=======
art.018/4/018/3/018/2/017/4/017/3/017/2
=======
ARTICLE 18 AS AMENDED
RELATING TO HEALTH REFORM ASSESSMENT AND HEALTH BENEFIT EXCHANGE

     SECTION 1. Section 42-11-2 of the General Laws in Chapter 42-11 entitled "Department
of Administration" is hereby amended to read as follows:
     42-11-2. Powers and duties of department. -- The department of administration shall
have the following powers and duties:
      (1) To prepare a budget for the several state departments and agencies, subject to the
direction and supervision of the governor;
      (2) To administer the budget for all state departments and agencies, except as
specifically exempted by law;
      (3) To devise, formulate, promulgate, supervise, and control accounting systems,
procedures, and methods for the state departments and agencies, conforming to such accounting
standards and methods as are prescribed by law;
      (4) To purchase or to contract for the supplies, materials, articles, equipment, printing,
and services needed by state departments and agencies, except as specifically exempted by law;
      (5) To prescribe standard specifications for those purchases and contracts and to enforce
compliance with specifications;
      (6) To supervise and control the advertising for bids and awards for state purchases;
      (7) To regulate the requisitioning and storage of purchased items, the disposal of surplus
and salvage, and the transfer to or between state departments and agencies of needed supplies,
equipment, and materials;
      (8) To maintain, equip, and keep in repair the state house, state office building, and other
premises owned or rented by the state for the use of any department or agency, excepting those
buildings, the control of which is vested by law in some other agency;
      (9) To provide for the periodic inspection, appraisal or inventory of all state buildings
and property, real and personal;
      (10) To require reports from state agencies on the buildings and property in their
custody;
      (11) To issue regulations to govern the protection and custody of the property of the
state;
      (12) To assign office and storage space and to rent and lease land and buildings for the
use of the several state departments and agencies in the manner provided by law;
      (13) To control and supervise the acquisition, operation, maintenance, repair, and
replacement of state-owned motor vehicles by state agencies;
      (14) To maintain and operate central duplicating and mailing service for the several state
departments and agencies;
      (15) To furnish the several departments and agencies of the state with other essential
office services;
      (16) To survey and examine the administration and operation of the state departments
and agencies, submitting to the governor proposals to secure greater administrative efficiency and
economy, to minimize the duplication of activities, and to effect a better organization and
consolidation of functions among state agencies;
      (17) To operate a merit system of personnel administration and personnel management
as defined in § 36-3-3 in connection with the conditions of employment in all state departments
and agencies within the classified service;
      (18) To assign or reassign, with the approval of the governor, any functions, duties, or
powers established by this chapter to any agency within the department;
      (19) To establish, maintain, and operate a data processing center or centers, approve the
acquisition and use of electronic data processing services by state agencies, furnish staff
assistance in methods, systems and programming work to other state agencies, and arrange for
and effect the centralization and consolidation of punch card and electronic data processing
equipment and services in order to obtain maximum utilization and efficiency;
      (20) To devise, formulate, promulgate, supervise, and control a comprehensive and
coordinated statewide information system designed to improve the data base used in the
management of public resources, to consult and advise with other state departments and agencies
and municipalities to assure appropriate and full participation in this system, and to encourage the
participation of the various municipalities of this state in this system by providing technical or
other appropriate assistance toward establishing, within those municipalities, compatible
information systems in order to obtain the maximum effectiveness in the management of public
resources;
      (i) The comprehensive and coordinated statewide information system may include a
Rhode Island geographic information system of land-related economic, physical, cultural and
natural resources.
      (ii) In order to ensure the continuity of the maintenance and functions of the geographic
information system, the general assembly may annually appropriate such sum as it may deem
necessary to the department of administration for its support.
      (21) To administer a statewide planning program including planning assistance to the
state departments and agencies;
      (22) To administer a statewide program of photography and photographic services;
      (23) To negotiate with public or private educational institutions in the state, in
cooperation with the department of health, for state support of medical education;
      (24) To promote the expansion of markets for recovered material and to maximize their
return to productive economic use through the purchase of materials and supplies with recycled
content by the state of Rhode Island to the fullest extent practically feasible;
      (25) To approve costs as provided in § 23-19-32; and
      (26) To provide all necessary civil service tests for child protective investigators and
social workers at least twice each year and to maintain an adequate hiring list for these positions
at all times.
      (27) (a) To prepare a report every three (3) months by all current property leases or
rentals by any state or quasi-state agency to include the following information:
      (i) Name of lessor;
      (ii) Description of the lease (purpose, physical characteristics, and location);
      (iii) Cost of the lease;
      (iv) Amount paid to date;
      (v) Date initiated;
      (vi) Date covered by the lease.
      (b) To prepare a report by October 31, 2014 of all current property owned by the state or
leased by any state agency or quasi-state agency to include the following information:
      (i) Total square feet for each building or leased space;
      (ii) Total square feet for each building and space utilized as office space currently;
      (iii) Location of each building or leased space;
      (iv) Ratio and listing of buildings owned by the state versus leased;
      (v) Total occupancy costs which shall include capital expenses, provided a proxy should
be provided to compare properties that are owned versus leased by showing capital expenses on
owned properties as a per square foot cost at industry depreciation rates;
      (vi) Expiration dates of leases;
      (vii) Number of workstations per building or leased space;
      (viii) Total square feet divided by number of workstations;
      (ix) Total number of vacant workstations;
      (x) Percentage of vacant workstations versus total workstations available;
      (xi) Date when an action is required by the state to renew or terminate a lease;
      (xii) Strategic plan for leases commencing or expiring by June 30, 2016;
      (xiii) Map of all state buildings which provides: cost per square foot to maintain, total
number of square feet, total operating cost, date each lease expires, number of persons per
building and total number of vacant seats per building; and
      (xiv) Industry benchmark report which shall include total operating cost by full-time
equivalent employee, total operating cost by square foot and total square feet divided by full-time
equivalent employee.
      (28) To provide by December 31, 1995 the availability of automatic direct deposit to any
recipient of a state benefit payment, provided that the agency responsible for making that
payment generates one thousand (1,000) or more such payments each month.
      (29) To encourage municipalities, school districts, and quasi-public agencies to achieve
cost savings in health insurance, purchasing, or energy usage by participating in state contracts, or
by entering into collaborative agreements with other municipalities, districts, or agencies. To
assist in determining whether the benefit levels including employee cost sharing and unit costs of
such benefits and costs are excessive relative to other municipalities, districts, or quasi-public
agencies as compared with state benefit levels and costs.
     (30) To administer a health benefit exchange in accordance with chapter 157 of title 42.
     SECTION 2. Title 42 of the General Laws entitled "STATE AFFAIRS AND
GOVERNMENT" is hereby amended by adding thereto the following chapter:
CHAPTER 157
RHODE ISLAND HEALTH BENEFIT EXCHANGE
     42-157-1. Establishment of exchange. -- Purpose. - The department of administration is
hereby authorized to establish the Rhode Island health benefit exchange, to be known as
HealthSource RI, to exercise the powers and authority of a state-based exchange which shall meet
the minimum requirements of the federal act.
     42-157-2. Definitions. -- As used in this section, the following words and terms shall
have the following meanings, unless the context indicates another or different meaning or intent:
     (1) "Director" means the director of the department of administration.
     (2) "Federal act" means the Federal Patient Protection and Affordable Care Act (Public
Law 111-148), as amended by the Federal Health Care and Education Reconciliation Act of 2010
(Public Law 111-152), and any amendments to, or regulations or guidance issued under, those
acts.
     (3) "Health plan" and "qualified health plan" have the same meanings as those terms are
defined in § 1301 of the Federal Act.
     (4) "Insurer" means every medical service corporation, hospital service corporation,
accident and sickness insurer, dental service corporation, and health maintenance organization
licensed under title 27, or as defined in § 42-62-4.
     (5) "Secretary'' means the secretary of the Federal Department of Health and Human
Services.
     (6) "Qualified dental plan" means a dental plan as described in § 1311(d)(2)B)(ii) of the
Federal Act.
     (7) "Qualified individuals'' and "qualified employers" shall have the same meaning as
defined in federal law.
     42-157-3. General requirements. -- (a) The exchange shall make qualified health plans
available to qualified individuals and qualified employers. The exchange shall not make available
any health benefit plan that has not been certified by the exchange as a qualified health plan in
accordance with federal law.
     (b) The exchange shall allow an insurer to offer a plan that provides limited scope dental
benefits meeting the requirements of § 9832 (c)(2)(A) of the Internal Revenue Code of 1986
through the exchange, either separately or in conjunction with a qualified health plan, if the plan
provides pediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of the Federal Act.
     (c) Any health plan that delivers a benefit plan on the exchange that covers abortion
services, as defined in 45 CFR § 156.280(d)(1), shall comply with segregation of funding
requirements, as well as an annual assurance statement to the Office of the Health Insurance
Commissioner, in accordance with 45 C.F.R. §§ 156.680(e)(3) and (5).
     (d) At least one plan variation for individual market plan designs offered on the exchange
at each level of coverage, as defined by section 1302(d)(1) of the federal act, at which the carrier
is offering a plan or plans, shall exclude coverage for abortion services as defined in 45 CFR §
156.280(d)(1). If the health plan proposes different rates for such plan variations, each listed plan
design shall include the associated rate. Except for Religious Employers (as defined in Section
6033(a)(3)(A)(i) of the Internal Revenue Code), employers selecting a plan under this religious
exemption subsection may not designate it as the single plan for employees, but shall offer their
employees full-choice of small employer plans on the exchange, using the employer-selected plan
as the base plan for coverage. The employer is not responsible for payment that exceeds that
designated for the employer-selected plan.
     (e) Health plans that offer a plan variation that excludes coverage for abortion services as
defined in 45 CFR § 156.280(d)(l) for a religious exemption variation in the small group market
shall treat such a plan as a separate plan offering with a corresponding rate.
     (f) An employer who elects a religious exemption variation shall provide written notice to
prospective enrollees prior to enrollment that the plan excludes coverage for abortion services as
defined in 45 CFR § 156.280(d)(1). The carrier must include notice that the plan excludes
coverage for abortion services as part of the Summary of Benefits and Coverage required by 42
U.S.C. § 300gg-15.
     42-157-4. Financing. -- (a) The department is authorized to assess insurers offering
qualified health plans and qualified dental plans. The revenue raised in accordance with this
subsection shall not exceed the revenue able to be raised through the federal government
assessment and shall be established in accordance and conformity with the federal government
assessment upon those insurers offering products on the Federal Health Benefit exchange.
Revenues from the assessment shall be deposited in a restricted receipt account for the sole use of
the exchange and shall be exempt from the indirect cost recovery provisions of § 35-4-27 of the
general laws.
     (b) The general assembly may appropriate general revenue to support the annual budget
for the exchange in lieu of or to supplement revenues raised from the assessment under § 42-157-
4(a).
     (c) If the director determines that the level of resources obtained pursuant to § 42-157-
4(a) will be in excess of the budget for the exchange, the department shall provide a report to the
governor, the speaker of the house and the senate president identifying the surplus and detailing
how the assessment established pursuant to § 42-157-4(a) may be offset in a future year to
reconcile with impacted insurers and how any future supplemental or annual budget submission
to the general assembly may be revised accordingly.
     42-157-5. Regional purchasing, efficiencies, and innovation. -- To take advantage of
economies of scale and to lower costs, the exchange is hereby authorized to pursue opportunities
to jointly negotiate, procure or otherwise purchase exchange services with or partner with another
state or multiple states and to pursue a Federal Affordable Care Act 1332 Waiver.
     42-157-6. Audit. -- (a) Annually, the exchange shall cause to have a financial and/or
performance audit of its functions and operations performed in compliance with the generally
accepted governmental auditing standards and conducted by the state bureau of audits or a
certified public accounting firm qualified in performance audits.
     (b) If the audit is not directly performed by the state bureau of audits, the selection of the
auditor and the scope of the audit shall be subject to the approval of the state bureau of audits.
     (c) The results of the audit shall be made public upon completion, posted on the
department's website and otherwise made available for public inspection.
     42-157-7. Exchange advisory board. -- The exchange shall maintain an advisory board
which shall be appointed by the director. The director shall consider the expertise of the members
of the board and make appointments so that the board's composition reflects a range and diversity
of skills, backgrounds and stakeholder perspectives.
     42-157-8. Reporting. -- HealthSource RI shall provide a monthly report to the
chairpersons of the house finance committee and the senate finance committee by the fifteenth
day of each month beginning in July 2015. The report shall include, but not be limited to, the
following information: actual enrollment data by market and insurer, total new and renewed
customers, number of paid customers, actual average premium costs by market and insurer,
number of enrollees receiving financial assistance as defined in the Federal Act, as well as the
number of inbound calls and the number of walk-ins received. The data on inbound calls shall be
segregated by type of call.
     42-157-9. Relation to other laws. -- Nothing in this chapter, and no action taken by the
exchange pursuant to this chapter. shall be construed to preempt or supersede the authority of the
health insurance commissioner to regulate the business of insurance within this state, the director
of the department of health to oversee the licensure of health care providers, the certification of
health plans under chapter 17.13 of title 23, or the licensure of utilization review agents wider
chapter 17.13 of title 23, or the director of the department of human services to oversee the
provision of medical assistance under chapter 8 of title 40. In addition to the provisions of this
chapter, all insurers offering qualified health plans or qualified dental plans in this state shall
comply fully with all applicable health insurance laws and regulations of this state.
     42-157-10. Severability. -- The provisions of this chapter are severable, and if any
provision hereof shall be held invalid in any circumstances, any invalidity shall not affect any
other provisions or circumstances. This chapter shall be construed in all respects so as to meet
any constitutional requirements. In carrying out the purposes and provisions of this chapter, all
steps shall be taken which are necessary to meet constitutional requirements.
     SECTION 3. This article shall be effective as of January 1, 2015.