Navigators and Health Insurance Exchanges
The Affordable Care Act of 2010 mandates states to establish health insurance exchanges – online marketplaces for selling and purchasing health plans and other services.
Navigators would be selected and appointed at exchanges based on certain eligibility criteria and would need to be certified and trained before the scheduled health insurance exchanges launch date of January 1, 2014.
The state of Minnesota had published a document in 2010 that analyzed and detailed the requirements that an exchange employed navigator is expected to fulfill and conform to. All prospective navigators need to possess the ability to establish business relationships with the exchange customers – uninsured or insured consumers, self-employed individuals, employers and employees - to help them quickly familiarize with the exchange operations.
The selected navigators may hail from different industries and businesses but to ensure objectivity and non-partiality towards any particular health plan or services, care should be taken to not employ navigators who are associated indirectly or directly with any health plan or employees of qualified participating health plans. To be qualified for the position of navigator, navigators should not be employed as a health insurance issuer. The US Department of Health and Human Services has been granted the autonomy to set further eligibility standards for navigators.
The Affordable Care Act has outlined some key health insurance exchange responsibilities of the selected navigators. A navigator that is employed with the state health insurance exchange would be responsible for conducting public initiatives to raise qualified health plan awareness among the consumers. The navigators would also be required to dispense objective and neutral advice to insurance consumers about the health plan enrollment process through the exchange and inform consumers on the availability and eligibility of consumers for various federal grants or tax subsidies. Navigators would act as facilitators between the end consumers and the health insurance and should be able to help consumers resolve any grievance, complaints or doubts in a swift and clear manner. The navigators would also be responsible for presenting the health plan related information to the users in a culturally and linguistically suitable manner to help consumers easily understand the information being presented.
If the health insurance exchanges launch as per the scheduled time, states would need to draw up documentation and standards for navigators to follow and would need to take care of the various certifications and trainings that these navigators would be required to qualify. With the exchange deadline scheduled at January 1, 2014, states would require to begin early with the selection and appointment of navigators for the health insurance exchanges. Navigators, once certified and appointed may prove to a worthy investment for health insurance exchanges as they would be instrumental in helping consumers easily purchase insurance off the insurance exchanges.
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ABOUT THE AUTHOR
Author is an expert on health insurance Exchange and he is currently studying about the intricacies of the state health insurance exchange that are to be formed soon.