HB 5015 2025
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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 state group insurance; amending s. 2
110.12315, F.S.; providing for state group health 3
insurance plan copayments, rather than State Group 4
Health Insurance Standard Plan copayments, for 5
prescription drugs; requiring that state group health 6
insurance plan copayments for prescription drugs be 7
established annually in the General Appropriations 8
Act; removing provisions relating to formulary 9
inclusions of specified drugs under certain 10
circumstances; updating certain dates relating to 11
prescription drugs and supplies; creating s. 12
110.12316, F.S.; defining the term "state agency"; 13
requiring the Department of Management Services to 14
make monthly administrative health insurance 15
assessments against state agencies based on certain 16
vacant positions within the agencies; requiring state 17
agencies to remit to the State Employees Health 18
Insurance Trust Fund the administrative health 19
insurance assessments; requiring the department to 20
certify to the Chief Financial Officer the amounts due 21
under specified circumsta nces; requiring the Chief 22
Financial Officer to transfer to the department the 23
amounts under specified circumstances; providing 24
applicability; providing assessment calculations; 25
HB 5015 2025
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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
requiring state agencies to provide the department 26
with a list of certain posit ions by position numbers, 27
include certain information in the list, and update 28
the list monthly; requiring state agencies to take 29
steps to include administrative health insurance 30
assessments in their indirect cost plans for each 31
fiscal year; requiring state agencies to notify 32
certain entities on updated indirect cost plans; 33
authorizing the Executive Office of the Governor to 34
transfer certain budget authority between state 35
agencies for a specified purpose; providing an 36
effective date. 37
38
Be It Enacted by the Legislature of the State of Florida: 39
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Section 1. Subsections (8) and (9) of section 110.12315, 41
Florida Statutes, are amended to read: 42
110.12315 Prescription drug program. —The state employees' 43
prescription drug program is established. This program s hall be 44
administered by the Department of Management Services, according 45
to the terms and conditions of the plan as established by the 46
relevant provisions of the annual General Appropriations Act and 47
implementing legislation, subject to the following condi tions: 48
(8)(a) Effective July 1, 2017, for The state group health 49
insurance Standard plan, copayments shall be established 50
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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
annually in the General Appropriations Act. must be made as 51
follows: 52
1. For a supply for up to 30 days from a retail pharmacy: 53
a. For generic drug ................................ ....$7. 54
b. For preferred brand name drug ...................... $30. 55
c. For nonpreferred brand name drug ...................$50. 56
2. For a supply for up to 90 days from a mail order 57
pharmacy or a retail pharmacy: 58
a. For generic drug ................................ ....$14. 59
b. For preferred brand name drug ....................... $60. 60
c. For nonpreferred brand name drug ...................$100. 61
(b) Effective July 1, 2017, for the State Group Health 62
Insurance High Deductible Plan, coinsurance must be paid as 63
follows: 64
1. For a supply for up to 30 days from a retail pharmacy: 65
a. For generic drug ................................ ...30%. 66
b. For preferred brand name drug ...................... 30%. 67
c. For nonpreferred brand name drug ...................50%. 68
2. For a supply for up to 90 days from a mail order 69
pharmacy or a retail pharmacy: 70
a. For generic drug ................................ ....30%. 71
b. For preferred brand name dr ug....................... 30%. 72
c. For nonpreferred brand name drug .................... 50%. 73
(9)(a) Beginning with the 2026 2020 plan year, the 74
department must implement formulary management for prescription 75
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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
drugs and supplies. Such management practices must require 76
prescription drugs to be subj ect to formulary inclusion or 77
exclusion but may not restrict access to the most clinically 78
appropriate, clinically effective, and lowest net -cost 79
prescription drugs and supplies. Drugs excluded from the 80
formulary must be available for inclusion if a physic ian, 81
advanced practice registered nurse, or physician assistant 82
prescribing a pharmaceutical clearly states on the prescription 83
that the excluded drug is medically necessary. Prescription 84
drugs and supplies first made available in the marketplace after 85
January 1, 2026 2020, may not be covered by the prescription 86
drug program until specifically included in the list of covered 87
prescription drugs and supplies. 88
(b) No later than October 1, 2025 2019, and by each 89
October 1 thereafter, the department must submi t to the 90
Governor, the President of the Senate, and the Speaker of the 91
House of Representatives the list of prescription drugs and 92
supplies that will be excluded from program coverage for the 93
next plan year. If the department proposes to exclude 94
prescription drugs and supplies after the plan year has 95
commenced, the department must provide notice to the Governor, 96
the President of the Senate, and the Speaker of the House of 97
Representatives of such exclusions at least 60 days before 98
implementation of such excl usions. 99
Section 2. Section 110.12316, Florida Statutes, is created 100
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to read: 101
110.12316 Administrative health insurance assessments 102
against state agencies for vacant positions. — 103
(1) As used in this section, the term "state agency" means 104
an agency within the State Personnel System, the Department of 105
the Lottery, the Justice Administrative Commission and all 106
entities administratively housed in the Justice Administrative 107
Commission, and the state courts system. 108
(2) Effective July 1, 2025, and on the fi rst day of each 109
month thereafter, the Department of Management Services shall 110
make an administrative health insurance assessment against each 111
state agency equal to the employer's cost of individual employee 112
health care coverage for each vacant position wit hin the state 113
agency eligible for coverage through the Division of State Group 114
Insurance. 115
(3) Within 30 days after receipt of the administrative 116
health insurance assessment under subsection (2) from the 117
department, each state agency shall remit to the S tate Employees 118
Health Insurance Trust Fund the assessment for the state group 119
insurance program, as provided in ss. 110.123 and 110.1239, from 120
currently allocated moneys for salaries and benefits. If a state 121
agency becomes more than 60 days delinquent in p ayment of the 122
assessment, the department shall certify to the Chief Financial 123
Officer the amount due and the Chief Financial Officer shall 124
transfer to the department the amount due. 125
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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
(4) The administrative health insurance assessment must 126
apply to all vacant positions funded with state funds, whether 127
fully or partially funded with state funds. Vacant positions 128
partially funded with state funds must pay a percentage of the 129
assessment imposed in subsection (2) equal to the percentage 130
share of state funds pro vided for the vacant positions. The 131
assessment does not apply to vacant positions that are fully 132
funded with federal funds. By July 31, 2025, each state agency 133
shall provide the department with a complete list of all 134
positions by position number which are fully or partially funded 135
with federal funds, and shall include the percentage of federal 136
funding for each position. Thereafter, each state agency shall 137
update the list on the last day of each month. For vacant 138
positions that are fully or partially funded with federal funds, 139
each state agency shall immediately take steps to include the 140
administrative health insurance assessment in its indirect cost 141
plan for the 2025-2026 fiscal year and each fiscal year 142
thereafter. A state agency shall notify the department , the 143
Executive Office of the Governor, and the chair and vice chair 144
of the Legislative Budget Commission of the updated indirect 145
cost plan, upon approval from the federal awarding agency. If 146
the state agency cannot obtain approval from its federal 147
awarding agency, the state agency shall notify the department, 148
the Executive Office of the Governor, and the chair and vice 149
chair of the Legislative Budget Commission no later than January 150
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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
15 of each calendar year. 151
(5) Pursuant to the notice, review, and object ion 152
procedures of s. 216.177, the Executive Office of the Governor 153
may transfer budget authority appropriated in the Salaries and 154
Benefits appropriation category between state agencies in order 155
to align the appropriations granted with the assessment that 156
must be paid by each state agency to the department for the 157
administrative health insurance assessment. 158
Section 3. This act shall take effect July 1, 2025. 159