Mental Health Parity Mandate
Coverage for mental/nervous and substance-related disorders, and developmental problems
(SB 164/HB 19):
•    Increased benefits: the current optional mandate with limited benefits would be expanded to offer treatment of all recognized mental and nervous disorders including paraphilia and eating disorders, substance abuse, and developmental problems (e. g., autism, Aspergers) as if they were medical conditions.
•    Decreased management ability: cost-effective tools such as partial hospitalization would be eliminated.
•    Efficacy concerns: mandate would cover conditions (e. g., cocaine addiction, autism) that lack effective treatment regimens, and even treatments which can be harmful (e. g., bariatric surgery)

The Senate Banking and Insurance Committee interim committee report recommends limit mandated parity coverage to those biologically-based mental and nervous conditions (such as bipolar disorder, schizophrenia) with the current optional coverage for other conditions.  While FIC does not support any mandates, the Senate report recommendation would be preferable.

Autism & Other Mandates
FIC opposes any benefit or provider mandate, including, but not limited to:
Autism - Mandated educational/health care treatments for autism are federally mandated and are the responsibility of the state.  Shifting the responsibility to health insurers would further increase costs for all insured Floridians.  Additionally, autism is not a rehabilitative condition; it may be treated but not cured.
Cystic Fibrosis,
Congenital craniofacial anomalies,
Surgical first assistants,
Infant eye examinations,
Lyme Disease out-of-network and investigative care,
Diabetes screening,
HPV vaccine and
Shingles vaccine.

With most of the proposed mandates, including autism, the state determines what is appropriate health care and what should be covered by insurers when, in most cases, these conditions do not affect or impact the vast majority of Floridians, and, if enacted, would drive up health care/medical costs for Florida’s employers and consumers.  And mandates do not benefit the growing number of Floridians with individual health insurance since their coverage is underwritten. 

In general, we support additional health insurance choices at less cost. Florida’s health insurers are offering more choices for coverage and benefits, and we don’t support legislation that limits choice or availability of health insurance, benefits or coverage for Floridians.
 
Health Insurance Claims Payments Bill (SB 1012/HB 405) (OPPOSE)
AMA priority bill
Mandatory assignment: out-of-network providers could receive assignment of in-network reimbursement at their inflated charges with no balance-billing
“Silent” PPOs prohibited: contracted reduced in-network reimbursement could not be “transferred” to other networks (that is, no visiting national insured could receive in-network care in Florida, and no self-funded employer – such as the State of Florida, counties/cities, School Boards, large employers, etc. -- could have network plans; again, in other words, all such health plans would be reimbursing providers at their inflated charge rates)

The uninsured
Efforts to cover the uninsured without increasing the state budget (SUPPORT):
Auto-enrollment: allow employers to enroll eligible employees in their health plans
Dependent coverage: allow health plans to keep dependents 19-25 years of age, or to age 30, on family plans, employers held harmless regarding premium contribution.  FIC would accept this as an alternative to proposed mandates requiring health plans to accept dependents whenever they become sick or injured, thus resulting in adverse selection.

HealthFlex reform: re-enact and reform HealthFlex to give health plans necessary flexibility to design low-cost network/benefit packages to cover the currently-uninsured; also relax current income eligibility upper limit (<200% FPL – SB 1022/HB 461 would increase threshold to 300% FPL)

Other alternatives being considered:
Florida Healthy Kids: allow state to use subsidy to put eligible FHK/SCHIP dependents on employer family policy, if cost-effective
Small employer subsidies: subsidies for uninsured small employers purchasing health coverage

Workgroups
Florida Health Insurance Advisory Board, chaired by OIR Commissioner McCarty.  The Advisory Board acts in an advisory role on health insurance issues to the Office of Insurance Regulation, AHCA, the Department of Financial Services other executive departments and to the Legislature.
 
FHIAB Legislative recommendations:
•    Removal of impediments that delay/discourage micro-groups (less than 10 employees) in obtaining health insurance including differing contribution and participation requirements, agent commission structure and documentation requirements.
•    In order to reduce further segmentation of the market as well as competitive advantages for out-of-state group plans, the board recommends applying all regulatory requirements to all insurers authorized to do business in Florida
•    Require all incoming freshman to have health insurance coverage

One recommendation would let all young adults in Florida stay on their parents' health insurance policies until age 25 (see uninsured item above). A second proposal would require all college students to have coverage as a prerequisite for taking classes.

Comprehensive recommendations will be released in Spring 2008.