2019 Pennsylvania Consolidated Statutes
Title 40 - INSURANCE
Chapter 93 - State-based Exchange
Section 9302 - Pennsylvania Health Insurance Exchange Authority
(a) Establishment.--The Pennsylvania Health Insurance Exchange Authority is established as a State-affiliated entity. The powers and duties of the exchange authority shall be vested in and exercised by a board, which shall have the sole power under section 9305 (relating to powers and duties of exchange authority) to employ staff, including an executive director. Individuals employed by the exchange authority shall be employees of the Commonwealth. The exchange authority may contract with persons or entities, including legal counsel, consultants or service providers, as deemed necessary in the exchange authority's discretion.
(b) Purpose.--The purpose of the exchange authority shall be to create, manage and maintain in this Commonwealth the Pennsylvania Health Insurance Exchange to do all of the following:
(1) Benefit the Pennsylvania health insurance market and persons enrolling in health insurance policies.
(2) Facilitate or assist in facilitating the purchase of on-exchange qualified plans by qualified enrollees in the individual market or the individual and small group markets.
(c) Composition.--The board shall consist of the following members:
(1) Three voting members who shall be the following heads of agencies or a designee who shall be an employee of the agency designated in writing by the head of the agency prior to service:
(i) The commissioner, ex-officio.
(ii) The Secretary of Human Services, ex-officio.
(iii) The Secretary of Health, ex-officio.
(2) Four voting members appointed by the Governor:
(i) One member from among the insurers that offer health insurance policies through the exchange that are a hospital plan corporation, a professional health services plan corporation or a parent, affiliate, subsidiary or other associated entity or successor of a hospital plan corporation or a professional health services plan.
(ii) One member from among the insurers that offer health insurance policies through the exchange that are not a hospital plan corporation, a professional health services plan corporation or a parent, affiliate, subsidiary or other associated entity or successor of a hospital plan corporation or a professional health services plan.
(iii) One member with experience in health care public education and consumer assistance activities who does not have a conflict of interest as described in subsection (k).
(iv) One member who is a consumer representative.
(3) Four voting members appointed by the General Assembly as follows:
(i) One individual appointed by the President pro tempore of the Senate.
(ii) One individual appointed by the Minority Leader of the Senate.
(iii) One individual appointed by the Speaker of the House of Representatives.
(iv) One individual appointed by the Minority Leader of the House of Representatives.
(4) The executive director shall attend meetings of the board but shall not be a member, may not vote and may not be counted for purposes of establishing a quorum.
(d) Chairperson.--The commissioner or a designee shall serve as chairperson.
(e) Compensation.--Board members shall not be entitled to any compensation for their services as members, except that, subject to the availability of funds, board members shall be entitled to reimbursement for actual and necessary travel expenses. The expenses shall be paid for by the exchange fund.
(f) Terms.--The terms of the board members shall be as follows:
(1) A board member appointed under subsection (c)(3) who:
(i) Is a member of the General Assembly shall serve a term concurrent with their holding of public office.
(ii) Is not a member of the General Assembly shall serve a term concurrent with their appointing official's holding of public office.
(2) A board member appointed under subsection (c)(2) shall serve a term of four years, not to exceed more than two full consecutive four-year terms, except that the following shall apply:
(i) Initial appointments shall be so staggered that less than 50% of the membership shall expire each year.
(ii) A member's term shall continue until the member's replacement is appointed.
(g) Vacancies.--Vacancies in appointed positions shall be filled in the same manner as the original appointment. Members shall serve until their successors are appointed and qualified.
(h) Formation.--The exchange authority shall be formed within 60 days of the effective date of this section. Prior to formation of the exchange authority, the commissioner may take action necessary to effect a timely transition from a federally administered exchange to the Pennsylvania Health Insurance Exchange.
(i) Quorum.--A majority of the appointed members of the board shall constitute a quorum. Action may be taken by the board at a meeting upon a vote of a quorum of its members present in person or through electronic means. If a tie vote occurs at any meeting, it shall be the duty of the chairperson of the board to cast a second and deciding vote.
(j) Meetings.--The board shall meet at the call of the chairperson or as may be provided in the bylaws of the board. The board shall hold meetings at least quarterly, which shall be subject to the requirements of 65 Pa.C.S. Ch. 7 (relating to open meetings).
(k) Experience and interests.--For purposes of this chapter, the board shall assure that it complies with section 1321 of the Affordable Care Act (Public Law 111-148, 42 U.S.C. § 18041) and regulations promulgated under the Affordable Care Act regarding conflicts of interest and relevant experience.
(l) Conflict of interest.--The following apply:
(1) Except as provided under paragraph (2), a non-State employee board member shall not be subject to 65 Pa.C.S. Ch. 11 (relating to ethics standards and financial disclosure), including the requirements for filing statements of financial interests.
(2) A non-State employee board member may not engage in conduct that, if that member were a State employee, would constitute a conflict of interest under 65 Pa.C.S. Ch. 11.
(3) A majority of the voting members of the board may not have a conflict of interest as set forth in section 1321 of the Affordable Care Act and regulations promulgated under the Affordable Care Act.
Cross References. Section 9302 is referred to in section 9103 of this title.
