103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2858

 

Introduced 1/19/2024, by Sen. Napoleon Harris, III

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 122/5-8 new
215 ILCS 122/5-23

    Amends the Illinois Health Benefits Exchange Law. Provides that the Department of Insurance and the Department of Healthcare and Family Services have the authority to require, when the Department of Insurance operates the Illinois Health Benefits Exchange as a State-based exchange, the Illinois Health Benefits Exchange to offer enhanced direct enrollment technology that allows approved enhanced direct enrollment entities to maintain enrollment services as offered through the Federally Facilitated Marketplace's enhanced direct enrollment implementation; to require enhanced direct enrollment to be available for the first open enrollment period for the State-based exchange; to require that the State-based exchange adopt the application programming interface for the Federally Facilitated Marketplace's enhanced direct enrollment or adopt an application programming interface that is substantially similar; and to require enhanced direct enrollment entities to be approved to operate in the Federally Facilitated Marketplace and maintain compliance with all Centers for Medicare and Medicaid Services' privacy, security, and business requirements. Defines terms.


LRB103 33840 RPS 63655 b

 

 

A BILL FOR

 

SB2858LRB103 33840 RPS 63655 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 5-23 and by adding Section 5-8 as
6follows:
 
7    (215 ILCS 122/5-8 new)
8    Sec. 5-8. Definitions. As used in this Act:
9    "Enhanced direct enrollment" means technology that allows
10approved third-party entities to build and host directly on
11their websites a version of the Illinois Health Benefits
12Exchange eligibility application that securely integrates with
13a back-end suite of application programming interfaces to
14support application, enrollment, and post-enrollment
15activities.
16    "Enhanced direct enrollment entity" means an entity
17approved by the Department of Insurance to integrate with and
18use the Enhanced Direct Enrollment technology operated by the
19Illinois Health Benefits Exchange and that allows for brokers
20and individuals to shop for, select, and enroll in qualified,
21affordable private health plans without the need to be
22redirected to the Illinois Health Benefits Exchange or contact
23a call center.
 

 

 

SB2858- 2 -LRB103 33840 RPS 63655 b

1    (215 ILCS 122/5-23)
2    Sec. 5-23. Department of Insurance and Department of
3Healthcare and Family Services authority.
4    (a) The Department of Insurance and the Department of
5Healthcare and Family Services, in addition to the powers
6granted under the Illinois Insurance Code and the Illinois
7Public Aid Code, have the power necessary to establish and
8operate the Illinois Health Benefits Exchange, including, but
9not limited to, the authority to:
10        (1) adopt rules deemed necessary by the departments to
11    implement this Law;
12        (2) employ or retain sufficient personnel to provide
13    administration, staffing, and necessary related support
14    required to adequately discharge the duties described in
15    this Law from funds held in the Illinois Health Benefits
16    Exchange Fund;
17        (3) procure services, including a call center, and
18    goods for the purpose of establishing the Illinois Health
19    Benefits Exchange, including, but not limited to,
20    procurements in conformance with paragraph (22) of
21    subsection (b) of Section 1-10 of the Illinois Procurement
22    Code; and
23        (4) require any exchange vendor to have experience
24    operating a State-based exchange in another state;and .
25        (5) require, when the Department of Insurance operates

 

 

SB2858- 3 -LRB103 33840 RPS 63655 b

1    the Illinois Health Benefits Exchange as a State-based
2    exchange, the Illinois Health Benefits Exchange to offer
3    enhanced direct enrollment technology that allows approved
4    enhanced direct enrollment entities to maintain enrollment
5    services as offered through the Federally Facilitated
6    Marketplace's enhanced direct enrollment implementation
7    and to require:
8            (A) enhanced direct enrollment to be available for
9        the first open enrollment period for the State-based
10        exchange;
11            (B) the State-based exchange to adopt the
12        application programming interface for the Federally
13        Facilitated Marketplace's enhanced direct enrollment
14        or an application programming interface that is
15        substantially similar; and
16            (C) enhanced direct enrollment entities to be
17        approved to operate in the Federally Facilitated
18        Marketplace and maintain compliance with all Centers
19        for Medicare and Medicaid Services' privacy, security,
20        and business requirements.
21    Subparagraph (C) of paragraph (4) of this subsection shall
22not be construed to limit the Department of Insurance's
23authority to adopt rules regarding enhanced direct enrollment
24entities beyond what the Centers for Medicare and Medicaid
25Services requires.
26    (b) The Department of Insurance has the authority to

 

 

SB2858- 4 -LRB103 33840 RPS 63655 b

1employ a Marketplace Director of the Illinois Health Benefits
2Exchange.
3(Source: P.A. 103-103, eff. 6-27-23.)