Florida § 627.443 Essential health benefits

Florida Statutes

§ 627.443 — Essential health benefits

Florida § 627.443

TitleXXXVII

Ch. 627INSURANCE RATES AND CONTRACTS

This text of Florida § 627.443 (Essential health benefits) is published on Counsel Stack Legal Research, covering Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Fla. Stat. § 627.443 (2026).

Text

(1)As used in this section, the term:

(a)“EHB-benchmark plan” has the same meaning as provided in 45 C.F.R. s. 156.20.

(b)“PPACA” has the same meaning as in s. 627.402.

(2)A health insurer or health maintenance organization issuing or delivering an individual or a group health insurance policy or health maintenance contract in this state may create a new health insurance policy or health maintenance contract that:

(a)Must include at least one service or coverage under each of the 10 essential health benefits categories under 42 U.S.C. s. 18022(b) which are required under PPACA;

(b)May fulfill the requirement in paragraph (a) by selecting one or more services or coverages for each of the required categories from the list of essential health benefits required by any single state or mu

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(1) As used in this section, the term: (a) “EHB-benchmark plan” has the same meaning as provided in 45 C.F.R. s. 156.20. (b) “PPACA” has the same meaning as in s. 627.402.

(2) A health insurer or health maintenance organization issuing or delivering an individual or a group health insurance policy or health maintenance contract in this state may create a new health insurance policy or health maintenance contract that: (a) Must include at least one service or coverage under each of the 10 essential health benefits categories under 42 U.S.C. s. 18022(b) which are required under PPACA; (b) May fulfill the requirement in paragraph (a) by selecting one or more services or coverages for each of the required categories from the list of essential health benefits required by any single state or multiple states; and (c) May comply with paragraphs (a) and (b) by selecting one or more services or coverages from any one or more of the required categories of essential health benefits from one state or multiple states.

(3) This section specifically authorizes an insurer or health maintenance organization to include any combination of services or coverages required by any one state or a combination of states to provide the 10 categories of essential health benefits required under PPACA in a policy or contract issued in this state.

(4) Health insurance policies and health maintenance contracts created by health insurers and health maintenance organizations under this section: (a) May be submitted to the office for consideration as part of the office’s study of this state’s essential health benefits benchmark plan; and (b) May also be submitted to the office for evaluation as equivalent to the current state EHB-benchmark plan or to any EHB-benchmark plan created in the future.