Changes could be in store for the state-employee health insurance program. Again.
A Senate committee Monday introduced legislation that would make changes to prescription drug benefits, require the state to competitively bid the insurance program to managed-care plans in nine regions and strike a 2017 law that required four different benefit plans to be offered to employees.
The bill (SPB 7046) did not draw debate before members of the Senate Governmental Oversight and Accountability Committee voted unanimously to move forward with it.
The proposal would amend a 2019 law that authorized the introduction of a prescription-drug formulary to make clear that pharmacy benefit managers working on behalf of the state cannot “substitute their judgment over the judgment of the prescriber regarding whether a prescription drug is medically necessary” for treatment of a patient.
The proposal also lays the groundwork for Florida to competitively bid by Jan. 1, 2023 the insurance program in nine regions. Also, the measure would delete from current law a requirement for the state to begin offering employees access to a variety of health insurance options that ranged in cost and value. The plan options were named after metals, from a high-end platinum plan to a lower-end bronze plan.
The tier plan was pushed by House Republican leaders in 2017. But an actuarial analysis showed that the introduction of high-deductible plans — along with pretax health-savings account contributions — could entice about 29,000 employees to enroll in the state program after turning down coverage in the past. As a result, the Legislature delayed the tier offering.
In his budget recommendation for the upcoming year, Gov. Ron DeSantis recommended continued delay of the tier plan. The Senate bill would eliminate the tier plan from law altogether.