Florida Senate - 2022 SB 1660 By Senator Gruters 23-01227-22 20221660__ 1 A bill to be entitled 2 An act relating to dependent eligibility for state 3 group health insurance enrollment; amending s. 4 110.12301, F.S.; designating the Department of 5 Management Services, rather than the Division of State 6 Group Insurance, as the entity that contracts for 7 dependent eligibility services in the state group 8 insurance program; authorizing the department or the 9 contractor providing dependent eligibility 10 verification services to require certain information 11 from subscribers; deleting obsolete language; revising 12 the records retention schedule regarding documents 13 obtained during the dependent eligibility verification 14 process; providing an effective date. 15 16 Be It Enacted by the Legislature of the State of Florida: 17 18 Section 1.Subsections (1) and (2) of section 110.12301, 19 Florida Statutes, are amended to read: 20 110.12301Competitive procurement of postpayment claims 21 review services and dependent eligibility verification services; 22 public records exemption. 23 (1)The Division of State Group Insurance is directed to 24 competitively procure postpayment claims review services for the 25 state group health insurance plans established pursuant to s. 26 110.123. Compensation under the contract must shall be paid from 27 amounts identified as claim overpayments that are made by or on 28 behalf of the health plans and that are recovered by the vendor. 29 The vendor may retain that portion of the amount recovered as 30 provided in the contract. The contract must require the vendor 31 to maintain all necessary documentation supporting the amounts 32 recovered, retained, and remitted to the division.; and 33 (2)The Department of Management Services Division of State 34 Group Insurance is directed to competitively procure a contract 35 for dependent eligibility verification services for the state 36 group insurance program; however, compensation under the 37 contract may not exceed historical claim costs for the prior 12 38 months for the dependent populations disenrolled as a result of 39 the contractors services. 40 (a)1.By September 1, 2017, the division shall notify all 41 subscribers regarding the eligibility rules for dependents. 42 Through November 30, 2017, the division must hold subscribers 43 harmless for past claims of ineligible dependents if such 44 dependents are removed from plan membership before December 1, 45 2017. 46 2.Subparagraph 1. does not apply to any dependent 47 identified as ineligible before July 1, 2017, for which the 48 department has notified the state agency employing the 49 associated subscriber. 50 (b)The department or the contractor providing dependent 51 eligibility verification services may require request the 52 following information from subscribers: 53 1.To prove a spouses eligibility: 54 a.If married less than 12 months and the subscriber and 55 his or her spouse have not filed a joint federal income tax 56 return, a government-issued marriage certificate; or 57 b.If married for 12 or more months, a transcript of the 58 most recently filed federal income tax return. 59 2.To prove a biological childs or a newborn grandchilds 60 eligibility, a government-issued birth certificate. 61 3.To prove an adopted childs eligibility: 62 a.An adoption certificate; or 63 b.An adoption placement agreement and a petition for 64 adoption. 65 4.To prove a stepchilds eligibility: 66 a.A government-issued birth certificate for the stepchild; 67 and 68 b.The transcript of the subscribers most recently filed 69 federal income tax return. 70 5.Any other information necessary to verify the 71 dependents eligibility for enrollment in the state group 72 insurance program. 73 (b)(c)If a document requested from a subscriber is not 74 confidential or exempt from public records requirements, the 75 division and the contractor shall disclose to all subscribers 76 that such information submitted to verify the eligibility of 77 dependents may be subject to disclosure and inspection under 78 chapter 119. 79 (c)(d)A government-issued marriage license or marriage 80 certificate submitted for dependent eligibility verification 81 must include the date of the marriage between the subscriber and 82 the spouse. 83 (d)(e)A government-issued birth certificate submitted for 84 dependent eligibility verification must list the parents names. 85 (e)(f)Foreign-born subscribers unable to obtain the 86 necessary documentation within the specified time period of 87 producing verification documentation may execute a signed 88 affidavit attesting to eligibility requirements. 89 (f)(g)Documentation submitted to verify eligibility may be 90 an original or a photocopy of an original document. Before 91 submitting a document, the subscriber may redact any information 92 on a document which is not necessary to verify the eligibility 93 of the dependent. 94 (g)(h)All documentation obtained by the contractor to 95 conduct the dependent eligibility verification services must be 96 retained in accordance with the applicable records retention 97 schedule until June 30, 2019. The department or the contractor 98 is not required to retain such documentation after June 30, 99 2019, and shall destroy such documentation as soon as 100 practicable after such date. 101 Section 2.This act shall take effect upon becoming a law.