Florida § 110.12304 - Independent benefits consultant.

§ 110.12304. Independent benefits consultant.

(1) The department shall competitively procure an independent benefits consultant. (2) The independent benefits consultant may not: (a) Be owned or controlled by a health maintenance organization or insurer. (b) Have an ownership interest in a health maintenance organization or insurer. (c) Have a direct or indirect financial interest in a health maintenance organization or insurer. (3) The independent benefits consultant must have substantial experience in consultation and design of employee benefit programs for large employers and public employers, including experience with plans that qualify as cafeteria plans under s. 125 of the Internal Revenue Code of 1986. (4) The independent benefits consultant shall: (a) Provide an ongoing assessment of trends in benefits and employer-sponsored insurance that affect the state group insurance program. (b) Conduct a comprehensive analysis of the state group insurance program, including available benefits, coverage options, and claims experience. (c) Identify and establish appropriate adjustment procedures necessary to respond to any risk segmentation that may occur when increased choices are offered to employees. (d) Assist the department with the submission of any necessary plan revisions for federal review. (e) Assist the department in ensuring compliance with applicable federal and state regulations. (f) Assist the department in monitoring the adequacy of funding and reserves for the state self-insured plan. (g) Assist the department in preparing recommendations for any modifications to the state group insurance program which shall be submitted to the Governor, the President of the Senate, and the Speaker of the House of Representatives by January 1 of each year.