2. Health Ins Info Marketplace

A BILL TO BE ENTITLED

THE PRIVATE HEALTH INSURANCE INFORMATION MARKETPLACE ACT

 

It is the intent of the General Assembly to authorize the Commissioner of Insurance to create criteria for granting the Georgia Department of Insurance certification of “State Approved Full Service Health Insurance Information Marketplace.”      

 

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

 

SECTION 1 – Definition of Health Insurance Information Marketplace

 

A Health Insurance Information Marketplace (HIIM) is a private company or division of a company providing health insurance information to the general public on all aspects of insurance purchasing, including but not limited to: premiums, coverages, limitations & exclusions, incentive programs, network providers, qualified agents, and other information deemed by the Commissioner of Insurance to be necessary for consumer understanding of comparative value among plans and options.

 

An HIIM is not an insurance company and to the extent it is not selling or issuing insurance products its operations are not regulated by the Department of Insurance.   

 

SECTION 2 – Certification Requirements

 

Under the guidance of this Act, the Commissioner shall establish a set of criteria that qualifies a private health insurance information marketplace as a state certified full-service information source that assists consumers with information and choices for selecting fully insured individual health policies, fully insured small group health plans, optional or supplemental plans, and eligibility for public programs.

 

SECTION 3 – Certification Process

 

The certification process is strictly voluntary.  To qualify for the certification the HIIM shall be accessible and available to all Georgians, allow any Georgia licensed company to participate in their information data-base, provide information on all health policies submitted by the participating insurers, have access to public insurance information and eligibility standards, and report consumer plan options in an unbiased way giving neither preference nor exclusivity to any single insurer or group(s) of insurers.

 

To qualify as certified Health Insurance Information Marketplace the HIIM must request the Department of Insurance to review its operations, scope of services, and operations. The department will score the HIIMs capabilities to become a state approved full-service health insurance information marketplace. Certified HIIMs must meet the standards for information as established by the Commissioner on health, dental, vision, legal and other supplemental products.   Information on consumer options for both public and private insurance options must be provided.

 

 SECTION 4 – Public Insurance Information

 

The Department of Insurance and the Department of Community Health are authorized to assist all requesting HIIMs with coverage information on public programs, provide access to eligibility standards, and connections to eligibility portals as otherwise legally allow and determined appropriate by the Commissioner of the Department of Community Health.

 

Inclusion of public health coverages and eligibility information may be included as a part of the certification process.

 

SECTION 5 – HIIM Grants   

 

To the extent funds are provided by the Georgia General Assembly for HIIM grants to encourage the grow and expansion of private HIIMs in the state of Georgia to serve the state of Georgia, the Department of Insurance can make grants of up to $100,000 for qualified businesses to conduct market research, planning, and business model development of HIIMs to be located in Georgia support a Georgia HIIM.

 

The Commissioner of the Department of Insurance shall develop the criteria for making any grants.  The Commissioner shall publish any such grants and report annually to the General Assembly the made during the previous year and the status and results of those grants.   

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