What’s Happening with Florida Health Insurance Exchanges?

On August 7, 2013 the Florida Office of Insurance Regulation (FOIR) released proposed individual health insurance plan rates and carriers for the new Florida Health Insurance Exchange. Last week, FNPN Board members participated in regional conference calls to learn more about the plans, particularity to learn how NPs will be included in the new plans throughout the state. 

The law provides: 2706(a) of Public Health Service Act, created by §1201 of Patient Protection and Affordable Care Act (“PPACA”) –“A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.” 42 U.S.C. 300gg-5(a).


So far, only 10 insurance companies have received federal approval to sell Floridians health plans on the federally assisted health exchange, which rolls out Oct. 1. In Florida's 67 counties, there will only one or two insurance companies selling plans predominately through the new marketplace as reported by the Insurance Commissioner’s Office. No county will offer plans from all 10, but apparently FL Blues will be in all 67 counties. Insurance Plans purchased through the exchange take effect Jan. 1, 2014 and all expect the rates to rise with this form of coverage. Unfortunately, consumers may not have the wide breath of choice once thought, and many of the rural counties with have only a single plan option. South Florida counties will have the greatest number of plans to choose from, so we are watching this closely to ensure NPs gain provider status.

The top 10 list are: Aetna Life Insurance Company, Blue Cross Blue Shield of Florida, Cigna Health and Life Insurance Company, Coventry Health Care of Florida, Inc., Florida Health Care Plan, Inc., Health First Health Plans, Health First Insurance Company, Health Options, Inc., Humana Medical Plan, Inc., and Molina Healthcare Of Florida, Inc.

FNPN would like our members to contact us if any questions or comments about the Florida Health Insurance Exchanges.