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Obamacare Navigators Continued from page 1 The rules allow navigators to come from the ranks of unions, health providers and community action groups such as ACORN and Planned Parenthood. They are required to provide unbiased advice. Navigators are only required to complete 30 hour online Federal training and certification unless your state Insurance Commissioner was successful in passing legislation that requires Navigators to undergo statespecific licensure and criminal background checks. Georgia’s Insurance Commissioner Ralph Hudgens was successful. Louisiana Insurance Commissioner Jim Donelon was not. Navigators are not required to have an Insurance Agency License nor carry E&O Insurance. Should they be required to be licensed? Not according to the NAIC. The National Association of Insurance Commissioners’ “Producer Licensing Model Act” requires people to be licensed if they “sell, solicit, or negotiate” insurance. [i] “Negotiate” is defined as offering advice about a particular contract of insurance by someone who “sells insurance or obtains insurance from insurers for purchasers.” People who provide general information about insurance but are not paid commissions are not required to be licensed, under the NAIC model.
The Marketplace will also tell you if you qualify for free or low-cost coverage available through Medicaid or the Children's Health Insurance Program (CHIP). The Health Insurance Marketplace is sometimes known as the health insurance "exchange." You can apply for Marketplace coverage three ways: online, by mail, or in-person with the help of a Navigator or other qualified helper. Telephone help and online chat will be available 24/7 to help you complete your application. Open enrollment starts October 1, 2013. Plans and prices will be available then. Coverage starts as soon as January 1, 2014. In-Person Assistance in the Health Insurance Marketplace Starting October 1, 2013, consumers in all states will be able to choose new affordable health insurance options through a new Health Insurance Marketplace. Some states are setting up a State-based Marketplace, other states will work with the federal government in a State Partnership Marketplace and the remaining states will have a Federally-facilitated Marketplace. No matter what state they live in, consumers can get help as they apply for and choose new insurance options. You can help provide that assistance in a number of different ways: by becoming Navigators, inperson assistance personnel, or certified application counselors. In addition, agents and brokers can also help consumers enroll in new insurance options. NAVIGATORS
What is the Health Insurance Marketplace? The Marketplace is a new way to find health coverage that fits your budget and meets your needs. With one application, you can see all your options and enroll. What you'll learn when you apply in the Health Insurance Marketplace When you use the Health Insurance Marketplace, you'll fill out an application and see all of the health plans available in your area. You'll find out if you can get lower costs on your monthly premiums for private insurance plans. You'll learn if you qualify for lower out-of-pocket costs. FYI EXPRESS Page 2
Navigators have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They will also provide outreach and education to raise awareness about the Marketplace, and will refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators will play a role in all types of Marketplaces, be funded through state and federal grant programs, and must complete comprehensive training. CERTIFIED APPLICATION COUNSELORS The Federally-facilitated Marketplace will designate organizations to certify application counselors who perform many of the same functions as Navigators and non-Navigator assistance personnel—including educating consumers and helping them complete an application for coverage. Continued on page 4
August, 2013