Florida Healthy Kids Corporation and HIV/AIDS testing requirements

Two Florida health statutes an agent should know

This objective pairs two Florida laws: the Florida Healthy Kids Corporation Act (Fla. Stat. 624.91), which creates a not-for-profit corporation that arranges health coverage for children, and Florida's HIV testing statute (Fla. Stat. 381.004), which sets rules for how HIV tests are offered, kept confidential and used.

The Florida Healthy Kids Corporation

The Act, also called the William G. "Doc" Myers Healthy Kids Corporation Act, reflects a legislative finding that many children lack comprehensive, affordable health care. The corporation is meant to provide comprehensive health insurance coverage to those children.

• Who it serves. It is one of several providers of services to children eligible under Title XXI of the Social Security Act. The primary intended recipients are school-age children with family income at or below 300 percent of the federal poverty level who do not qualify for Medicaid.
• State-funded premium help is limited to Florida residents eligible for Florida Kidcare, plus certain legal aliens enrolled as of January 31, 2004.
• No entitlement. The Act creates no entitlement to health care services and no cause of action against the state or the corporation for failing to make services available.

How it works

• It is a private not-for-profit corporation, run by a board of directors chaired by the Chief Financial Officer (or designee) plus 12 other members serving 3-year terms.
• It contracts with authorized insurers or other health care providers, with health plans selected by competitive bid. Administrative cost on a contract may not exceed 15 percent, and health contracts carry a minimum 85 percent medical loss ratio; a plan that falls below 85 percent must refund an amount to the state.
• Its coverage is secondary to any other available private coverage, and its contracted insurers are the payors of last resort.
• A family that voluntarily cancels by not paying premiums can face a 30-day waiting period before reinstatement.

Why an agent cares

The corporation is not deemed an insurer, and its officers, directors and employees are not agents of an insurer and are not subject to insurance licensing. However, any marketing representative the corporation uses and pays must be appointed as a representative of the insurers or health services providers it contracts with. The Department of Financial Services supervises any liquidation or dissolution of the corporation.

HIV testing rules

Florida's HIV testing law protects people who are tested:

• Results cannot drive insurance decisions. The result of a serologic test conducted under the auspices of the Department of Health may not be used to decide whether a person may be insured for disability, health or life insurance, or to screen, hire or fire for employment. Violation is a first-degree misdemeanor.
• No test as a condition of service. A facility or practitioner licensed by the Agency for Health Care Administration, the Department of Health or the Department of Business and Professional Regulation may not require an HIV test as a condition of admission or of obtaining the licensed service or product.
• Confidentiality. Except as the statute provides, the identity of a person tested and the test results are confidential.
• Voluntary testing network. Every county health department offers counseling and testing on both an anonymous and a confidential basis.
• Registered testing sites. Anyone running an HIV or AIDS testing program must register with the Department of Health and re-register each year; private sites pay a fee capped at $100.

Remember the split: Healthy Kids is about access to children's coverage; the HIV statute is about consent, confidentiality and non-discrimination.