Illinois General Assembly - Full Text of HB4175
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Full Text of HB4175  102nd General Assembly

HB4175 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4175

 

Introduced 10/19/2021, by Rep. Thaddeus Jones

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 122/5-5
215 ILCS 122/5-30 new
215 ILCS 122/5-35 new
215 ILCS 122/5-40 new
215 ILCS 122/5-45 new

    Amends the Illinois Health Benefits Exchange Law. Provides that the Department of Insurance has the authority to operate the Illinois Health Benefits Exchange. Provides that the Director of Insurance may require plans in the individual market to be made available for comparison on the exchange, but may not require all plans be purchased exclusively on the exchange. Provides that the Director may require that plans offered on the exchange conform with standardized plan designs. Provides that the Director may apply a monthly assessment to each health benefits plan sold in the Illinois Health Benefits Exchange according to specified rates. Provides that the Director shall establish an advisory committee to provide advice to the Director concerning the operation of the exchange and that the advisory committee shall include specified members. Provides that the Department shall also have the authority to coordinate the operations of the exchange with the operations of the State Medicaid program and the FamilyCare Program to determine eligibility for those programs as soon as practicable. Provides that the Department shall adopt rules. Removes provisions concerning small employer health insurance coverage and markets. Makes other changes. Effective January 1, 2023.


LRB102 20089 BMS 29425 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4175LRB102 20089 BMS 29425 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Health Benefits Exchange Law is
5amended by changing Section 5-5 and by adding Sections 5-30,
65-35, 5-40, and 5-45 as follows:
 
7    (215 ILCS 122/5-5)
8    Sec. 5-5. State health benefits exchange. It is declared
9that this State, beginning October 1, 2013, in accordance with
10Section 1311 of the federal Patient Protection and Affordable
11Care Act, shall establish a State health benefits exchange to
12be known as the Illinois Health Benefits Exchange in order to
13help individuals and small employers with no more than 50
14employees shop for, select, and enroll in qualified,
15affordable private health plans that fit their needs at
16competitive prices. The Exchange shall separate coverage pools
17for individuals and small employers and shall supplement and
18not supplant any existing private health insurance market for
19individuals and small employers. The Department of Insurance
20has the authority to operate the Illinois Health Benefits
21Exchange. The Director of Insurance may require that all plans
22in the individual market be made available for comparison on
23the Illinois Health Benefits Exchange, but may not require

 

 

HB4175- 2 -LRB102 20089 BMS 29425 b

1that all plans in the individual market be purchased
2exclusively on the Illinois Health Benefits Exchange. The
3Director of Insurance has the authority to require that plans
4offered on the exchange conform with standardized plan designs
5that provide for standardized cost-sharing for covered health
6services.
7(Source: P.A. 97-142, eff. 7-14-11.)
 
8    (215 ILCS 122/5-30 new)
9    Sec. 5-30. Monthly assessments.
10    (a) The Director of Insurance may apply a monthly
11assessment to each health benefits plan sold in the Illinois
12Health Benefits Exchange. The assessment shall be paid by the
13insurer and to the Department of Insurance and shall be used
14only for the purpose of supporting the exchange through
15exchange operations, outreach, enrollment, and other means of
16supporting the exchange, including any efforts that can
17increase market stabilization and that may result in a net
18benefit to policyholders. The assessment may be applied at a
19rate of:
20        (1) 1% of the total monthly premium charged by an
21    insurer for each health benefits plan during any period
22    that the State is on a State-based exchange using the
23    federal platform; or
24        (2) 2.75% of the total monthly premium charged by an
25    insurer for each health benefits plan during any period

 

 

HB4175- 3 -LRB102 20089 BMS 29425 b

1    that the State is on the Illinois Health Benefits
2    Exchange. The Director of Insurance may adjust this rate
3    to ensure that the Illinois Health Benefits Exchange is
4    fully funded, but shall not apply the assessment at a rate
5    that exceeds 4% of the total monthly premium charged by an
6    insurer. If the Director of Insurance determines it is
7    necessary to adjust the rate above 2.75% pursuant to this
8    paragraph (2), the Director of Insurance shall, in advance
9    of the adjustment, post on the Department of Insurance's
10    website a report describing the reasons and justifications
11    for the adjustment, which shall be consistent with the
12    purposes of supporting the exchange as provided in this
13    Section.
14    (b) The Director of Insurance shall notify an insurer of
15its assessment rate for the subsequent year at least 20 days
16before the date the insurer is required to file its rate filing
17with the Department of Insurance. In the case of an assessment
18for the 2022 plan year, the Director of Insurance shall notify
19insurers as soon as is practicable of the assessment amount.
20    (c) The Director of Insurance shall consider any amount of
21assessments unexpended from a previous year when calculating
22the monthly assessment.
 
23    (215 ILCS 122/5-35 new)
24    Sec. 5-35. Health benefits exchange advisory committee.
25The Director of Insurance shall establish an advisory

 

 

HB4175- 4 -LRB102 20089 BMS 29425 b

1committee to provide advice to the Director of Insurance
2concerning the operation of the exchange. The advisory
3committee shall include at least 9 members, as follows:
4        (1) The Director of Insurance, or a designee, who
5    shall serve ex officio.
6        (2) The Director of Healthcare and Family Services, or
7    a designee, who shall serve ex officio.
8        (3) The Director of Public Health, or a designee, who
9    shall serve ex officio.
10        (4) Six public members, who shall be residents of the
11    State, appointed by the Director of Insurance. Each public
12    member shall have demonstrated experience in one or more
13    of the following areas: health insurance consumer
14    advocacy, individual health insurance coverage, health
15    benefits plan marketing, the provision of health care
16    services, or academic or professional research relating to
17    health insurance.
 
18    (215 ILCS 122/5-40 new)
19    Sec. 5-40. State Medicaid program coordination. The
20Department of Insurance shall also have the authority to
21coordinate the operations of the exchange with the operations
22of the State Medicaid program and the FamilyCare Program to
23determine eligibility for those programs as soon as
24practicable.
 

 

 

HB4175- 5 -LRB102 20089 BMS 29425 b

1    (215 ILCS 122/5-45 new)
2    Sec. 5-45. Rulemaking. The Department of Insurance shall
3adopt rules implementing this Law.
 
4    Section 99. Effective date. This Act takes effect January
51, 2023.