Access to Professional Health Insurance Advisors Act of 2015

Access to Professional Health Insurance Advisors Act of 2015

Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative costs for purposes of calculating the medical-loss ratio of a health insurance plan.

Defines "independent insurance producer" to mean an insurance agent or broker, insurance consultant, benefit specialist, limited insurance representative, and any other person required to be licensed under state law to sell, solicit, negotiate, service, effect, procure, renew, or bind policies of insurance coverage or offer advice, counsel, opinions, or services related to insurance.

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 815 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 815

   To amend title XXVII of the Public Health Service Act to preserve 
    consumer and employer access to licensed independent insurance 
                               producers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 9, 2015

   Mr. Long (for himself, Mr. Schrader, Mr. Burgess, Mrs. Brooks of 
Indiana, Mr. Mullin, Mr. Byrne, Mr. Murphy of Pennsylvania, Mr. Olson, 
Mr. Griffith, Mr. DeFazio, Mr. David Scott of Georgia, Mr. Peters, Mr. 
  Stivers, Mr. Westmoreland, Mr. Johnson of Ohio, and Mrs. Blackburn) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend title XXVII of the Public Health Service Act to preserve 
    consumer and employer access to licensed independent insurance 
                               producers.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Access to Professional Health 
Insurance Advisors Act of 2015''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Licensed independent insurance producers (agents and 
        brokers) provide a wide range of services for both individual 
        consumers and the business community. Producers interface with 
        insurers, acquire quotes, analyze plan options, and consult 
        clients through the purchase of health insurance.
            (2) Licensed independent insurance producers provide 
        guidance regarding benefit and contribution arrangements to 
        ensure compliance with applicable State and Federal laws and 
        regulations; assist with establishing section 125 plan tax 
        savings under the Internal Revenue Code, health reimbursement 
        arrangements, flexible spending arrangements, and other 
        programs to maximize tax advantages and ensure compliance with 
        applicable Internal Revenue Service guidelines; create 
        educational materials and provide on-site assistance to aid in 
        employee benefit communication; assist in managing eligibility 
        for new hires and terminated employees; provide advocacy for 
        employees through the health insurance claim process; and 
        advocate for employers with insurers in developing proposals, 
        renewals, and for service issues throughout the year.
            (3) In order to meet these responsibilities, licensed 
        independent insurance producers are required to complete 
        continuing education on an ongoing basis in order to maintain 
        appropriate licenses. This requirement to maintain educational 
        standards helps assure the insured public that producers remain 
        current with the ever-evolving insurance market.
            (4) It is essential that licensed independent insurance 
        producers continue to perform these duties, and others, as the 
        Patient Protection and Affordable Care Act has made significant 
        changes to the regulatory environment for health plans. To 
        understand these changes, employers and consumers will need 
        professional guidance even more in the future. This service is 
        especially important for small businesses, as such producers 
        often fill the role of a human resources department as well as 
        professional consultant.
            (5) The National Association of Insurance Commissioners--
        whose core mission is to protect consumers in all aspects of 
        the business of insurance--strongly advocates for the 
        continuing role of licensed independent insurance producers in 
        health insurance, and has expressed that the ability of 
        insurance agents and brokers to continue assisting health 
        insurance consumers at a time of rapid insurance market changes 
        is more essential than ever.
            (6) It is critical that the indispensable role played by 
        licensed independent insurance producers is recognized and 
        protected.

SEC. 3. PROTECTING THE ABILITY OF LICENSED INDEPENDENT INSURANCE 
              PRODUCERS TO CONTINUE TO SERVE THE PUBLIC.

    (a) In General.--Section 2718 of the Public Health Service Act (42 
U.S.C. 300gg et seq.), as inserted by section 1001 and amended by 
section 10101(f) of the Patient Protection and Affordable Care Act, is 
amended--
            (1) in subsection (a)(3), by inserting ``, remuneration 
        paid for licensed independent insurance producers,'' after 
        ``State taxes'';
            (2) in subsection (b)(1)(A)--
                    (A) in the matter preceding clause (i), by 
                inserting ``, remuneration paid for licensed 
                independent insurance producers,'' after ``State 
                taxes''; and
                    (B) in clause (ii), by inserting ``or small group 
                market'' before ``in such State'';
            (3) in subsection (b)(1)(B), by inserting ``, remuneration 
        paid for licensed independent insurance producers,'' after 
        ``State taxes'';
            (4) in subsection (d), by inserting ``or small group 
        market'' after ``individual market''; and
            (5) by adding at the end the following new subsection:
    ``(f) Independent Insurance Producer Remuneration Definitions.--For 
purposes of this section:
            ``(1) The term `independent insurance producer' means an 
        insurance agent or broker, insurance consultant, benefit 
        specialist, limited insurance representative, and any other 
        person required to be licensed under the laws of the particular 
        State to sell, solicit, negotiate, service, effect, procure, 
        renew or bind policies of insurance coverage or offer advice, 
        counsel, opinions, or services related to insurance.
            ``(2) The term `remuneration' means compensation earned 
        from an insurance issuer for services rendered under 
        contractual agreement which may include commissions or any 
        other thing of value but which shall not include production 
        bonuses.''.
    (b) Regulations.--Not later than 60 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
coordination with the National Association of Insurance Commissioners, 
shall amend any applicable regulations so as to take the amendments 
made by subsection (a) into account.
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