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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
A bill to be entitled 1
An act relating to the Florida Health Choices Program; 2
amending s. 408.910, F.S.; revising the name of the 3
"Florida Health Choices Program" to the "Florida 4
Employee Health Choices Program"; revising legislative 5
intent; revising definitions; revising program purpose 6
and components to provide for the sale and purchase of 7
individual health insurance plans to employees 8
enrolled in individual coverage health reimb ursement 9
arrangements; removing provisions relating to certain 10
health care service providers, organizations, 11
entities, and vendors, vendor procedures, products 12
available for purchase through the program, pricing, 13
risk pooling, and exemptions; revising the marketplace 14
process; revising corporation responsibilities; 15
revising the fiscal year in which the corporation's 16
annual report is due; amending ss. 409.821, 409.9122, 17
and 409.977, F.S.; conforming provisions to changes 18
made by the act; providing an effectiv e date. 19
20
Be It Enacted by the Legislature of the State of Florida: 21
22
Section 1. Section 408.910, Florida Statutes, is amended 23
to read: 24
408.910 Florida Employee Health Choices Program. — 25
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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
(1) LEGISLATIVE INTENT. —The Legislature finds that a 26
significant number of employers and employees in the residents 27
of this state do not have adequate access to affordable, quality 28
health insurance that meets their needs care. The Legislature 29
further finds that individual coverage health reimbursement 30
arrangements offer a novel way for employers of any size to give 31
health care contributions directly to employees and empower them 32
to choose their own health plan in a broad marketplace based on 33
individual financial needs and health factors. The Legislature 34
further finds that increasing access to affordable, quality 35
health care through individual coverage health reimbursement 36
arrangements can be best accomplished by establishing a 37
competitive marketplace market for employees that receive 38
employer premium contributions th rough individual coverage 39
health reimbursement arrangements purchasing health insurance 40
and health services. It is therefore the intent of the 41
Legislature to create the Florida Employee Health Choices 42
Program to: 43
(a) Expand opportunities for employers and employees 44
Floridians to access purchase affordable health insurance in 45
this state and health services. 46
(b) Create a platform that streamlines the purchase of 47
individual coverage for employees enrolled in individual 48
coverage health reimbursement arrange ments Preserve the benefits 49
of employment-sponsored insurance while easing the 50
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administrative burden for employers who offer these benefits . 51
(c) Enable individual choice in both the manner and amount 52
of health care purchased. 53
(d) Provide for the purcha se of individual, portable 54
health care coverage. 55
(e) Disseminate information to employers and employees 56
about individual coverage health reimbursement arrangements 57
consumers on the price and quality of health services . 58
(f) Sponsor a competitive market that stimulates product 59
innovation, quality improvement, and efficiency in the 60
production and delivery of individual health insurance plans to 61
employees enrolled in individual coverage health reimbursement 62
arrangements health services. 63
(2) DEFINITIONS.—As used in this section, the term: 64
(a) "Corporation" means the Florida Employee Health 65
Choices, Inc., established under this section. 66
(b) "Corporation's marketplace" means the single, 67
centralized market established by the program that facilitates 68
the purchase of products made available in the marketplace. 69
(c) "Health insurance agent" means an agent licensed under 70
part IV of chapter 626. 71
(d) "Insurer" means an entity licensed under chapter 624 72
which offers an individual health insurance policy or a group 73
health insurance policy , a preferred provider organization as 74
defined in s. 627.6471, an exclusive provider organization as 75
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defined in s. 627.6472, or a health maintenance organization 76
licensed under part I of chapter 641 , or a prepaid limited 77
health service organization or discount plan organization 78
licensed under chapter 636 . 79
(e) "Program" means the Florida Employee Health Choices 80
Program established by this section. 81
(3) PROGRAM PURPOSE AND COMPONENTS. —The Florida Employee 82
Health Choices Program is created as a single, centralized 83
market for the sale and purchase of individual health insurance 84
plans to employees enrolled in individual coverage health 85
reimbursement arrangements various products that enable 86
individuals to pay for health care. These products include, but 87
are not limited to, health insurance plans, health maintenance 88
organization plans, prepaid services, service contracts, and 89
flexible spending accounts . The components of the program 90
include: 91
(a) Enrollment of employers. 92
(b) Administrative services for participating employers, 93
including: 94
1. Assistance in seeking federal approval of cafeteria 95
plans. 96
2. Collection of premiums and other payments. 97
3. Management of individual benefit accounts. 98
4. Distribution of premiums to insu rers and payments to 99
other eligible vendors. 100
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5. Assistance for participants in complying with reporting 101
requirements. 102
(c) Services to individual participants, including: 103
1. Information about available products and participating 104
vendors. 105
2. Assistance with assessing the benefits and limits of 106
each product, including information necessary to distinguish 107
between policies offering creditable coverage and other products 108
available through the program . 109
3. Account information to assist individual particip ants 110
with managing available resources. 111
4. Services that promote healthy behaviors. 112
(d) Recruitment of vendors, including insurers and, health 113
maintenance organizations , prepaid clinic service providers, 114
provider service networks, and other providers . 115
(e) Certification of vendors to ensure capability, 116
reliability, and validity of offerings. 117
(f) Collection of data, monitoring, assessment, and 118
reporting of vendor performance. 119
(g) Information services for individuals and employers. 120
(h) Program evaluation. 121
(4) ELIGIBILITY AND PARTICIPATION. —Participation in the 122
program is voluntary and shall be available to employers, 123
individuals, vendors, and health insurance agents as specified 124
in this subsection. 125
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(a) Employers eligible to enroll in the program include 126
those employers that meet criteria established by the 127
corporation and elect to make their employees eligible through 128
the program. 129
(b) Individuals eligible to participate in the program 130
include: 131
1. Individual employees of enrolled employers. 132
2. Other individuals that meet criteria established by the 133
corporation. 134
(c) Employers who choose to participate in the program may 135
enroll by complying with the procedures established by the 136
corporation. The procedures must include, but are not limited 137
to: 138
1. Submission of required information. 139
2. Compliance with federal tax requirements for the 140
establishment of a cafeteria plan, pursuant to s. 125 of the 141
Internal Revenue Code, including designation of the employer's 142
plan as a premium payment plan, a s alary reduction plan that has 143
flexible spending arrangements, or a salary reduction plan that 144
has a premium payment and flexible spending arrangements. 145
3. Determination of the employer's contribution, if any, 146
per employee, provided that such contribution is equal for each 147
eligible employee. 148
4. Establishment of payroll deduction procedures, subject 149
to the agreement of each individual employee who voluntarily 150
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participates in the program. 151
5. Designation of the corporation as the third -party 152
administrator for the employer's health benefit plan. 153
6. Identification of eligible employees. 154
7. Arrangement for periodic payments. 155
8. Employer notification to employees of the intent to 156
transfer from an existing employee health plan to the program at 157
least 90 days before the transition. 158
(d) All eligible vendors who choose to participate and the 159
products and services that the vendors are permitted to sell are 160
as follows: 161
1. Insurers licensed under chapter 624 may sell health 162
insurance policies, limited benefit policies, other risk -bearing 163
coverage, and other products or services . 164
2. Health maintenance organizations licensed under part I 165
of chapter 641 may sell health maintenance contracts , limited 166
benefit policies, other risk -bearing products, and other 167
products or services. 168
3. Prepaid limited health service organizations may sell 169
products and services as authorized under part I of chapter 636, 170
and discount plan organizations may sell products and services 171
as authorized under part II of chapter 636. 172
4. Prepaid health clinic service providers licensed under 173
part II of chapter 641 may sell prepaid service contracts and 174
other arrangements for a specified amount and type of health 175
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services or treatments. 176
5. Health care providers, including hospitals and othe r 177
licensed health facilities, health care clinics, licensed health 178
professionals, pharmacies, and other licensed health care 179
providers, may sell service contracts and arrangements for a 180
specified amount and type of health services or treatments. 181
6. Provider organizations, including service networks, 182
group practices, professional associations, and other 183
incorporated organizations of providers, may sell service 184
contracts and arrangements for a specified amount and type of 185
health services or treatments. 186
7. Corporate entities providing specific health services 187
in accordance with applicable state law may sell service 188
contracts and arrangements for a specified amount and type of 189
health services or treatments. 190
191
A vendor described in subparagraphs 3. -7. may not sell products 192
that provide risk-bearing coverage unless that vendor is 193
authorized under a certificate of authority issued by the Office 194
of Insurance Regulation and is authorized to provide coverage in 195
the relevant geographic area. Otherwise Eligible vendors may be 196
excluded from participating in the program for deceptive or 197
predatory practices, financial insolvency, or failure to comply 198
with the terms of the participation agreement or other standards 199
set by the corporation. 200
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(e) Eligible individuals may par ticipate in the program 201
voluntarily. Individuals who join the program may participate by 202
complying with the procedures established by the corporation. 203
These procedures must include, but are not limited to: 204
1. Submission of required information. 205
2. Authorization for payroll deduction. 206
3. Compliance with federal tax requirements. 207
4. Arrangements for payment. 208
5. Selection of products and services. 209
(f) Vendors who choose to participate in the program may 210
enroll by complying with the procedures estab lished by the 211
corporation. These procedures may include, but are not limited 212
to: 213
1. Submission of required information, including a 214
complete description of the coverage, services, provider 215
network, payment restrictions, and other requirements of each 216
product offered through the program. 217
2. Execution of an agreement to comply with requirements 218
established by the corporation. 219
3. Execution of an agreement that prohibits refusal to 220
sell any offered product or service to a participant who elects 221
to buy it. 222
4. Establishment of product prices based on applicable 223
criteria. 224
4.5. Arrangements for receiving payment for enrolled 225
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participants. 226
5.6. Participation in ongoing reporting processes 227
established by the corporation. 228
6.7. Compliance with grievance procedures established by 229
the corporation. 230
(g) Health insurance agents licensed under part IV of 231
chapter 626 are eligible to voluntarily participate as buyers' 232
representatives. A buyer's representative acts on behalf of an 233
individual purchasing health insurance and health services 234
through the program by providing information about products and 235
services available through the program and assisting the 236
individual with both the decision and the procedure of selecting 237
specific products. Serving as a buyer's representative does not 238
constitute a conflict of interest with continuing 239
responsibilities as a health insurance agent if the relationship 240
between each agent and any participating vendor is disclosed 241
before advising an individual participant about the products and 242
services available through the program. In order to participate, 243
a health insurance agent shall comply with the procedures 244
established by the corporation, including: 245
1. Completion of training requirements. 246
2. Execution of a participation agreement specifying the 247
terms and conditions of participation. 248
3. Disclosure of any appointments to solicit insurance or 249
procure applications for vendors participating in the program. 250
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4. Arrangements to receive payment from the co rporation 251
for services as a buyer's representative. 252
(5) PRODUCTS.— 253
(a) The products that may be made available for purchase 254
through the program include , but are not limited to : 255
(a)1. Health insurance policies. 256
(b)2. Health maintenance contracts. 257
3. Limited benefit plans. 258
4. Prepaid clinic services. 259
5. Service contracts. 260
6. Arrangements for purchase of specific amounts and types 261
of health services and treatments. 262
7. Flexible spending accounts. 263
(b) Health insurance policies, health mainten ance 264
contracts, limited benefit plans, prepaid service contracts, and 265
other contracts for services must ensure the availability of 266
covered services. 267
(c) Products may be offered for multiyear periods provided 268
the price of the product is specified for the entire period or 269
for each separately priced segment of the policy or contract. 270
(d) The corporation shall provide a disclosure form for 271
consumers to acknowledge their understanding of the nature of, 272
and any limitations to, the benefits provided by the pro ducts 273
and services being purchased by the consumer. 274
(e) The corporation must determine that making the plan 275
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available through the program is in the interest of eligible 276
individuals and eligible employers in the state. 277
(6) SURCHARGE PRICING.—Prices for the products and 278
services sold through the program must be transparent to 279
participants and established by the vendors. The corporation 280
shall annually assess a surcharge for each premium or price set 281
by a participating vendor. The surcharge may not be more than 282
2.5 percent of the price and shall be used to generate funding 283
for administrative services provided by the corporation and 284
payments to buyers' representatives. 285
(7) THE MARKETPLACE PROCESS. —The program shall provide a 286
single, centralized market for access to purchase of health 287
insurance and, health maintenance contracts by an employee 288
enrolled in an individual coverage health reimbursement 289
arrangement, and other health products and services . Purchases 290
may be made by participating individuals over the Internet or 291
through the services of a participating health insurance agent. 292
Information about each product and service available through the 293
program shall be made available through printed material and an 294
interactive Internet website. A participant needing personal 295
assistance to select products and services shall be referred to 296
a participating agent in his or her area. 297
(a) Participation in the program may begin at any time 298
during a year after the employer completes enrollment and meets 299
the requirements specified by the corporation pursuant to 300
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paragraph (4)(c). 301
(b) Initial selection of products and services must be 302
made by an individual participant within the applicable open 303
enrollment period. 304
(c) Initial enrollment periods for each product selected 305
by an individual participant must last at least 12 months, 306
unless the individual participant specifically agrees to a 307
different enrollment period. 308
(d) If an individual has selected one or more products and 309
enrolled in those products for at least 12 months o r any other 310
period specifically agreed to by the individual participant, 311
changes in selected products and services may only be made 312
during the annual enrollment period established by the 313
corporation. 314
(e) The limits established in paragraphs (b) -(d) apply to 315
any risk-bearing product that promises future payment or 316
coverage for a variable amount of benefits or services. The 317
limits do not apply to initiation of flexible spending plans if 318
those plans are not associated with specific high -deductible 319
insurance policies or the use of spending accounts for any 320
products offering individual participants specific amounts and 321
types of health services and treatments at a contracted price. 322
(8) CONSUMER INFORMATION. —The corporation shall: 323
(a) Establish a secure websi te to facilitate the purchase 324
of products and services by participating individuals. The 325
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website must provide information about each product or service 326
available through the program. 327
(b) Inform individuals about other public health care 328
programs. 329
(9) RISK POOLING.—The program may use methods for pooling 330
the risk of individual participants and preventing selection 331
bias. These methods may include, but are not limited to, a 332
postenrollment risk adjustment of the premium payments to the 333
vendors. The corpora tion may establish a methodology for 334
assessing the risk of enrolled individual participants based on 335
data reported annually by the vendors about their enrollees. 336
Distribution of payments to the vendors may be adjusted based on 337
the assessed relative risk pr ofile of the enrollees in each 338
risk-bearing product for the most recent period for which data 339
is available. 340
(9)(10) EXEMPTIONS.— 341
(a) Products, other than the products set forth in 342
subparagraphs (4)(d)1. -4., sold as part of the program are not 343
subject to the licensing requirements of the Florida Insurance 344
Code, as defined in s. 624.01 or the mandated offerings or 345
coverages established in part VI of chapter 627 and chapter 641. 346
(b) The corporation may act as an administrator as defined 347
in s. 626.88 but is not required to be certified pursuant to 348
part VII of chapter 626. However, a third party administrator 349
used by the corporation must be certified under part VII of 350
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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
chapter 626. 351
(c) Any standard forms, website design, or marketing 352
communication develope d by the corporation and used by the 353
corporation, or any vendor that meets the requirements of 354
paragraph (4)(f) is not subject to the Florida Insurance Code, 355
as established in s. 624.01. 356
(10)(11) CORPORATION.—There is created the Florida 357
Employee Health Choices, Inc., which shall be registered, 358
incorporated, organized, and operated in compliance with part 359
III of chapter 112 and chapters 119, 286, and 617. The purpose 360
of the corporation is to administer the program created in this 361
section and to conduct such other business as may further the 362
administration of the program. 363
(a) The corporation shall be governed by a 15 -member board 364
of directors consisting of: 365
1. Three ex officio, nonvoting members to include: 366
a. The Secretary of Health Care Admi nistration or a 367
designee with expertise in health care services. 368
b. The Secretary of Management Services or a designee with 369
expertise in state employee benefits. 370
c. The commissioner of the Office of Insurance Regulation 371
or a designee with expertise in insurance regulation. 372
2. Four members appointed by and serving at the pleasure 373
of the Governor. 374
3. Four members appointed by and serving at the pleasure 375
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of the President of the Senate. 376
4. Four members appointed by and serving at the pleasure 377
of the Speaker of the House of Representatives. 378
5. Board members may not include insurers, health 379
insurance agents or brokers, health care providers, health 380
maintenance organizations, prepaid service providers, or any 381
other entity, affiliate , or subsidiary of eligible vendors. 382
(b) Members shall be appointed for terms of up to 3 years. 383
Any member is eligible for reappointment. A vacancy on the board 384
shall be filled for the unexpired portion of the term in the 385
same manner as the original appointment. 386
(c) The board shall select a chief executive officer for 387
the corporation who shall be responsible for the selection of 388
such other staff as may be authorized by the corporation's 389
operating budget as adopted by the board. 390
(d) Board members are entitled to receive, f rom funds of 391
the corporation, reimbursement for per diem and travel expenses 392
as provided by s. 112.061. No other compensation is authorized. 393
(e) There is no liability on the part of, and no cause of 394
action shall arise against, any member of the board or its 395
employees or agents for any action taken by them in the 396
performance of their powers and duties under this section. 397
(f) The board shall develop and adopt bylaws and other 398
corporate procedures as necessary for the operation of the 399
corporation and carry ing out the purposes of this section. The 400
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bylaws shall: 401
1. Specify procedures for selection of officers and 402
qualifications for reappointment, provided that no board member 403
shall serve more than 9 consecutive years. 404
2. Require an annual membership meeti ng that provides an 405
opportunity for input and interaction with individual 406
participants in the program. 407
3. Specify policies and procedures regarding conflicts of 408
interest, including the provisions of part III of chapter 112, 409
which prohibit a member from p articipating in any decision that 410
would inure to the benefit of the member or the organization 411
that employs the member. The policies and procedures shall also 412
require public disclosure of the interest that prevents the 413
member from participating in a decisi on on a particular matter. 414
(g) The corporation may exercise all powers granted to it 415
under chapter 617 necessary to carry out the purposes of this 416
section, including, but not limited to, the power to receive and 417
accept grants, loans, or advances of funds from any public or 418
private agency and to receive and accept from any source 419
contributions of money, property, labor, or any other thing of 420
value to be held, used, and applied for the purposes of this 421
section. 422
(h) The corporation shall: 423
1. Determine eligibility of employers, vendors, 424
individuals, and agents in accordance with subsection (4). 425
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2. Establish procedures necessary for the operation of the 426
program, including, but not limited to, procedures for 427
application, enrollment, risk assessment, risk a djustment, plan 428
administration, performance monitoring, and consumer education. 429
3. Arrange for collection of contributions from 430
participating employers and individuals. 431
4. Arrange for payment of premiums and other appropriate 432
disbursements based on the selections of products and services 433
by the individual participants. 434
5. Establish criteria for disenrollment of participating 435
individuals based on failure to pay the individual's share of 436
any contribution required to maintain enrollment in selected 437
products. 438
6. Establish criteria for exclusion of vendors pursuant to 439
paragraph (4)(d). 440
7. Develop and implement a plan for promoting public 441
awareness of and participation in the program. 442
8. Secure staff and consultant services necessary to the 443
operation of the program. 444
9. Establish policies and procedures regarding 445
participation in the program for individuals, vendors, health 446
insurance agents, and employers. 447
10. Provide for the operation of a toll -free hotline to 448
respond to requests for assistance . 449
11. Provide for initial, open, and special enrollment 450
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periods. 451
12. Evaluate options for employer participation which may 452
conform with common insurance practices. 453
(11)(12) REPORT.—Beginning in the 2026-2027 2009-2010 454
fiscal year, submit by February 1 an annual report to the 455
Governor, the President of the Senate, and the Speaker of the 456
House of Representatives documenting the corporation's 457
activities in compliance with the duties delineated in this 458
section. 459
(12)(13) PROGRAM INTEGRITY.—To ensure program integrity 460
and to safeguard the financial transactions made under the 461
auspices of the program, the corporation is authorized to 462
establish qualifying criteria and certification procedures for 463
vendors, require performance bonds or other guarantees of 464
ability to complete contractual obligations, monitor the 465
performance of vendors, and enforce the agreements of the 466
program through financial penalty or disqualification from the 467
program. 468
(13)(14) EXEMPTION FROM PUBLIC RECORDS REQUIREMENTS. — 469
(a) Definitions.—For purposes of this subsection, the 470
term: 471
1. "Buyer's representative" means a participating 472
insurance agent as described in paragraph (4)(g). 473
2. "Enrollee" means an employer who is eligible to enroll 474
in the program pursuant to paragraph (4)(a). 475
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3. "Participant" means an individual who is eligible to 476
participate in the program pursuant to paragraph (4)(b). 477
4. "Proprietary confidential business information" means 478
information, regardless of form or characteristics, that is 479
owned or controlled by a v endor requesting confidentiality under 480
this section; that is intended to be and is treated by the 481
vendor as private in that the disclosure of the information 482
would cause harm to the business operations of the vendor; that 483
has not been disclosed unless disc losed pursuant to a statutory 484
provision, an order of a court or administrative body, or a 485
private agreement providing that the information may be released 486
to the public; and that is information concerning: 487
a. Business plans. 488
b. Internal auditing contro ls and reports of internal 489
auditors. 490
c. Reports of external auditors for privately held 491
companies. 492
d. Client and customer lists. 493
e. Potentially patentable material. 494
f. A trade secret as defined in s. 688.002. 495
5. "Vendor" means a participating ins urer or health 496
maintenance organization or other provider of services as 497
described in paragraph (4)(d) . 498
(b) Public record exemptions. — 499
1. Personal identifying information of an enrollee or 500
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participant who has applied for or participates in the Florida 501
Employee Health Choices Program is confidential and exempt from 502
s. 119.07(1) and s. 24(a), Art. I of the State Constitution. 503
2. Client and customer lists of a buyer's representative 504
held by the corporation are confidential and exempt from s. 505
119.07(1) and s. 24(a), Art. I of the State Constitution. 506
3. Proprietary confidential business information held by 507
the corporation is confidential and exempt from s. 119.07(1) and 508
s. 24(a), Art. I of the State Constitution. 509
(c) Retroactive application. —The public record exemptions 510
provided for in paragraph (b) apply to information held by the 511
corporation before, on, or after the effective date of this 512
exemption. 513
(d) Authorized release. — 514
1. Upon request, information made confidential and exempt 515
pursuant to this subsection shall be disclosed to: 516
a. Another governmental entity in the performance of its 517
official duties and responsibilities. 518
b. Any person who has the written consent of the program 519
applicant. 520
c. The Florida Kidcare program for the purpose of 521
administering the program authorized in ss. 409.810 -409.821. 522
2. Paragraph (b) does not prohibit a participant's legal 523
guardian from obtaining confirmation of coverage, dates of 524
coverage, the name of the participant's health plan, and the 525
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amount of premium being paid. 526
(e) Penalty.—A person who knowingly and willfully violates 527
this subsection commits a misdemeanor of the second degree, 528
punishable as provided in s. 775.082 or s. 775.083. 529
Section 2. Paragraph (a) of subsection (2) of section 530
409.821, Florida Statutes, is amended to read: 531
409.821 Florida Kidcare program public records exemption. — 532
(2)(a) Upon request, such information shall be disclosed 533
to: 534
1. Another governmental entity in the performance of its 535
official duties and responsibilities; 536
2. The Department of Revenue for purposes of administering 537
the state Title IV-D program; 538
3. The Florida Employee Health Choices, Inc., for the 539
purpose of administering the program authorized pursuant to s. 540
408.910; or 541
4. Any person who has the written consent of the program 542
applicant. 543
Section 3. Subsection (3) of section 409.9122, Florida 544
Statutes, is amended to read: 545
409.9122 Medicaid managed care enrollment; HIV/AIDS 546
patients; procedures; data collection; accounting; information 547
system; medical loss ratio.— 548
(3) The agency shall develop a process to enable any 549
recipient with access to employer -sponsored health care coverage 550
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to opt out of all eligible plans in the Medicaid program and to 551
use Medicaid financial assistance to pay for the recipient' s 552
share of cost in any such employer -sponsored coverage. 553
Contingent on federal approval, the agency shall also enable 554
recipients with access to other insurance or related products 555
that provide access to health care services created pursuant to 556
state law, including any plan or product available pursuant to 557
the Florida Employee Health Choices Program or any health 558
exchange, to opt out. The amount of financial assistance 559
provided for each recipient may not exceed the amount of the 560
Medicaid premium that would h ave been paid to a plan for that 561
recipient. 562
Section 4. Subsection (4) of section 409.977, Florida 563
Statutes, is amended to read: 564
409.977 Enrollment. — 565
(4) The agency shall develop a process to enable a 566
recipient with access to employer -sponsored health care coverage 567
to opt out of all managed care plans and to use Medicaid 568
financial assistance to pay for the recipient's share of the 569
cost in such employer -sponsored coverage. The agency shall also 570
enable recipients with access to other insurance or relat ed 571
products providing access to health care services created 572
pursuant to state law, including any product available under the 573
Florida Employee Health Choices Program, or any health exchange, 574
to opt out. The amount of financial assistance provided for each 575
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recipient may not exceed the amount of the Medicaid premium that 576
would have been paid to a managed care plan for that recipient. 577
The agency shall require Medicaid recipients with access to 578
employer-sponsored health care coverage to enroll in that 579
coverage and use Medicaid financial assistance to pay for the 580
recipient's share of the cost for such coverage. The amount of 581
financial assistance provided for each recipient may not exceed 582
the amount of the Medicaid premium that would have been paid to 583
a managed care plan for that recipient. 584
Section 5. This act shall take effect July 1, 2025. 585