Bill Amendment: IL HB0579 | 2023-2024 | 103rd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

---

Bill Title: REGULATION-TECH

Status: 2023-06-27 - Public Act . . . . . . . . . 103-0103 [HB0579 Detail]

Download: Illinois-2023-HB0579-House_Amendment_001.html

---

Rep. Robyn Gabel

Filed: 3/16/2023

10300HB0579ham001 LRB103 04164 BMS 58897 a
AMENDMENT TO HOUSE BILL 579
AMENDMENT NO. ______. Amend House Bill 579 by replacing
everything after the enacting clause with the following:
"Section 5. The Illinois Administrative Procedure Act is
amended by adding Section 5-45.35 as follows:
(5 ILCS 100/5-45.35 new)
Sec. 5-45.35. Emergency rulemaking; Illinois Health
Benefits Exchange Law. To provide for the expeditious and
timely implementation of Section 5-23 of the Illinois Health
Benefits Exchange Law, emergency rules implementing Section
5-23 of the Illinois Health Benefits Exchange Law may be
adopted in accordance with Section 5-45 of this Act by the
Department of Insurance and the Department of Healthcare and
Family Services. The adoption of emergency rules authorized by
Section 5-45 and this Section is deemed to be necessary for the
public interest, safety, and welfare.

10300HB0579ham001 - 2 - LRB103 04164 BMS 58897 a
This Section is repealed 3 years after the effective date
of this amendatory Act of the 103rd General Assembly.
Section 10. The Illinois Health Benefits Exchange Law is
amended by changing Section 5-5 and by adding Sections 5-21,
5-22, and 5-23 as follows:
(215 ILCS 122/5-5)
Sec. 5-5. State health benefits exchange. It is declared
that this State, beginning October 1, 2013, in accordance with
Section 1311 of the federal Patient Protection and Affordable
Care Act, shall establish a State health benefits exchange to
be known as the Illinois Health Benefits Exchange in order to
help individuals and small employers with no more than 50
employees shop for, select, and enroll in qualified,
affordable private health plans that fit their needs at
competitive prices. The Exchange shall separate coverage pools
for individuals and small employers and shall supplement and
not supplant any existing private health insurance market for
individuals and small employers. The Department of Insurance
shall operate the Illinois Health Benefits Exchange as a
State-based exchange using the federal platform by plan year
2025 and as a State-based exchange by plan year 2026. The
Director of Insurance may require that all plans in the
individual and small group markets, other than grandfathered
health plans, be made available for comparison on the Illinois

10300HB0579ham001 - 3 - LRB103 04164 BMS 58897 a
Health Benefits Exchange, but may not require that all plans
in the individual and small group markets be purchased
exclusively on the Illinois Health Benefits Exchange. The
Director of Insurance may require that plans offered on the
exchange conform with standardized plan designs that provide
for standardized cost sharing for covered health services.
Except when it is inconsistent with State law, the Department
of Insurance may enforce the coverage requirements under the
federal Patient Protection and Affordable Care Act that apply
to the individual and small group markets. The Director of
Insurance may elect to add a small business health options
program to the Illinois Health Benefits Exchange to help small
employers enroll their employees in qualified health plans in
the small group market. The General Assembly shall appropriate
funds to establish the Illinois Health Benefits Exchange.
(Source: P.A. 97-142, eff. 7-14-11.)
(215 ILCS 122/5-21 new)
Sec. 5-21. Monthly assessments.
(a) The Director of Insurance may apply a monthly
assessment to each health benefits plan sold on the Illinois
Health Benefits Exchange. The assessment shall be paid by the
issuer and to the Department of Insurance and shall be used
only for the purpose of supporting the exchange through
exchange operations, outreach, enrollment, and other means of
supporting the exchange, including any efforts that may

10300HB0579ham001 - 4 - LRB103 04164 BMS 58897 a
increase market stabilization and that may result in a net
benefit to policyholders. The assessment may be applied at a
rate of:
(1) 0.5% of the total monthly premium charged by an
issuer for each health benefits plan during any period
that the State is on a State-based exchange using the
federal platform; or
(2) 2.75% of the total monthly premium charged by an
issuer for each health benefits plan during any period
that the State is on the State-based exchange. The
Director of Insurance may adjust this rate to ensure that
the Illinois Health Benefits Exchange is fully funded.
(b) The Director of Insurance shall notify an issuer of
its assessment rate for the subsequent year. Issuers must
remit the assessment due in monthly installments to the
Department of Insurance.
(c) The assessment described in this Section shall be
considered a special purpose obligation and may not be applied
by issuers to vary premium rates at the plan level.
(d) There is created a revolving fund to be known as the
Illinois Health Benefits Exchange Fund, to be held by the
Department of Insurance. The Illinois Health Benefits Exchange
Fund shall be the repository for moneys collected pursuant to
fees or assessments on exchange issuers, federal financial
participation as appropriate, and other moneys received as
grants or otherwise appropriated for the purposes of

10300HB0579ham001 - 5 - LRB103 04164 BMS 58897 a
supporting health insurance outreach, enrollment efforts, and
plan management operations through an exchange. All moneys in
the Fund shall be used only for the purpose of supporting the
exchange through exchange operations, outreach, enrollment,
and other means of supporting the exchange, including any
efforts that may increase market stabilization and that may
result in a net benefit to policyholders.
(215 ILCS 122/5-22 new)
Sec. 5-22. State medical assistance program coordination.
(a) The Department of Insurance and the Department of
Healthcare and Family Services shall coordinate the operations
of the exchange with the operations of State medical
assistance programs. The Department of Healthcare and Family
Services shall oversee and operate the exchange eligibility
rules engine to ensure accurate assessments and determinations
of exchange and State medical assistance program eligibility.
(b) The exchange may determine eligibility for State
medical assistance programs that use the modified adjusted
gross income methodology.
(c) The exchange may be used for enrollment into State
medical assistance program health plans.
(d) The Department of Healthcare and Family Services may
request federal financial participation funds from the Centers
for Medicare and Medicaid Services for any integrated
eligibility and enrollment functions of the exchange.

10300HB0579ham001 - 6 - LRB103 04164 BMS 58897 a
(215 ILCS 122/5-23 new)
Sec. 5-23. Department of Insurance and Department of
Healthcare and Family Services authority.
(a) The Department of Insurance and the Department of
Healthcare and Family Services, in addition to the powers
granted under the Illinois Insurance Code and the Illinois
Public Aid Code, have the power necessary to establish and
operate the Illinois Health Benefits Exchange, including, but
not limited to, the authority to:
(1) adopt rules deemed necessary by the departments to
implement this Law;
(2) employ or retain sufficient personnel to provide
administration, staffing, and necessary related support
required to adequately discharge the duties described in
this Law from funds held in the Illinois Health Benefits
Exchange Fund;
(3) procure services, including a call center, and
goods for the purpose of establishing the Illinois Health
Benefits Exchange as emergency purchases as set forth in
Section 20-30 of the Illinois Procurement Code; and
(4) require any exchange vendor to have experience
operating a State-based exchange in another state.
(b) The Department of Insurance has the authority to
employ a Chief Operating Officer of the Illinois Health
Benefits Exchange. The Chief Operating Officer shall be

10300HB0579ham001 - 7 - LRB103 04164 BMS 58897 a
subject to confirmation by the Senate.
Section 99. Effective date. This Act takes effect upon
becoming law.".