§ 23-64-603 — [See Note] Navigator license required

(a) (1) A person shall not act as a navigator in this state through a health insurance marketplace unless licensed under this subchapter as an eligible entity. (2) A health insurer or an affiliate of a health insurer is not an eligible entity. (b) A grant awarded under a navigator contract is contingent on a person's: (1) Being licensed under this subchapter; (2) Becoming licensed under this subchapter by September 30, 2013, or within ninety (90) days after the receipt of funding; or (3) Employing a licensee that meets the requirements in subdivision (b)(1) or subdivision (b)(2) of this section. (c) A navigator shall: (1) Conduct public education activities to raise awareness of the availability of qualified health plans; (2) Distribute fair and impartial information concerning enrollment in qualified health plans and the availability of premium tax credits under section 36B of the Internal Revenue Code of 1986 as existing on the effective date of this act and cost-sharing reductions under section 1402 of the federal act; (3) Facilitate enrollment in qualified health plans; (4) Provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman or to any other appropriate state agency or agencies for any enrollee with a grievance, complaint, or question regarding his or her health benefit plan, coverage, or a determination under that plan or coverage; and (5) Provide enrollment information in a culturally and linguistically appropriate manner that meets the needs of the population being served by a health insurance marketplace in this state, including those individuals with limited English proficiency or who are protected under section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 and Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12131-12165 , as they existed on January 1, 2013. (d) A navigator shall not advise a person to select a particular plan.

Legislative History

Added by Act 2013, No. 1439,§ 1, eff. when (1) The United States Department of Health and Human Services or other responsible federal agency or federal official notifies the Governor, the Insurance Commissioner, or other responsible state agency or state official pursuant to the federal healthcare laws established by Pub. L. No. 111-148, as amended by Pub. L. No. 111-152, and any amendments thereto, or regulations or guidance issued under those federal statutes; or (2) A health insurance marketplace is initiated and is operable in this state..