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Sub. H. B. No. 613 As Passed by the HouseAs Passed by the House
|129th General Assembly|
Representatives Hackett, Blessing, Bubp, Buchy, Combs, Henne, Hill, Huffman, Maag, Terhar, Wachtmann Speaker Batchelder
To amend section 3905.01 and to enact sections
3905.47, 3905.471, 3905.472, and 3905.473 of the
Revised Code to specify licensing and continuing
education requirements for insurance agents
involved in selling, soliciting, or negotiating
sickness and accident insurance through a health
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 3905.01 be amended and sections
3905.47, 3905.471, 3905.472, and 3905.473 of the Revised Code be
enacted to read as follows:
Sec. 3905.01. As used in this chapter:
(A) "Affordable Care Act" means the "Patient Protection and
Affordable Care Act," 124 Stat. 119, 42 U.S.C. 18031 (2011).
(B) "Business entity" means a corporation, association,
partnership, limited liability company, limited liability
partnership, or other legal entity.
(B)(C) "Home state" means the state or territory of the
United States, including the District of Columbia, in which an
insurance agent maintains the insurance agent's principal place of
residence or principal place of business and is licensed to act as
an insurance agent.
(C)(D) "Insurance" means any of the lines of authority set
forth in Chapter 1739., 1751., or 1761. or Title XXXIX of the
Revised Code, or as additionally determined by the superintendent
(D)(E) "Insurance agent" or "agent" means any person that, in
order to sell, solicit, or negotiate insurance, is required to be
licensed under the laws of this state, including limited lines
insurance agents and surplus line brokers.
(E)(F) "Insurer" has the same meaning as in section 3901.32
of the Revised Code.
(F)(G) "License" means the authority issued by the
superintendent to a person to act as an insurance agent for the
lines of authority specified, but that does not create any actual,
apparent, or inherent authority in the person to represent or
commit an insurer.
(G)(H) "Limited line credit insurance" means credit life,
credit disability, credit property, credit unemployment,
involuntary unemployment, mortgage life, mortgage guaranty,
mortgage disability, guaranteed automobile protection insurance,
or any other form of insurance offered in connection with an
extension of credit that is limited to partially or wholly
extinguishing that credit obligation and that is designated by the
superintendent as limited line credit insurance.
(H)(I) "Limited line credit insurance agent" means a person
that sells, solicits, or negotiates one or more forms of limited
line credit insurance to individuals through a master, corporate,
group, or individual policy.
(I)(J) "Limited lines insurance" means those lines of
authority set forth in divisions (B)(7) to (11) of section 3905.06
of the Revised Code or in rules adopted by the superintendent, or
any lines of authority the superintendent considers necessary to
recognize for purposes of complying with section 3905.072 of the
(J)(K) "Limited lines insurance agent" means a person
authorized by the superintendent to sell, solicit, or negotiate
limited lines insurance.
(K)(L) "NAIC" means the national association of insurance
(L)(M) "Navigator" means a person selected to perform the
activities and duties identified in division (i) of section 1311
of the Affordable Care Act that is certified by the superintendent
of insurance under section 3905.471 of the Revised Code.
(N) "Negotiate" means to confer directly with, or offer
advice directly to, a purchaser or prospective purchaser of a
particular contract of insurance with respect to the substantive
benefits, terms, or conditions of the contract, provided the
person that is conferring or offering advice either sells
insurance or obtains insurance from insurers for purchasers.
(M)(O) "Person" means an individual or a business entity.
(N)(P) "Sell" means to exchange a contract of insurance by
any means, for money or its equivalent, on behalf of an insurer.
(O)(Q) "Solicit" means to attempt to sell insurance, or to
ask or urge a person to apply for a particular kind of insurance
from a particular insurer.
(P)(R) "Superintendent" or "superintendent of insurance"
means the superintendent of insurance of this state.
(Q)(S) "Terminate" means to cancel the relationship between
an insurance agent and the insurer or to terminate an insurance
agent's authority to transact insurance.
(R)(T) "Uniform application" means the NAIC uniform
application for resident and nonresident agent licensing, as
amended by the NAIC from time to time.
(S)(U) "Uniform business entity application" means the NAIC
uniform business entity application for resident and nonresident
business entities, as amended by the NAIC from time to time.
(V) "Exchange" means a health benefit exchange established by
the state government of Ohio or an exchange established by the
United States department of health and human services in
accordance with the "Patient Protection and Affordable Care Act,"
124 Stat. 119, 42 U.S.C. 18031 (2011).
Sec. 3905.47. (A)(1) No agent shall sell, solicit, or
negotiate insurance through an exchange on or after January 1,
2014, without first completing training approved by the
superintendent of insurance in accordance with division (B) of
(2) Any agent that sells, solicits, or negotiates insurance
through an exchange shall complete continuing education, as
required by the superintendent in accordance with division (B) of
this section, as applicable.
(B) The superintendent shall approve courses to be used for
compliance with division (A) of this section. Division (B) of this
section may be satisfied by those continuing education courses
approved by the superintendent under sections 3905.481 to 3905.486
of the Revised Code. Any course the superintendent approves shall
consist of topics related to insurance offered within an exchange,
including all of the following:
(1) The levels of coverage provided in an exchange;
(2) The eligibility requirements for individuals to purchase
insurance through an exchange;
(3) The eligibility requirements for employers to make
insurance available to their employees through a small business
health options program;
(4) Individual eligibility requirements for medicaid;
(5) The use of enrollment forms used in an exchange;
(6) Any other topics as required by the superintendent.
(C) The superintendent shall certify an agent who
successfully completes the courses approved by the superintendent.
(D) An individual who receives a resident insurance agent
license under section 3905.06 of the Revised Code and that is
certified under this section shall submit to the exchange the
individual's name, business address, telephone number, electronic
mail address, and any other information required by the exchange.
Sec. 3905.471. (A) A navigator may do any of the following:
(1) Conduct public education activities to raise awareness of
the availability of qualified health plans;
(2) Distribute fair and impartial general information
concerning enrollment in all qualified health plans offered within
the exchange and the availability of the premium tax credits under
section 36B of the Internal Revenue Code of 1986, 26 U.S.C. 36B,
and cost-sharing reductions under section 1402 of the Affordable
(3) Facilitate enrollment in qualified health plans, without
suggesting that an individual select a particular plan.
(B) A navigator shall not do any of the following, unless
that navigator is otherwise licensed to do so under this chapter:
(1) Sell, solicit, or negotiate health insurance;
(2) Enroll an individual or employee in a qualified health
plan offered through an exchange;
(3) Assist or provide information to an individual or entity
seeking to purchase health insurance through the small business
health options program portion of an exchange.
(C) An individual, or an individual performing navigator
duties on behalf of an organization serving as a navigator, shall
not act in the capacity of a navigator unless the individual has
met all of the following requirements, as applicable:
(1) Is at least eighteen years of age;
(2) Has completed and submitted the disclosure form required
under division (D)(2) of this section and has declared, under
penalty of refusal, suspension, or revocation of the navigator's
certification, that the statements made in the form are true,
correct, and complete to the best of the applicant's knowledge and
(3) Has completed a criminal records check under section
3905.051 of the Revised Code, as required by the superintendent;
(4) Has successfully completed the certification and training
requirements adopted by the superintendent in accordance with
division (D) of this section;
(5) Has paid all fees required by the superintendent.
(D) The superintendent of insurance shall, prior to any
exchange becoming operational in this state, do all of the
(1)(a) Adopt rules to establish a certification and training
program for a prospective navigator and the navigator's employees
that includes screening via a criminal records check performed in
accordance with section 3905.051 of the Revised Code, initial and
continuing education requirements, and an examination;
(b) The certification and training program shall include
training on compliance with the "Health Insurance Portability and
Accountability Act of 1996," 110 Stat. 1955, 42 U.S.C. 1320d, et
seq., as amended, training on ethics, and training on provisions
of the Affordable Care Act relating to navigators and exchanges.
(2) Develop a disclosure form by which a navigator may
disclose any potential conflicts of interest, as well as any other
information the superintendent considers pertinent.
(E)(1) The superintendent may suspend, revoke, or refuse to
issue or renew the navigator certification of any person that has
committed any act that would be a ground for denial, suspension,
or revocation of an insurance agent license, as prescribed in
section 3905.14 of the Revised Code.
(2) The superintendent shall not certify as a navigator, and
shall revoke any existing navigator certification of, any
individual, organization, or business entity that is receiving
financial compensation, including monetary and in-kind
compensation, gifts, or grants, on or after October 1, 2013, from
an insurer offering a qualified health benefit plan through an
exchange operating in this state.
(F) Navigators are subject to the laws of this chapter, and
any rules adopted pursuant to the chapter, in so far as such laws
(G) The superintendent may deny, suspend, approve, renew, or
revoke the certification of a navigator if the superintendent
determines that doing so would be in the interest of Ohio insureds
or the general public. Such an action is not subject to Chapter
119. of the Revised Code.
(H) The superintendent may adopt rules in accordance with
Chapter 119. of the Revised Code to implement sections 3905.47 to
3905.473 of the Revised Code.
(I) Any fees collected under this section shall be paid into
the state treasury to the credit of the department of insurance
operating fund created under section 3901.021 of the Revised Code.
Sec. 3905.472. An exchange shall permit an insurer to offer
any health benefit plan that the insurer seeks to offer through
the exchange, so long as the health benefit plan in question is a
qualified health plan under the Affordable Care Act, as approved
by the superintendent of insurance.
Sec. 3905.473. (A) An exchange operating in this state shall
maintain a current list of both of the following:
(1) Licensed insurance agents that have met all of the
requirements necessary to sell insurance through an exchange;
(2) Individuals or entities that are not licensed insurance
agents that have met all the requirements to be certified by the
superintendent as a navigator.
(B) An exchange shall make available to an individual upon
request a list of insurance agents operating near the individual's
residence address that are certified to sell a health benefit plan
through an exchange and navigators that are certified under
section 3905.471 of the Revised Code. An exchange operating in
this state shall maintain a means of communication by which an
individual may make such a request.
(C) Any web site, software application, or other electronic
medium, or an exchange-sanctioned outreach event that enables a
consumer to determine eligibility for and to purchase a qualified
health plan through an exchange shall include information on how
an individual can obtain from an exchange the contact information
of insurance agents operating near the individual's residence
address that are certified to sell health benefit plans through an
exchange and navigators that are certified under section 3905.471
of the Revised Code.
Section 2. That existing section 3905.01 of the Revised Code
is hereby repealed.