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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
As Introduced
| 129th General Assembly | | Regular Session | | 2011-2012 |
| |
A BILL
| To amend section 3905.01 and to enact sections | 1 |
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3905.47, 3905.471, 3905.472, and 3905.473 of the | 2 |
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Revised Code to specify licensing and continuing | 3 |
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education requirements for insurance agents | 4 |
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involved in selling, soliciting, or negotiating | 5 |
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sickness and accident insurance through a health | 6 |
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
| Section 1. That section 3905.01 be amended and sections | 8 |
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3905.47, 3905.471, 3905.472, and 3905.473 of the Revised Code be | 9 |
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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 |
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Affordable Care Act," 124 Stat. 119, 42 U.S.C. 18031 (2011). | 13 |
| (B) "Business entity" means a corporation, association, | 14 |
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partnership, limited liability company, limited liability | 15 |
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partnership, or other legal entity. | 16 |
(B)(C) "Home state" means the state or territory of the | 17 |
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United States, including the District of Columbia, in which an | 18 |
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insurance agent maintains the insurance agent's principal place of | 19 |
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residence or principal place of business and is licensed to act as | 20 |
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an insurance agent. | 21 |
(C)(D) "Insurance" means any of the lines of authority set | 22 |
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forth in Chapter 1739., 1751., or 1761. or Title XXXIX of the | 23 |
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Revised Code, or as additionally determined by the superintendent | 24 |
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of insurance. | 25 |
(D)(E) "Insurance agent" or "agent" means any person that, in | 26 |
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order to sell, solicit, or negotiate insurance, is required to be | 27 |
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licensed under the laws of this state, including limited lines | 28 |
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insurance agents and surplus line brokers. | 29 |
(E)(F) "Insurer" has the same meaning as in section 3901.32 | 30 |
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of the Revised Code. | 31 |
(F)(G) "License" means the authority issued by the | 32 |
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superintendent to a person to act as an insurance agent for the | 33 |
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lines of authority specified, but that does not create any actual, | 34 |
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apparent, or inherent authority in the person to represent or | 35 |
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commit an insurer. | 36 |
(G)(H) "Limited line credit insurance" means credit life, | 37 |
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credit disability, credit property, credit unemployment, | 38 |
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involuntary unemployment, mortgage life, mortgage guaranty, | 39 |
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mortgage disability, guaranteed automobile protection insurance, | 40 |
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or any other form of insurance offered in connection with an | 41 |
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extension of credit that is limited to partially or wholly | 42 |
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extinguishing that credit obligation and that is designated by the | 43 |
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superintendent as limited line credit insurance. | 44 |
(H)(I) "Limited line credit insurance agent" means a person | 45 |
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that sells, solicits, or negotiates one or more forms of limited | 46 |
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line credit insurance to individuals through a master, corporate, | 47 |
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group, or individual policy. | 48 |
(I)(J) "Limited lines insurance" means those lines of | 49 |
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authority set forth in divisions (B)(7) to (11) of section 3905.06 | 50 |
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of the Revised Code or in rules adopted by the superintendent, or | 51 |
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any lines of authority the superintendent considers necessary to | 52 |
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recognize for purposes of complying with section 3905.072 of the | 53 |
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Revised Code. | 54 |
(J)(K) "Limited lines insurance agent" means a person | 55 |
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authorized by the superintendent to sell, solicit, or negotiate | 56 |
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limited lines insurance. | 57 |
(K)(L) "NAIC" means the national association of insurance | 58 |
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commissioners. | 59 |
(L)(M) "Navigator" means a person selected to perform the | 60 |
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activities and duties identified in division (i) of section 1311 | 61 |
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of the Affordable Care Act that is certified by the superintendent | 62 |
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of insurance under section 3905.471 of the Revised Code. | 63 |
| (N) "Negotiate" means to confer directly with, or offer | 64 |
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advice directly to, a purchaser or prospective purchaser of a | 65 |
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particular contract of insurance with respect to the substantive | 66 |
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benefits, terms, or conditions of the contract, provided the | 67 |
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person that is conferring or offering advice either sells | 68 |
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insurance or obtains insurance from insurers for purchasers. | 69 |
(M)(O) "Person" means an individual or a business entity. | 70 |
(N)(P) "Sell" means to exchange a contract of insurance by | 71 |
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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 |
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ask or urge a person to apply for a particular kind of insurance | 74 |
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from a particular insurer. | 75 |
(P)(R) "Superintendent" or "superintendent of insurance" | 76 |
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means the superintendent of insurance of this state. | 77 |
(Q)(S) "Terminate" means to cancel the relationship between | 78 |
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an insurance agent and the insurer or to terminate an insurance | 79 |
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agent's authority to transact insurance. | 80 |
(R)(T) "Uniform application" means the NAIC uniform | 81 |
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application for resident and nonresident agent licensing, as | 82 |
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amended by the NAIC from time to time. | 83 |
(S)(U) "Uniform business entity application" means the NAIC | 84 |
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uniform business entity application for resident and nonresident | 85 |
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business entities, as amended by the NAIC from time to time. | 86 |
| (V) "Exchange" means a health benefit exchange established by | 87 |
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the state government of Ohio or an exchange established by the | 88 |
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United States department of health and human services in | 89 |
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accordance with the "Patient Protection and Affordable Care Act," | 90 |
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124 Stat. 119, 42 U.S.C. 18031 (2011). | 91 |
| Sec. 3905.47. (A)(1) No agent shall sell, solicit, or | 92 |
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negotiate insurance through an exchange on or after January 1, | 93 |
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2014, without first completing training approved by the | 94 |
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superintendent of insurance in accordance with division (B) of | 95 |
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this section. | 96 |
| (2) Any agent that sells, solicits, or negotiates insurance | 97 |
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through an exchange shall complete continuing education, as | 98 |
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required by the superintendent in accordance with division (B) of | 99 |
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this section. | 100 |
| (B) The superintendent shall approve courses to be used for | 101 |
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compliance with division (A) of this section. Division (B) of this | 102 |
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section may be satisfied by those continuing education courses | 103 |
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approved by the superintendent under sections 3905.481 to 3905.486 | 104 |
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of the Revised Code. Any course the superintendent approves shall | 105 |
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consist of topics related to insurance offered within an exchange, | 106 |
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including all of the following: | 107 |
| (1) The levels of coverage provided in an exchange; | 108 |
| (2) The eligibility requirements for individuals to purchase | 109 |
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insurance through an exchange; | 110 |
| (3) The eligibility requirements for employers to make | 111 |
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insurance available to their employees through a small business | 112 |
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health options program; | 113 |
| (4) Individual eligibility requirements for medicaid; | 114 |
| (5) The use of enrollment forms used in an exchange; | 115 |
| (6) Any other topics as required by the superintendent. | 116 |
| (C) The superintendent shall certify as a navigator an agent | 117 |
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who successfully completes the courses approved by the | 118 |
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superintendent. | 119 |
| (D) An individual who receives a resident insurance agent | 120 |
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license under section 3905.06 of the Revised Code and that is | 121 |
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certified under this section shall submit to the exchange the | 122 |
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individual's name, business address, telephone number, electronic | 123 |
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mail address, and any other information required by the exchange. | 124 |
| Sec. 3905.471. (A) A navigator shall not do any of the | 125 |
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following, unless that navigator is otherwise licensed to do so | 126 |
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under this chapter: | 127 |
| (1) Sell, solicit, or negotiate health insurance; | 128 |
| (2) Enroll an individual or employee in a qualified health | 129 |
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plan offered through an exchange; | 130 |
| (3) Assist or provide information to an individual or entity | 131 |
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seeking to purchase health insurance through the small business | 132 |
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health options program portion of an exchange. | 133 |
| (B) An individual, or an individual performing navigator | 134 |
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duties on behalf of an organization serving as a navigator, shall | 135 |
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not act in the capacity of a navigator unless the individual has | 136 |
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met all of the following requirements: | 137 |
| (1) Is at least eighteen years of age; | 138 |
| (2) Has completed and submitted the disclosure form required | 139 |
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under division (C)(2) of this section and has declared, under | 140 |
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penalty of refusal, suspension, or revocation of the navigator's | 141 |
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certification, that the statements made in the form are true, | 142 |
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correct, and complete to the best of the applicant's knowledge and | 143 |
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belief; | 144 |
| (3) Has completed a criminal records check under section | 145 |
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3905.051 of the Revised Code, as required by the superintendent; | 146 |
| (4) Has successfully completed the certification and training | 147 |
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requirements adopted by the superintendent in accordance with | 148 |
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division (C) of this section; | 149 |
| (5) Has paid all fees required by the superintendent. | 150 |
| (C) The superintendent of insurance shall, prior to any | 151 |
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exchange becoming operational in this state, do all of the | 152 |
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following: | 153 |
| (1)(a) Adopt rules to establish a certification and training | 154 |
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program for a prospective navigator and the navigator's employees | 155 |
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that includes screening via a criminal records check performed in | 156 |
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accordance with section 3905.051 of the Revised Code, initial and | 157 |
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continuing education requirements, and an examination; | 158 |
| (b) The certification and training program shall include | 159 |
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training on compliance with the "Health Insurance Portability and | 160 |
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Accountability Act of 1996," 110 Stat. 1955, 42 U.S.C. 1320d, et | 161 |
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seq., as amended, training on ethics, and training on provisions | 162 |
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of the Affordable Care Act relating to navigators and exchanges. | 163 |
| (2) Develop a disclosure form by which a navigator may | 164 |
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disclose any potential conflicts of interest, as well as any other | 165 |
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information the superintendent considers pertinent. | 166 |
| (D)(1) The superintendent may suspend, revoke, or refuse to | 167 |
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issue or renew the navigator certification of any person that has | 168 |
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committed any act that would be a ground for denial, suspension, | 169 |
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or revocation of an insurance agent license, as prescribed in | 170 |
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section 3905.14 of the Revised Code. | 171 |
| (2) The superintendent shall not certify as a navigator, and | 172 |
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shall revoke any existing navigator certification of, any | 173 |
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individual, organization, or business entity that has received | 174 |
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financial compensation, including monetary and in-kind | 175 |
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compensation, gifts, or grants, on or after October 1, 2013, from | 176 |
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an insurer offering a qualified health benefit plan through an | 177 |
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exchange operating in this state. | 178 |
| (E) Navigators are subject to the laws of this chapter, and | 179 |
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any rules adopted pursuant to the chapter, in so far as such laws | 180 |
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are applicable. | 181 |
| (F) The superintendent may deny, suspend, approve, renew, or | 182 |
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revoke the certification of a navigator if the superintendent | 183 |
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determines that doing so would be in the interest of Ohio insureds | 184 |
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or the general public. Such an action is not subject to Chapter | 185 |
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119. of the Revised Code. | 186 |
| (G) The superintendent may adopt rules in accordance with | 187 |
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Chapter 119. of the Revised Code to implement sections 3905.47 to | 188 |
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3905.473 of the Revised Code. | 189 |
| (H) Any fees collected under this section shall be paid into | 190 |
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the state treasury to the credit of the department of insurance | 191 |
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operating fund created under section 3901.021 of the Revised Code. | 192 |
| Sec. 3905.472. An exchange shall permit an insurer to offer | 193 |
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any health benefit plan that the insurer seeks to offer through | 194 |
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the exchange, so long as the health benefit plan in question is a | 195 |
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qualified health plan under the Affordable Care Act, as determined | 196 |
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by the superintendent of insurance. | 197 |
| Sec. 3905.473. (A) An exchange operating in this state shall | 198 |
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maintain a current list of licensed insurance agents that have met | 199 |
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all of the requirements necessary to sell insurance through an | 200 |
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exchange. | 201 |
| (B) An exchange shall make available to an individual upon | 202 |
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request a list of insurance agents operating near the individual's | 203 |
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residence address that are certified to sell a health benefit plan | 204 |
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through an exchange. An exchange operating in this state shall | 205 |
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maintain a means of communication by which an individual may make | 206 |
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such a request. | 207 |
| (C) Any web site, software application, or other electronic | 208 |
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medium, or an exchange-sanctioned outreach event that enables a | 209 |
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consumer to determine eligibility for and to purchase a qualified | 210 |
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health plan through an exchange shall include information on how | 211 |
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an individual can obtain from an exchange the contact information | 212 |
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of insurance agents operating near the individual's residence | 213 |
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address that are certified to sell health benefit plans through an | 214 |
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exchange. | 215 |
| Section 2. That existing section 3905.01 of the Revised Code | 216 |
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is hereby repealed. | 217 |
