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Navigator program to provide instruction on new health care insurance marketplacecomment (0)

July 18, 2013

Wondering who will be on hand to explain — and train consumers on — the new Health Insurance Marketplace (or exchange) when it opens Oct. 1? 

The elite group is currently being selected and should be announced by the end of summer.

Up to $54 million in new funding has been allotted for the formation of the Centers for Medicare & Medicaid Services (CMS) Navigator program.

“Navigators are individuals and entities that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans and public programs including Medicaid and the Children’s Health Insurance Program,” according to an April 9 news release on www.cms.gov.

“Navigators will be an important resource for the millions of Americans who are eligible to enroll in new coverage opportunities through the marketplace starting in October of 2013,” said CMS Acting Administrator Marilyn Tavenner.

Licensed agents and brokers were eligible to apply. However during their term as Navigators, individuals and entities are not permitted to receive any direct or indirect consideration from a health insurance issuer connected to the enrollment of individuals into Qualified Health Plans (QHPs) or non-QHPs.

Those now allowed to serve as Navigators are health insurance issuers; subsidiaries of health insurance issuers; associations that include members of, or lobby on behalf of, the insurance industry; or recipients of any direct or indirect consideration from any health insurance issuer in connection with the enrollment of any individuals or employees in a QHP or non-QHP.

Gene Ramsay, president of the Birmingham Association of Health Underwriters, said the navigator concept developed because of the mandate requiring all individuals to have health insurance by Jan. 1, 2014.

“I feel for the people who don’t know what to do (as related to understanding and purchasing health insurance),” he said. “The navigators will be paid to point individuals in a direction. … They do not have to be licensed insurance agents to give guidance. They will be paid per application.”


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