Column 5- Assistors-Navigators- Agents

Column 5- Assistors-Navigators- Agents

When do I enroll for individual health coverage to keep in compliance with the new law?

The open enrollment period will begin Oct. 1, 2013, but coverage cannot be effective before 1/1/2014.

How do I enroll in a health plan?  Who can help me?

There are multiple ways to enroll in an individual health plan and they will be expanded with Health Care Reform.  If you are only interested in looking at plans on the Exchange, you may use a Navigator, Assistor, Certified Application Counselor or an approved Broker.  You may also go directly to the website and enroll. 

If you wish to be advised about other options in addition to plans sold in the Exchange, you will need to go to a licensed insurance broker that is also appointed by the Exchange.

What's the difference?  Does it cost me more?

Navigators: Navigators will take steps to help consumers find out if they qualify for insurance affordability programs (including a premium tax credit, cost sharing reductions, Medicaid and the Children's Health Insurance Program), and if they're eligible, to get enrolled.

Navigators will also provide outreach and education to consumers to raise awareness about the Marketplace, and will refer consumers to ombudsmen and other consumer assistance programs when necessary. They'll be funded through state and federal grant programs, and must complete comprehensive training.

Non-Navigator assistance personnel: These are also known as in-person assistance personnel) will perform generally the same functions as Navigators, but will exist in either a State-based Marketplace or a State Partnership Marketplace.

Non-Navigator assistance personnel will serve as a part of an optional program that the state can set up before its Marketplace is economically self-sustaining, and before its Navigator program is fully functional. Though they perform the same functions as Navigators, non-Navigator assistance personnel will be funded through separate grants or contracts administered by a state. They must also complete comprehensive training

Licensed health insurance agents and brokers may enroll individuals, small employers, and employees in coverage through the Marketplace. Agents and brokers will be compensated by the issuer or by the consumer to the extent permitted under state law. Federal and state training and certification requirements will apply to agents and brokers who enroll or assist consumers in the Marketplace.  Under their state insurance license, they will also be able to propose commercial health plans that are not