Health care reform
State and federal regulators have begun developing a framework for licensing Health Insurance Exchange “navigators.” Starting shortly before the exchanges go live in 2014, navigators will be responsible for helping to educate or enroll individuals or small businesses in exchange plans. A navigator is intended to serve as a neutral advisor who will help consumers, including people who have never used any kind of public or private health insurance, determine how to use the new exchange system and make decisions about their coverage.
The Producer Licensing Task Force, a part of the National Association of Insurance Commissioners, is seeking public comments on a "discussion framework," or an outline of ideas about navigator oversight. The task force draft lays out recommendations for application information requirements, training and continuing education, and mechanisms for addressing consumer complaints.1 Federal guidance on navigators is tentatively set to be released in January 2013.
Under the health care law, a navigator’s purpose is to:
Federal guidance from August 2012 calls for oversight to make sure navigators are properly trained to:2
Each Health Insurance Exchange is required to institute a program that will award grants to help establish navigator resources. The money for these grants will come from the exchange’s operational funds, not from the federal funds that states can receive to establish their exchanges. The NAIC task force suggests that states can wait to find out which navigator regulations HHS will implement — or they can proceed, basing their navigator standards on those already applied to agents and brokers who sell Medicare supplement plans and other health insurance plans to seniors. Navigators need to be ready to help consumers use exchanges by October 1, 2013.