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2014 SESSION

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SB 542 Health benefit exchanges; regulation of navigators.

Introduced by: Stephen H. Martin | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED SENATE:

Health benefit exchanges; regulation of navigators. Requires navigators, on and after September 1, 2014, to be registered with the State Corporation Commission, in addition to being certified by the federal Department of Health and Human Services (HHS). The measure prohibits navigators from receiving compensation for services when prohibited by federal law. The Commission shall register a navigator if his character and general fitness warrant belief that he will act fairly, in the public interest, and in accordance with law. Navigators are required to submit an application to the Commission in a form the Commission prescribes, pay an application fee, and provide a criminal record history. The Commission is authorized to examine and investigate those involved in navigator activities and requires them to report to the Commission (i) any action taken by HHS, (ii) any felony conviction, and (iii) any administrative action taken in another jurisdiction or by another governmental agency in the Commonwealth. The Commission may determine whether the federal standards and qualifications for navigators are sufficient to ensure that navigators can perform their required duties. If the Commission finds that they are not, it is required to make a good faith effort to work in cooperation with the U.S. Secretary of HHS to propose improvements. If the Commission determines the standards and qualifications remain insufficient, the Commission is directed to adopt the necessary regulations to ensure that navigators can perform their required duties. This bill is identical to HB 1043.

SUMMARY AS INTRODUCED:

Navigator regulation. Creates registration and reporting procedures for health care insurance navigators. The measure prohibits a person from acting as or holding himself out to be a navigator unless he registers with the State Corporation Commission and meets certain requirements that include having a high school diploma or general equivalency diploma and passing a state and federal criminal history background check. A person who has been convicted of a misdemeanor involving fraud or dishonesty or any felony shall not be registered as a navigator. The Commission may deny, suspend, or revoke a registration of a navigator if he is charged with a felony or a misdemeanor involving fraud or dishonesty, if the Commission receives credible reports that the navigator has provided false or fraudulent information to consumers, or person has engaged in intentional or negligent conduct that has resulted in the release of a consumer's personally identifiable information. The measure prohibits navigators from selling, soliciting, or negotiating insurance when assisting individuals with enrollment or any other navigator activities or duties through a health care exchange. Navigators and their administrative staff are required to secure personal health information in accordance with health care industry standards. Finally, the measure requires the Commission to maintain a website for the purpose of providing the public with a complete list of all currently registered navigators.