Florida Health Insurance Coverage – Continuation Act

The Florida Health Insurance Coverage Continuation Act was enacted in 1997 by the State of Florida. Technically, it is Title XXXVII, Chapter 627 (627.6692) in the 2009 Florida Statutes, and is subsumed by the section on Insurance Rates and Contracts. The general purpose of this legislation is to provide small business employees, as well as their dependents and beneficiaries, the continuation of health insurance coverage upon removal of their existing health insurance plan.

This act requires an extension of Florida health insurance coverage be provided to employees and their families when certain situations occur that would end the coverage, called “qualifying events”. The Insurance Continuation Act only applies to those employers with less than twenty eligible employees. Specific instances in which this law would apply include an employee’s loss of group health insurance coverage due to reduction of work hours or employment termination. Covered spouses may be entitled to a continuation of coverage if the spouse is an employee who loses their employment, is a deceased or divorced spouse, or if the spouse is an employee who is currently eligible for Medicare. Dependents may become eligible if their parent is an employee, who is recently divorced or deceased, if the parent recently becomes eligible for Medicare, or if the dependent no longer qualifies, most likely due to the age of the child.

It is the responsibility of the covered persons to notify the insurance company within thirty days of the occurrence of a qualifying event, listed above. This notice must contain: name and addresses of each beneficiary, date and type of the qualifying event, name of the employer and group plan number. After notification, the insurance company will advise the beneficiaries of their rights and responsibilities to an extension of Florida health insurance coverage, in the form of an Election and Premium Notice.

Upon receipt of notification, beneficiaries have another thirty days to elect a continuation of insurance coverage, by returning the completed form. If you chose to decline the continuation benefit, your existing plan will terminate based on documented company and plan policy. If you elect to continue your Florida health insurance coverage, your plan’s benefits will not change for the next eighteen months. Coverage will become effective immediately upon prior coverage termination. However, this continuation could be terminated if: your former employer ceases all group health care plans, you do not pay your premiums on time, you become covered under another plan or you transition to Medicare coverage.