Insurance: health insurers; state-based insurance exchange; provide for. Creates new act. TIE BAR WITH: SB 0977'26

The conflict of interest definition no longer requires that a pecuniary benefit or detriment be 'direct.' Previously, only direct financial gains or losses to a board member (or their family/affiliated entity) triggered the conflict of interest rule. Now, indirect financial benefits or detrimets also count, making it easier to disqualify a board member from participating in a decision.

The conflict-of-interest definition for board members was narrowed by adding the word 'direct' before 'pecuniary benefit or detriment.' Previously, any pecuniary benefit or detriment (including indirect ones) could trigger a recusal requirement. Now only direct financial interests trigger it, making it easier for board members to participate in decisions where they have an indirect financial stake.

The definition of 'conflict of interest' in Section 103(b) was changed by removing the word 'direct' before 'pecuniary benefit or detriment.' Previously, only a direct financial gain or loss to a board member (or their family/affiliated entity) constituted a conflict. Now, any pecuniary benefit or detriment - whether direct or indirect - triggers the conflict of interest rules, making it easier to disqualify board members from participating in certain decisions.

The conflict-of-interest definition for board members was narrowed from any 'pecuniary benefit or detriment' to only a 'direct pecuniary benefit or detriment,' making it harder to find a conflict of interest.

A provision limiting carriers to no more than 4 nonstandardized plan options per network type, metal level, and dental/vision inclusion was entirely removed, giving carriers more flexibility in how many plan variations they can offer on the exchange.

A new requirement was added obligating the exchange to provide daily electronic enrollment and disenrollment data to carriers.

The navigator funding requirement was changed from a general obligation to 'award grants' to a specific minimum of $5,000,000 in grants, with the funding source explicitly tied to assessments and user fees under section 217.

The department of insurance and financial services' authority to spend from the exchange fund was changed from 'either of the following' (choose one) to 'all of the following' (must do all), and a new permitted use was added: operating and funding a reinsurance program under section 3406nn of the insurance code.

The direct enrollment implementation deadline was tightened from 'by the first open enrollment period' to 'before the first open enrollment period,' requiring it to be fully operational prior to rather than during the first enrollment window.