September 19, 2020
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CS/HB 591

A bill to be entitled
2An act relating to health insurance; creating ss.
3627.6404, 627.6572, and 641.31093, F.S.; requiring all
4antiretroviral agents to be included on health plan
5formularies; prohibiting access-limiting procedures used
6to restrict antiretroviral agents prescribed to treat a
7person with HIV; amending s. 627.6515, F.S.; including
8reference to such requirements on policies issued by out-
9of-state groups; providing an effective date.
11Be It Enacted by the Legislature of the State of Florida:
13     Section 1.  Section 627.6404, Florida Statutes, is created
14to read:
15     627.6404  HIV treatment.-Antiretroviral agents prescribed
16to treat a person with HIV must be included on a health plan
17formulary and may not be restricted through a requirement for
18prior authorization, step therapy, or other limitation that
19limits access to any antiretroviral agent.
20     Section 2.  Subsection (2) of section 627.6515, Florida
21Statutes, is amended to read:
22     627.6515  Out-of-state groups.-
23     (2)  Except as otherwise provided in this part, this part
24does not apply to a group health insurance policy issued or
25delivered outside this state under which a resident of this
26state is provided coverage if:
27     (a)  The policy is issued to an employee group the
28composition of which is substantially as described in s.
29627.653; a labor union group or association group the
30composition of which is substantially as described in s.
31627.654; an additional group the composition of which is
32substantially as described in s. 627.656; a group insured under
33a blanket health policy when the composition of the group is
34substantially in compliance with s. 627.659; a group insured
35under a franchise health policy when the composition of the
36group is substantially in compliance with s. 627.663; an
37association group to cover persons associated in any other
38common group, which common group is formed primarily for
39purposes other than providing insurance; a group that is
40established primarily for the purpose of providing group
41insurance, provided the benefits are reasonable in relation to
42the premiums charged thereunder and the issuance of the group
43policy has resulted, or will result, in economies of
44administration; or a group of insurance agents of an insurer,
45which insurer is the policyholder.;
46     (b)  Certificates evidencing coverage under the policy are
47issued to residents of this state and contain in contrasting
48color and not less than 10-point type the following statement:
49"The benefits of the policy providing your coverage are governed
50primarily by the law of a state other than Florida".; and
51     (c)  The policy provides the benefits specified in ss.
52627.419, 627.6572, 627.6574, 627.6575, 627.6579, 627.6612,
53627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and
55     (d)  Applications for certificates of coverage offered to
56residents of this state must contain, in contrasting color and
57not less than 12-point type, the following statement on the same
58page as the applicant's signature:
60"This policy is primarily governed by the laws of ...insert
61state where the master policy if filed.... As a result, all of
62the rating laws applicable to policies filed in this state do
63not apply to this coverage, which may result in increases in
64your premium at renewal that would not be permissible under a
65Florida-approved policy. Any purchase of individual health
66insurance should be considered carefully, as future medical
67conditions may make it impossible to qualify for another
68individual health policy. For information concerning individual
69health coverage under a Florida-approved policy, consult your
70agent or the Florida Department of Financial Services."
72This paragraph applies only to group certificates providing
73health insurance coverage which require individualized
74underwriting to determine coverage eligibility for an individual
75or premium rates to be charged to an individual except for the
77     1.  Policies issued to provide coverage to groups of
78persons all of whom are in the same or functionally related
79licensed professions, and providing coverage only to such
80licensed professionals, their employees, or their dependents;
81     2.  Policies providing coverage to small employers as
82defined by s. 627.6699. Such policies shall be subject to, and
83governed by, the provisions of s. 627.6699;
84     3.  Policies issued to a bona fide association, as defined
85by s. 627.6571(5), provided that there is a person or board
86acting as a fiduciary for the benefit of the members, and such
87association is not owned, controlled by, or otherwise associated
88with the insurance company; or
89     4.  Any accidental death, accidental death and
90dismemberment, accident-only, vision-only, dental-only, hospital
91indemnity-only, hospital accident-only, cancer, specified
92disease, Medicare supplement, products that supplement Medicare,
93long-term care, or disability income insurance, or similar
94supplemental plans provided under a separate policy,
95certificate, or contract of insurance, which cannot duplicate
96coverage under an underlying health plan, coinsurance, or
97deductibles or coverage issued as a supplement to workers'
98compensation or similar insurance, or automobile medical-payment
100     Section 3.  Section 627.6572, Florida Statutes, is created
101to read:
102     627.6572  HIV treatment.-Antiretroviral agents prescribed
103to treat a person with HIV must be included on a health plan
104formulary and may not be restricted through a requirement for
105prior authorization, step therapy, or other limitation that
106limits access to any antiretroviral agent.
107     Section 4.  Section 641.31093, Florida Statutes, is created
108to read:
109     641.31093  HIV treatment.-Antiretroviral agents prescribed
110to treat a person with HIV must be included on a health plan
111formulary and may not be restricted through a requirement for
112prior authorization, step therapy, or other limitation that
113limits access to any antiretroviral agent.
114     Section 5.  This act shall take effect July 1, 2010.

CODING: Words stricken are deletions; words underlined are additions.
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