A 8514 - Health Benefit Exchange Act - New York Key Vote

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Title: Health Benefit Exchange Act

Vote Smart's Synopsis:

Vote to pass a bill that establishes the New York Health Benefit Exchange as a public benefit corporation in order to facilitate the purchase and sale of qualified health plans to individuals and small businesses in conformance with the Patient Protection and Affordable Care Act.

Highlights:

  • Defines "small employer" to mean, for plan years prior to January 1, 2016, as an employer that employed at least one, but not more than 50 employees on business days during the preceding calendar year, and for plan years beginning on and after January 1, 2016, as an employer that employed at least 1 but not more than 100 employees on business days during the preceding calendar year (Sec. 2).
  • Specifies that the exchange shall be governed by a board of directors consisting of 9 voting directors, including the commissioner and the superintendent, who shall serve as ex officio directors (Sec. 2).
  • Authorizes the Governor to appoint 7 of the directors, 2 of whom shall be appointed upon the recommendation of the temporary president of the Senate, and 2 of whom shall be appointed upon the recommendation of the speaker of the assembly (Sec. 2).
  • Requires each person appointed as director to have expertise in one or more of the following areas (Sec. 2):
    • Individual health care coverage;
    • Small employer health care coverage;
    • Health care finance;
    • Public or private health care delivery systems; or
    • Purchasing health plan coverage.
  • Specifies that it is the responsibility of the board of directors to meet the requirements of this bill and to serve the public interest of the individuals and small businesses seeking health care coverage through the exchange (Sec. 2).
  • Requires the board of directors, or any committee appointed for such a purpose, to assign a rating for each qualified health plan offered and to ensure that the state exchange health plan is in accordance with the federal Patient Protection and Affordable Care Act (Sec. 2).
  • Requires each insurer certified or seeking certification as a qualified health plan to submit to the Exchange a justification for any premium increase prior to the implementation of the increase (Sec. 2).
  • Requires the Exchange to establish and maintain an Internet website through which enrollees and prospective enrollees may compare health plans and public health care programs (Sec. 2).
  • Establishes 5 regional advisory committees and authorizes the board of directors to determine which counties shall make up the following regions (Sec. 2):
    • The New York City region;
    • The metropolitan suburban region;
    • The northern region;
    • The central region; and
    • The western region.
  • Requires each regional advisory committee to make finding and recommendations to the board of directors regarding variations in the operation of the health exchange (Sec. 2).

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