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Healthcare Frequently Asked Question

What is a “navigator?”...
March 27, 2013

What is a “navigator?”

Federal law requires exchanges to establish a navigator program. Responsibilities of a navigator include to:

  • Conduct public education;
  • Distribute fair and impartial information;
  • Facilitate enrollment in QHPs;
  • Provide referrals to the appropriate entity for an enrollee with a grievance, complaint or question;
  • Provide information that is both “culturally and linguistically appropriate”.

Exchanges may require that navigators meet additional standards and carry out additional duties consistent with the listed minimum duties.

The Affordable Care Act and regulations list the types of entities that may be navigators. The regulations clarify that the exchange must select entities from at least two of the following categories to serve as navigators:

  • A community- and consumer-focused nonprofit group;
  • A trade, industry or professional association;
  • A commercial fishing industry, ranching or farming organization;
  • Chambers of commerce;
  • Unions;
  • Resource partners of the Small Business Administration;
  • Licensed agents and brokers.

Federal regulation states that navigators cannot be forced to hold a producer license or carry errors and omissions insurance.

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