409.817 Approval of health benefits coverage; financial assistance. - Florida Statutes

409.817 Approval of health benefits coverage; financial assistance.

In order for health insurance coverage to qualify for premium assistance payments for an eligible child under ss. 409.810-409.821, the health benefits coverage must:

   (1) Be certified by the Office of Insurance Regulation of the Financial Services Commission under s. 409.818 as meeting, exceeding, or being actuarially equivalent to the benchmark benefit plan;

   (2) Be guarantee issued;

   (3) Be community rated;

   (4) Not impose any preexisting condition exclusion for covered benefits; however, group health insurance plans may permit the imposition of a preexisting condition exclusion, but only insofar as it is permitted under s. 627.6561;

   (5) Comply with the applicable limitations on premiums and cost-sharing in s. 409.816;

   (6) Comply with the quality assurance and access standards developed under s. 409.820; and

   (7) Establish periodic open enrollment periods, which may not occur more frequently than quarterly.

History. ss. 42, 57, ch. 98-288; s. 447, ch. 2003-261; s. 22, ch. 2003-405; s. 10, ch. 2009-113.