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Regulation and Compliance > State Regulation

Texas adds navigator rules

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Husbands in Houston can help their wives, parents and grandparents use the public exchange without any special training.

But people in Dallas who want to help their great-great-grandparents – or first cousins, great aunts or fellow Masonic lodge members – tackle might need to get 20 hours of training and endure a background check.

Texas Insurance Commissioner Julia Rathgeber talks about who must get and who need not go through a formal navigation registration process in the state’s new final regulations for navigators.

Rathgeber developed the regulations to implement a Texas law created by state Senate Bill 1795.

The Patient Protection and Affordable Care Act navigator program is supposed to provide a temporary, independent source of help for new exchange users.

Critics say PPACA and the U.S. Department of Health and Human Services have skimped on navigator standards.

The HHS standards apply only to navigators getting federal navigator grant money, and even the standards for the grant recipients are hidden inside navigator contracts, Rathgeber writes in a justification of the Texas regulations.

The final Texas regulations set standards for background checks, training and proof identity for people who work as navigators, and they set financial responsibility standards for the organizations that employ the navigators.

Both individual navigators and navigator groups must register with the Texas Department of Insurance by March 1. Individual navigators must get 20 hours of department-approved training by May 1.

Registration requirements for people who want to help friends and relatives use the exchange system came up in a discussion of exceptions to navigator registration requirements.

Human resources personnel at companies using small-group exchange plans need not register as navigators.

Would-be exchange helpers also are exempt if they are helping only people “within the third degree by consanguinity or within the second degree by affinity,” Rathgeber says.

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