Bill Text: IL HB4175 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: 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.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-04-11 - Rule 19(a) / Re-referred to Rules Committee [HB4175 Detail]

Download: Illinois-2021-HB4175-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB4175 Introduced , 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.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Health Benefits Exchange Law is
amended by changing Section 5-5 and by adding Sections 5-30,
5-35, 5-40, and 5-45 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
has the authority to operate the Illinois Health Benefits
Exchange. The Director of Insurance may require that all plans
in the individual market be made available for comparison on
the Illinois Health Benefits Exchange, but may not require

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that all plans in the individual market be purchased
exclusively on the Illinois Health Benefits Exchange. The
Director of Insurance has the authority to require that plans
offered on the exchange conform with standardized plan designs
that provide for standardized cost-sharing for covered health
services.
(Source: P.A. 97-142, eff. 7-14-11.)
(215 ILCS 122/5-30 new)
Sec. 5-30. Monthly assessments.
(a) The Director of Insurance may apply a monthly
assessment to each health benefits plan sold in the Illinois
Health Benefits Exchange. The assessment shall be paid by the
insurer 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 can
increase market stabilization and that may result in a net
benefit to policyholders. The assessment may be applied at a
rate of:
(1) 1% of the total monthly premium charged by an
insurer 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
insurer for each health benefits plan during any period

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

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committee to provide advice to the Director of Insurance
concerning the operation of the exchange. The advisory
committee shall include at least 9 members, as follows:
(1) The Director of Insurance, or a designee, who
shall serve ex officio.
(2) The Director of Healthcare and Family Services, or
a designee, who shall serve ex officio.
(3) The Director of Public Health, or a designee, who
shall serve ex officio.
(4) Six public members, who shall be residents of the
State, appointed by the Director of Insurance. Each public
member shall have demonstrated experience in one or more
of the following areas: health insurance consumer
advocacy, individual health insurance coverage, health
benefits plan marketing, the provision of health care
services, or academic or professional research relating to
health insurance.
(215 ILCS 122/5-40 new)
Sec. 5-40. State Medicaid program coordination. The
Department of Insurance 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.

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