SB2858 103RD GENERAL ASSEMBLY

LRB103 33840 RPS 63655 b

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.

A BILL FOR

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 5-23 and by adding Section 5-8 as follows:

(215 ILCS 122/5-8 new)

Sec. 5-8. Definitions. As used in this Act:

"Enhanced direct enrollment" means technology that allows approved third-party entities to build and host directly on their websites a version of the Illinois Health Benefits Exchange eligibility application that securely integrates with a back-end suite of application programming interfaces to support application, enrollment, and post-enrollment activities.

"Enhanced direct enrollment entity" means an entity approved by the Department of Insurance to integrate with and use the Enhanced Direct Enrollment technology operated by the Illinois Health Benefits Exchange and that allows for brokers and individuals to shop for, select, and enroll in qualified, affordable private health plans without the need to be redirected to the Illinois Health Benefits Exchange or contact a call center.

(215 ILCS 122/5-23)

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, including, but not limited to, procurements in conformance with paragraph (22) of subsection (b) of Section 1-10 of the Illinois Procurement Code; and

(4) require any exchange vendor to have experience operating a State-based exchange in another state;and .

(5) 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 and to require:

(A) enhanced direct enrollment to be available for the first open enrollment period for the State-based exchange;

(B) the State-based exchange to adopt the application programming interface for the Federally Facilitated Marketplace's enhanced direct enrollment or an application programming interface that is substantially similar; and

(C) 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.

Subparagraph (C) of paragraph (4) of this subsection shall not be construed to limit the Department of Insurance's authority to adopt rules regarding enhanced direct enrollment entities beyond what the Centers for Medicare and Medicaid Services requires.

(b) The Department of Insurance has the authority to employ a Marketplace Director of the Illinois Health Benefits Exchange.

(Source: P.A. 103-103, eff. 6-27-23.)