GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 418
Short Title: NC Health Benefits Exchange Implementation. (Public)
Sponsors: Senator Burgin (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 25, 2025
*S418 -v-1*
A BILL TO BE ENTITLED 1
AN ACT AUTHORIZING THE COMMISSIONER OF INSURANCE TO ESTABLISH AND 2
OPERATE A STATE-RUN HEALTH BENEFITS EXCHANGE. 3
The General Assembly of North Carolina enacts: 4
SECTION 1.(a) G.S. 58-2-40(2) is recodified as G.S. 58-2-40(b). 5
SECTION 1.(b) G.S. 58-2-40, as amended by subsection (a) of this section, reads as 6
rewritten: 7
"§ 58-2-40. Powers and duties of Commissioner. 8
(a) The Commissioner shall:has the duty to do all of the following: 9
(1) See that all laws of this State that the Commissioner is responsible for 10
administering and the provisions of this Chapter are faithfully executed; and 11
to executed. To that end end, the Commissioner is authorized to adopt rules 12
rules, in accordance with Chapter 150B of the General Statutes, in order to 13
enforce, carry out and make effective the provisions of those laws. The 14
Commissioner is also authorized to adopt such further rules not contrary to 15
those laws that will prevent persons subject to the Commissioner's regulatory 16
authority from engaging in practices injurious to the public. 17
… 18
(b) Have The Commissioner shall have the power and authority to adopt rules pertaining 19
to and governing the solicitation of proxies, including related financial reporting in connection 20
therewith, reporting requirements, with respect to the capital stock or other equity securities of 21
any domestic stock insurance company. 22
(c) The Commissioner shall establish a State-run Health Benefits Exchange, as provided 23
for under the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended, or 24
other applicable federal law and regulations. The Commissioner has the authority to do all of the 25
following: 26
(1) Change any established program, adopt or amend any rule, or establish or 27
change any policy, guideline, or plan as necessary to implement, establish, 28
create, administer, or otherwise operate the Exchange. 29
(2) Apply for and accept federal moneys related to the creation, implementation, 30
or operation of the Exchange. 31
(3) Create any advisory board or committee for providing recommendations on 32
the creation, implementation, or operation of the exchange." 33
SECTION 2. G.S. 143B-24 reads as rewritten: 34
"§ 143B-24. Cooperative agreements; prohibition regarding Health Benefit 35
Exchanges.agreements. 36 General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 418-First Edition
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(b) The General Assembly reserves the authority to define the State's level of interaction, 2
if any, with the federally facilitated Health Benefit Exchange that will operate in the State. No 3
department, agency, or institution of this State shall enter into any contracts or commit any 4
resources for the provision of any services related to the federally facilitated Health Benefit 5
Exchange under a "Partnership" Exchange model, except as authorized by the General Assembly. 6
No department, agency, or institution of this State shall take any actions not authorized by the 7
General Assembly toward the formation of a State-run Health Benefit Exchange. It is not the 8
intent of this section to prohibit State-federal interaction that does not pursue a State-run 9
Exchange or "Partnership" Exchange model." 10
SECTION 3. Effective July 1, 2025, there is appropriated from the General Fund to 11
the Department of Insurance the sum of one hundred thousand dollars ($100,000) in recurring 12
funds for the 2025-2026 fiscal year to be used to establish and operate a State-run Health Benefits 13
Exchange, as authorized under G.S. 58-2-40(c). 14
SECTION 4. Except as otherwise provided, this act is effective when it becomes 15
law. 16