SB359,25,22 16(3) Neither the authority nor a health carrier offering health benefit plans
17through the exchange under sub. (1) may charge an individual a fee or penalty for
18termination of coverage if the individual enrolls in another type of minimum
19essential coverage because the individual has become newly eligible for that
20coverage or because the individual's employer-sponsored coverage has become
21affordable under the standards of section 36B (c) (2) (C) of the Internal Revenue
22Code.
SB359,26,2 23(4) The authority may enter into information-sharing agreements with federal
24and state agencies and entities operating exchanges in other states to carry out its
25responsibilities under this chapter, provided that such agreements include adequate

1protections with respect to the confidentiality of the information to be shared and
2comply with all state and federal laws and rules and regulations.
SB359,26,5 3636.30 Exchange duties and powers. (1) In addition to all other duties
4imposed under this chapter, the authority shall do all of the following relating to the
5exchange under s. 636.25 (1):
SB359,26,96 (a) Implement procedures for the certification, recertification, and
7decertification, consistent with guidelines developed by the secretary under section
81311 (c) of the federal act and s. 636.42, of health benefit plans as qualified health
9plans.
SB359,26,1110 (b) Provide for the operation of a toll-free telephone hotline to respond to
11requests for assistance.
SB359,26,1312 (c) Provide for enrollment periods, as provided under section 1311 (c) (6) of the
13federal act.
SB359,26,1614 (d) Maintain an Internet site through which enrollees and prospective
15enrollees of qualified health plans may obtain standardized comparative
16information on such plans.
SB359,26,2117 (e) Assign a rating to each qualified health plan offered through the exchange
18in accordance with the criteria developed by the secretary under section 1311 (c) (3)
19of the federal act, and determine each qualified health plan's level of coverage in
20accordance with regulations issued by the secretary under section 1302 (d) (2) (A) of
21the federal act.
SB359,26,2422 (f) Use a standardized format for presenting health benefit options in the
23exchange, including the use of the uniform outline of coverage established under 42
24USC 300gg-15
.
SB359,27,2
1(g) Establish quality improvement standards for health benefit plans offered
2through the exchange.
SB359,27,43 (h) Establish a system for enrolling eligible groups and individuals, using a
4standard application form developed by the commissioner under s. 636.46 (2).
SB359,27,65 (i) Establish procedures for collecting premiums and remitting premium
6payments and providing enrollment information to health carriers.
SB359,27,97 (j) Establish, in consultation with the commissioner, the method for
8determining the amount of the surcharge under s. 636.45 (1) and establish the
9procedure for imposing and collecting the surcharge.
SB359,27,1110 (k) Establish a plan for publicizing the exchange and the eligibility
11requirements and enrollment procedures.
SB359,27,1312 (L) Establish and operate a service center to provide information to small
13employers, individuals, enrollees, and insurance intermediaries about the exchange.
SB359,27,1514 (m) Establish a mechanism for regular communication and cooperation with
15insurance intermediaries.
SB359,27,1716 (n) Establish an independent and binding appeals process for resolving
17disputes over eligibility and other determinations made by the authority.
SB359,27,2218 (o) In accordance with section 1413 of the federal act, inform individuals of
19eligibility requirements for Medical Assistance under subch. IV of ch. 49 or any other
20applicable state or local public program and if, through screening of the application
21by the authority, the authority determines that any individual is eligible for any such
22program, assist that individual to enroll in that program.
SB359,28,223 (p) Establish and make available by electronic means a calculator to determine
24the actual cost of coverage after application of any premium tax credit under section

136B of the Internal Revenue Code and any cost-sharing reduction under section
21402 of the federal act.
SB359,28,63 (q) Establish a SHOP Exchange through which qualified employers may access
4health care coverage for their employees and that shall enable any qualified
5employer to specify the level of coverage at which its employees may enroll in any
6qualified health plan offered through the SHOP Exchange.
SB359,28,97 (r) Perform duties required of the authority by the secretary or the federal
8secretary of the treasury related to determining eligibility for premium tax credits,
9reduced cost sharing, or individual responsibility requirement exemptions.
SB359,28,1310 (s) Select entities, which may include insurance intermediaries, that are
11qualified to serve as navigators in accordance with section 1311 (i) of the federal act
12and standards developed by the secretary, and award grants to enable navigators to
13do all of the following:
SB359,28,1514 1. Conduct public education activities to raise awareness of the availability of
15qualified health plans.
SB359,28,1916 2. Distribute fair and impartial information concerning enrollment in qualified
17health plans and concerning the availability of premium tax credits under section
1836B of the Internal Revenue Code and cost-sharing reductions under section 1402
19of the federal act.
SB359,28,2020 3. Facilitate enrollment in qualified health plans.
SB359,28,2521 4. Provide referrals to any applicable office of health insurance consumer
22assistance or health insurance ombudsman established under 42 USC 300gg-93, or
23to any other appropriate state agency or agencies, for any enrollee with a grievance,
24complaint, or question regarding the enrollee's health benefit plan, coverage, or
25determination under that plan or coverage.
SB359,29,2
15. Provide information in a manner that is culturally and linguistically
2appropriate to the needs of the population being served by the exchange.
SB359,29,53 (t) Assist in the coordination of any necessary administrative operations
4between the department of corrections and the department of health services to
5ensure all of the following:
SB359,29,86 1. That an individual, upon placement in a correctional facility, is disenrolled
7for the duration of his or her incarceration from any health care coverage in which
8he or she is enrolled.