SB 70: "An Act establishing the Alaska Health Benefit Exchange; and providing for an effective date."
00 SENATE BILL NO. 70 01 "An Act establishing the Alaska Health Benefit Exchange; and providing for an effective 02 date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 05 to read: 06 INTENT. It is the intent of the legislature in this Act 07 (1) to facilitate the purchase and sale of qualified health plans in the individual 08 market in this state; 09 (2) to establish a small business health options program exchange to assist 10 qualified small employers in the state in enrolling employees in qualified health plans offered 11 in the small group market; 12 (3) to provide consumer education and assist individuals with access to 13 programs, credits, and cost-sharing reductions; 14 (4) to reduce the number of uninsured Alaskans by creating an organized,
01 transparent, and easy-to-navigate health insurance marketplace that offers a choice of high 02 value health plans with low administrative costs for individuals and employers; and 03 (5) that the Alaska Health Benefit Exchange Board recommend to the 04 legislature and the Office of the Governor methods to keep premium costs low and risk pools 05 strong in the health insurance market place. 06 * Sec. 2. AS 21.54 is amended by adding new sections to read: 07 Article 2A. Alaska Health Benefit Exchange. 08 Sec. 21.54.200. Alaska Health Benefit Exchange. The Alaska Health Benefit 09 Exchange is established as a public corporation of the state in the Department of 10 Commerce, Community, and Economic Development but with separate and 11 independent legal existence. 12 Sec. 21.54.210. Alaska Health Benefit Exchange Board. (a) The Alaska 13 Health Benefit Exchange Board is established to manage the exchange. 14 (b) The board consists of 13 members, including 12 members appointed by the 15 governor, and the commissioner of health and social services or the commissioner's 16 designee, serving ex officio. The members of the board appointed by the governor are 17 (1) one representative who is a licensed insurance producer; 18 (2) one representative from a health insurance company licensed to 19 transact health care insurance in the state; 20 (3) two representatives of the business community other than health 21 care insurers, one representing large businesses, and one representing small 22 businesses; 23 (4) two representatives from two separate hospitals located in the state; 24 (5) one representative of a labor organization; 25 (6) two physicians licensed in the state; 26 (7) two health care consumer advocates; and 27 (8) one registered nurse. 28 (c) Except for the commissioner or the commissioner's designee, who serves 29 ex officio, each board member serves for a term of three years beginning on January 1 30 and until a successor has been appointed. A member is eligible for reappointment. 31 (d) The board shall select a member to serve as chair and a member to serve as
01 vice-chair for a term and with duties and powers necessary to perform their functions. 02 (e) A majority of the board constitutes a quorum for transacting business. 03 (f) If a vacancy occurs, the governor shall make an appointment, effective 04 immediately, for the balance of the unexpired term. 05 (g) Board members and the executive director hired under (i) of this section 06 shall comply with the requirements of AS 39.50 (public official financial disclosure) 07 and shall disclose an affiliation with an insurer, agent, broker, or other representative 08 of an insurer, a health care provider, or a health care facility. 09 (h) Members of the board are entitled to per diem and transportation costs 10 under AS 39.20.180. 11 (i) The board shall employ an executive director to administer the exchange. 12 The executive director shall perform duties as prescribed by the board and may 13 employ a staff to assist in the performance of the duties of the executive director. The 14 executive director and staff employed under this subsection are in the partially exempt 15 service under AS 39.25.120. 16 Sec. 21.54.220. Duties and powers of the Alaska Health Benefit Exchange; 17 limitation. (a) The Alaska Health Benefit Exchange Board shall 18 (1) make qualified health plans available to qualified individuals and 19 qualified employers; 20 (2) facilitate the purchase and sale of qualified health plans; 21 (3) establish a small business health options program exchange to 22 assist qualified small employers in the state in enrolling employees in a qualified 23 health plan; 24 (4) provide for the operation of a toll-free telephone hotline to respond 25 to requests for assistance; 26 (5) provide for enrollment periods under sec. 1311(c)(6), P.L. 111-148 27 (Patient Protection and Affordable Care Act), as amended, and regulations adopted 28 under that Act; 29 (6) maintain an Internet website through which enrollees and 30 prospective enrollees of qualified health plans may obtain standardized comparative 31 information on those plans;
01 (7) implement procedures for the certification, recertification, and 02 decertification of qualified health plans consistent with guidelines developed by the 03 United States Secretary of Health and Human Services under sec. 1311(c), P.L. 111- 04 148 (Patient Protection and Affordable Care Act), as amended, and regulations 05 adopted under that Act; 06 (8) assign a rating to each qualified health plan offered through the 07 exchange in accordance with the criteria developed by the United States Secretary of 08 Health and Human Services under sec. 1311(c)(3), P.L. 111-148 (Patient Protection 09 and Affordable Care Act), as amended, and regulations adopted under that Act; 10 (9) determine the level of coverage of each qualified health plan under 11 regulations issued by the United States Secretary of Health and Human Services under 12 sec. 1302(d)(2)(A), P.L. 111-148 (Patient Protection and Affordable Care Act), as 13 amended, and regulations adopted under that Act; 14 (10) use a standardized format for presenting health benefit options in 15 the exchange, including the use of the uniform outline of coverage established under 16 42 U.S.C. 300gg et seq. (sec. 2715, Part A, subpart II, title XXVII, Public Health 17 Service Act); 18 (11) in accordance with sec. 1413, P.L. 111-148 (Patient Protection 19 and Affordable Care Act), as amended, and regulations adopted under that Act, inform 20 individuals of title XIX, Social Security Act eligibility requirements for the Medicaid 21 program under 42 U.S.C. 1396 - 1396w-2, the Children's Health Insurance Program 22 under 42 U.S.C. 1397aa - 1397mm (title XXI of the Social Security Act), or any 23 applicable state or local public program; and, if the exchange determines that any 24 individual is eligible for a program, enroll that individual in that program; 25 (12) establish and make available by electronic means a calculator to 26 determine the actual cost of coverage after application of any premium tax credit 27 under 26 U.S.C. 36B (Internal Revenue Code of 1986), and any cost-sharing reduction 28 under sec. 1402, P.L. 111-148 (Patient Protection and Affordable Care Act), as 29 amended, and regulations adopted under that Act; 30 (13) establish a small business health options program exchange 31 through which qualified employers may access coverage for their employees and
01 which shall enable a qualified employer to specify a level of coverage so that any of 02 its employees may enroll in any qualified health plan offered through the small 03 business health options program exchange at the specified level of coverage; 04 (14) subject to sec. 1411, P.L. 111-148 (Patient Protection and 05 Affordable Care Act), as amended, and regulations adopted under that Act, grant a 06 certification attesting that, for purposes of the individual responsibility penalty under 07 26 U.S.C. 5000A (Internal Revenue Code of 1986), an individual is exempt from the 08 individual responsibility requirement or from the penalty imposed by that section 09 because 10 (A) an affordable qualified health plan covering the individual 11 is not available through the exchange or through the individual's employer; or 12 (B) the individual meets the requirements for another 13 exemption from the individual responsibility requirement or penalty; 14 (15) provide the following information to the United States Secretary 15 of the Treasury: 16 (A) the name and taxpayer identification number of each 17 individual issued a certification under (14) of this subsection; 18 (B) the name and taxpayer identification number of each 19 individual who was an employee but who was determined to be eligible for the 20 premium tax credit under 26 U.S.C. 36B (Internal Revenue Code of 1986) 21 because 22 (i) the employer did not provide minimum essential 23 coverage; or 24 (ii) the employer provided the minimum essential 25 coverage, but it was determined under 26 U.S.C. 36B(c)(2)(C) (Internal 26 Revenue Code of 1986), to be unaffordable to the employee or not to 27 provide the required minimum actuarial value; and 28 (C) the name and taxpayer identification number of each 29 individual who 30 (i) notifies the exchange under sec. 1411(b)(4), P.L. 31 111-148 (Patient Protection and Affordable Care Act), as amended, and
01 regulations adopted under that Act, that the individual has changed 02 employers; and 03 (ii) ceases coverage under a qualified health plan during 04 a plan year and the effective date of that cessation; 05 (16) provide to each employer the name of each employee of the 06 employer described in (15)(B) of this subsection who ceases coverage under a 07 qualified health plan during a plan year and the effective date of the cessation; 08 (17) perform duties required of the exchange by the United States 09 Secretary of Health and Human Services or the United States Secretary of the 10 Treasury related to determining eligibility for premium tax credits, reduced cost- 11 sharing, or individual responsibility requirement exemptions; 12 (18) select entities qualified to serve as navigators in accordance with 13 sec. 1311(i), P.L. 111-148 (Patient Protection and Affordable Care Act), as amended, 14 and regulations adopted under that Act, and standards developed by the United States 15 Secretary of Health and Human Services and award grants to enable navigators to 16 (A) conduct public education activities to raise awareness of 17 the availability of qualified health plans; 18 (B) distribute fair and impartial information concerning 19 enrollment in qualified health plans, the availability of premium tax credits 20 under 26 U.S.C. 36B (Internal Revenue Code of 1986), and the availability of 21 cost-sharing reductions under sec. 1402, P.L. 111-148 (Patient Protection and 22 Affordable Care Act), as amended, and regulations adopted under that Act; 23 (C) facilitate enrollment in qualified health plans; 24 (D) provide referrals to any applicable office of health 25 insurance consumer assistance or health insurance ombudsman established 26 under 42 U.S.C. 300gg-93 (sec. 2793, Part C, title XXVII, Public Health 27 Service Act), or any other appropriate state agency or agencies, for any 28 enrollee with a grievance, complaint, or question regarding the enrollee's 29 health benefit plan or coverage, or a determination under that plan or coverage; 30 and 31 (E) provide information in a manner that is culturally and
01 linguistically appropriate to the needs of the population being served by the 02 exchange; 03 (19) review the rate of premium growth within the exchange and 04 outside the exchange and consider the information in developing recommendations on 05 whether to continue limiting qualified employer status to small employers; 06 (20) develop policies and procedures to minimize adverse selection 07 among plans sold within the exchange and review policies within the exchange and 08 outside the exchange to monitor the effect of adverse selection between the two 09 marketplaces; 10 (21) credit the amount of any free choice voucher to the monthly 11 premium of the plan in which a qualified employee is enrolled, in accordance with sec. 12 10108, P.L. 111-148 (Patient Protection and Affordable Care Act), as amended, and 13 regulations adopted under that Act, and collect the amount credited from the offering 14 employer; 15 (22) consult with persons having an interest in the activities of the 16 exchange, including 17 (A) health care insurers; 18 (B) health care consumers who are enrollees in qualified health 19 plans; 20 (C) individuals and entities with experience in facilitating 21 enrollment in qualified health plans; 22 (D) representatives of small businesses and self-employed 23 individuals; 24 (E) the division in the Department of Health and Social 25 Services responsible for administering Medicaid; and 26 (F) advocates for enrolling hard-to-reach populations; 27 (23) maintain an accurate accounting of all activities, receipts, and 28 expenditures; 29 (24) submit an annual accounting report to the United States Secretary 30 of Health and Human Services, the Governor, the director and the legislature; 31 (25) cooperate with an investigation conducted by the United States
01 Secretary of Health and Human Services under the Secretary's authority under P.L. 02 111-148 (Patient Protection and Affordable Care Act), as amended, and regulations 03 adopted under that Act, and allow the Secretary, in coordination with the Inspector 04 General of the United States Department of Health and Human Services, to 05 (A) investigate the affairs of the exchange; 06 (B) examine the properties and records of the exchange; 07 (C) require periodic reports in relation to the activities 08 undertaken by the exchange; 09 (26) allow a health care insurer to offer a plan that provides limited 10 scope dental benefits under 26 U.S.C. 9832(c)(2)(A) (Internal Revenue Code of 1986), 11 through the exchange, either separately or in conjunction with a qualified health plan, 12 if the plan provides pediatric dental benefits under sec. 1302(b)(1)(J), P.L. 111-148 13 (Patient Protection and Affordable Care Act), as amended, and regulations adopted 14 under that Act; 15 (27) apply for planning and establishment grants made available to the 16 exchange under sec. 1311, P.L. 111-148 (Patient Protection and Affordable Care Act), 17 as amended, and regulations adopted under that Act; and 18 (28) study the potential for interstate compacts that would permit the 19 sale and purchase of health care insurance across state borders and recommend 20 particular compact arrangements for legislative approval. 21 (b) The exchange may 22 (1) enter into a contract for the performance of the exchange's duties 23 with the Department of Health and Social Services or another entity that has 24 experience in individual and small group health insurance or benefit administration, or 25 other experience relevant to the responsibilities to be assumed by the entity, except 26 that the exchange may not contract for the performance of its duties with a health care 27 insurer or an affiliate of a health care insurer; 28 (2) enter into information-sharing agreements with federal and state 29 agencies and other state exchanges to carry out its duties if the agreements include 30 adequate protections with respect to the confidentiality of the information to be shared 31 and comply with all state and federal laws and regulations; and
01 (3) apply for and receive grants or donations from federal, state, local 02 government, foundation, or private entities. 03 (c) The exchange may not use money intended for the administrative and 04 operational expenses of the exchange for staff retreats, promotional giveaways, or 05 excessive executive compensation. 06 (d) Neither the exchange nor a health care insurer offering a health benefit 07 plan through the exchange may charge an individual a fee or penalty for termination of 08 coverage if the individual enrolls in another type of minimum essential coverage 09 because 10 (1) the individual has become newly eligible for that coverage; or 11 (2) the individual's employer-sponsored coverage has become 12 affordable under the standards of 26 U.S.C. 36B(c)(2)(C) (Internal Revenue Code of 13 1986). 14 Sec. 21.54.230. Health benefit plan certification. (a) The exchange may 15 certify a health benefit plan as a qualified health plan if 16 (1) the plan provides the essential health benefits described in sec. 17 1302(a), P.L. 111-148 (Patient Protection and Affordable Care Act), as amended, and 18 regulations adopted under that Act, except that the plan is not required to provide 19 essential benefits that duplicate the minimum benefits of qualified dental plans if 20 (A) the exchange has determined that at least one qualified 21 dental plan is available to supplement the plan's coverage; and 22 (B) the health care insurer makes prominent disclosure at the 23 time it offers the plan, in a form approved by the exchange, that the plan does 24 not provide the full range of essential pediatric benefits, and that qualified 25 dental plans providing those benefits and other dental benefits not covered by 26 the plan are offered through the exchange; 27 (2) the premium rates and contract language have been approved by 28 the director; 29 (3) the plan provides at least a bronze level of coverage under 30 AS 21.54.220(a)(8) unless the plan is certified as a qualified catastrophic plan, meets 31 the requirements of P.L. 111-148 (Patient Protection and Affordable Care Act), as
01 amended, and regulations adopted under that Act, for catastrophic plans, and will only 02 be offered to individuals eligible for catastrophic coverage; 03 (4) the cost-sharing requirements of the plan do not exceed the limits 04 established under sec. 1302(c)(1), P.L. 111-148 (Patient Protection and Affordable 05 Care Act), as amended, and regulations adopted under that Act, and, if the plan is 06 offered through the small business health options program exchange, the deductible 07 for the plan does not exceed the limits established under sec. 1302(c)(2), P.L. 111-148 08 (Patient Protection and Affordable Care Act), as amended, and regulations adopted 09 under that Act; 10 (5) the health care insurer offering the plan 11 (A) is licensed and in good standing to offer health insurance 12 coverage in the state; 13 (B) offers at least one qualified health plan that provides a 14 silver level of coverage under AS 21.54.220(a)(8) and at least one plan that 15 provides a gold level of coverage through each small business health options 16 program exchange and exchange for individual coverage in which the health 17 care insurer participates; 18 (C) charges the same premium rate for each qualified health 19 plan without regard to whether the plan is offered through the exchange and 20 without regard to whether the plan is offered directly from the health care 21 insurer or through an insurance producer; 22 (D) does not charge cancellation fees or penalties in violation 23 of AS 21.54.220(d); and 24 (E) complies with the regulations developed by the United 25 States Secretary of Health and Human Services under sec. 1311(d), P.L. 111- 26 148 (Patient Protection and Affordable Care Act), as amended, and regulations 27 adopted under that Act, and other requirements the exchange establishes; 28 (6) the plan meets the requirements of certification as adopted by 29 regulation under AS 21.54.250 and by the United States Secretary of Health and 30 Human Services under sec. 1311(c), P.L. 111-148 (Patient Protection and Affordable 31 Care Act), as amended, and regulations adopted under that Act, which include
01 minimum standards in the areas of marketing practices, network adequacy, essential 02 community providers in underserved areas, accreditation, quality improvement, 03 uniform enrollment forms, and descriptions of coverage and information on quality 04 measures for health benefit plan performance; and 05 (7) the exchange determines that making the plan available through the 06 exchange is in the interest of qualified individuals and qualified employers in this 07 state. 08 (b) The exchange may not exclude a health benefit plan 09 (1) because the plan is a fee-for-service plan; 10 (2) by imposing premium price controls; or 11 (3) because the plan provides treatments necessary to prevent patients' 12 deaths that the exchange determines are inappropriate or too costly. 13 (c) The exchange shall require each health care insurer seeking certification of 14 a plan as a qualified health plan to 15 (1) submit to the exchange a justification for any premium increase 16 before implementation of that increase; the health care insurer shall prominently post 17 the justification information on the health care insurer's Internet website; the exchange 18 shall consider the information submitted, along with the information and the 19 recommendations provided to the exchange by the director under 42 U.S.C. 300gg-94 20 (sec. 2794(b), Part C, title XXVII, Public Health Service Act) when determining 21 whether to allow the health care insurer to make plans available through the exchange; 22 (2) make available to the public in plain language, as defined in sec. 23 1311(e)(3)(B), P.L. 111-148 (Patient Protection and Affordable Care Act), as 24 amended, and regulations adopted under that Act, and submit to the exchange, the 25 United States Secretary of Health and Human Services, and the director accurate and 26 timely disclosure of the following: 27 (A) claims payment policies and practices; 28 (B) periodic financial disclosures; 29 (C) data on enrollment; 30 (D) data on disenrollment; 31 (E) data on the number of claims that are denied;
01 (F) data on rating practices; 02 (G) information on cost-sharing and payments with respect to 03 any out-of-network coverage; 04 (H) information on enrollee and participant rights under Title I 05 of P.L. 111-148 (Patient Protection and Affordable Care Act), as amended, and 06 regulations adopted under that Act; and 07 (I) other appropriate information as determined by the United 08 States Secretary of Health and Human Services. 09 (3) permit individuals to learn, in a timely manner on the request of the 10 individual, the amount of cost-sharing, including deductibles, copayments, and 11 coinsurance, under the individual's plan or coverage that the individual would be 12 responsible for paying with respect to the furnishing of a specific item or service by a 13 participating provider; a minimum, that information must be made available to the 14 individual through an Internet website and through other means for individuals 15 without access to the Internet. 16 (d) The exchange may not exempt a health care insurer seeking certification of 17 a qualified health plan from state licensure or solvency requirements, regardless of the 18 type or size of the health care insurer, and shall apply the criteria of this section in a 19 manner that ensures equality between or among health care insurers participating in 20 the exchange. 21 (e) The provisions of AS 21.54.200 - 21.54.270 that are applicable to qualified 22 health plans also apply, to the extent relevant, to qualified dental plans, except as 23 modified under (1) - (3) of this subsection or by regulations adopted by the exchange. 24 Under this subsection, 25 (1) the health care insurer shall be licensed to offer dental coverage, 26 but need not be licensed to offer other health benefits; 27 (2) the plan must be limited to dental and oral health benefits, without 28 substantially duplicating the benefits typically offered by a health benefit plan without 29 dental coverage and must include, at a minimum, the essential pediatric dental benefits 30 prescribed by the United States Secretary of Health and Human Services under sec. 31 1302(b)(1)(J), P.L. 111-148 (Patient Protection and Affordable Care Act), as amended,
01 and regulations adopted under that Act, and other dental benefits as the exchange or 02 the Secretary may specify by regulation; and 03 (3) the health care insurer may jointly offer a comprehensive plan 04 through the exchange in which the dental benefits are provided by a health care insurer 05 through a qualified dental plan and the other benefits are provided by a health care 06 insurer through a qualified health plan if the plans are priced separately and are also 07 made available for purchase separately at the same price. 08 Sec. 21.54.240. Exchange funding; publication of costs of the exchange. (a) 09 The exchange may charge assessments or user fees to health care insurers or otherwise 10 generate funding necessary to support its operations provided under AS 21.54.200 - 11 21.54.270. 12 (b) The exchange shall publish the average costs of licensing, regulatory fees, 13 and any other payments required by the exchange, and the administrative costs of the 14 exchange, on its Internet website. That information must include information on 15 money lost to waste, fraud, and abuse. 16 Sec. 21.54.250. Regulations. The exchange may adopt regulations to 17 implement the provisions of AS 21.54.200 - 21.54.270. Regulations adopted under this 18 section may not conflict with or prevent the application of regulations adopted by the 19 United States Secretary of Health and Human Services under P.L. 111-148 (Patient 20 Protection and Affordable Care Act), as amended, and regulations adopted under that 21 Act. 22 Sec. 21.54.260. Relation to other laws. Provisions of AS 21.54.200 - 23 21.54.270, and actions taken by the exchange under AS 21.54.200 - 21.54.270 may 24 not be construed to preempt or supersede the authority of the director to regulate the 25 business of insurance in the state. Except as expressly provided to the contrary in 26 AS 21.54.200 - 21.54.270, all health care insurers offering qualified health plans in the 27 state shall comply fully with all applicable health insurance laws of the state and 28 regulations adopted and orders issued by the director. 29 Sec. 21.54.270. Definitions. In AS 21.54.200 - 21.54.270, 30 (1) "board" means the Alaska Health Benefit Exchange Board 31 established AS 21.54.210;
01 (2) "exchange" means the Alaska Health Benefit Exchange established 02 under AS 21.54.200; 03 (3) "health benefit plan" has the meaning given in AS 21.54.500, 04 except that, notwithstanding AS 21.54.500, it does not include 05 (A) coverage only for accident or disability income insurance, 06 or any combination of accident or disability income insurance; 07 (B) coverage issued as a supplement to liability insurance; 08 (C) liability insurance, including general liability insurance and 09 automobile liability insurance; 10 (D) workers' compensation insurance or similar insurance; 11 (E) automobile medical payment insurance; 12 (F) credit-only insurance; 13 (G) coverage for on-site medical clinics; 14 (H) insurance coverage specified in federal regulations issued 15 under the P.L. 104-191 (Health Insurance Portability and Accountability Act of 16 1996), under which benefits for health care services are secondary or incidental 17 to other insurance benefits; 18 (I) the following benefits if they are provided under a separate 19 policy, certificate, or contract of insurance or are otherwise not an integral part 20 of the plan: 21 (i) limited scope dental or vision benefits; 22 (ii) benefits for long-term care, nursing home care, 23 home health care, community-based care, or any combination of long- 24 term care, nursing home care, home health care, or community based 25 care; 26 (J) limited benefits specified in federal regulations issued under 27 P. L. 104-191 (Health Insurance Portability and Accountability Act of 1996); 28 (K) the following benefits if the benefits are provided under a 29 separate policy, certificate, or contract of insurance; there is no coordination 30 between the provision of the benefits and any exclusion of benefits under any 31 group health plan maintained by the same plan sponsor; and the benefits are
01 paid with respect to an event without regard to whether benefits are provided 02 with respect to an event under any group health plan maintained by the same 03 plan sponsor: 04 (i) coverage for only a specified disease or illness; or 05 (ii) hospital indemnity or other fixed indemnity 06 insurance; 07 (L) the following benefits if offered as a separate policy, 08 certificate, or contract of insurance: 09 (i) Medicare supplemental health insurance as defined 10 in 42 U.S.C. 1395ss(g)(1) (sec. 1882(g)(1) ch. 7, Subchapter XVIII, 11 Part E, Social Security Act); 12 (ii) coverage supplemental to the coverage provided 10 13 U.S.C. 1071 - 1110a (Civilian Health and Medical Program of the 14 Uniformed Services (CHAMPUS)); or 15 (iii) similar supplemental coverage provided to 16 coverage under a group health plan; 17 (4) "qualified dental plan" means a limited scope dental plan that has 18 been certified under AS 21.54.230(e); 19 (5) "qualified employer" means a small employer that elects to make 20 its full-time employees and, at the option of the employer, some or all of its part-time 21 employees, eligible for one or more qualified health plans offered through the small 22 business health options program exchange if the employer 23 (A) has its principal place of business in this state and elects to 24 provide coverage through the small business health options program exchange 25 to all of its eligible employees, wherever employed; or 26 (B) elects to provide coverage through the small business 27 health options program exchange to all of its eligible employees who are 28 principally employed in this state; 29 (6) "qualified health plan" means a health benefit plan that has in effect 30 a certification that the plan meets the criteria for certification described in sec. 31 1311(c), P.L. 111-148 (Patient Protection and Affordable Care Act), as amended, and
01 regulations adopted under that Act, and AS 21.54.230; 02 (7) "qualified individual" means an individual, including a minor, who 03 (A) is seeking to enroll in a qualified health plan offered to 04 individuals through the exchange; 05 (B) resides in this state; 06 (C) at the time of enrollment, is not incarcerated, other than 07 incarceration pending the disposition of charges; and 08 (D) for the entire period for which enrollment is sought, is and 09 is reasonably expected to be a citizen or national of the United States or an 10 alien lawfully present in the United States; 11 (8) "small business health options program exchange" means the small 12 business health options exchange under AS 21.54.220(a)(13) and sec. 1321, P.L. 111- 13 148, (Patient Protection and Affordable Care Act), as amended, and regulations 14 adopted under that Act; 15 (9) "small employer," notwithstanding AS 21.54.500, means an 16 employer that employed an average of not more than 50 employees during the 17 preceding calendar year; for purposes of this paragraph, 18 (A) a person treated as a single employer under 26 U.S.C. 414 19 (b), (c), (m), or (o) (Internal Revenue Code of 1986), shall be treated as a 20 single employer; 21 (B) an employer and any predecessor employer shall be treated 22 as a single employer; 23 (C) all employees shall be counted, including a part-time 24 employee and an employee who is not eligible for coverage through the 25 employer; 26 (D) if an employer was not in existence throughout the 27 preceding calendar year, the determination of whether that employer is a small 28 employer shall be based on the average number of employees the employer is 29 reasonably expected to employ on business days in the current calendar year; 30 and 31 (E) an employer that makes enrollment in qualified health plans
01 available to its employees through the small business health options program 02 exchange and that would cease to be a small employer because of an increase 03 in the number of its employees, shall continue to be treated as a small 04 employer for purposes of AS 21.54.200 - 21.54.270 as long as the employer 05 continuously makes enrollment through the small business health options 06 program exchange available to its employees. 07 * Sec. 3. AS 39.25.120(c) is amended by adding a new paragraph to read: 08 (21) the executive director and employees of the Alaska Health Benefit 09 Exchange Board employed under AS 21.54.210(i). 10 * Sec. 4. AS 39.50.200(a)(9) is amended to read: 11 (9) "public official" means 12 (A) a judicial officer; 13 (B) the governor or the lieutenant governor; 14 (C) a person hired or appointed in a department in the 15 executive branch as 16 (i) the head or deputy head of the department; 17 (ii) the director or deputy director of a division; 18 (iii) a special assistant to the head of the department; 19 (iv) a person serving as the legislative liaison for the 20 department; 21 (D) an assistant to the governor or the lieutenant governor; 22 (E) the chair or a member of a state commission or board; 23 (F) state investment officers and the state comptroller in the 24 Department of Revenue; 25 (G) the chief procurement officer appointed under 26 AS 36.30.010; 27 (H) the executive director of the Alaska Workforce Investment 28 Board; 29 (I) each appointed or elected municipal officer; [AND] 30 (J) the members of the board of trustees, the executive director, 31 and the investment officers of the Alaska Permanent Fund Corporation; and
01 (K) the executive director of the Alaska Health Benefit 02 Exchange employed under AS 21.54.210; 03 * Sec. 5. AS 39.50.200(b) is amended by adding a new paragraph to read: 04 (64) the Alaska Health Benefit Exchange Board (AS 21.54.210). 05 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 06 read: 07 TRANSITIONAL PROVISIONS. Notwithstanding AS 21.54.210(c), enacted by sec. 08 2 of this Act, the initial terms for members of the Alaska Health Benefit Exchange Board, 09 except for the commissioner of health of social services who serves ex officio, are as follows: 10 (1) four members shall be appointed to serve for terms ending December 31, 11 2011; 12 (2) four members shall be appointed to serve for terms ending December 31, 13 2012; and 14 (3) the remaining members shall be appointed to serve for terms ending 15 December 31, 2013. 16 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 17 read: 18 TRANSITION: REGULATIONS. The Alaska Health Benefit Exchange Board 19 established under AS 21.54.200, enacted by sec. 2 of this Act, may adopt regulations 20 necessary to implement this Act under AS 21.54.250, enacted by sec. 2 of this Act. The 21 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 22 effective date of the statutory changes. 23 * Sec. 8. AS 21.54.200, 21.54.210, 21.54.220, 21.54.250, and 21.54.270, enacted by sec. 2 24 of this Act, and secs. 3 - 5 of this Act take effect July 1, 2011. 25 * Sec. 9. Sections 6 and 7 of this Act take effect immediately under AS 01.10.070(c). 26 * Sec. 10. Except as provided in secs. 8 and 9 of this Act, this Act takes effect July 1, 2012.