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ENROLLED HB 5001, ENGROSSED 1 2024 LEGISLATURE ______________________________________________________________________________ the provisions of the federal Patient Protection and Affordable Care Act of 2010 and the Internal Revenue Code. Medical and prescription drug cost sharing amounts incurred by a plan participant for covered in-network service shall be aggregated to record the participant’s total amount of plan cost sharing limitations. The plan shall pay 100 percent of covered in-network services for a plan participant during the applicable calendar year once the federal cost share limitations are reached. 5. Effective July 1, 2024, a participant has the option to receive a covered immunization from a participating provider pursuant to a participant’s current State Employees’ PPO Plan Group Health Insurance Plan Booklet and Benefit Document, a participating provider pursuant to a participant’s current Health Maintenance Organization contract and benefits document, or a participating pharmacy in the State Employees’ pharmacy benefit manager’s network. 6. Effective January 1, 2025, the Division of State Group Insurance shall continue to allow service delivery through telehealth in its health benefits contracts. 7. The high deductible health plans shall continue to include an integrated Health Savings Account (HSA). Such plans and accounts shall be administered in accordance with the requirements and limitations of federal provisions related to the Medicare Prescription Drug Improvement and Modernization Act of 2003. The state shall make a monthly contribution to the employee’s health savings account, as authorized in section 110.123(12), Florida Statutes, of $41.66 for employees with individual coverage and $83.33 for employees with family coverage. 8.a. The Department of Management Services shall continue the pilot program within the PPO plan and the HMO plans to provide coverage for the treatment and management of obesity and related conditions during the 2025 plan year. b. For the pilot program, the department shall contract with a third party provider through a competitive solicitation to establish the third-party solution to treat, reduce, and prevent obesity and obesity-related conditions in the State Group Insurance program population. The third party provider must demonstrate a unique competency to focus on member wellness and the capacity to educate State Group Insurance Participants regarding healthy lifestyle and habit changing decisions to improve the overall health of the participant. Specific education around the efficacy and potential impacts of glucagon-like peptide 1 agonists (GLP1) is required, along with education regarding tapering or continued use of these medications. c. The participation in the pilot program will be limited to 2,800 members. The department shall establish criteria, which shall include, but not be limited to: i. Members of the PPO plan or HMO plan during the 2024 and 2025 plan year; ii. Members 18 years of age or older; iii. Consent to provide personal and medical information to the department; and iv. Referral and supervision of a physician participating in the PPO and HMO networks during the 2024 and 2025 plan year. By January 15, 2025, the Department of Management Services will report to the Legislature the number of individuals who applied to participate in the pilot program and the number of participants who enrolled in the pilot program. d. Members participating in the pilot program will be responsible for all applicable copayments, coinsurance, deductibles, and other out-of-pocket expenses that would be incurred if the pilot program services were provided by the PPO plan or self-insured HMO plans. The pilot program will provide coverage for all Federal Drug Administration approved medications for chronic weight management for patients. e. Compensation under the contract shall be paid from the State Employees Health Insurance Trust Fund. The third-party provider shall be compensated based solely on a per-enrollee fee which in the aggregate may not exceed $3.0 million for Plan Year 2025. 470