On March 26, 2020, as part of Florida's response to the Novel Coronavirus (COVID-19) pandemic and resulting state of emergency, Florida Governor Ron DeSantis issued Executive Order 20-85 (the Order), mandating insurance coverage for telehealth services and certain immunizations for state employees under the State Group Insurance Program (SGI). The State of Florida offers comprehensive insurance benefits through the SGI to eligible full-time or part-time state employees, retirees, spouses, and other dependents identified in subsection 110.123(2), Florida Statutes.
The Order goes into effect immediately, and directs the Department of Management Services, which administers the SGI, to make the following changes related to telehealth and immunization coverage:
- Amend the state employee health benefits plan documents to
include telehealth services at no additional cost to state
employees. Interestingly, the introductory language of the Order
appears to limit the Order to existing in-network or contracted
Florida-licensed telehealth providers, which seems inconsistent
with other recently issued Executive Orders, which have expanded
the pool of telehealth providers to out-of-state medical doctors,
osteopathic physicians, physician assistants, and nurse
practitioners (Executive Order
20-002), and later, out-of-state licensed clinical social
workers, marriage and family therapists, mental health counselors,
and psychologists (Executive Order
- Amend the state employee pharmacy benefits plan documents to include telehealth services to employees participating in the SGI plan. Telehealth pharmacy services generally allow patients to have remote access to pharmacists, who can provide remote drug counseling, dosing guidelines, medication management guidance, and information on generic or alternative options, without the need for an in-person, face-to-face interaction.
- Ensure that all state employees have access to telehealth services through the state's contracted HMO and PPO plans without cost-sharing obligations (i.e., deductibles, coinsurance, and copayments, or similar charges).
- Amend the state employee health plan benefits plan to allow employees participating in the State Employees' Group Insurance Program the option to receive immunizations covered by the employee's plan in either a participating physician's office under the participant's current PPO Plan Group Health Insurance Plan Booklet or a participant's current HMO contract, or a participating pharmacy in the State Employees' pharmacy benefit manager's network.
- Waives all cost-sharing obligations (i.e., co-pays or deductibles) relating to the influenza vaccine for state employees.
The Order, which seeks to encourage vital employees to remain at home in order to contain the spread of the virus, is less comprehensive than those of other states that have issued orders expanding coverage for telehealth services during the emergency, such as Massachusetts. The Order is effective throughout the duration of the emergency period (until the expiration of Executive Order 20-52, or any extensions thereto).
For more information, please contact your Foley relationship partner or the Foley colleagues listed below. For additional web-based resources available to assist you in monitoring the spread of the coronavirus on a global basis, you may wish to visit the websites of the CDC and the World Health Organization.
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