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2013 SESSION

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HB 2246 Health benefit exchange; regulation of navigators, report.

Introduced by: John M. O'Bannon, III | all patrons    ...    notes | add to my profiles | history

SUMMARY AS ENACTED WITH GOVERNOR'S RECOMMENDATION:

Health benefit exchange; regulation of navigators. Prohibits an individual or entity selected to serve as a navigator in a health benefit exchange from engaging in any activity that would require an insurance agent license under Title 38.2, offering advice about which qualified health plan or qualified dental plan is better or worse for a particular individual or employer, acting as an intermediary between an employer and an insurer that offers a qualified health plan or qualified dental plan offered through an exchange, or violating certain unfair trade practice and privacy requirements. The measure also prohibits an individual or entity from claiming to be, or holding himself or itself out as, a navigator or conducting business as a navigator in the Commonwealth without having been selected as a navigator in accordance with applicable federal law and without having evidence of successful completion of requirements prescribed by the federal Secretary of Health and Human Services. The State Corporation Commission is authorized to order violators to cease and desist prohibited conduct and is required to monitor and report on the activities of navigators in the Commonwealth.

SUMMARY AS PASSED HOUSE:

Health benefit exchange; regulation of navigators. Prohibits an individual or entity selected to serve as a navigator in a health benefit exchange from engaging in any activity that would require an insurance agent license under Title 38.2, offering advice about which qualified health plan or qualified dental plan is better or worse for a particular individual or employer, acting as an intermediary between an employer and an insurer that offers a qualified health plan or qualified dental plan offered through an exchange, or violating certain unfair trade practice and privacy requirements. The measure also prohibits an individual or entity from claiming to be, or holding himself or itself out as, a navigator or conducting business as a navigator in the Commonwealth without having been selected as a navigator in accordance with applicable federal law and without having evidence of successful completion of requirements prescribed by the federal Secretary of Health and Human Services. The State Corporation Commission is authorized to order violators to cease and desist prohibited conduct and is required to monitor and report on the activities of navigators in the Commonwealth. This bill is identical to SB 1261.

SUMMARY AS INTRODUCED:

Health benefit exchange; regulation of navigators. Establishes requirements for persons that serve as navigators in any health benefit exchange established for the Commonwealth. Navigators are required by the federal Affordable Care Act to perform certain functions relating to the operation of an exchange, including informing individuals and small employers about the availability of qualified health plans, facilitating enrollment of qualified individuals into health plans, and performing outreach and education efforts. This measure requires that an individual or entity obtain a license from the State Corporation Commission prior to acting as a navigator. A navigator is prohibited from engaging in activities that would require an insurance agent or producer license under this title; from providing advice concerning the benefits, terms, and features of a particular health plan or offering advice about which health plan is better or worse for a particular individual or employer; from making recommendations concerning the substantive benefits, terms, or conditions of health plans; or from enrolling an individual or employee in a qualified health plan offered through an exchange. The Commission is required to establish a certification and training program that includes initial and continuing education requirements and an examination and to adopt rules, to the extent permitted by the Affordable Care Act, that require a navigator to carry and maintain errors and omissions insurance. Navigators are required to obtain a surety bond or provide evidence of financial responsibility.