Replaces everything after the enacting clause. Creates the Health Insurance Coverage Premium Misalignment Study Act. Sets forth provisions concerning the purpose of the Act and findings. Provides that the Department of Insurance shall oversee a study to explore rate setting approaches that may yield a misalignment of premiums across different tiers of coverage in Illinois’ individual health insurance market. Provides that the study shall produce cost estimates for Illinois residents addressing metal-level premium misalignment policy along with the impact of the policy on health insurance affordability and access and the uninsured rates for low-income and middle-income residents, with break-out data by geography, race, ethnicity, and income level. Provides that the study shall evaluate how premium realignment if implemented would affect costs and outcomes for Illinoisans. Provides that the Department shall develop and submit, no later than January 1, 2024, a report to the General Assembly and the Governor concerning the design, costs, benefits, and implementation of premium realignment to increase affordability and access to health care coverage that leverages existing State infrastructure. Amends the Illinois Insurance Code and the Health Maintenance Organization Act. Provides that all individual and small group accident and health policies written in compliance with the Patient Protection and Affordable Care Act must file rates with the Department for approval. Provides that rate increases found to be unreasonable rate increases in relation to benefits under the policy provided shall be disapproved. Requires the Department to provide a report to the General Assembly after January 1, 2023 regarding both on and off exchange individual and small group rates in the Illinois market. Requires that the Department approve or deny rate increases within 60 calendar days after the rate increase is filed with the Department and that a rate increase that is not approved or denied by the Department on the 61st calendar day shall be automatically approved. Provides that no less than 30 days after the federal Centers for Medicare and Medicaid Services has certified the plans described for the upcoming plan year, the Department shall publish on its website a report explaining the rates for the subsequent calendar year’s certified policies.