contract to retain the services of 96
146+professional administrators for the state group insurance 97
147+program. The agency shall follow good purchasing practices of 98
148+state procurement to the extent practicabl e under the 99
149+circumstances. 100
150+
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158158 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162- (3) STATE GROUP INSURANCE PROGRAM. — 101
163- (d)1. Notwithstanding chapter 287 and the authority of the 102
164-department, for the purpose of protecting the health of, and 103
165-providing medical services to, state employees and eligible 104
166-former employees participating in the state group insurance 105
167-program, the department may contract to retain the services of 106
168-professional administrators for the state group insurance 107
169-program. The agency shall follow good purchasing pr actices of 108
170-state procurement to the extent practicable under the 109
171-circumstances. 110
172- 2. Each vendor in a major procurement, and any other 111
173-vendor if the department deems it necessary to protect the 112
174-state's financial interests, shall, at the time of executing a ny 113
175-contract with the department, post an appropriate bond with the 114
176-department in an amount determined by the department to be 115
177-adequate to protect the state's interests but not higher than 116
178-the full amount estimated to be paid annually to the vendor 117
179-under the contract. 118
180- 3. Each major contract entered into by the department 119
181-under pursuant to this section must shall contain a provision 120
182-for payment of liquidated damages to the department for material 121
183-noncompliance by a vendor with a contract provision. The 122
184-department may require a liquidated damages provision in any 123
185-contract if the department deems it necessary to protect the 124
186-state's financial interests. 125
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162+ 2. Each vendor in a major procurement, and any other 101
163+vendor if the department deems it necessary to protect the 102
164+state's financial interests, shall, at the time of executing any 103
165+contract with the department, post an appropriate bond with the 104
166+department in an amount determined by the department to be 105
167+adequate to protect the state's interests but not higher than 106
168+the full amount estimated to be paid annually to the vendor 107
169+under the contract. 108
170+ 3. Each major contract entered into by the department 109
171+under pursuant to this section must shall contain a provision 110
172+for payment of liquidated damages to the department for material 111
173+noncompliance by a vendor with a contract provision. The 112
174+department may require a liquidated damages provision in any 113
175+contract if the department deems it necessary to protect the 114
176+state's financial interests. 115
177+ 4. Section 120.57(3) applies to the department's 116
178+contracting process, except: 117
179+ a. A formal written protest of any decision, intended 118
180+decision, or other action subject to protest must shall be filed 119
181+within 72 hours after receipt of notice of the decision, 120
182+intended decision, or other action. 121
183+ b. As an alternative to any provision of s. 120.57(3), the 122
184+department may proceed with the bid s election or contract award 123
185+process if the director of the department sets forth, in 124
186+writing, particular facts and circumstances that demonstrate the 125
187+
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195195 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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199- 4. Section 120.57(3) applies to the department's 126
200-contracting process, except: 127
201- a. A formal written pro test of any decision, intended 128
202-decision, or other action subject to protest must shall be filed 129
203-within 72 hours after receipt of notice of the decision, 130
204-intended decision, or other action. 131
205- b. As an alternative to any provision of s. 120.57(3), the 132
206-department may proceed with the bid selection or contract award 133
207-process if the director of the department sets forth, in 134
208-writing, particular facts and circumstances that demonstrate the 135
209-necessity of continuing the procurement process or the contract 136
210-award process in order to avoid a substantial disruption to the 137
211-provision of any scheduled insurance services. 138
212- 5. The department shall make arrangements as necessary to 139
213-contribute claims data of the state group health insurance plan 140
214-to the contracted vendor selected by the Agency for Health Care 141
215-Administration under pursuant to s. 408.05(3)(c). 142
216- 6. Each contracted vendor for the state group health 143
217-insurance plan shall contribute Florida claims data to the 144
218-contracted vendor selected by the Agency for Health Care 145
219-Administration under pursuant to s. 408.05(3)(c). 146
220- (g) Participation by individuals in the program is 147
221-available to all state officers, full -time state employees, and 148
222-part-time state employees , and eligible former employees and is 149
223-voluntary. Participation in the program is also available to 150
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199+necessity of continuing the procurement process or the contract 126
200+award process in order to avoid a substanti al disruption to the 127
201+provision of any scheduled insurance services. 128
202+ 5. The department shall make arrangements as necessary to 129
203+contribute claims data of the state group health insurance plan 130
204+to the contracted vendor selected by the Agency for Health Care 131
205+Administration under pursuant to s. 408.05(3)(c). 132
206+ 6. Each contracted vendor for the state group health 133
207+insurance plan shall contribute Florida claims data to the 134
208+contracted vendor selected by the Agency for Health Care 135
209+Administration under pursuant to s. 408.05(3)(c). 136
210+ (g) Participation by individuals in the program is 137
211+available to all state officers, full -time state employees, and 138
212+part-time state employees , and eligible former employees and is 139
213+voluntary. Participation in the program is also available to 140
214+retired state officers and employees who elect at the time of 141
215+retirement to continue coverage under the program, but may elect 142
216+to continue all or only part of the coverage they had at the 143
217+time of retirement. A surviving spouse may elect to continue 144
218+coverage only under a state group health insurance plan, a 145
219+TRICARE supplemental insurance plan, or a health maintenance 146
220+organization plan. 147
221+ (j) For the 2020 plan year and each plan year thereafter, 148
222+health plans shall be offered in the following benefit levels: 149
223+ 1. Platinum level, which shall have an actuarial value of 150
224+
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232232 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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236-retired state officers and employees who elect at the time of 151
237-retirement to continue coverage under the program, but may elect 152
238-to continue all or only part of the coverage they had at the 153
239-time of retirement. A surviving spouse may elect to continue 154
240-coverage only under a state group health insurance plan, a 155
241-TRICARE supplemental insurance plan, or a health maintenance 156
242-organization plan. 157
243- (j) For the 2020 plan year and each plan year thereafter, 158
244-health plans shall be offere d in the following benefit levels: 159
245- 1. Platinum level, which shall have an actuarial value of 160
246-at least 90 percent. 161
247- 2. Gold level, which shall have an actuarial value of at 162
248-least 80 percent. 163
249- 3. Silver level, which shall have an actuarial value of at 164
250-least 70 percent. 165
251- 4. Bronze level, which shall have an actuarial value of at 166
252-least 60 percent. 167
253- (4) PAYMENT OF PREMIUMS; CONTRIBUTION BY STATE; LIMITATION 168
254-ON ACTIONS TO PAY AND COLLECT PREMIUMS. — 169
255- (e) No state contribution for the cost of any part of the 170
256-premium shall be made for retirees , or surviving spouses, or 171
257-eligible former employees for any type of coverage under the 172
258-state group insurance program. However, any state agency that 173
259-employs a full-time law enforcement officer, correctional 174
260-officer, or correctional probation officer who is killed or 175
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236+at least 90 percent. 151
237+ 2. Gold level, which shall have an actuarial value of at 152
238+least 80 percent. 153
239+ 3. Silver level, which shall have an actuarial value of at 154
240+least 70 percent. 155
241+ 4. Bronze level, which shall have an actuarial value of at 156
242+least 60 percent. 157
243+ (4) PAYMENT OF PREMIUMS; CONTRIBUTION BY STATE; LIMITATION 158
244+ON ACTIONS TO PAY AND COLLECT PREMIUMS. — 159
245+ (e) A No state contribution for the cost of any part of 160
246+the premium may not shall be made for retirees , or surviving 161
247+spouses, or eligible former employees for any type of coverage 162
248+under the state group insurance program. However, any state 163
249+agency that employs a full -time law enforcement officer, 164
250+correctional officer, or correcti onal probation officer who is 165
251+killed or suffers catastrophic injury in the line of duty as 166
252+provided in s. 112.19, or a full -time firefighter who is killed 167
253+or suffers catastrophic injury in the line of duty as provided 168
254+in s. 112.191, shall pay the entire pr emium of the state group 169
255+health insurance plan selected for the employee's surviving 170
256+spouse until remarried, and for each dependent child of the 171
257+employee, subject to the conditions and limitations set forth in 172
258+s. 112.19 or s. 112.191, as applicable. 173
259+ (13) OTHER-PERSONAL-SERVICES EMPLOYEES (OPS). — 174
260+ (c) The initial measurement period used to determine 175
261+
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269269 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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273-suffers catastrophic injury in the line of duty as provided in 176
274-s. 112.19, or a full -time firefighter who is killed or suffers 177
275-catastrophic injury in the line of duty as provided in s. 178
276-112.191, shall pay the en tire premium of the state group health 179
277-insurance plan selected for the employee's surviving spouse 180
278-until remarried, and for each dependent child of the employee, 181
279-subject to the conditions and limitations set forth in s. 112.19 182
280-or s. 112.191, as applicable. 183
281- (13) OTHER-PERSONAL-SERVICES EMPLOYEES (OPS). — 184
282- (c) The initial measurement period used to determine 185
283-whether an employee hired before April 1, 2013, and paid from 186
284-OPS funds is a full-time employee described in subparagraph 187
285-(2)(e)1. subparagraph (2)(c)1 . is the 6-month period from April 188
286-1, 2013, through September 30, 2013. 189
287- (d) All other measurement periods used to determine 190
288-whether an employee paid from OPS funds is a full -time employee 191
289-described in paragraph (2)(e) paragraph (2)(c) must be for 12 192
290-consecutive months. 193
291- Section 2. Paragraph (a) of subsection (2) of section 194
292-110.12303, Florida Statutes, is amended to read: 195
293- 110.12303 State group insurance program; additional 196
294-benefits; price transparency program; reporting. — 197
295- (2)(a) The department shall contract with at least one 198
296-entity that provides comprehensive pricing and inclusive 199
297-services for surgery and other medical procedures which may be 200
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273+whether an employee hired before April 1, 2013, and paid from 176
274+OPS funds is a full-time employee described in subparagraph 177
275+(2)(d)1. subparagraph (2)(c)1. is the 6-month period from April 178
276+1, 2013, through September 30, 2013. 179
277+ (d) All other measurement periods used to determine 180
278+whether an employee paid from OPS funds is a full -time employee 181
279+described in paragraph (2)(d) paragraph (2)(c) must be for 12 182
280+consecutive months. 183
281+ Section 2. Section 110.12306, Florida Statutes, is created 184
282+to read: 185
283+ 110.12306 Anti-fraud investigative units. — 186
284+ (1) As used in this section, the term "designated anti -187
285+fraud unit" means a distinct unit within the Division of State 188
286+Group Insurance which is made up of employees whose principal 189
287+responsibilities are the investigation and disposition of claims 190
288+and who are also assigned to investigate fraud. 191
289+ (2) By December 31, 2022, the division: 192
290+ (a)1. Shall establish and maintain a designated anti-fraud 193
291+unit to investigate and report possible fraudulent insurance 194
292+acts by insureds, persons making claims for services against the 195
293+State Employees Health Insurance Trust Fund, or vendors under 196
294+contract with the division. 197
295+ 2. May contract with other entities to investigate and 198
296+report possible fraudulent insurance acts by insureds, persons 199
297+making claims for services against the State Employees Health 200
298+
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306306 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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310-accessed at the option of the enrollee. The contract shall 201
311-require the entity to: 202
312- 1. The entity to have procedures and evidence -based 203
313-standards to ensure the inclusion of only high -quality health 204
314-care providers. 205
315- 2. The entity to provide assistance to the enrollee in 206
316-accessing and coordinating care. 207
317- 3. The entity to provide cost savings to the state group 208
318-insurance program to be shared with both the state and the 209
319-enrollee. Cost savings payable to an enrollee must, unless 210
320-prohibited by first-dollar coverage rules under applicable tax 211
321-law, include a waiver of enrollee cost -sharing liability for 212
322-surgery and other medical procedures. Cost savings may 213
323-additionally include amounts payable to an enrollee or 214
324-beneficiary as follows may be: 215
325- a. Credited to the enrollee's flexible spending account; 216
326- b. Credited to the enrollee's health savings account; 217
327- c. Credited to the enrollee's health reimbursement 218
328-account; or 219
329- d. Paid as additional health plan reimbursements not 220
330-exceeding the amount of the enrollee's out -of-pocket medical 221
331-expenses. 222
332- 4. The entity, in conjunction with the department, to 223
333-provide an educational c ampaign for enrollees to learn about the 224
334-services offered by the entity. 225
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310+Insurance Trust Fund, or vendors under contract with the 201
311+division. 202
312+ (b) Shall adopt an anti -fraud plan. 203
313+ (c) Shall designate staff with the primary responsibility 204
314+of implementing the requirements of this section. 205
315+ Section 3. Section 110.12313, Florida Statutes, is created 206
316+to read: 207
317+ 110.12313 Open enrollment period for eligible former 208
318+employees.—On or after October 1, 2022, for the plan year 209
319+beginning January 1, 2023, the Department of Management Services 210
320+shall provide an open enrollment period for eligible former 211
321+employees who want to obtain health insurance coverage under s. 212
322+110.123. The options offe red during the open enrollment period 213
323+must provide the same health insurance coverage as the coverage 214
324+provided to active employees and under the same premium payment 215
325+conditions in effect for early retirees. The department shall 216
326+continue to provide an open enrollment period for eligible 217
327+former employees for each successive plan year. An eligible 218
328+former employee who wishes to obtain health insurance coverage 219
329+under s. 110.123 must enroll in the state group insurance 220
330+program within 24 months after his or her da te of separation 221
331+from employment. 222
332+ Section 4. (1) The following rules, as filed for adoption 223
333+with the Department of State pursuant to the certification 224
334+packages dated October 1, 2019, and November 3, 2021, are 225
335+
336+HB 5009 2022
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338338
339339
340340 CODING: Words stricken are deletions; words underlined are additions.
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343343 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
344344
345345
346346
347- Section 3. Section 110.12306, Florida Statutes, is created 226
348-to read: 227
349- 110.12306 Anti-fraud investigative units. — 228
350- (1) As used in this section, the term "designated anti -229
351-fraud unit" means a distinct unit within the Division of State 230
352-Group Insurance which is made up of employees whose principal 231
353-responsibilities are the investigation and disposition of claims 232
354-and who are also assigned to investigate fraud. 233
355- (2) By December 31, 2022, the division: 234
356- (a)1. Shall establish and maintain a designated anti -fraud 235
357-unit to investigate and report possible fraudulent insurance 236
358-acts by insureds, persons making claims for services against the 237
359-State Employees Health Insurance Trust Fund, or vendors under 238
360-contract with the division. 239
361- 2. May contract with other entities to investigate and 240
362-report possible fraudulent insurance acts by insureds, persons 241
363-making claims for services against the State Employees Health 242
364-Insurance Trust Fund, or vend ors under contract with the 243
365-division. 244
366- (b) Shall adopt an anti -fraud plan. 245
367- (c) Shall designate staff with the primary responsibility 246
368-of implementing the requirements of this section. 247
369- Section 4. Section 110.12313, Florida Statutes, is created 248
370-to read: 249
371- 110.12313 Enrollment for eligible former employees. —An 250
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347+ratified for the sole and exclusive purpos e of satisfying any 226
348+condition on their effectiveness imposed under s. 227
349+110.123(3)(h)2.d., Florida Statutes: 228
350+ (a) Rule 60P-1.003, Florida Administrative Code, entitled 229
351+Definitions. 230
352+ (b) Rule 60P-2.002, Florida Administrative Code, entitled 231
353+Eligibility and Enrollment. 232
354+ (c) Rule 60P-2.003, Florida Administrative Code, entitled 233
355+Changes in Coverage. 234
356+ (2) This section serves no other purpose and may not be 235
357+codified in the Florida Statutes. The enactment and effective 236
358+dates of this act shall be noted in the Florida Administrative 237
359+Code, the Florida Administrative Register, or both, as 238
360+appropriate after the act becomes law. This section does not 239
361+alter rulemaking authority delegated by prior law, does not 240
362+constitute legislative preemption of or exception to any law 241
363+governing adoption or enforcement of the rule cited, and is 242
364+intended to preserve the status of any cited rule as a rule 243
365+under chapter 120, Florida Statutes. This section does not cure 244
366+any rulemaking defect or pre empt any challenge based on lack of 245
367+authority or a violation of the legal requirements governing the 246
368+adoption of any rule cited. 247
369+ (3) This section shall take effect upon becoming a law. 248
370+ Section 5. Except as otherwise expressly provided in this 249
371+act and except for this section, which shall take effect upon 250
372+
373+HB 5009 2022
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380380 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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384-eligible former employee may obtain health insurance coverage 251
385-under s. 110.123, and enroll in the state group insurance 252
386-program at any time within 24 months after his or her separation 253
387-from employment. The options provided to an eligible former 254
388-employee must be the same health insurance coverage and premium 255
389-payment conditions provided to covered retirees, except for life 256
390-insurance and flexible spending account plans. 257
391- Section 5. Subsection (3) of section 110.1239, Florida 258
392-Statutes, is amended to read: 259
393- 110.1239 State group health insurance program funding. —It 260
394-is the intent of the Legislature that the state group health 261
395-insurance program be managed, administered, operated, and funded 262
396-in such a manner as to maximize the protection of state employee 263
397-health insurance benefits. Inherent in this intent is the 264
398-recognition that the health insurance liabilities attributable 265
399-to the benefits offered state employees should be fairly, 266
400-orderly, and equitably fu nded. Accordingly: 267
401- (3) For purposes of funding, any additional appropriation 268
402-amounts allocated to the state group health insurance program by 269
403-the Legislature shall be considered as a state contribution and 270
404-thus an increase in the state premiums. 271
405- Section 6. (1) The following rules are ratified for the 272
406-sole and exclusive purpose of satisfying any condition on 273
407-effectiveness imposed under s. 110.123(3)(h)2.d., Florida 274
408-Statutes: Rules 60P-1.003, 60P-2.002, and 60P-2.003, Florida 275
409-ENROLLED
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417-F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
418-
419-
420-
421-Administrative Code, title d "Definitions," "Eligibility and 276
422-Enrollment," and "Changes in Coverage," respectively, as filed 277
423-for adoption with the Department of State pursuant to the 278
424-certification packages dated October 1, 2019, and November 4, 279
425-2021. 280
426- (2) This act may not be codifie d in the Florida Statutes. 281
427-After this act becomes law, its enactment and effective dates 282
428-shall be noted in the Florida Administrative Code or the Florida 283
429-Administrative Register, or both, as appropriate. This act does 284
430-not alter rulemaking authority delegat ed by prior law; provided 285
431-any amendment to a rule ratified pursuant to this act which 286
432-would modify the designated geographical areas for use in 287
433-procurements of Health Maintenance Organization services before 288
434-January 1, 2024, would require ratification by t he Legislature 289
435-before taking effect. This act does not constitute legislative 290
436-preemption of or exception to any provision of law governing 291
437-adoption or enforcement of the rules cited, and is intended to 292
438-preserve the status of any cited rule as a rule under chapter 293
439-120, Florida Statutes. This act does not cure any rulemaking 294
440-defect or preempt any challenge based on lack of authority or a 295
441-violation of the legal requirements governing the adoption of 296
442-any rule cited. 297
443- (3) This section shall take effect upon becoming a law. 298
444- Section 7. Except as otherwise expressly provided in this 299
445-act and except for this section, which shall take effect upon 300
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454-F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
455-
456-
457-
458-this act becoming a law, this act shall take effect July 1, 301
459-2022. 302
384+this act becoming a law, this act shall take effect July 1, 251
385+2022. 252