Bill Text: OH HB613 | 2011-2012 | 129th General Assembly | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
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-Comm_Sub.html
As Reported by the House Health and Aging Committee
A BILL
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
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-Comm_Sub.html
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Representative Sears
Cosponsor:
Representative Hackett
To amend section 3905.01 and to enact sections | 1 |
3905.47, 3905.471, 3905.472, and 3905.473 of the | 2 |
Revised Code to specify licensing and continuing | 3 |
education requirements for insurance agents | 4 |
involved in selling, soliciting, or negotiating | 5 |
sickness and accident insurance through a health | 6 |
benefit exchange. | 7 |
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 |
| 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 |
| 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 |
| 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 |
| 30 |
of the Revised Code. | 31 |
| 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 |
| 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 |
| 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 |
| 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 |
| 55 |
authorized by the superintendent to sell, solicit, or negotiate | 56 |
limited lines insurance. | 57 |
| 58 |
commissioners. | 59 |
| 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 |
| 70 |
| 71 |
any means, for money or its equivalent, on behalf of an insurer. | 72 |
| 73 |
ask or urge a person to apply for a particular kind of insurance | 74 |
from a particular insurer. | 75 |
| 76 |
means the superintendent of insurance of this state. | 77 |
| 78 |
an insurance agent and the insurer or to terminate an insurance | 79 |
agent's authority to transact insurance. | 80 |
| 81 |
application for resident and nonresident agent licensing, as | 82 |
amended by the NAIC from time to time. | 83 |
| 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, as applicable. | 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; | 108 |
(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; | 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 an agent who | 117 |
successfully completes the courses approved by the superintendent. | 118 |
(D) An individual who receives a resident insurance agent | 119 |
license under section 3905.06 of the Revised Code and that is | 120 |
certified under this section shall submit to the exchange the | 121 |
individual's name, business address, telephone number, electronic | 122 |
mail address, and any other information required by the exchange. | 123 |
Sec. 3905.471. (A) A navigator may do any of the following: | 124 |
(1) Conduct public education activities to raise awareness of | 125 |
the availability of qualified health plans; | 126 |
(2) Distribute fair and impartial general information | 127 |
concerning enrollment in all qualified health plans offered within | 128 |
the exchange and the availability of the premium tax credits under | 129 |
section 36B of the Internal Revenue Code of 1986, 26 U.S.C. 36B, | 130 |
and cost-sharing reductions under section 1402 of the Affordable | 131 |
Care Act; | 132 |
(3) Facilitate enrollment in qualified health plans, without | 133 |
suggesting that an individual select a particular plan. | 134 |
(B) A navigator shall not do any of the following, unless | 135 |
that navigator is otherwise licensed to do so under this chapter: | 136 |
(1) Sell, solicit, or negotiate health insurance; | 137 |
(2) Enroll an individual or employee in a qualified health | 138 |
plan offered through an exchange; | 139 |
(3) Assist or provide information to an individual or entity | 140 |
seeking to purchase health insurance through the small business | 141 |
health options program portion of an exchange. | 142 |
(C) An individual, or an individual performing navigator | 143 |
duties on behalf of an organization serving as a navigator, shall | 144 |
not act in the capacity of a navigator unless the individual has | 145 |
met all of the following requirements, as applicable: | 146 |
(1) Is at least eighteen years of age; | 147 |
(2) Has completed and submitted the disclosure form required | 148 |
under division (D)(2) of this section and has declared, under | 149 |
penalty of refusal, suspension, or revocation of the navigator's | 150 |
certification, that the statements made in the form are true, | 151 |
correct, and complete to the best of the applicant's knowledge and | 152 |
belief; | 153 |
(3) Has completed a criminal records check under section | 154 |
3905.051 of the Revised Code, as required by the superintendent; | 155 |
(4) Has successfully completed the certification and training | 156 |
requirements adopted by the superintendent in accordance with | 157 |
division (D) of this section; | 158 |
(5) Has paid all fees required by the superintendent. | 159 |
(D) The superintendent of insurance shall, prior to any | 160 |
exchange becoming operational in this state, do all of the | 161 |
following: | 162 |
(1)(a) Adopt rules to establish a certification and training | 163 |
program for a prospective navigator and the navigator's employees | 164 |
that includes screening via a criminal records check performed in | 165 |
accordance with section 3905.051 of the Revised Code, initial and | 166 |
continuing education requirements, and an examination; | 167 |
(b) The certification and training program shall include | 168 |
training on compliance with the "Health Insurance Portability and | 169 |
Accountability Act of 1996," 110 Stat. 1955, 42 U.S.C. 1320d, et | 170 |
seq., as amended, training on ethics, and training on provisions | 171 |
of the Affordable Care Act relating to navigators and exchanges. | 172 |
(2) Develop a disclosure form by which a navigator may | 173 |
disclose any potential conflicts of interest, as well as any other | 174 |
information the superintendent considers pertinent. | 175 |
(E)(1) The superintendent may suspend, revoke, or refuse to | 176 |
issue or renew the navigator certification of any person that has | 177 |
committed any act that would be a ground for denial, suspension, | 178 |
or revocation of an insurance agent license, as prescribed in | 179 |
section 3905.14 of the Revised Code. | 180 |
(2) The superintendent shall not certify as a navigator, and | 181 |
shall revoke any existing navigator certification of, any | 182 |
individual, organization, or business entity that is receiving | 183 |
financial compensation, including monetary and in-kind | 184 |
compensation, gifts, or grants, on or after October 1, 2013, from | 185 |
an insurer offering a qualified health benefit plan through an | 186 |
exchange operating in this state. | 187 |
(F) Navigators are subject to the laws of this chapter, and | 188 |
any rules adopted pursuant to the chapter, in so far as such laws | 189 |
are applicable. | 190 |
(G) The superintendent may deny, suspend, approve, renew, or | 191 |
revoke the certification of a navigator if the superintendent | 192 |
determines that doing so would be in the interest of Ohio insureds | 193 |
or the general public. Such an action is not subject to Chapter | 194 |
119. of the Revised Code. | 195 |
(H) The superintendent may adopt rules in accordance with | 196 |
Chapter 119. of the Revised Code to implement sections 3905.47 to | 197 |
3905.473 of the Revised Code. | 198 |
(I) Any fees collected under this section shall be paid into | 199 |
the state treasury to the credit of the department of insurance | 200 |
operating fund created under section 3901.021 of the Revised Code. | 201 |
Sec. 3905.472. An exchange shall permit an insurer to offer | 202 |
any health benefit plan that the insurer seeks to offer through | 203 |
the exchange, so long as the health benefit plan in question is a | 204 |
qualified health plan under the Affordable Care Act, as approved | 205 |
by the superintendent of insurance. | 206 |
Sec. 3905.473. (A) An exchange operating in this state shall | 207 |
maintain a current list of both of the following: | 208 |
(1) Licensed insurance agents that have met all of the | 209 |
requirements necessary to sell insurance through an exchange; | 210 |
(2) Individuals or entities that are not licensed insurance | 211 |
agents that have met all the requirements to be certified by the | 212 |
superintendent as a navigator. | 213 |
(B) An exchange shall make available to an individual upon | 214 |
request a list of insurance agents operating near the individual's | 215 |
residence address that are certified to sell a health benefit plan | 216 |
through an exchange and navigators that are certified under | 217 |
section 3905.471 of the Revised Code. An exchange operating in | 218 |
this state shall maintain a means of communication by which an | 219 |
individual may make such a request. | 220 |
(C) Any web site, software application, or other electronic | 221 |
medium, or an exchange-sanctioned outreach event that enables a | 222 |
consumer to determine eligibility for and to purchase a qualified | 223 |
health plan through an exchange shall include information on how | 224 |
an individual can obtain from an exchange the contact information | 225 |
of insurance agents operating near the individual's residence | 226 |
address that are certified to sell health benefit plans through an | 227 |
exchange and navigators that are certified under section 3905.471 | 228 |
of the Revised Code. | 229 |
Section 2. That existing section 3905.01 of the Revised Code | 230 |
is hereby repealed. | 231 |