This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1545a.IBS
DATE: 3/27/2023
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1545 Health Insurance Identification Cards
SPONSOR(S): Stevenson
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Insurance & Banking Subcommittee 13 Y, 0 N Sellas Lloyd
2) Commerce Committee
SUMMARY ANALYSIS
The Department of Financial Services (DFS) has broad duties, including insurance consumer assistance and
protection. DFS conducts insurance-related consumer outreach through its Division of Consumer Services
(DCS). DCS provides education, information, and assistance to consumers for all products or services
regulated by DFS or the Financial Services Commission. The Florida Insurance Code (Code) regulates the
insurance industry in Florida and is primarily administered by the Florida Office of Insurance Regulation (OIR).
The Code requires certain content for prescription identification cards, health benefit plan identification cards,
and health management organization identification cards (collectively referred to as health-related identification
cards). This requirement includes required information such as the insured’s name, identification number, and
policy/group number.
The bill requires that health plans regulated by the state of Florida print the letters “FL” on the back left of the
health-related identification card accompanied with a quick response (QR) code that links to DCS consumer
complaint website. For health plans regulated by the federal government, the letters “FED” must be printed on
the back of the health-related identification card accompanied with a QR code that links to consumer complaint
website of the Centers for Medicare and Medicaid Services.
The bill has no impact on state and local government and an indeterminant negative fiscal impact on the
private sector.
The bill has an effective date of January 1, 2024. STORAGE NAME: h1545a.IBS PAGE: 2
DATE: 3/27/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Department of Financial Services and Division of Consumer Finance
The Department of Financial Services (DFS) has a number of regulatory responsibilities over the
Florida insurance market. DFS conducts insurance-related consumer outreach through its Division of
Consumer Services (DCS). DCS provides education, information, and assistance to consumers for all
products or services regulated by DFS or the Financial Services Commission (via the Office of
Insurance Regulation).
1
The divisions’ duties specifically include:
Receiving consumer questions and complaints;
Educating the public about insurance-related topics;
Providing mediation to resolve disputes between a consumer and insurance company; and
Serving as a conduit for referrals for further legal action by DFS.
2
Office of Insurance Regulation
The Office of Insurance Regulation (OIR) is the primary regulator over the transaction of insurance in
the state, in accordance with the Florida Insurance Code (Code). The Life and Health Unit of OIR
provides financial, conduct, and product oversight of health insurers, health maintenance organizations,
and other regulated entities providing health care coverage pursuant to various chapters of the Code.
The following laws constitute the Code:
3
Chapter 624, F.S. – Insurance Code: Administration and General Provisions
Chapter 626, F.S. – Insurance Field Representatives and Operations
Chapter 627, F.S. – Insurance Rates and Contracts
Chapter 631, F.S. – Insurer Insolvency; Guaranty of Payment
Chapter 632, F.S. – Fraternal Benefit Societies
Chapter 636, F.S. – Prepaid Limited Health Service Organizations and Discount Medical Plan
Organizations
Chapter 641, F.S. – Health Care Service Programs
Chapter 651, F.S. – Continuing Care Contracts
OIR regulatory activities include licensing, rate and form approval, market conduct review, issuing
certificates of authority, ensuring solvency, and administrative supervision.
Health Insurance
Health insurance is the insurance of human beings against bodily injury or disablement by accident or
sickness, including the expenses associated with such injury, disablement, or sickness.
4
Individuals
purchase health insurance coverage with the purpose of managing anticipated expenses related to
health or protecting themselves from unexpected medical bills or large health care costs. Managed
care systems combine the delivery and financing of health care services by limiting the choice of
doctors and hospitals.
In return for this limited choice, however, medical care is less costly due to the
1
DFS, Department of Financial Services Long Range Program Plan: Fiscal Years 2020-21 through 2024-25, 15 (Sept. 30,
2019), available at http://floridafiscalportal.state.fl.us/Document.aspx?ID=19566&DocType=PDF (last visited
March 23, 2023).
2
S. 624.307(10)(a), F.S.
3
S. 624.01, F.S.
4
S. 624.603, F.S. STORAGE NAME: h1545a.IBS PAGE: 3
DATE: 3/27/2023
managed care network’s ability to control health care services.
5
Some common forms of managed care
are preferred provider organizations
6
and health maintenance organizations
7
(HMO).
There are three types of health-related identification cards that require specific information to be printed
on the card under Florida law. This includes prescription benefits identification cards,
8
health benefit
plans identification cards,
9
and health management organization identification cards.
10
Some of the
statutorily required information on these cards include the insured’s name, identification number, and
group number.
11
This information is provided to “improve patient care by minimizing confusion,
eliminating unnecessary work, decreasing patient wait time, and improving business efficiencies.”
12
ERISA
The federal Employee Retirement and Income Security Act (ERISA) was passed in 1974 and prevents
states from directly regulating employee welfare benefits, including employer-sponsored health plans.
13
Even though ERISA preempts state regulation over employer-sponsored health plans, states retain
regulatory power over insurance carriers and health maintenance organizations (HMOs).
14
However,
employers that choose to “self-fund” are not subject to traditional state insurance laws. ERISA has
directly contributed to the current legal environment where a sizeable portion of health insurance plans
are regulated by the federal government.
15
Effect of the Bill
The bill specifies additional information that must be included on prescription identification cards, health
benefit plan identification cards, and health maintenance organization identification cards. If the
insurance plan is subject to state regulation the identification card must include the letters “FL” on the
back left of the card and a quick response (QR) code that links to the consumer complaint website of
DCS. If the insurance plan is subject to Federal regulation the identification card must include the
letters “FED” on the back left of the card and a QR code that links to the consumer complaint website of
the Centers for Medicare and Medicaid Services. Finally, the bill allows for DFS to adopt rules to
implement necessary changes to the consumer complaint website and hotline of DCS.
B. SECTION DIRECTORY:
Section 1: Amends s. 627.4302, F.S., relating to identification cards for processing prescription
drug claims.
Section 2: Amends s. 627.642, F.S., relating to outline of coverage.
Section 3: Amends s. 627.657, F.S., relating to provisions of group health insurance policies.
Section 4: Amends s. 641.31, F.S., relating to health maintenance contracts.
Section 5: Provides an effective date of January 1, 2024.
5
MedlinePlus, Managed Care, https://medlineplus.gov/managedcare.html (last visited March 23, 2023).
6
See s. 627.6471, F.S.
7
See part I of chapter 641, F.S.
8
See s. 627.4302., F.S.
9
Health benefit plan is defined in s. 627.6699(3)(k). See ss. 627.642 and 627.657, F.S.
10
See s. 641.31, F.S.
11
See s. 627.4302(2), F.S.
12
S. 627.4302(1), F.S.
13
Kaiser Family Foundation, ERISA Plans, https://www.kff.org/wp-content/uploads/sites/3/2015/06/c11.pdf (last visited
March 23, 2023).
14
Id.
15
U.S. Department of Labor, Fact Sheet: What Is ERISA, https://www.dol.gov/agencies/ebsa/about-ebsa/our-
activities/resource-center/fact-sheets/what-is-erisa (last visited March 23, 2023). As of 2013 ERISA covered 141 million
individuals. Id. STORAGE NAME: h1545a.IBS PAGE: 4
DATE: 3/27/2023
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
16
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
Private businesses will be required to add content to health-related identification cards that are not
currently required. This will have an indeterminant negative impact as businesses will need to comply
with the bill’s requirements.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not Applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
This bill provides DFS with the authority necessary to implement the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
It is unclear what power, if any, the state has to regulate the identification cards of federally regulated
health plans. Additionally, the Centers for Medicare and Medicaid Services is the regulator for Medicare
plans but does not regulate self-funded plans. Self-funded plans are regulated by the Department of
Labor and would be the appropriate resource for individuals with a self-funded plan to refer to.
16
While health insurance cards issued under the authority of the Division of State Group Insurance, for current and former
state employees, and the Agency for Health Care Administration, for Medicaid and other state health program
beneficiaries, will need to comply with the bill, this will be done as new and replacement cards are issued. This should
mitigate any fiscal impact on the state. STORAGE NAME: h1545a.IBS PAGE: 5
DATE: 3/27/2023
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES