HB 109 Summary: Ohio Health Benefit Exchange

• Creates the Ohio Health Benefit Exchange Agency with a board of directors consisting of three ex-officio members (superintendent of insurance, director of medicaid, director of health) and six appointed members representing diverse stakeholder interests, with terms up to three years.

• Establishes the Ohio Health Benefit Exchange Program with an individual coverage exchange and a Small Business Health Options Program (SHOP exchange) to facilitate purchase and sale of qualified health plans beginning January 1, 2016.

• Designates an executive director (unclassified civil service) responsible for certifying qualified health plans and dental plans, establishing enrollment procedures, maintaining a website for plan comparison, and ensuring availability of plans at multiple coverage levels (catastrophic, bronze, silver, gold, platinum).

• Creates a navigator program to advise consumers and employers on exchange use, with navigators selected based on existing relationships with target populations and inability to receive compensation from health insurers.

• Establishes the Ohio Health Benefit Exchange Operating Fund through assessments or user fees on carriers, with provisions requiring publication of administrative costs and prohibition of frivolous expenditures.