S418 - North Carolina Health Benefit Exchange Act

• Creates a nonprofit North Carolina Health Benefit Exchange to facilitate the purchase and sale of qualified health plans for individuals and small employers, with operations beginning January 1, 2014.

• Establishes a Board of Directors consisting of the Insurance Commissioner (ex officio nonvoting), the Director of Medical Assistance (ex officio nonvoting), and seven voting members appointed by the Commissioner, Governor, and General Assembly with expertise in health insurance, finance, and related fields.

• Requires the Exchange to certify health benefit plans meeting federal Affordable Care Act standards, provide enrollment assistance through Navigators, determine eligibility for premium tax credits and cost-sharing reductions, and operate a Small Business Health Options Program (SHOP Exchange) for employers with 50 or fewer employees.

• Prohibits the Exchange from excluding plans based on premium price controls or plan type, requires health carriers to disclose claims practices and financial data, and mandates annual audits by the State Auditor with costs paid from Exchange funds.

• Funding for the Exchange beginning in 2014 shall come from the existing North Carolina Health Insurance Risk Pool funding stream, and the Exchange remains subject to state insurance regulation by the Insurance Commissioner.