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.



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 
 
 
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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 
 
 
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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 
 
 
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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.

 
 
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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.