Requirements for small employers

Question 1

Definitions:

Answer 1

Small Group Employer: 1 to 50 eligible employees.
Eligible Employee: Full-time with a normal workweek of 25 or more hours

Question 2

Florida Employee Health Care Access Act

Answer 2

Small employer group health insurance contracts must comply with specified conditions.
Guaranteed issue basis for all small group health insurance benefits.
Premium determination based on gender, age, family composition, tobacco use, or geographic area.

Question 3

Coverages and Benefits:

Answer 3

Offer basic and standard plans with required benefits.
All health benefit plans must be guaranteed-issue.

Question 4

Special Provisions:

Answer 4

Statements by applicants are deemed representations, not warranties.
Policy benefits cannot be reduced without written acknowledgment.
Requirements for identification cards for insureds

Question 5

Termination and Nonrenewal:

Answer 5

Renewability of coverage for eligible employees and dependents.
Circumstances for termination include nonpayment of premium, fraud, noncompliance, or discontinuance of coverage.

Question 6

Fair Marketing Standards

Answer 6

Prohibition on discriminatory practices in marketing.
Prohibition on varying compensation based on health status.
Requirements for disclosure of reasons for denial of coverage.

Question 7

Disclosure Requirements:

Answer 7

Reasonable disclosure of premium rate changes, renewability, exclusions, and limitations.
Disclosure of benefits and premiums available under all qualified health insurance coverage

Question 8

Small Employer Rating, Renewability and Portability Act:

Answer 8

Continuation of coverage under the employer’s group health plan for qualified beneficiaries.
Coverage duration and premium limitations specified.
Provisions for continuation in case of disability