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May 21, 2008

ShareSB 2534 Cover Florida Health Care Access Program

The legislation, signed into law on May 21, 2008, creates an exemption in the state health insurance codes for faith-based health care cost sharing programs. Such groups are now exempt from oversight by the states Office of Insurance Regulation. The exemption applies to programs offered by non-profit religious organizations that meet the following requirements:

  • Limit membership to those of the same religion
     

  • Act as an organizational clearing house for information between members who have financial, physical, or medical needs and those members with the ability to pay for the benefit of those members in need
     

  • Provide for medical and financial needs of members through payments directly from one member to another
     

  • Suggest amounts that members may voluntarily give with no assumption of risk or promise to pay either among the participants or between the participants
     

  • State clearly that the program is not an insurance plan

The Cover Florida Health Care Access Program is designed to provide affordable health care options for uninsured residents of Florida between the ages of 19-64 who meet certain other criteria. A Cover Florida plan entity must provide non-catastrophic coverage and may provide catastrophic coverage, supplemental insurance, prepaid health clinics, and discount medical plan product options to enrollees. The Agency for Health Care Administration (agency) and the Office of Insurance Regulation (office) are responsible for jointly establishing and administering the Cover Florida Program. The agency and the office are required to issue an invitation to negotiate no later than July 1, 2008, to health insurers, health maintenance organizations (HMO), health care provider-sponsored organizations, and health care districts. The agency and the office are required to approve at least one Cover Florida plan entity having an existing statewide provider network and may approve at least one regional network plan in each Medicaid area.
 

 

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