Bill Text: OH HB613 | 2011-2012 | 129th General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: To specify licensing and continuing education requirements for insurance agents involved in selling, soliciting, or negotiating sickness and accident insurance through a health benefit exchange.

Spectrum: Partisan Bill (Republican 13-0)

Status: (Engrossed - Dead) 2012-12-06 - To Insurance, Commerce, & Labor [HB613 Detail]

Download: Ohio-2011-HB613-Introduced.html

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As Introduced

129th General Assembly Regular Session 2011-2012

H. B. No. 613

Representative Sears 

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A BILL

To amend section 3905.01 and to enact sections

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3905.47, 3905.471, 3905.472, and 3905.473 of the

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Revised Code to specify licensing and continuing

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education requirements for insurance agents

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involved in selling, soliciting, or negotiating

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sickness and accident insurance through a health

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benefit exchange.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1.  That section 3905.01 be amended and sections	8
3905.47, 3905.471, 3905.472, and 3905.473 of the Revised Code be	9
enacted to read as follows:	10

Sec. 3905.01.  As used in this chapter:

11

(A) "Affordable Care Act" means the "Patient Protection and	12
Affordable Care Act," 124 Stat. 119, 42 U.S.C. 18031 (2011).	13

(B) "Business entity" means a corporation, association,	14
partnership, limited liability company, limited liability	15
partnership, or other legal entity.	16

(B)(C) "Home state" means the state or territory of the	17
United States, including the District of Columbia, in which an	18
insurance agent maintains the insurance agent's principal place of	19
residence or principal place of business and is licensed to act as	20
an insurance agent.	21

(C)(D) "Insurance" means any of the lines of authority set	22
forth in Chapter 1739., 1751., or 1761. or Title XXXIX of the	23
Revised Code, or as additionally determined by the superintendent	24
of insurance.	25

(D)(E) "Insurance agent" or "agent" means any person that, in	26
order to sell, solicit, or negotiate insurance, is required to be	27
licensed under the laws of this state, including limited lines	28
insurance agents and surplus line brokers.	29

(E)(F) "Insurer" has the same meaning as in section 3901.32	30
of the Revised Code.	31

(F)(G) "License" means the authority issued by the	32
superintendent to a person to act as an insurance agent for the	33
lines of authority specified, but that does not create any actual,	34
apparent, or inherent authority in the person to represent or	35
commit an insurer.	36

(G)(H) "Limited line credit insurance" means credit life,	37
credit disability, credit property, credit unemployment,	38
involuntary unemployment, mortgage life, mortgage guaranty,	39
mortgage disability, guaranteed automobile protection insurance,	40
or any other form of insurance offered in connection with an	41
extension of credit that is limited to partially or wholly	42
extinguishing that credit obligation and that is designated by the	43
superintendent as limited line credit insurance.	44

(H)(I) "Limited line credit insurance agent" means a person	45
that sells, solicits, or negotiates one or more forms of limited	46
line credit insurance to individuals through a master, corporate,	47
group, or individual policy.	48

(I)(J) "Limited lines insurance" means those lines of	49
authority set forth in divisions (B)(7) to (11) of section 3905.06	50
of the Revised Code or in rules adopted by the superintendent, or	51
any lines of authority the superintendent considers necessary to	52
recognize for purposes of complying with section 3905.072 of the	53
Revised Code.	54

(J)(K) "Limited lines insurance agent" means a person	55
authorized by the superintendent to sell, solicit, or negotiate	56
limited lines insurance.	57

(K)(L) "NAIC" means the national association of insurance	58
commissioners.	59

(L)(M) "Navigator" means a person selected to perform the	60
activities and duties identified in division (i) of section 1311	61
of the Affordable Care Act that is certified by the superintendent	62
of insurance under section 3905.471 of the Revised Code.	63

(N) "Negotiate" means to confer directly with, or offer	64
advice directly to, a purchaser or prospective purchaser of a	65
particular contract of insurance with respect to the substantive	66
benefits, terms, or conditions of the contract, provided the	67
person that is conferring or offering advice either sells	68
insurance or obtains insurance from insurers for purchasers.	69

(M)(O) "Person" means an individual or a business entity.

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(N)(P) "Sell" means to exchange a contract of insurance by	71
any means, for money or its equivalent, on behalf of an insurer.	72

(O)(Q) "Solicit" means to attempt to sell insurance, or to	73
ask or urge a person to apply for a particular kind of insurance	74
from a particular insurer.	75

(P)(R) "Superintendent" or "superintendent of insurance"	76
means the superintendent of insurance of this state.	77

(Q)(S) "Terminate" means to cancel the relationship between	78
an insurance agent and the insurer or to terminate an insurance	79
agent's authority to transact insurance.	80

(R)(T) "Uniform application" means the NAIC uniform	81
application for resident and nonresident agent licensing, as	82
amended by the NAIC from time to time.	83

(S)(U) "Uniform business entity application" means the NAIC	84
uniform business entity application for resident and nonresident	85
business entities, as amended by the NAIC from time to time.	86

(V) "Exchange" means a health benefit exchange established by	87
the state government of Ohio or an exchange established by the	88
United States department of health and human services in	89
accordance with the "Patient Protection and Affordable Care Act,"	90
124 Stat. 119, 42 U.S.C. 18031 (2011).	91

Sec. 3905.47. (A)(1) No agent shall sell, solicit, or	92
negotiate insurance through an exchange on or after January 1,	93
2014, without first completing training approved by the	94
superintendent of insurance in accordance with division (B) of	95
this section.	96

(2) Any agent that sells, solicits, or negotiates insurance	97
through an exchange shall complete continuing education, as	98
required by the superintendent in accordance with division (B) of	99
this section.	100

(B) The superintendent shall approve courses to be used for	101
compliance with division (A) of this section. Division (B) of this	102
section may be satisfied by those continuing education courses	103
approved by the superintendent under sections 3905.481 to 3905.486	104
of the Revised Code. Any course the superintendent approves shall	105
consist of topics related to insurance offered within an exchange,	106
including all of the following:	107

(1) The levels of coverage provided in an exchange;

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(2) The eligibility requirements for individuals to purchase	109
insurance through an exchange;	110

(3) The eligibility requirements for employers to make	111
insurance available to their employees through a small business	112
health options program;	113

(4) Individual eligibility requirements for medicaid;

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(5) The use of enrollment forms used in an exchange;

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(6) Any other topics as required by the superintendent.

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(C) The superintendent shall certify as a navigator an agent	117
who successfully completes the courses approved by the	118
superintendent.	119

(D) An individual who receives a resident insurance agent	120
license under section 3905.06 of the Revised Code and that is	121
certified under this section shall submit to the exchange the	122
individual's name, business address, telephone number, electronic	123
mail address, and any other information required by the exchange.	124

Sec. 3905.471. (A) A navigator shall not do any of the	125
following, unless that navigator is otherwise licensed to do so	126
under this chapter:	127

(1) Sell, solicit, or negotiate health insurance;

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(2) Enroll an individual or employee in a qualified health	129
plan offered through an exchange;	130

(3) Assist or provide information to an individual or entity	131
seeking to purchase health insurance through the small business	132
health options program portion of an exchange.	133

(B) An individual, or an individual performing navigator	134
duties on behalf of an organization serving as a navigator, shall	135
not act in the capacity of a navigator unless the individual has	136
met all of the following requirements:	137

(1) Is at least eighteen years of age;

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(2) Has completed and submitted the disclosure form required	139
under division (C)(2) of this section and has declared, under	140
penalty of refusal, suspension, or revocation of the navigator's	141
certification, that the statements made in the form are true,	142
correct, and complete to the best of the applicant's knowledge and	143
belief;	144

(3) Has completed a criminal records check under section	145
3905.051 of the Revised Code, as required by the superintendent;	146

(4) Has successfully completed the certification and training	147
requirements adopted by the superintendent in accordance with	148
division (C) of this section;	149

(5) Has paid all fees required by the superintendent.

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(C) The superintendent of insurance shall, prior to any	151
exchange becoming operational in this state, do all of the	152
following:	153

(1)(a) Adopt rules to establish a certification and training	154
program for a prospective navigator and the navigator's employees	155
that includes screening via a criminal records check performed in	156
accordance with section 3905.051 of the Revised Code, initial and	157
continuing education requirements, and an examination;	158

(b) The certification and training program shall include	159
training on compliance with the "Health Insurance Portability and	160
Accountability Act of 1996," 110 Stat. 1955, 42 U.S.C. 1320d, et	161
seq., as amended, training on ethics, and training on provisions	162
of the Affordable Care Act relating to navigators and exchanges.	163

(2) Develop a disclosure form by which a navigator may	164
disclose any potential conflicts of interest, as well as any other	165
information the superintendent considers pertinent.	166

(D)(1) The superintendent may suspend, revoke, or refuse to	167
issue or renew the navigator certification of any person that has	168
committed any act that would be a ground for denial, suspension,	169
or revocation of an insurance agent license, as prescribed in	170
section 3905.14 of the Revised Code.	171

(2) The superintendent shall not certify as a navigator, and	172
shall revoke any existing navigator certification of, any	173
individual, organization, or business entity that has received	174
financial compensation, including monetary and in-kind	175
compensation, gifts, or grants, on or after October 1, 2013, from	176
an insurer offering a qualified health benefit plan through an	177
exchange operating in this state.	178

(E) Navigators are subject to the laws of this chapter, and	179
any rules adopted pursuant to the chapter, in so far as such laws	180
are applicable.	181

(F) The superintendent may deny, suspend, approve, renew, or	182
revoke the certification of a navigator if the superintendent	183
determines that doing so would be in the interest of Ohio insureds	184
or the general public. Such an action is not subject to Chapter	185
119. of the Revised Code.	186

(G) The superintendent may adopt rules in accordance with	187
Chapter 119. of the Revised Code to implement sections 3905.47 to	188
3905.473 of the Revised Code.	189

(H) Any fees collected under this section shall be paid into	190
the state treasury to the credit of the department of insurance	191
operating fund created under section 3901.021 of the Revised Code.	192

Sec. 3905.472. An exchange shall permit an insurer to offer	193
any health benefit plan that the insurer seeks to offer through	194
the exchange, so long as the health benefit plan in question is a	195
qualified health plan under the Affordable Care Act, as determined	196
by the superintendent of insurance.	197

Sec. 3905.473. (A) An exchange operating in this state shall	198
maintain a current list of licensed insurance agents that have met	199
all of the requirements necessary to sell insurance through an	200
exchange.	201

(B) An exchange shall make available to an individual upon	202
request a list of insurance agents operating near the individual's	203
residence address that are certified to sell a health benefit plan	204
through an exchange. An exchange operating in this state shall	205
maintain a means of communication by which an individual may make	206
such a request.	207

(C) Any web site, software application, or other electronic	208
medium, or an exchange-sanctioned outreach event that enables a	209
consumer to determine eligibility for and to purchase a qualified	210
health plan through an exchange shall include information on how	211
an individual can obtain from an exchange the contact information	212
of insurance agents operating near the individual's residence	213
address that are certified to sell health benefit plans through an	214
exchange.	215

Section 2.  That existing section 3905.01 of the Revised Code	216
is hereby repealed.	217