On April 3, 2025, Florida Senate passed bill SB480. The bill, if enacted into law, will authorize nonprofit agricultural organizations to provide “medical benefit plans” to their members. These medical benefit plans are not considered health insurance under Florida or Federal law; therefore, they will not be subject to the Florida Insurance Code. This means these plans are not subject to the same regulations and oversight as traditional health insurance.
There is risk that these plans could be structured in a way that is averse to consumers. The bill explicitly states that these plans are not subject to the Patient Protection and Affordable Care Act. Accordingly, individuals may be medically underwritten and subject to waiting periods for preexisting conditions. There could be no requirement for the plan to adhere to premium rate regulations, potentially leading to higher rates for individual based on health history. Additionally, it is unlikely these plans would be subject to protections afforded by the No Surprises Act, meaning that individuals could receive unexpected medical bills from out-of-network providers for emergency services and non-emergent services provided by an out-of-network provider working at an in-network facility.
Further, medical providers and facilities rely on statutory law to pursue payment from insurance companies for treating their insureds in certain circumstances. As the nonprofit agricultural organization benefit plan is not a health insurance product subject to the Florida Insurance Code, there would limited legal protections for medical providers and facilities when inevitable reimbursement issues arise.
If SB480 is enacted into law, consumers and providers should be on the lookout for how these nonprofit agricultural organizations will structure their medical benefit plans. Consumers can protect themselves by carefully considering the potential financial implications of choosing a medical benefit plan under SB480. Similarly, providers can protect themselves by understanding and adhering to the new laws in healthcare.
