HB 897 2023
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FL 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
A bill to be entitled 1
An act relating to group health plans; amending s. 2
624.438, F.S.; revising the definition of and 3
providing requirements for bona fide groups for 4
purposes of issuance of certificates of authority and 5
multiple-employer welfare arrangements; providing an 6
effective date. 7
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Be It Enacted by the Legislature of the State of Florida: 9
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Section 1. Paragraph (b) of subsection (1) of section 11
624.438, Florida Statutes, is amended to read: 12
624.438 General eligibility. — 13
(1) To meet the requirements for issuance of a certificate 14
of authority and to maintain a multiple -employer welfare 15
arrangement, an arrangement: 16
(b) Must be established by a trade asso ciation, industry 17
association, professional association of employers or 18
professionals, or a bona fide group that as defined in 29 C.F.R. 19
part 2510.3-5 which has a constitution or bylaws specifically 20
stating its purpose and that which has been organized for 21
purposes in addition to obtaining or providing insurance. 22
1. A trade association consists of member employers who 23
are in the same trade as recognized by the appropriate licensing 24
agency. 25
HB 897 2023
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FL 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
2. An industry association consists of member employers 26
who are in the same major group code, as defined by the Standard 27
Industrial Classification Manual issued by the federal Office of 28
Management and Budget, unless restricted by subparagraph 1. or 29
subparagraph 3. 30
3. A professional association consists of member empl oyers 31
who are of the same profession as recognized by the appropriate 32
licensing agency. 33
4. A bona fide group is an employee welfare benefit plan 34
consisting of a group or association of member employers which 35
meets the following requirements: 36
a. The primary purpose of the group or association may be 37
to offer and provide health coverage to its member employers and 38
their employees, but the group or association has at least one 39
substantial business purpose that is unrelated to offering and 40
providing health coverage or other employee benefits to its 41
member employers and their employees. For purposes of this 42
subparagraph, as a safe harbor, a substantial business purpose 43
is considered to exist if the group or association would be a 44
viable entity in the absence of sponsoring an employee benefit 45
plan. The business purpose includes promoting common business 46
interests of its members or the common economic interests in a 47
given trade or employer community, and is not required to be a 48
for-profit activity. 49
b. Each member employer of the group or association 50
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FL 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
participating in the group health plan is a person acting 51
directly as an employer of at least one employee who is a 52
participant covered under the plan. 53
c. The group or association has a formal organizational 54
structure with a governing body. 55
d. The functions and activities of the group or 56
association are controlled by its member employers, and the 57
group's or association's member employers that participate in 58
the group health plan control the plan. Control must be present 59
both in form and in substance. 60
e. The member employers have a principal place of business 61
in the same region that does not exceed the boundaries of a 62
single state or a metropolitan area, even if the metropolitan 63
area includes more than one state. 64
f. The group or association does not make health coverage 65
through the group's or association's group health plan available 66
other than to: 67
(I) Participating member employers. 68
(II) An employee of a current participating member 69
employer. 70
(III) A former employee of a current participating 71
employer member who became eligible for coverage under the group 72
health plan when the former employee was an employee of the 73
employer. 74
(IV) A spouse, a dependent child, or any other 75
HB 897 2023
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FL 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
beneficiaries of an individual described in sub -sub-subparagraph 76
(I) or sub-sub-subparagraph (II). 77
g. The group or association and the health coverage 78
offered by the group or association comply with the 79
nondiscrimination provisions of s. 627.6699. 80
h. The group or associat ion is not a health insurance 81
issuer, or owned or controlled by a health insurance issuer or 82
by a subsidiary or affiliate of a health insurance issuer, other 83
than to the extent such entities participate in the group or 84
association in their capacity as memb er employers of the group 85
or association. 86
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The requirements of this paragraph do not apply to an 88
arrangement licensed before April 1, 1995, regardless of the 89
nature of its business. However, an arrangement exempt from the 90
requirements of this paragraph may not expand the nature of its 91
business beyond that set forth in the articles of incorporation 92
of its sponsoring association as of April 1, 1995, except as 93
authorized in this paragraph. 94
Section 2. This act shall take effect July 1, 2023. 95