§ 27-19-4-3 — Requirements for navigator and application organization; violation

Indiana § 27-19-4-3

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 19: HEALTH BENEFIT EXCHANGE
• Ch. 4: Health Benefit Exchange Navigators and Application

Text

(a) A person that is a navigator or an
application organization must meet all the following:
(1) Shall not provide incorrect, misleading, incomplete, or
materially untrue information in an application for certification or
registration.
(2) Shall not violate any of the following:
(A) An insurance law.
(B) A regulation.
(C) A subpoena of the commissioner.
(D) An order of the commissioner.
(E) A rule of a health benefit exchange operating in Indiana.
(F) A rule adopted under IC 27-19-3-3(d).
(G) PPACA or a federal regulation adopted under PPACA.
(3) Shall not intentionally misrepresent the terms of an actual or
proposed insurance contract or application for insurance.
(4) Must not have had:
(A) an insurance producer or consultant license;
(B) a navigator certification or an application organization
registration; or
(C) an equivalent to a license, certification, or registration
described in clause (A) or (B);
denied, suspended, or revoked in any state, province, district, or
territory.
(5) If the person is a navigator, shall not fail to satisfy the
continuing education requirements established under section 12
of this chapter.
(6) Shall not obtain or attempt to obtain a license, certification, or
registration through misrepresentation or fraud.
(7) Shall not fail to disclose a conflict of interest to the
commissioner:
(A) in an application under this chapter; or
(B) arising after application is made under this chapter.
(8) If the person is a navigator, must not have been convicted of
a felony or other crimes determined by the commissioner or
secretary.
(9) Must not have admitted to committing or have been found to
have committed an unfair trade practice or fraud in the business
of insurance.
(10) Shall not use fraudulent, coercive, or dishonest practices, or
demonstrate incompetence or untrustworthiness, in acting as a
navigator or an application organization.
(11) Shall not improperly use notes or other reference material to
complete an examination for certification under this chapter.
(12) If the person is a navigator, must not have failed, and shall
not fail, to comply with an administrative or court order imposing
a child support obligation.
(13) Must not have failed, and shall not fail, to pay state income
tax or comply with any administrative or court order directing
payment of state income tax.
(14) Shall not fail to timely inform the commissioner of a change
in legal name or address.
(15) If the person is an application organization, shall not fail to
verify that each navigator working for the application
organization meets the following requirements:
(A) The navigator is certified under this chapter.
(B) The navigator has not committed an act that would be
grounds for denial, suspension, or revocation of certification
under this chapter.
(16) Shall not receive consideration from a health insurance issuer
(as defined in Section 2791 of the federal Public Health Service
Act (42 U.S.C. 300gg-91)) in connection with the enrollment of
an individual in a health plan.
(b) The commissioner may:
(1) reprimand a navigator or an application organization;
(2) levy a civil penalty against a navigator or an application
organization;
(3) place a navigator or an application organization on probation;
(4) suspend a navigator's certification or an application
organization's registration;
(5) revoke a navigator's certification or an application
organization's registration for a period of years;
(6) permanently revoke a navigator's certification or an
application organization's registration;
(7) issue a cease and desist order to a navigator or an application
organization; or
(8) take any combination of the actions described in subdivisions
(1) through (7);
for a violation described in subsection (a).

Legislative History

As added by P.L.278-2013, SEC.27.