Makes organizational changes to GS 58-2-40, which lists the duties of the Commissioner of Insurance (Commissioner), including recodifying subdivision (2) as new subsection (b). Enacts a new subsection (c) to require the Commissioner to establish a State-run Health Benefits Exchange (Exchange) pursuant to the federal Patient Protection and Affordable Care Act, PL 111-148 as amended, or other applicable federal laws and regulations. Grants the Commissioner authorities related to the creation, implementation, and operation of the Exchange, including making program, rule or policy changes; applying for and accepting federal moneys; and creating advisory boards or committees. 

Amends GS 143B-24, eliminating provisions which condition State interaction with the federally-facilitated Health Benefit Exchange upon legislative authorization.

Appropriates $100,000 in recurring funds from the General Fund to the Department of Insurance for 2024-25 to establish and operate a State-run Health Benefits Exchange pursuant to GS 58-2-40, as amended. Effective July 1, 2024.