Bill > SB0973

This bill, titled the "Michigan Health Insurance Exchange Act," establishes a state-based health insurance exchange as a nonprofit corporation to foster a competitive health insurance market and facilitate the purchase and sale of qualified health plans, which are health benefit plans certified to meet federal and state requirements. The exchange will be governed by a 12-member board, including ex officio members from the departments of insurance and financial services and health and human services, with the remaining members appointed by the governor and confirmed by the senate, ensuring representation from various stakeholders and a majority without conflicts of interest. This board will organize the nonprofit corporation and oversee its operations, including contracting for services, managing finances, and establishing a marketplace accessible via a website and hotline by January 1, 2028. The exchange will also offer a Small Business Health Options Program (SHOP) for employers and can facilitate enhanced direct enrollment processes, allowing approved entities to manage eligibility, enrollment, and customer service on their own websites. The act defines key terms such as "health carrier" (including insurers, health maintenance organizations, and health care corporations), "qualified health plan," and "qualified dental plan," and outlines the exchange's powers and duties, including certifying plans, providing consumer assistance, and determining eligibility for subsidies. Funding for the exchange will come from assessments and user fees charged to health carriers, with an exchange fund created within the state treasury to manage these revenues and support operations and a reinsurance program. The bill also clarifies that it does not supersede the authority of the director of the department of insurance and financial services to regulate insurance or the department of health and human services to administer state medical assistance programs, and provides a process for carriers to appeal exchange decisions to the director.