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Small Business Employee Benefits and HR Blog

Florida Health Insurance Exchange Guide

Starting in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance marketplaces. 

Florida Health Insurance Marketplace Guide @ZaneBenefits

As a recap, all states have three options for setting up a state health insurance exchange for 2014:

  1. Build a State-Based Exchange

  2. Enter into a State-Federal Partnership Exchange

  3. Default to the Federally-Facilitated Exchange

Florida will default to the federally-facilitated health insurance exchange which opens October 1, 2013 for coverage starting January 1, 2014.

Florida Health Insurance Exchange - Defaulting to Federal Exchange

On December 14, 2012, Governor Rick Scott announced that Florida would not be pursuing efforts to implement a state-based health insurance exchange. So, Florida will default to using the federally-run exchange.

Governor Scott has been a vocal opponent of federal health reform and the state has refused multiple funding opportunities available through the Affordable Care Act (ACA). Florida was the lead plaintiff in a lawsuit brought by 26 states seeking to declare parts of federal health reform unconstitutional.

Florida Health Insurance Exchange - What About Florida Health Choices?

Florida HealthChoices

Starting in 2008, Florida began creating Florida Health Choices (myfloridachoices.org), an exchange for small businesses that predated the passage of federal health reform. 

  • The initiative began in 2008 with the enactment of SB 2534.

  • Florida Health Choices is a web portal where employers with 50 or fewer employees and some individuals, such as state retirees, can shop for health plans offered in their county. 

  • Florida Health Choices does not currently comply with provisions in the ACA, such as providing subsidies to assist eligible low-income individuals with purchasing insurance or mandating that health plans sold through the exchange cover certain health benefits. 

So, how will this fit into Florida's Health Insurance Exchange? This is yet to be seen.

According to Florida Health Choices' website, it will run alongside the federally-run exchange available to Florida residents. While both programs are web-based and allow for choice among available products and programs, there are some differences in how they work.

According to their website, a wider range of service providers, insurance options, benefit levels, and a greater number of consumer choices are planned for Florida Health Choice. For example, there are no ACA mandates as to the products and plans that an insurer is allowed to offer, and there are no requirements for a small business to participate. A preview of the Florida Health Choices web portal is available here.

However, there will likely be additional Florida legislation introduced in the next few months to determine if and how the Florida Health Choices will exist past 2014.  We'll provide an update as public information is released.

state by state guide to health insurance marketplaces

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