Florida Health Choices Program

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A bill to be entitled 1
An act relating to the Florida Health Choices Program; 2
amending s. 408.910, F.S.; renaming the "Florida 3
Health Choices Program" as the "Florida Employee 4
Health Choices Program"; revising legislative findings 5
and intent; revising definitions; revising the purpose 6
and components of the program; revising eligibility 7
and participation requirements for vendors under the 8
program; revising the types of health insurance 9
products that are available for purchase through the 10
program; deleting certain pricing transparency 11
requirements to conform to changes made by the act; 12
revising the structure of the insurance marketplace 13
process under the program; deleting the option for 14
risk pooling under the program; deleting exemptions 15
from certain requirements of the Florida Insurance 16
Code under the program; renaming the corporation 17
administering the program as "Florida Employee Health 18
Choices, Inc."; revising membership of the board of 19
directors; authorizing the corporation to exercise 20
certain powers; revising duties of the board and the 21
corporation; revising the fiscal year in which the 22
corporation's annual report is due; amending ss. 23
409.821, 409.9122, and 409.977, F.S.; conforming 24
provisions to changes made by the act; providing an 25

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effective date. 26
27
Be It Enacted by the Legislature of the State of Florida: 28
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Section 1. Section 408.910, Florida Statutes, is amended 30
to read: 31
408.910 Florida Employee Health Choices Program.— 32
(1) LEGISLATIVE INTENT.—The Legislature finds that a 33
significant number of employers and employees in the residents 34
of this state do not have adequate access to affordable, quality 35
health insurance that meets their needs care. The Legislature 36
further finds that individual coverage health reimbursement 37
arrangements offer a novel way for employers of any size to give 38
health care contributions directly to employees to empower them 39
to choose their own health plan in a broad marketplace based on 40
individual financial needs and health factors. The Legislature 41
further finds that increasing access to affordable, quality 42
health care through individual coverage health reimbursement 43
arrangements can be best accomplished by establishing a 44
competitive marketplace market for employees who receive 45
employer premium contributions through individual coverage 46
health reimbursement arrangements purchasing health insurance 47
and health services. It is therefore the intent of the 48
Legislature to create the Florida Employee Health Choices 49
Program to do the following: 50

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(a) Expand opportunities for employers and employees 51
Floridians to access purchase affordable health insurance in 52
this state and health services. 53
(b) Create a platform that streamlines the purchase of 54
individual coverage for employees enrolled in individual 55
coverage health reimbursement arrangements Preserve the benefits 56
of employment-sponsored insurance while easing the 57
administrative burden for employers who offer these benefits. 58
(c) Enable individual choice in both the manner and amount 59
of health care purchased. 60
(d) Provide for the purchase of individual, portable 61
health care coverage. 62
(e) Disseminate information to employers and employees 63
about individual coverage health reimbursement arrangements 64
consumers on the price and quality of health services. 65
(f) Sponsor a competitive marketplace market that 66
stimulates product innovation, quality improvement, and 67
efficiency in the production and delivery of individual health 68
insurance plans to employees enrolled in individual coverage 69
health reimbursement arrangements health services. 70
(2) DEFINITIONS.—As used in this section, the term: 71
(a) "Corporation" means the Florida Employee Health 72
Choices, Inc., established under this section. 73
(b) "Corporation's marketplace" means the single, 74
centralized market established by the program which that 75

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facilitates the purchase of products made available in the 76
marketplace. 77
(c) "Health insurance agent" means an agent licensed under 78
part IV of chapter 626. 79
(d) "Insurer" means an entity licensed under chapter 624 80
which offers an individual health insurance policy or a group 81
health insurance policy, a preferred provider organization as 82
defined in s. 627.6471, an exclusive provider organization as 83
defined in s. 627.6472, or a health maintenance organization 84
licensed under part I of chapter 641, or a prepaid limited 85
health service organization or discount plan organization 86
licensed under chapter 636. 87
(e) "Program" means the Florida Employee Health Choices 88
Program established by this section. 89
(3) PROGRAM PURPOSE AND COMPONENTS.—The Florida Employee 90
Health Choices Program is created as a single, centralized 91
marketplace market for the sale and purchase of individual 92
health insurance plans by employees enrolled in an individual 93
coverage health reimbursement arrangement various products that 94
enable individuals to pay for health care. These products 95
include, but are not limited to, health insurance plans, health 96
maintenance organization plans, prepaid services, service 97
contracts, and flexible spending accounts. The components of the 98
program include: 99
(a) Enrollment of employers. 100

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(b) Administrative services for participating employers, 101
including: 102
1. Assistance in seeking federal approval of cafeteria 103
plans. 104
2. Collection of premiums and other payments. 105
3. Management of individual benefit accounts. 106
4. Distribution of premiums to insurers and payments to 107
other eligible vendors. 108
5. Assistance for participants in complying with reporting 109
requirements. 110
(c) Services to individual participants, including: 111
1. Information about available products and participating 112
vendors. 113
2. Assistance with assessing the benefits and limits of 114
each product, including information necessary to distinguish 115
between policies offering creditable coverage and other products 116
available through the program. 117
3. Account information to assist individual participants 118
with managing available resources. 119
4. Services that promote healthy behaviors. 120
(d) Recruitment of vendors, including insurers and, health 121
maintenance organizations, prepaid clinic service providers, 122
provider service networks, and other providers. 123
(e) Certification of vendors to ensure capability, 124
reliability, and validity of offerings. 125

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(f) Collection of data, monitoring, assessment, and 126
reporting of vendor performance. 127
(g) Information services for individuals and employers. 128
(h) Program evaluation. 129
(4) ELIGIBILITY AND PARTICIPATION.—Participation in the 130
program is voluntary and shall be available to employers, 131
individuals, vendors, and health insurance agents as specified 132
in this subsection. 133
(a) Employers eligible to enroll in the program include 134
those employers that meet criteria established by the 135
corporation and elect to make their employees eligible through 136
the program. 137
(b) Individuals eligible to participate in the program 138
include: 139
1. Individual employees of enrolled employers. 140
2. Other individuals that meet criteria established by the 141
corporation. 142
(c) Employers who choose to participate in the program may 143
enroll by complying with the procedures established by the 144
corporation. The procedures must include, but are not limited 145
to: 146
1. Submission of required information. 147
2. Compliance with federal tax requirements for the 148
establishment of a cafeteria plan, pursuant to s. 125 of the 149
Internal Revenue Code, including designation of the employer's 150

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plan as a premium payment plan, a salary reduction plan that has 151
flexible spending arrangements, or a salary reduction plan that 152
has a premium payment and flexible spending arrangements. 153
3. Determination of the employer's contribution, if any, 154
per employee, provided that such contribution is equal for each 155
eligible employee. 156
4. Establishment of payroll deduction procedures, subject 157
to the agreement of each individual employee who voluntarily 158
participates in the program. 159
5. Designation of the corporation as the third-party 160
administrator for the employer's health benefit plan. 161
6. Identification of eligible employees. 162
7. Arrangement for periodic payments. 163
8. Employer notification to employees of the intent to 164
transfer from an existing employee health plan to the program at 165
least 90 days before the transition. 166
(d) All eligible vendors who choose to participate and the 167
products and services that the vendors are permitted to sell are 168
as follows: 169
1. Insurers licensed under chapter 624 may sell health 170
insurance policies, limited benefit policies, other risk-bearing 171
coverage, and other products or services. 172
2. Health maintenance organizations licensed under part I 173
of chapter 641 may sell health maintenance contracts, limited 174
benefit policies, other risk-bearing products, and other 175

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products or services. 176
3. Prepaid limited health service organizations may sell 177
products and services as authorized under part I of chapter 636, 178
and discount plan organizations may sell products and services 179
as authorized under part II of chapter 636. 180
4. Prepaid health clinic service providers licensed under 181
part II of chapter 641 may sell prepaid service contracts and 182
other arrangements for a specified amount and type of health 183
services or treatments. 184
5. Health care providers, including hospitals and other 185
licensed health facilities, health care clinics, licensed health 186
professionals, pharmacies, and other licensed health care 187
providers, may sell service contracts and arrangements for a 188
specified amount and type of health services or treatments. 189
6. Provider organizations, including service networks, 190
group practices, professional associations, and other 191
incorporated organizations of providers, may sell service 192
contracts and arrangements for a specified amount and type of 193
health services or treatments. 194
7. Corporate entities providing specific health services 195
in accordance with applicable state law may sell service 196
contracts and arrangements for a specified amount and type of 197
health services or treatments. 198
199
A vendor described in subparagraphs 3.-7. may not sell products 200

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that provide risk-bearing coverage unless that vendor is 201
authorized under a certificate of authority issued by the Office 202
of Insurance Regulation and is authorized to provide coverage in 203
the relevant geographic area. Otherwise Eligible vendors may be 204
excluded from participating in the program for deceptive or 205
predatory practices, financial insolvency, or failure to comply 206
with the terms of the participation agreement or other standards 207
set by the corporation. 208
(e) Eligible individuals may participate in the program 209
voluntarily. Individuals who join the program may participate by 210
complying with the procedures established by the corporation. 211
These procedures must include, but are not limited to: 212
1. Submission of required information. 213
2. Authorization for payroll deduction. 214
3. Compliance with federal tax requirements. 215
4. Arrangements for payment. 216
5. Selection of products and services. 217
(f) Vendors who choose to participate in the program may 218
enroll by complying with the procedures established by the 219
corporation. These procedures may include, but are not limited 220
to: 221
1. Submission of required information, including a 222
complete description of the coverage, services, provider 223
network, payment restrictions, and other requirements of each 224
product offered through the program. 225

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2. Execution of an agreement to comply with requirements 226
established by the corporation. 227
3. Execution of an agreement that prohibits refusal to 228
sell any offered product or service to a participant who elects 229
to buy it. 230
4. Establishment of product prices based on applicable 231
criteria. 232
5. Arrangements for receiving payment for enrolled 233
participants. 234
5.6. Participation in ongoing reporting processes 235
established by the corporation. 236
6.7. Compliance with grievance procedures established by 237
the corporation. 238
(g) Health insurance agents licensed under part IV of 239
chapter 626 are eligible to voluntarily participate as buyers' 240
representatives. A buyer's representative acts on behalf of an 241
individual purchasing health insurance and health services 242
through the program by providing information about products and 243
services available through the program and assisting the 244
individual with both the decision and the procedure of selecting 245
specific products. Serving as a buyer's representative does not 246
constitute a conflict of interest with continuing 247
responsibilities as a health insurance agent if the relationship 248
between each agent and any participating vendor is disclosed 249
before advising an individual participant about the products and 250

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services available through the program. In order to participate, 251
a health insurance agent shall comply with the procedures 252
established by the corporation, including: 253
1. Completion of training requirements. 254
2. Execution of a participation agreement specifying the 255
terms and conditions of participation. 256
3. Disclosure of any appointments to solicit insurance or 257
procure applications for vendors participating in the program. 258
4. Arrangements to receive payment from the corporation 259
for services as a buyer's representative. 260
(5) PRODUCTS.— 261
(a) The products that may be made available for purchase 262
through the program include, but are not limited to: 263
1. health insurance policies and. 264
2. health maintenance contracts. 265
3. Limited benefit plans. 266
4. Prepaid clinic services. 267
5. Service contracts. 268
6. Arrangements for purchase of specific amounts and types 269
of health services and treatments. 270
7. Flexible spending accounts. 271
(b) Health insurance policies, health maintenance 272
contracts, limited benefit plans, prepaid service contracts, and 273
other contracts for services must ensure the availability of 274
covered services. 275

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(c) Products may be offered for multiyear periods provided 276
the price of the product is specified for the entire period or 277
for each separately priced segment of the policy or contract. 278
(d) The corporation shall provide a disclosure form for 279
consumers to acknowledge their understanding of the nature of, 280
and any limitations to, the benefits provided by the products 281
and services being purchased by the consumer. 282
(e) The corporation must determine that making the plan 283
available through the program is in the interest of eligible 284
individuals and eligible employers in the state. 285
(6) SURCHARGE PRICING.—Prices for the products and 286
services sold through the program must be transparent to 287
participants and established by the vendors. The corporation 288
shall annually assess a surcharge for each premium or price set 289
by a participating vendor. The surcharge may not be more than 290
2.5 percent of the price and must shall be used to generate 291
funding for administrative services provided by the corporation 292
and payments to buyers' representatives. 293
(7) THE MARKETPLACE PROCESS.—The program shall provide a 294
single, centralized marketplace market for access to purchase of 295
health insurance and, health maintenance contracts by an 296
employee enrolled in an individual coverage health reimbursement 297
arrangement, and other health products and services. Purchases 298
may be made by participating individuals over the Internet or 299
through the services of a participating health insurance agent. 300

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Information about each product and service available through the 301
program must shall be made available through printed material 302
and an interactive Internet website. A participant needing 303
personal assistance to select products and services must shall 304
be referred to a participating agent in his or her area. 305
(a) Participation in the program may begin at any time 306
during a year after the employer completes enrollment and meets 307
the requirements specified by the corporation pursuant to 308
paragraph (4)(c). 309
(b) Initial selection of products and services must be 310
made by an individual participant within the applicable open 311
enrollment period. 312
(c) Initial enrollment periods for each product selected 313
by an individual participant must last at least 12 months, 314
unless the individual participant specifically agrees to a 315
different enrollment period. 316
(d) If an individual has selected one or more products and 317
enrolled in those products for at least 12 months or any other 318
period specifically agreed to by the individual participant, 319
changes in selected products and services may only be made 320
during the annual enrollment period established by the 321
corporation. 322
(e) The limits established in paragraphs (b)-(d) apply to 323
any risk-bearing product that promises future payment or 324
coverage for a variable amount of benefits or services. The 325

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limits do not apply to initiation of flexible spending plans if 326
those plans are not associated with specific high-deductible 327
insurance policies or the use of spending accounts for any 328
products offering individual participants specific amounts and 329
types of health services and treatments at a contracted price. 330
(8) CONSUMER INFORMATION.—The corporation shall: 331
(a) Establish a secure website to facilitate the purchase 332
of products and services by participating individuals. The 333
website must provide information about each product or service 334
available through the program. 335
(b) Inform individuals about other public health care 336
programs. 337
(9) RISK POOLING.—The program may use methods for pooling 338
the risk of individual participants and preventing selection 339
bias. These methods may include, but are not limited to, a 340
postenrollment risk adjustment of the premium payments to the 341
vendors. The corporation may establish a methodology for 342
assessing the risk of enrolled individual participants based on 343
data reported annually by the vendors about their enrollees. 344
Distribution of payments to the vendors may be adjusted based on 345
the assessed relative risk profile of the enrollees in each 346
risk-bearing product for the most recent period for which data 347
is available. 348
(10) EXEMPTION EXEMPTIONS.— 349
(a) Products, other than the products set forth in 350

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subparagraphs (4)(d)1.-4., sold as part of the program are not 351
subject to the licensing requirements of the Florida Insurance 352
Code, as defined in s. 624.01 or the mandated offerings or 353
coverages established in part VI of chapter 627 and chapter 641. 354
(b) The corporation may act as an administrator as defined 355
in s. 626.88 but is not required to be certified pursuant to 356
part VII of chapter 626. However, a third party administrator 357
used by the corporation must be certified under part VII of 358
chapter 626. 359
(c) Any standard forms, website design, or marketing 360
communication developed by the corporation and used by the 361
corporation, or any vendor that meets the requirements of 362
paragraph (4)(f) is not subject to the Florida Insurance Code, 363
as established in s. 624.01. 364
(10) CORPORATION.—There is created Florida Employee Health 365
Choices, Inc., which shall be registered, incorporated, 366
organized, and operated in compliance with part III of chapter 367
112 and chapters 119, 286, and 617. The purpose of the 368
corporation is to administer the program created in this section 369
and to conduct such other business as may further the 370
administration of the program. The Department of Management 371
Services shall facilitate the formation of the corporation and 372
provide administrative support for the corporation until January 373
1, 2029. The corporation must be self-sustaining and no longer 374
require administrative assistance from the Department of 375

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Management Services by January 1, 2029. 376
(a) The corporation shall be governed by an eight-member 377
board of directors. Board members shall be appointed for terms 378
of up to 3 years and shall be eligible for reappointment. A 379
vacancy on the board shall be filled for the unexpired portion 380
of the term in the same manner as the original appointment. 381
Board members may not include an individual who is affiliated 382
with or employed by an eligible vendor or a subsidiary of an 383
eligible vendor. Board members shall serve without compensation, 384
but are entitled to receive, from funds of the corporation, 385
reimbursement for per diem and travel expenses as provided in s. 386
112.061. The membership of the board shall consist of: 387
1. Three members appointed by the Governor. 388
2. Two members appointed by the President of the Senate. 389
3. Two members appointed by the Speaker of the House of 390
Representatives. 391
4. The Secretary of Management Services or a designee with 392
expertise in state employee benefits and procurement, as an ex 393
officio nonvoting member. 394
(b) The corporation may exercise all powers granted to it 395
under chapter 617 necessary to carry out the purposes of this 396
section, including, but not limited to, the power to receive and 397
accept grants, loans, or advances of funds from any public or 398
private agency and to receive and accept from any source 399
contributions of money, property, labor, or any other thing of 400

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value to be held, used, and applied for the purposes of this 401
section. 402
(c) There is no liability on the part of, and a cause of 403
action may not arise against, any member of the board or its 404
employees or agents for any action taken by them in exercising 405
their powers and performing their duties under this section. 406
(d) The board shall develop and adopt bylaws and other 407
corporate procedures necessary for the operation of the 408
corporation and carrying out the purposes of this section. At a 409
minimum, the bylaws must: 410
1. Specify procedures for selection of officers and 411
qualifications for reappointment, provided that a board member 412
may not serve more than 9 consecutive years. 413
2. Require an annual membership meeting that provides an 414
opportunity for input and interaction with individual 415
participants in the program. 416
3. Specify policies and procedures regarding conflicts of 417
interest, including part III of chapter 112, which prohibit a 418
member from participating in any decision that would inure to 419
the benefit of the member or the organization that employs the 420
member. The policies and procedures must also require public 421
disclosure of the interest that prevents the member from 422
participating in a decision on a particular matter. 423
4. Specify procedures for adopting an annual budget. 424
5. Specify procedures for selecting a chief executive 425

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officer for the corporation who shall be responsible for 426
securing staff and consultant services necessary for the 427
operation of the program as may be authorized by the 428
corporation's operating budget. 429
(e) The corporation shall establish policies and 430
procedures for application, enrollment, plan administration, 431
performance monitoring, and consumer education, and other 432
policies and procedures necessary for the operation of the 433
program, including, but not limited to: 434
1. Criteria for participation in the program and 435
procedures for determining the eligibility of employers, 436
vendors, individuals, and health insurance agents and employers 437
to participate in the program. 438
2. Exclusion of vendors pursuant to paragraph (4)(d). 439
3. Collection of contributions from participating 440
employers and individuals. 441
4. Payment of premiums and other appropriate disbursements 442
based on the selections of products and services by 443
participating individuals. 444
5. Disenrollment of participating individuals based on 445
failure to pay the individual's share of any contribution 446
required to maintain enrollment in selected products. 447
(f) The corporation shall procure a vendor to facilitate a 448
platform that streamlines the purchase of individual coverage 449
for employees enrolled in individual coverage health 450

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reimbursement arrangements. 451
1. Within 90 days after the formation of the corporation, 452
the department shall, as directed by the board, issue an 453
invitation to negotiate to procure the vendor. Responsive 454
bidders must demonstrate the ability to establish a platform 455
fully operational for open enrollment by January 1, 2028, and 456
provide for initial, open, and special enrollment periods. 457
2. The department shall evaluate and score the procurement 458
bids, enter into negotiations at the direction of the board, and 459
make recommendations to the board related to the contract award. 460
The corporation shall select the vendor and execute the contract 461
within 180 days after the issuance of the invitation to 462
negotiate. 463
(g) The corporation shall develop and implement a plan for 464
promoting public awareness of and participation in the program 465
and shall establish a toll-free hotline to respond to requests 466
for assistance from employers and plan enrollees. 467
(h) The corporation may evaluate and implement additional 468
options for employer participation which conform with common 469
insurance practices. 470
(11) CORPORATION.—There is created the Florida Health 471
Choices, Inc., which shall be registered, incorporated, 472
organized, and operated in compliance with part III of chapter 473
112 and chapters 119, 286, and 617. The purpose of the 474
corporation is to administer the program created in this section 475

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and to conduct such other business as may further the 476
administration of the program. 477
(a) The corporation shall be governed by a 15-member board 478
of directors consisting of: 479
1. Three ex officio, nonvoting members to include: 480
a. The Secretary of Health Care Administration or a 481
designee with expertise in health care services. 482
b. The Secretary of Management Services or a designee with 483
expertise in state employee benefits. 484
c. The commissioner of the Office of Insurance Regulation 485
or a designee with expertise in insurance regulation. 486
2. Four members appointed by and serving at the pleasure 487
of the Governor. 488
3. Four members appointed by and serving at the pleasure 489
of the President of the Senate. 490
4. Four members appointed by and serving at the pleasure 491
of the Speaker of the House of Representatives. 492
5. Board members may not include insurers, health 493
insurance agents or brokers, health care providers, health 494
maintenance organizations, prepaid service providers, or any 495
other entity, affiliate or subsidiary of eligible vendors. 496
(b) Members shall be appointed for terms of up to 3 years. 497
Any member is eligible for reappointment. A vacancy on the board 498
shall be filled for the unexpired portion of the term in the 499
same manner as the original appointment. 500

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(c) The board shall select a chief executive officer for 501
the corporation who shall be responsible for the selection of 502
such other staff as may be authorized by the corporation's 503
operating budget as adopted by the board. 504
(d) Board members are entitled to receive, from funds of 505
the corporation, reimbursement for per diem and travel expenses 506
as provided by s. 112.061. No other compensation is authorized. 507
(e) There is no liability on the part of, and no cause of 508
action shall arise against, any member of the board or its 509
employees or agents for any action taken by them in the 510
performance of their powers and duties under this section. 511
(f) The board shall develop and adopt bylaws and other 512
corporate procedures as necessary for the operation of the 513
corporation and carrying out the purposes of this section. The 514
bylaws shall: 515
1. Specify procedures for selection of officers and 516
qualifications for reappointment, provided that no board member 517
shall serve more than 9 consecutive years. 518
2. Require an annual membership meeting that provides an 519
opportunity for input and interaction with individual 520
participants in the program. 521
3. Specify policies and procedures regarding conflicts of 522
interest, including the provisions of part III of chapter 112, 523
which prohibit a member from participating in any decision that 524
would inure to the benefit of the member or the organization 525

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that employs the member. The policies and procedures shall also 526
require public disclosure of the interest that prevents the 527
member from participating in a decision on a particular matter. 528
(g) The corporation may exercise all powers granted to it 529
under chapter 617 necessary to carry out the purposes of this 530
section, including, but not limited to, the power to receive and 531
accept grants, loans, or advances of funds from any public or 532
private agency and to receive and accept from any source 533
contributions of money, property, labor, or any other thing of 534
value to be held, used, and applied for the purposes of this 535
section. 536
(h) The corporation shall: 537
1. Determine eligibility of employers, vendors, 538
individuals, and agents in accordance with subsection (4). 539
2. Establish procedures necessary for the operation of the 540
program, including, but not limited to, procedures for 541
application, enrollment, risk assessment, risk adjustment, plan 542
administration, performance monitoring, and consumer education. 543
3. Arrange for collection of contributions from 544
participating employers and individuals. 545
4. Arrange for payment of premiums and other appropriate 546
disbursements based on the selections of products and services 547
by the individual participants. 548
5. Establish criteria for disenrollment of participating 549
individuals based on failure to pay the individual's share of 550

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any contribution required to maintain enrollment in selected 551
products. 552
6. Establish criteria for exclusion of vendors pursuant to 553
paragraph (4)(d). 554
7. Develop and implement a plan for promoting public 555
awareness of and participation in the program. 556
8. Secure staff and consultant services necessary to the 557
operation of the program. 558
9. Establish policies and procedures regarding 559
participation in the program for individuals, vendors, health 560
insurance agents, and employers. 561
10. Provide for the operation of a toll-free hotline to 562
respond to requests for assistance. 563
11. Provide for initial, open, and special enrollment 564
periods. 565
12. Evaluate options for employer participation which may 566
conform with common insurance practices. 567
(11)(12) REPORT.—Beginning in the 2027-2028 2009-2010 568
fiscal year, the corporation shall submit by February 1 an 569
annual report to the Governor, the President of the Senate, and 570
the Speaker of the House of Representatives documenting the 571
corporation's activities in compliance with the duties 572
delineated in this section. 573
(12)(13) PROGRAM INTEGRITY.—To ensure program integrity 574
and to safeguard the financial transactions made under the 575

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auspices of the program, the corporation is authorized to 576
establish qualifying criteria and certification procedures for 577
vendors, require performance bonds or other guarantees of 578
ability to complete contractual obligations, monitor the 579
performance of vendors, and enforce the agreements of the 580
program through financial penalty or disqualification from the 581
program. 582
(13)(14) EXEMPTION FROM PUBLIC RECORDS REQUIREMENTS.— 583
(a) Definitions.—For purposes of this subsection, the 584
term: 585
1. "Buyer's representative" means a participating 586
insurance agent as described in paragraph (4)(g). 587
2. "Enrollee" means an employer who is eligible to enroll 588
in the program pursuant to paragraph (4)(a). 589
3. "Participant" means an individual who is eligible to 590
participate in the program pursuant to paragraph (4)(b). 591
4. "Proprietary confidential business information" means 592
information, regardless of form or characteristics, that is 593
owned or controlled by a vendor requesting confidentiality under 594
this section; that is intended to be and is treated by the 595
vendor as private in that the disclosure of the information 596
would cause harm to the business operations of the vendor; that 597
has not been disclosed unless disclosed pursuant to a statutory 598
provision, an order of a court or administrative body, or a 599
private agreement providing that the information may be released 600

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to the public; and that is information concerning: 601
a. Business plans. 602
b. Internal auditing controls and reports of internal 603
auditors. 604
c. Reports of external auditors for privately held 605
companies. 606
d. Client and customer lists. 607
e. Potentially patentable material. 608
f. A trade secret as defined in s. 688.002. 609
5. "Vendor" means a participating insurer or other 610
provider of services as described in paragraph (4)(d). 611
(b) Public record exemptions.— 612
1. Personal identifying information of an enrollee or 613
participant who has applied for or participates in the Florida 614
Employee Health Choices Program is confidential and exempt from 615
s. 119.07(1) and s. 24(a), Art. I of the State Constitution. 616
2. Client and customer lists of a buyer's representative 617
held by the corporation are confidential and exempt from s. 618
119.07(1) and s. 24(a), Art. I of the State Constitution. 619
3. Proprietary confidential business information held by 620
the corporation is confidential and exempt from s. 119.07(1) and 621
s. 24(a), Art. I of the State Constitution. 622
(c) Retroactive application.—The public record exemptions 623
provided for in paragraph (b) apply to information held by the 624
corporation before, on, or after the effective date of this 625

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exemption. 626
(d) Authorized release.— 627
1. Upon request, information made confidential and exempt 628
pursuant to this subsection must shall be disclosed to: 629
a. Another governmental entity in the performance of its 630
official duties and responsibilities. 631
b. Any person who has the written consent of the program 632
applicant. 633
c. The Florida Kidcare program for the purpose of 634
administering the program authorized in ss. 409.810-409.821. 635
2. Paragraph (b) does not prohibit a participant's legal 636
guardian from obtaining confirmation of coverage, dates of 637
coverage, the name of the participant's health plan, and the 638
amount of premium being paid. 639
(e) Penalty.—A person who knowingly and willfully violates 640
this subsection commits a misdemeanor of the second degree, 641
punishable as provided in s. 775.082 or s. 775.083. 642
Section 2. Paragraph (a) of subsection (2) of section 643
409.821, Florida Statutes, is amended to read: 644
409.821 Florida Kidcare program public records exemption.— 645
(2)(a) Upon request, such information shall be disclosed 646
to: 647
1. Another governmental entity in the performance of its 648
official duties and responsibilities; 649
2. The Department of Revenue for purposes of administering 650

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the state Title IV-D program; 651
3. The Florida Employee Health Choices, Inc., for the 652
purpose of administering the program authorized pursuant to s. 653
408.910; or 654
4. Any person who has the written consent of the program 655
applicant. 656
Section 3. Subsection (3) of section 409.9122, Florida 657
Statutes, is amended to read: 658
409.9122 Medicaid managed care enrollment; HIV/AIDS 659
patients; procedures; data collection; accounting; information 660
system; medical loss ratio.— 661
(3) The agency shall develop a process to enable any 662
recipient with access to employer-sponsored health care coverage 663
to opt out of all eligible plans in the Medicaid program and to 664
use Medicaid financial assistance to pay for the recipient's 665
share of cost in any such employer-sponsored coverage. 666
Contingent on federal approval, the agency shall also enable 667
recipients with access to other insurance or related products 668
that provide access to health care services created pursuant to 669
state law, including any plan or product available pursuant to 670
the Florida Employee Health Choices Program or any health 671
exchange, to opt out. The amount of financial assistance 672
provided for each recipient may not exceed the amount of the 673
Medicaid premium that would have been paid to a plan for that 674
recipient. 675

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Section 4. Subsection (4) of section 409.977, Florida 676
Statutes, is amended to read: 677
409.977 Enrollment.— 678
(4) The agency shall develop a process to enable a 679
recipient with access to employer-sponsored health care coverage 680
to opt out of all managed care plans and to use Medicaid 681
financial assistance to pay for the recipient's share of the 682
cost in such employer-sponsored coverage. The agency shall also 683
enable recipients with access to other insurance or related 684
products providing access to health care services created 685
pursuant to state law, including any product available under the 686
Florida Employee Health Choices Program, or any health exchange, 687
to opt out. The amount of financial assistance provided for each 688
recipient may not exceed the amount of the Medicaid premium that 689
would have been paid to a managed care plan for that recipient. 690
The agency shall require Medicaid recipients with access to 691
employer-sponsored health care coverage to enroll in that 692
coverage and use Medicaid financial assistance to pay for the 693
recipient's share of the cost for such coverage. The amount of 694
financial assistance provided for each recipient may not exceed 695
the amount of the Medicaid premium that would have been paid to 696
a managed care plan for that recipient. The agency may exceed 697
this amount for a high-cost patient if it determines it would be 698
cost effective to do so. The agency shall annually, beginning 699
June 30, 2026, submit an annual report on the program to the 700

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Legislature including, but not limited to, the level of 701
participation; participant demographics, income levels, type of 702
employer-based coverage, and amount of health care utilization; 703
and a cost-effectiveness analysis both in the aggregate and on 704
an individual patient basis. 705
Section 5. This act shall take effect July 1, 2026. 706