Organizers of the Nevada health insurance exchange are thinking about the approach their exchange will take to working with agents, brokers and “Navigators.”
Staff members at Nevada’s Silver State Health Insurance Exchange have covered that topic in a new draft report on “Navigators, Producers and Outreach Specialists in the Silver State Health Insurance Exchange.”
The Nevada exchange organizers want to get any Navigator staffers who help consumers enroll in exchange plans licensed as “exchange producers,” and the organizers also want to encourage traditional health insurance agents and brokers to sell exchange plan coverage to consumers, according to a report draft posted on the Nevada exchange program website.
The Nevada exchange staff members note that, when they came up with the current draft of the report, they tried to accommodate the views of U.S. Health and Human Services Secretary Kathleen Sebelius and the views of officials at the Nevada Division of Insurance.
An exchange panel, the Consumer Assistance Advisory Committee, plans to review the report Wednesday during a public meeting.
The Exchange System
The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for states to work with federal agencies to set up a system of exchanges, or Web-based health insurance supermarkets, by 2014.
PPACA opponents continue to work through the courts, Congress and the election process to repeal PPACA or block implementation of the law. If the law takes effect on schedule and works as drafters expect, consumers will be able to use new PPACA tax credit subsidies to buy coverage — and enroll in public health programs, such as Medicaid — through the exchanges.
Navigators — new consumer assistance entities to be created by PPACA — will help consumers figure out how to use the exchanges and the subsidies.
States can choose how to run the exchanges, and whether to turn part or all of the responsibility for running an exchange over to the federal government. Nevada has chosen to build its own exchange.
Insurance trade groups have argued that Navigators should be licensed as brokers; consumer groups have argued that Navigators need not be licensed as producers because the role Navigators will play will be different from the role producers typically play.
PPACA itself has limited traditional brokers’ ability to serve as Navigators by stating that Navigators cannot be affiliated with insurers and cannot get any form of compensation, such as commissions, from insurers.
The Sebelius Letter
The Nevada exchange staff members have included a copy of a letter that U.S. Health and Human Services Secretary Kathleen Sebelius sent to Rep. Adam Kinzinger, R-Ill., July 11 in a packet of consumer assistance committee meeting materials.
Kinzinger and colleagues asked Sebelius about getting Navigators licensed as producers.
Sebelius told Kinzinger that she believes that states should have the authority to develop licensing standards for Navigators, and that a U.S. Department of Health and Human Services (HHS) final rule states that an exchange must develop training standards for Navigators.