Volume 2 Number 31
August 1, 2005


Consumer Services HelpLine Number 800-342-2762






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Small Group Market Carriers

Florida Small Employer Benefit Plan

 

OPEN ENROLLMENT STARTS TODAY FOR SOLE PROPRIETORS

One-life group open enrollment starts today, August 1, and continues through August 31.  A sole proprietor that applies during the month of August and is deemed eligible for coverage will have a policy effective date of October 1.  This is the month for new one-life groups to apply for coverage and for existing one-life groups to shop around and/or switch carriers if they wish.  Insurers and HMOs have to offer small group Standard and Basic policies to one-life groups.  The benefits provided under these two standardized policies can be viewed on the website at Florida Small Employer Benefit Plan.

All companies and HMOs that participate in the small group market must accept all eligible one-life groups during the month of August.  A list of insurance companies offering coverage is posted on the Department of Financial Servicesí website at this link: Small Group Market Carriers.

The one-life group coverage is guaranteed issue if the sole proprietor can meet the statutory requirements. Florida Statute 627.6699(3)(u) states that a self-employed individual must have taxable income as indicated on IRS Form 1040, Schedule C or F, in one of the two previous years.  Under section (3)(v), it states that a small employer, including sole proprietors, must be actively engaged in business, have its primary place of business in this state, and employ at least one person on the first day of the plan year.

With the passage of the Affordable Healthcare for Floridians Act last year, coverage options for employers include health savings accounts (HSAs) or health reimbursement arrangements (HRAs).  HSAs, which operate like Individual Retirement Accounts (IRAs), allow people to save their own money in a tax-free account for use on health related expenses. If the money is not spent, it will roll over annually and continue to accumulate until the policyholder is age 65 at which time the money can be used for any purpose.

Consumers are encouraged to contact the departmentís toll-free consumer helpline at 1-800-342-2762 to request a free copy of our health insurance consumer guide.  It can be downloaded at Health Insurance: A Guide for Consumers.

Night falls over the 1908 Lafayette County courthouse in Mayo, the county seat.  The two-story frame building across the street was an earlier courthouse. The county was formed in 1856 and named after the French marquis who assisted the colonies during the Revolutionary War.