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art.018/4/018/3/018/2/017/4/017/3/017/2

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     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.