Cover Florida gives laid-off workers an unexpected break

By Carol Gentry and Christine Jordan Sexton
12/12/2008 © Florida Health News

Sometime between passage of the Cover Florida legislation in the spring and the announcement of the signed contracts this week, newly jobless Floridians caught a much-needed break.

They won’t have to wait six months to qualify for the state-sponsored program for the uninsured, as others do. The requirement that Floridians be uninsured for six months before qualifying for the reduced-price plans was intended to keep employers and individuals from dumping standard, full-price plans.

Agency for Health Care Administration Secretary Holly Benson said the break for the newly jobless was hashed out in negotiations between state officials and the six insurance companies that tossed their hats in the Cover Florida ring.

“Isn’t that nice?” said Benson at the news conference where the contracts were signed Wednesday. “Considering the number of people who are worried about losing their jobs, this is a really attractive alternative for them.”

There’s just one catch: The newly jobless won’t qualify if they’ve already signed up for coverage under COBRA, an acronym for a federal law that allows workers to keep their health insurance after leaving a job if they pay the employer’s share of the premium as well as their own. But most laid-off workers don’t take COBRA because they can’t afford it.

Two groups besides the recently laid-off can enroll in a Cover Florida plan when they become available Jan. 5 without having to show they’ve been uninsured for six months or more: Those who lost a spouse who had employer-sponsored insurance, either through divorce or death, and those who have exhausted their COBRA coverage, which has time limits.

In Cover Florida, six companies are authorized to sell a total of 25 health plans that lack some features legally required under state law, so they can be marketed at a lower, more affordable price. The state negotiated the deals but put no taxpayer money up. There’s not even any money to advertise that the plans will be available Jan. 5.

At the contract-signing ceremony Wednesday, which Benson attended along with Insurance Commissioner Kevin McCarty and Gov. Charlie Crist, McCarty stressed the historic nature of the event. The products are “guarantee-issue,” available to Floridians who have tried to buy individual health insurance products and been turned down because of their health status.

Unless Floridians who’ve been turned down are offered coverage by an employer, they are currently out of luck. Unlike some other states, Florida does not operate a high-risk pool -- a government market where sicker people can purchase health care -- and doesn’t let people to "buy in" to its Medicaid program.

While celebrating the event, McCarty did stress that potential customers closely examine the details of the plans before enrolling and suggested they consult insurance agents for advice.

Five companies will sell Cover Florida plans in Miami Dade County, four in Broward County and three in Volusia and Flagler counties. All other counties have two Cover Florida sponsors, United Healthcare and Blue Cross & Blue Shield of Florida.

At the beginning of this year, when Gov. Crist was developing the Cover Florida proposal, the number of uninsured Floridians was estimated at 3.8 million. The “challenging economy” and high costs of health insurance probably have increased the number of uninsured residents, he said.

It’s hard to predict how many will buy one of the plans, which vary widely in price and extent of coverage. “This would be a lot more affordable than what they are used to in the past,” Crist said. Time will tell.”

--Contact information for the reporters: Carol.Gentry@FloridaHealthNews.org and ChristineSextonWork@hotmail.com.