eLaws of Florida

  SECTION 627.65625. Prohibiting discrimination against individual participants and beneficiaries based on health status.  


Latest version.
  • 1(1) 2Subject to subsection (2), an insurer that offers a group health insurance policy may not establish rules for eligibility, including continued eligibility, of an individual to enroll under the terms of the policy based on any of the following health-status-related factors in relation to the individual or a dependent of the individual:
    54(a) 55Health status.
    57(b) 58Medical condition, including physical and mental illnesses.
    65(c) 66Claims experience.
    68(d) 69Receipt of health care.
    73(e) 74Medical history.
    76(f) 77Genetic information.
    79(g) 80Evidence of insurability, including conditions arising out of acts of domestic violence.
    92(h) 93Disability.
    94(2) 95Subsection (1) does not:
    99(a) 100Require an insurer to provide particular benefits other than those provided under the terms of such plan or coverage.
    119(b) 120Prevent such a plan or coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the plan or coverage.
    153(3) 154For purposes of subsection (1), rules for eligibility to enroll under a policy include rules for defining any applicable waiting periods of enrollment.
    177(4)(a) 178An insurer that offers health insurance coverage may not require any individual, as a condition of enrollment or continued enrollment under the policy, to pay a premium or contribution that is greater than such premium or contribution for a similarly situated individual enrolled under the policy on the basis of any health-status-related factor in relation to the individual or to an individual enrolled under the policy as a dependent of the individual.
    250(b) 251This subsection does not:
    2551. 256Restrict the amount that an employer may be charged for coverage under a group health insurance policy; or
    2742. 275Prevent an insurer that offers group health insurance coverage from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.
History.-s. 10, ch. 97-179.

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