Please see the below Bestwire article on the recent HHS regs re: Navigators and our response. The Big I is the only group quoted. We have been leading the charge on this at both the state and federal level. We will also be submitting formal comments as Ryan notes in the article. Please read IN&V later today for an article on the Navigator regs and others on the individual mandate and plan networks. Believe it or not this weekend marks the four year anniversary of the ACA becoming law. HHS Rule Would Block States From Requiring ACA Navigators to Carry E&O Coverage WASHINGTON - Proposed rules released by the U.S. Department of Health and Human Services would prohibit states from requiring health insurance navigators to carry errors and omissions coverage. The rules would also bar states from requiring navigators to become licensed agents and from imposing other requirements that would keep them from fulfilling their statutory and regulatory duties. HHS said the Affordable Care Act mandates at least two types of entities, including one community and consumer-focused nonprofit group, must serve as navigators for all health insurance exchanges. If states impose additional requirements along those lines that exceed the federal minimums, it would make it impossible for those two types of entities to serve as navigators for all exchanges. However, some worry that allowing navigators to advise consumers without carrying some form of financial protection like errors and omissions could leave consumers exposed if they receive bad advice from the navigator helping them obtain health insurance. HHS has not said who would cover the financial fallout if a navigator improperly advises a consumer. Ryan Young, senior director of federal government affairs for the Independent Insurance Agents and Brokers of America, said the rule would also infringe upon the traditional role of state regulators to act as consumer protectors. Were very disappointed that the administration has decided to go this direction, Young said. It chips away at the states role of regulating insurance intermediaries. Young said the IIABA intends to submit written comments on the rules, about which the public has 30 days to comment. Under the ACA, navigators may not tell consumers which health insurance product to buy. But they are allowed to offer advice on things like how to provide the necessary data to qualify for federal health insurance subsidies. Navigators are required to undergo between five and 20 hours of training before they can begin working with consumers. Recently, several states have moved to enact laws designed to regulate navigators operating within their jurisdiction. But in one state, Missouri, a federal judge struck down an attempt to require navigators to meet additional requirements. In January, U.S. Judge Ortrie Smith issued an injunction blocking a state law that requires health insurance navigators to obtain a license before advising consumers looking to purchase coverage on the states federally run exchange (Bests News Service, Jan. 24, 2014). Smith said Missouris Health Insurance Marketplace Innovation Act was unconstitutional because it went beyond the scope of the ACA, despite Missouris decision to allow the federal government to set up an exchange rather than creating one of its own. By allowing the U.S. Department of Health and Human Services to take control of the states exchange, Smith said Missouri confined itself to the restrictions on navigators included in the ACA. Placing additional requirements on navigators violated the U.S. Constitutions Supremacy Clause. The proposed rules released by HHS gives states some leeway in enacting additional restrictions on navigators. But they would bar E&O coverage and licensing requirements, even in states that decided to create their own exchange. It is less clear what the proposed HHS rules would mean for legislation currently under consideration by the South Dakota Legislature. A bill in that senate would require extra training beyond that required in the ACA, require criminal background checks for navigator employees and assess a registration fee to navigators and their sponsoring entities. SB 120 would require navigators to be registered by the state and prohibits navigators from providing advice, guidance or other assistance with regard to health benefit plans. Navigators would have to show the Division of Insurance director that they have the competency in the subject matter to deliver accurate information to consumers. The bill requires applicants to complete 35 hours instruction in health benefit insurance and the ACAs exchange provisions and will be required to pass an examination unless the director awards an exemption based on the applicants experience. Also, the bill would prevent navigators from soliciting people or businesses currently insured in an existing health plan. (By Jeff Jeffrey, Washington Bureau manager: jeff.jeffrey@ambest) Charles E. Symington, Jr. Senior Vice President, External & Government Affairs Independent Insurance Agents & Brokers of America PH: (202) 863-7000 FAX: (202) 863-7015
Posted on: Thu, 20 Mar 2014 17:58:49 +0000
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