Florida Employee Health Choices Program

Florida Senate
-
2026

SB 440

By
Senator Leek

7-00343-26 2026440__
1 A bill to be entitled
2 An act relating to the Florida Employee Health Choices
3 Program; amending s. 408.910, F.S.; renaming the
4 “Florida Health Choices Program” as the “Florida
5 Employee Health Choices Program”; revising legislative
6 findings and intent; revising definitions; revising
7 the purpose and components of the program; revising
8 eligibility and participation requirements for vendors
9 under the program; revising the types of health
10 insurance products that are available for purchase
11 through the program; deleting certain pricing
12 transparency requirements to conform to changes made
13 by the act; revising the structure of the insurance
14 marketplace process under the program; deleting the
15 option for risk pooling under the program; deleting
16 exemptions from certain requirements of the Florida
17 Insurance Code under the program; renaming the
18 corporation administering the program as “Florida
19 Employee Health Choices, Inc.”; revising membership of
20 the board of directors; authorizing the corporation to
21 exercise certain powers; revising duties of the board
22 and the corporation; revising the fiscal year in which
23 the corporation’s annual report is due; amending ss.
24 409.821, 409.9122, and 409.977, F.S.; conforming
25 provisions to changes made by the act; providing an
26 effective date.
27
28 Be It Enacted by the Legislature of the State of Florida:
29
30 Section 1. Section 408.910, Florida Statutes, is amended to
31 read:
32 408.910 Florida
Employee
Health Choices Program.—
33 (1) LEGISLATIVE INTENT.—The Legislature finds that a
34 significant number of
employers and employees in

the residents

35
of
this state do not have adequate access to affordable, quality
36 health
insurance that meets their needs

care
. The Legislature
37 further finds that
individual coverage health reimbursement

38
arrangements offer a novel way for employers of any size to give

39
health care contributions directly to employees to empower them

40
to choose their own health plan in a broad marketplace based on

41
individual financial needs and health factors. The Legislature

42
further finds that
increasing access to affordable, quality
43 health care
through individual coverage health reimbursement

44
arrangements
can be best accomplished by establishing a
45 competitive
marketplace

market
for
employees who receive

46
employer premium contributions through individual coverage

47
health reimbursement arrangements

purchasing health insurance

48
and health services
. It is therefore the intent of the
49 Legislature to create the Florida
Employee
Health Choices
50 Program to
do the following
:
51 (a) Expand opportunities for
employers and employees

52
Floridians
to
access

purchase
affordable health insurance
in

53
this state

and health services
.
54 (b)
Create a platform that streamlines the purchase of

55
individual coverage for employees enrolled in individual

56
coverage health reimbursement arrangements

Preserve the benefits

57
of employment-sponsored insurance while easing the

58
administrative burden for employers who offer these benefits
.
59 (c) Enable individual choice in both the manner and amount
60 of health care purchased.
61 (d) Provide for the purchase of individual, portable health
62 care coverage.
63 (e) Disseminate information to
employers and employees

64
about individual coverage health reimbursement arrangements

65
consumers on the price and quality of health services
.
66 (f) Sponsor a competitive
marketplace

market
that
67 stimulates product innovation, quality improvement, and
68 efficiency in the production and delivery of
individual health

69
insurance plans to employees enrolled in individual coverage

70
health reimbursement arrangements

health services
.
71 (2) DEFINITIONS.—As used in this section, the term:
72 (a) “Corporation” means
the
Florida
Employee
Health
73 Choices, Inc., established under this section.
74 (b) “Corporation’s marketplace” means the
single,

75 centralized market established by the program
which

that

76 facilitates the purchase of products made available in the
77 marketplace.
78 (c) “Health insurance agent” means an agent licensed under
79 part IV of chapter 626.
80 (d) “Insurer” means an entity licensed under chapter 624
81 which offers an individual health insurance policy
or a group

82
health insurance policy
, a preferred provider organization as
83 defined in s. 627.6471, an exclusive provider organization as
84 defined in s. 627.6472,
or
a health maintenance organization
85 licensed under part I of chapter 641
, or a prepaid limited

86
health service organization or discount plan organization

87
licensed under chapter 636
.
88 (e) “Program” means the Florida
Employee
Health Choices
89 Program established by this section.
90 (3) PROGRAM PURPOSE AND COMPONENTS.—The Florida
Employee

91 Health Choices Program is created as a
single,
centralized
92
marketplace

market
for the sale and purchase of
individual

93
health insurance plans by employees enrolled in an individual

94
coverage health reimbursement arrangement

various products that

95
enable individuals to pay for health care. These products

96
include, but are not limited to, health insurance plans, health

97
maintenance organization plans, prepaid services, service

98
contracts, and flexible spending accounts
. The components of the
99 program include:
100 (a) Enrollment of employers.
101 (b) Administrative services for participating employers,
102 including:
103 1. Assistance in seeking federal approval of cafeteria
104 plans.
105 2. Collection of premiums and other payments.
106 3. Management of individual benefit accounts.
107 4. Distribution of premiums to insurers and payments to
108 other eligible vendors.
109 5. Assistance for participants in complying with reporting
110 requirements.
111 (c) Services to individual participants, including:
112 1. Information about available products and participating
113 vendors.
114 2. Assistance with assessing the benefits and limits of
115 each product
, including information necessary to distinguish

116
between policies offering creditable coverage and other products

117
available through the program
.
118 3. Account information to assist individual participants
119 with managing available resources.
120 4. Services that promote healthy behaviors.
121 (d) Recruitment of vendors, including insurers
and
,
health
122 maintenance organizations
, prepaid clinic service providers,

123
provider service networks, and other providers
.
124 (e) Certification of vendors to ensure capability,
125 reliability, and validity of offerings.
126 (f) Collection of data, monitoring, assessment, and
127 reporting of vendor performance.
128 (g) Information services for individuals and employers.
129 (h) Program evaluation.
130 (4) ELIGIBILITY AND PARTICIPATION.—Participation in the
131 program is voluntary and shall be available to employers,
132 individuals, vendors, and health insurance agents as specified
133 in this subsection.
134 (a) Employers eligible to enroll in the program include
135 those employers that meet criteria established by the
136 corporation and elect to make their employees eligible through
137 the program.
138 (b) Individuals eligible to participate in the program
139 include:
140 1. Individual employees of enrolled employers.
141 2. Other individuals that meet criteria established by the
142 corporation.
143 (c) Employers who choose to participate in the program may
144 enroll by complying with the procedures established by the
145 corporation. The procedures must include, but are not limited
146 to:
147 1. Submission of required information.
148 2. Compliance with federal tax requirements for the
149 establishment of a cafeteria plan, pursuant to s. 125 of the
150 Internal Revenue Code, including designation of the employer’s
151 plan as a premium payment plan, a salary reduction plan that has
152 flexible spending arrangements, or a salary reduction plan that
153 has a premium payment and flexible spending arrangements.
154 3. Determination of the employer’s contribution, if any,
155 per employee, provided that such contribution is equal for each
156 eligible employee.
157 4. Establishment of payroll deduction procedures, subject
158 to the agreement of each individual employee who voluntarily
159 participates in the program.
160 5. Designation of the corporation as the third-party
161 administrator for the employer’s health benefit plan.
162 6. Identification of eligible employees.
163 7. Arrangement for periodic payments.
164 8. Employer notification to employees of the intent to
165 transfer from an existing employee health plan to the program at
166 least 90 days before the transition.
167 (d) All eligible vendors who choose to participate and the
168 products and services that the vendors are permitted to sell are
169 as follows:
170 1. Insurers licensed under chapter 624 may sell health
171 insurance policies
, limited benefit policies, other risk-bearing

172
coverage, and other products or services
.
173 2. Health maintenance organizations licensed under part I
174 of chapter 641 may sell health maintenance contracts
, limited

175
benefit policies, other risk-bearing products, and other

176
products or services
.
177
3.

Prepaid limited health service organizations may sell

178
products and services as authorized under part I of chapter 636,

179
and discount plan organizations may sell products and services

180
as authorized under part II of chapter 636.

181
4.

Prepaid health clinic service providers licensed under

182
part II of chapter 641 may sell prepaid service contracts and

183
other arrangements for a specified amount and type of health

184
services or treatments.

185
5.

Health care providers, including hospitals and other

186
licensed health facilities, health care clinics, licensed health

187
professionals, pharmacies, and other licensed health care

188
providers, may sell service contracts and arrangements for a

189
specified amount and type of health services or treatments.

190
6.

Provider organizations, including service networks,

191
group practices, professional associations, and other

192
incorporated organizations of providers, may sell service

193
contracts and arrangements for a specified amount and type of

194
health services or treatments.

195
7.

Corporate entities providing specific health services in

196
accordance with applicable state law may sell service contracts

197
and arrangements for a specified amount and type of health

198
services or treatments.

199
200
A vendor described in subparagraphs 3.-7. may not sell products

201
that provide risk-bearing coverage unless that vendor is

202
authorized under a certificate of authority issued by the Office

203
of Insurance Regulation and is authorized to provide coverage in

204
the relevant geographic area. Otherwise
Eligible vendors may be
205 excluded from participating in the program for deceptive or
206 predatory practices, financial insolvency, or failure to comply
207 with the terms of the participation agreement or other standards
208 set by the corporation.
209 (e) Eligible individuals may participate in the program
210 voluntarily. Individuals who join the program may participate by
211 complying with the procedures established by the corporation.
212 These procedures must include, but are not limited to:
213 1. Submission of required information.
214 2. Authorization for payroll deduction.
215 3. Compliance with federal tax requirements.
216 4. Arrangements for payment.
217 5. Selection of products and services.
218 (f) Vendors who choose to participate in the program may
219 enroll by complying with the procedures established by the
220 corporation. These procedures may include, but are not limited
221 to:
222 1. Submission of required information, including a complete
223 description of the coverage, services, provider network, payment
224 restrictions, and other requirements of each product offered
225 through the program.
226 2. Execution of an agreement to comply with requirements
227 established by the corporation.
228 3. Execution of an agreement that prohibits refusal to sell
229 any offered product or service to a participant who elects to
230 buy it.
231 4.
Establishment of product prices based on applicable

232
criteria.

233
5.
Arrangements for receiving payment for enrolled
234 participants.
235
5.
6.
Participation in ongoing reporting processes
236 established by the corporation.
237
6.
7.
Compliance with grievance procedures established by
238 the corporation.
239 (g) Health insurance agents licensed under part IV of
240 chapter 626 are eligible to voluntarily participate as buyers’
241 representatives. A buyer’s representative acts on behalf of an
242 individual purchasing health insurance and health services
243 through the program by providing information about products and
244 services available through the program and assisting the
245 individual with both the decision and the procedure of selecting
246 specific products. Serving as a buyer’s representative does not
247 constitute a conflict of interest with continuing
248 responsibilities as a health insurance agent if the relationship
249 between each agent and any participating vendor is disclosed
250 before advising an individual participant about the products and
251 services available through the program. In order to participate,
252 a health insurance agent shall comply with the procedures
253 established by the corporation, including:
254 1. Completion of training requirements.
255 2. Execution of a participation agreement specifying the
256 terms and conditions of participation.
257 3. Disclosure of any appointments to solicit insurance or
258 procure applications for vendors participating in the program.
259 4. Arrangements to receive payment from the corporation for
260 services as a buyer’s representative.
261 (5) PRODUCTS.—
262
(a)
The products that may be made available for purchase
263 through the program include
, but are not limited to
:

264
1.
health insurance policies
and
.

265
2.
health maintenance contracts.
266
3.

Limited benefit plans.

267
4.

Prepaid clinic services.

268
5.

Service contracts.

269
6.

Arrangements for purchase of specific amounts and types

270
of health services and treatments.

271
7.

Flexible spending accounts.

272
(b)

Health insurance policies, health maintenance

273
contracts, limited benefit plans, prepaid service contracts, and

274
other contracts for services must ensure the availability of

275
covered services.

276
(c)

Products may be offered for multiyear periods provided

277
the price of the product is specified for the entire period or

278
for each separately priced segment of the policy or contract.

279
(d)

The corporation shall provide a disclosure form for

280
consumers to acknowledge their understanding of the nature of,

281
and any limitations to, the benefits provided by the products

282
and services being purchased by the consumer.

283
(e)

The corporation must determine that making the plan

284
available through the program is in the interest of eligible

285
individuals and eligible employers in the state.

286 (6)
SURCHARGE

PRICING
.—
Prices for the products and services

287
sold through the program must be transparent to participants and

288
established by the vendors.
The corporation shall annually
289 assess a surcharge for each premium or price set by a
290 participating vendor. The surcharge may not be more than 2.5
291 percent of the price and
must

shall
be used to generate funding
292 for administrative services provided by the corporation and
293 payments to buyers’ representatives.
294 (7)
THE
MARKETPLACE PROCESS.—The program shall provide a
295
single,
centralized
marketplace

market
for
access to

purchase of

296 health insurance
and
,
health maintenance contracts
by an

297
employee enrolled in an individual coverage health reimbursement

298
arrangement
, and other health products and services
. Purchases
299 may be made by participating individuals over the Internet or
300 through the services of a participating health insurance agent.
301 Information about each product and service available through the
302 program
must

shall
be made available through printed material
303 and an interactive Internet website. A participant needing
304 personal assistance to select products and services
must

shall

305 be referred to a participating agent in his or her area.
306 (a) Participation in the program may begin at any time
307 during a year after the employer completes enrollment and meets
308 the requirements specified by the corporation pursuant to
309 paragraph (4)(c).
310 (b) Initial selection of products and services must be made
311 by an individual participant within the applicable open
312 enrollment period.
313
(c)

Initial enrollment periods for each product selected by

314
an individual participant must last at least 12 months, unless

315
the individual participant specifically agrees to a different

316
enrollment period.

317
(d)

If an individual has selected one or more products and

318
enrolled in those products for at least 12 months or any other

319
period specifically agreed to by the individual participant,

320
changes in selected products and services may only be made

321
during the annual enrollment period established by the

322
corporation.

323
(e)

The limits established in paragraphs (b)-(d) apply to

324
any risk-bearing product that promises future payment or

325
coverage for a variable amount of benefits or services. The

326
limits do not apply to initiation of flexible spending plans if

327
those plans are not associated with specific high-deductible

328
insurance policies or the use of spending accounts for any

329
products offering individual participants specific amounts and

330
types of health services and treatments at a contracted price.

331 (8) CONSUMER INFORMATION.—The corporation shall:
332 (a) Establish a secure website to facilitate the purchase
333 of products and services by participating individuals. The
334 website must provide information about each product or service
335 available through the program.
336 (b) Inform individuals about other public health care
337 programs.
338 (9)
RISK POOLING.—The program may use methods for pooling

339
the risk of individual participants and preventing selection

340
bias. These methods may include, but are not limited to, a

341
postenrollment risk adjustment of the premium payments to the

342
vendors. The corporation may establish a methodology for

343
assessing the risk of enrolled individual participants based on

344
data reported annually by the vendors about their enrollees.

345
Distribution of payments to the vendors may be adjusted based on

346
the assessed relative risk profile of the enrollees in each

347
risk-bearing product for the most recent period for which data

348
is available.

349
(10)

EXEMPTION

EXEMPTIONS
.—
350
(a)

Products, other than the products set forth in

351
subparagraphs (4)(d)1.-4., sold as part of the program are not

352
subject to the licensing requirements of the Florida Insurance

353
Code, as defined in s. 624.01 or the mandated offerings or

354
coverages established in part VI of chapter 627 and chapter 641.

355
(b)
The corporation may act as an administrator as defined
356 in s. 626.88 but is not required to be certified pursuant to
357 part VII of chapter 626. However, a third party administrator
358 used by the corporation must be certified under part VII of
359 chapter 626.
360
(c)

Any standard forms, website design, or marketing

361
communication developed by the corporation and used by the

362
corporation, or any vendor that meets the requirements of

363
paragraph (4)(f) is not subject to the Florida Insurance Code,

364
as established in s. 624.01.

365
(10)

CORPORATION.—There is created Florida Employee Health

366
Choices, Inc., which shall be registered, incorporated,

367
organized, and operated in compliance with part III of chapter

368
112 and chapters 119, 286, and 617. The purpose of the

369
corporation is to administer the program created in this section

370
and to conduct such other business as may further the

371
administration of the program. The Department of Management

372
Services shall facilitate the formation of the corporation and

373
provide administrative support for the corporation until January

374
1, 2029. The corporation must be self-sustaining and no longer

375
require administrative assistance from the Department of

376
Management Services by January 1, 2029.

377
(a)

The corporation shall be governed by an eight-member

378
board of directors. Board members shall be appointed for terms

379
of up to 3 years and shall be eligible for reappointment. A

380
vacancy on the board shall be filled for the unexpired portion

381
of the term in the same manner as the original appointment.

382
Board members may not include an individual who is affiliated

383
with or employed by an eligible vendor or a subsidiary of an

384
eligible vendor. Board members shall serve without compensation,

385
but are entitled to receive, from funds of the corporation,

386
reimbursement for per diem and travel expenses as provided in s.

387
112.061. The membership of the board shall consist of:

388
1.

Three members appointed by the Governor.

389
2.

Two members appointed by the President of the Senate.

390
3.

Two members appointed by the Speaker of the House of

391
Representatives.

392
4.

The Secretary of Management Services or a designee with

393
expertise in state employee benefits and procurement, as an ex

394
officio nonvoting member.

395
(b)

The corporation may exercise all powers granted to it

396
under chapter 617 necessary to carry out the purposes of this

397
section, including, but not limited to, the power to receive and

398
accept grants, loans, or advances of funds from any public or

399
private agency and to receive and accept from any source

400
contributions of money, property, labor, or any other thing of

401
value to be held, used, and applied for the purposes of this

402
section.

403
(c)

There is no liability on the part of, and a cause of

404
action may not arise against, any member of the board or its

405
employees or agents for any action taken by them in exercising

406
their powers and performing their duties under this section.

407
(d)

The board shall develop and adopt bylaws and other

408
corporate procedures necessary for the operation of the

409
corporation and carrying out the purposes of this section. At a

410
minimum, the bylaws must:

411
1.

Specify procedures for selection of officers and

412
qualifications for reappointment, provided that a board member

413
may not serve more than 9 consecutive years.

414
2.

Require an annual membership meeting that provides an

415
opportunity for input and interaction with individual

416
participants in the program.

417
3.

Specify policies and procedures regarding conflicts of

418
interest, including part III of chapter 112, which prohibit a

419
member from participating in any decision that would inure to

420
the benefit of the member or the organization that employs the

421
member. The policies and procedures must also require public

422
disclosure of the interest that prevents the member from

423
participating in a decision on a particular matter.

424
4.

Specify procedures for adopting an annual budget.

425
5.

Specify procedures for selecting a chief executive

426
officer for the corporation who shall be responsible for

427
securing staff and consultant services necessary for the

428
operation of the program as may be authorized by the

429
corporation’s operating budget.

430
(e)

The corporation shall establish policies and procedures

431
for application, enrollment, plan administration, performance

432
monitoring, and consumer education, and other policies and

433
procedures necessary for the operation of the program,

434
including, but not limited to:

435
1.

Criteria for participation in the program and procedures

436
for determining the eligibility of employers, vendors,

437
individuals, and health insurance agents and employers to

438
participate in the program.

439
2.

Exclusion of vendors pursuant to paragraph (4)(d).

440
3.

Collection of contributions from participating employers

441
and individuals.

442
4.

Payment of premiums and other appropriate disbursements

443
based on the selections of products and services by

444
participating individuals.

445
5.

Disenrollment of participating individuals based on

446
failure to pay the individual’s share of any contribution

447
required to maintain enrollment in selected products.

448
(f)

The corporation shall procure a vendor to facilitate a

449
platform that streamlines the purchase of individual coverage

450
for employees enrolled in individual coverage health

451
reimbursement arrangements.

452
1.

Within 90 days after the formation of the corporation,

453
the department shall, as directed by the board, issue an

454
invitation to negotiate to procure the vendor. Responsive

455
bidders must demonstrate the ability to establish a platform

456
fully operational for open enrollment by January 1, 2028, and

457
provide for initial, open, and special enrollment periods.

458
2.

The department shall evaluate and score the procurement

459
bids, enter into negotiations at the direction of the board, and

460
make recommendations to the board related to the contract award.

461
The corporation shall select the vendor and execute the contract

462
within 180 days after the issuance of the invitation to

463
negotiate.

464
(g)

The corporation shall develop and implement a plan for

465
promoting public awareness of and participation in the program

466
and shall establish a toll-free hotline to respond to requests

467
for assistance from employers and plan enrollees.

468
(h)

The corporation may evaluate and implement additional

469
options for employer participation which conform with common

470
insurance practices.

471
(11)

CORPORATION.—There is created the Florida Health

472
Choices, Inc., which shall be registered, incorporated,

473
organized, and operated in compliance with part III of chapter

474
112 and chapters 119, 286, and 617. The purpose of the

475
corporation is to administer the program created in this section

476
and to conduct such other business as may further the

477
administration of the program.

478
(a)

The corporation shall be governed by a 15-member board

479
of directors consisting of:

480
1.

Three ex officio, nonvoting members to include:

481
a.

The Secretary of Health Care Administration or a

482
designee with expertise in health care services.

483
b.

The Secretary of Management Services or a designee with

484
expertise in state employee benefits.

485
c.

The commissioner of the Office of Insurance Regulation

486
or a designee with expertise in insurance regulation.

487
2.

Four members appointed by and serving at the pleasure of

488
the Governor.

489
3.

Four members appointed by and serving at the pleasure of

490
the President of the Senate.

491
4.

Four members appointed by and serving at the pleasure of

492
the Speaker of the House of Representatives.

493
5.

Board members may not include insurers, health insurance

494
agents or brokers, health care providers, health maintenance

495
organizations, prepaid service providers, or any other entity,

496
affiliate or subsidiary of eligible vendors.

497
(b)

Members shall be appointed for terms of up to 3 years.

498
Any member is eligible for reappointment. A vacancy on the board

499
shall be filled for the unexpired portion of the term in the

500
same manner as the original appointment.

501
(c)

The board shall select a chief executive officer for

502
the corporation who shall be responsible for the selection of

503
such other staff as may be authorized by the corporation’s

504
operating budget as adopted by the board.

505
(d)

Board members are entitled to receive, from funds of

506
the corporation, reimbursement for per diem and travel expenses

507
as provided by s. 112.061. No other compensation is authorized.

508
(e)

There is no liability on the part of, and no cause of

509
action shall arise against, any member of the board or its

510
employees or agents for any action taken by them in the

511
performance of their powers and duties under this section.

512
(f)

The board shall develop and adopt bylaws and other

513
corporate procedures as necessary for the operation of the

514
corporation and carrying out the purposes of this section. The

515
bylaws shall:

516
1.

Specify procedures for selection of officers and

517
qualifications for reappointment, provided that no board member

518
shall serve more than 9 consecutive years.

519
2.

Require an annual membership meeting that provides an

520
opportunity for input and interaction with individual

521
participants in the program.

522
3.

Specify policies and procedures regarding conflicts of

523
interest, including the provisions of part III of chapter 112,

524
which prohibit a member from participating in any decision that

525
would inure to the benefit of the member or the organization

526
that employs the member. The policies and procedures shall also

527
require public disclosure of the interest that prevents the

528
member from participating in a decision on a particular matter.

529
(g)

The corporation may exercise all powers granted to it

530
under chapter 617 necessary to carry out the purposes of this

531
section, including, but not limited to, the power to receive and

532
accept grants, loans, or advances of funds from any public or

533
private agency and to receive and accept from any source

534
contributions of money, property, labor, or any other thing of

535
value to be held, used, and applied for the purposes of this

536
section.

537
(h)

The corporation shall:

538
1.

Determine eligibility of employers, vendors,

539
individuals, and agents in accordance with subsection (4).

540
2.

Establish procedures necessary for the operation of the

541
program, including, but not limited to, procedures for

542
application, enrollment, risk assessment, risk adjustment, plan

543
administration, performance monitoring, and consumer education.

544
3.

Arrange for collection of contributions from

545
participating employers and individuals.

546
4.

Arrange for payment of premiums and other appropriate

547
disbursements based on the selections of products and services

548
by the individual participants.

549
5.

Establish criteria for disenrollment of participating

550
individuals based on failure to pay the individual’s share of

551
any contribution required to maintain enrollment in selected

552
products.

553
6.

Establish criteria for exclusion of vendors pursuant to

554
paragraph (4)(d).

555
7.

Develop and implement a plan for promoting public

556
awareness of and participation in the program.

557
8.

Secure staff and consultant services necessary to the

558
operation of the program.

559
9.

Establish policies and procedures regarding

560
participation in the program for individuals, vendors, health

561
insurance agents, and employers.

562
10.

Provide for the operation of a toll-free hotline to

563
respond to requests for assistance.

564
11.

Provide for initial, open, and special enrollment

565
periods.

566
12.

Evaluate options for employer participation which may

567
conform with common insurance practices.

568
(11)
(12)
REPORT.—Beginning in the
2027-2028

2009-2010

569 fiscal year,
the corporation shall
submit by February 1 an
570 annual report to the Governor, the President of the Senate, and
571 the Speaker of the House of Representatives documenting the
572 corporation’s activities in compliance with the duties
573 delineated in this section.
574
(12)
(13)
PROGRAM INTEGRITY.—To ensure program integrity and
575 to safeguard the financial transactions made under the auspices
576 of the program, the corporation is authorized to establish
577 qualifying criteria and certification procedures for vendors,
578 require performance bonds or other guarantees of ability to
579 complete contractual obligations, monitor the performance of
580 vendors, and enforce the agreements of the program through
581 financial penalty or disqualification from the program.
582
(13)
(14)
EXEMPTION FROM PUBLIC RECORDS REQUIREMENTS.—
583 (a)
Definitions.
—For purposes of this subsection, the term:
584 1. “Buyer’s representative” means a participating insurance
585 agent as described in paragraph (4)(g).
586 2. “Enrollee” means an employer who is eligible to enroll
587 in the program pursuant to paragraph (4)(a).
588 3. “Participant” means an individual who is eligible to
589 participate in the program pursuant to paragraph (4)(b).
590 4. “Proprietary confidential business information” means
591 information, regardless of form or characteristics, that is
592 owned or controlled by a vendor requesting confidentiality under
593 this section; that is intended to be and is treated by the
594 vendor as private in that the disclosure of the information
595 would cause harm to the business operations of the vendor; that
596 has not been disclosed unless disclosed pursuant to a statutory
597 provision, an order of a court or administrative body, or a
598 private agreement providing that the information may be released
599 to the public; and that is information concerning:
600 a. Business plans.
601 b. Internal auditing controls and reports of internal
602 auditors.
603 c. Reports of external auditors for privately held
604 companies.
605 d. Client and customer lists.
606 e. Potentially patentable material.
607 f. A trade secret as defined in s. 688.002.
608 5. “Vendor” means a participating insurer or other provider
609 of services as described in paragraph (4)(d).
610 (b)
Public record exemptions.
—
611 1. Personal identifying information of an enrollee or
612 participant who has applied for or participates in the Florida
613
Employee
Health Choices Program is confidential and exempt from
614 s. 119.07(1) and s. 24(a), Art. I of the State Constitution.
615 2. Client and customer lists of a buyer’s representative
616 held by the corporation are confidential and exempt from s.
617 119.07(1) and s. 24(a), Art. I of the State Constitution.
618 3. Proprietary confidential business information held by
619 the corporation is confidential and exempt from s. 119.07(1) and
620 s. 24(a), Art. I of the State Constitution.
621 (c)
Retroactive application.
—The public record exemptions
622 provided for in paragraph (b) apply to information held by the
623 corporation before, on, or after the effective date of this
624 exemption.
625 (d)
Authorized release.
—
626 1. Upon request, information made confidential and exempt
627 pursuant to this subsection
must

shall
be disclosed to:
628 a. Another governmental entity in the performance of its
629 official duties and responsibilities.
630 b. Any person who has the written consent of the program
631 applicant.
632 c. The Florida Kidcare program for the purpose of
633 administering the program authorized in ss. 409.810-409.821.
634 2. Paragraph (b) does not prohibit a participant’s legal
635 guardian from obtaining confirmation of coverage, dates of
636 coverage, the name of the participant’s health plan, and the
637 amount of premium being paid.
638 (e)
Penalty.
—A person who knowingly and willfully violates
639 this subsection commits a misdemeanor of the second degree,
640 punishable as provided in s. 775.082 or s. 775.083.
641 Section 2. Paragraph (a) of subsection (2) of section
642 409.821, Florida Statutes, is amended to read:
643 409.821 Florida Kidcare program public records exemption.—
644 (2)(a) Upon request, such information shall be disclosed
645 to:
646 1. Another governmental entity in the performance of its
647 official duties and responsibilities;
648 2. The Department of Revenue for purposes of administering
649 the state Title IV-D program;
650 3.
The
Florida
Employee
Health Choices, Inc., for the
651 purpose of administering the program authorized pursuant to s.
652 408.910; or
653 4. Any person who has the written consent of the program
654 applicant.
655 Section 3. Subsection (3) of section 409.9122, Florida
656 Statutes, is amended to read:
657 409.9122 Medicaid managed care enrollment; HIV/AIDS
658 patients; procedures; data collection; accounting; information
659 system; medical loss ratio.—
660 (3) The agency shall develop a process to enable any
661 recipient with access to employer-sponsored health care coverage
662 to opt out of all eligible plans in the Medicaid program and to
663 use Medicaid financial assistance to pay for the recipient’s
664 share of cost in any such employer-sponsored coverage.
665 Contingent on federal approval, the agency shall also enable
666 recipients with access to other insurance or related products
667 that provide access to health care services created pursuant to
668 state law, including any plan or product available pursuant to
669 the Florida
Employee
Health Choices Program or any health
670 exchange, to opt out. The amount of financial assistance
671 provided for each recipient may not exceed the amount of the
672 Medicaid premium that would have been paid to a plan for that
673 recipient.
674 Section 4. Subsection (4) of section 409.977, Florida
675 Statutes, is amended to read:
676 409.977 Enrollment.—
677 (4) The agency shall develop a process to enable a
678 recipient with access to employer-sponsored health care coverage
679 to opt out of all managed care plans and to use Medicaid
680 financial assistance to pay for the recipient’s share of the
681 cost in such employer-sponsored coverage. The agency shall also
682 enable recipients with access to other insurance or related
683 products providing access to health care services created
684 pursuant to state law, including any product available under the
685 Florida
Employee
Health Choices Program, or any health exchange,
686 to opt out. The amount of financial assistance provided for each
687 recipient may not exceed the amount of the Medicaid premium that
688 would have been paid to a managed care plan for that recipient.
689 The agency shall require Medicaid recipients with access to
690 employer-sponsored health care coverage to enroll in that
691 coverage and use Medicaid financial assistance to pay for the
692 recipient’s share of the cost for such coverage. The amount of
693 financial assistance provided for each recipient may not exceed
694 the amount of the Medicaid premium that would have been paid to
695 a managed care plan for that recipient. The agency may exceed
696 this amount for a high-cost patient if it determines it would be
697 cost effective to do so. The agency shall annually, beginning
698 June 30, 2026, submit an annual report on the program to the
699 Legislature including, but not limited to, the level of
700 participation; participant demographics, income levels, type of
701 employer-based coverage, and amount of health care utilization;
702 and a cost-effectiveness analysis both in the aggregate and on
703 an individual patient basis.
704 Section 5. This act shall take effect July 1, 2026.