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Program Overview

Florida’s Health Insurance Marketplace

Florida’s Health Insurance Marketplace was designed by the State of Florida to serve Florida’s unique insurance market and to connect consumers with the health benefit providers they are seeking. A wide range of service providers, insurance options, benefit levels, and consumer choices are planned.

Florida’s Health Insurance Marketplace is launching in phases, with additional vendors, products and functionality being added over time. The major components of the Marketplace may include:

  • Web-based portals specifically designed for individuals, children, families, employers, employees, licensed professionals, associations, and agents
  • Shop-and-compare functionality to facilitate choice
  • Decision-making tools
  • Ability to find an agent
  • Back-office product, service and financial support
  • Customer contact centers
  • Provider searches

Florida Health Choices will continue to examine the overall health and insurance markets in Florida with an eye toward any segments that can be supported without over-reaching sustainability. Additional expansions to support other vendors and products will coincide with consumer need, vendor interest, and demonstrated commitment to Marketplace participation.

Governance and Stakeholders

The 12 voting members of the Florida Health Choices Board of Directors are appointed by the Governor, President of the Senate and Speaker of the House of Representatives. In addition, by law the Board includes three non-voting ex-officio members, one each from the Agency for Health Care Administration, Department of Management Services, and the Office of Insurance Regulation, which serve as important state agency partners.

Funding

Start-up funding to design and launch the program was provided by the State. The Marketplace must become financially self-sustaining through the use of a minimal surcharge on the products it sells which cannot exceed 2.5 percent.

Eligibility for Florida’s Health Insurance Marketplace

Participation is purely voluntary. Participants may include the categories listed below:

Individuals

  • Employees of enrolled employers
  • Individuals and their family members
  • Children only

Employers

  • Florida employers

Associations

  • Florida associations

Agents/Buyer’s Representatives

  • Health insurance agents licensed by the state of Florida

Vendors

  • Insurers
  • Health Maintenance Organizations
  • Discount Medical Plan Organizations
  • Limited Benefit Plans
  • Prepaid health clinics
  • Licensed health care providers including hospitals, licensed health facilities, health care clinics, licensed health professionals, pharmacies
  • Provider organizations including service networks, group practices, professional associations and other incorporated organizations of providers

History

The health care landscape in our country is constantly evolving. As new federal regulations change the way we deliver services, employers, individuals and providers must navigate the landscape to ensure that health insurance remains accessible and affordable.

Florida legislators foresaw that the ever-changing health care environment created a need for small employers and individuals to be able to access health insurance and health services without the hassle of dealing with the “insurance buying process” or only providing a “one-size-fits-all” plan.

In May 2008, SB 2534 was signed into law, which created the Florida Health Choices Corporation. The Corporation was established with the goal of increasing access to affordable, quality health care by creating a competitive market for purchasing health insurance and health services. Insurers and other companies will be able to offer more flexible insurance options and other products geared toward businesses, associations, individuals, kids, and families. The Corporation is administered by a 15-member board made up of appointees chosen by the Governor, the Senate president and the House speaker.

In 2014, Florida Health Choices began to roll out Florida’s Health Insurance Marketplace in phases. The Marketplace is a central web portal where businesses and eligible individuals can choose from a variety of health plans and services. Currently, the Marketplace serves individuals, children, families, and professionals licensed by the state of Florida, offering comprehensive coverage, kids’ insurance, dental, vision, and more. With a single point of access to compare multiple insurance products, consumers are able to enroll in the product that best meets their needs. Florida Health Choices also serves one of the largest trade associations in the state.

With several phases planned, Florida’s Marketplace will evolve and grow to include more vendors, products and web-based functionality.

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