April 12, 2013

In This Issue
Congress May Need to Designate a Special HHS Parking Spot at the Capitol
The White House Releases a Budget…Finally
So You Want to Be a Navigator?
Higher Premium Rates and Less Employer Coverage under Health Reform
Now Accepting Legislative Council Applications
What We’re Reading
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So You Want to Be a Navigator?

Just one week after the administration released the long-awaited proposed rule to govern exchange navigators, the Center for Consumer Information and Insurance Oversight (CCIIO) released a grant application for individuals and groups that wish to serve as navigators helping to set up federally facilitated and partnership exchanges. CMS has allocated $54 million for this grant. 

The funding announcement states that applicants must be “self-employed individuals and private and public entities" and lists approximately a dozen eligible groups, among them commercial fishing industry organizations and ranching and farming organizations. The navigators, which CMS envisions as individuals and entities that will provide consumers with unbiased information about exchanges, health insurance plans, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program, are a brand-new facet of the healthcare industry.

The grant program announcement specifies that there are 33 eligible states with either partnership or fully federally facilitated exchanges. CMS anticipates that each state will be awarded at least two grants, one of which will go to a well-established charity. Amounts however, will vary by state population, with the largest award expected to go to Texas. The grant also specified that applicants must be conflict-free and will not be allowed to “to receive any direct or indirect consideration” from a health insurer. The awarded grants will initially provide funding for one year. CMS will train the navigators, but navigators must also comply with state licensing or certification requirements.

Those who are interested in applying for navigator funds must submit a letter of intent to CCIIO by May 1 with the final application due may June 7. Grant award recipients are expected to be announced by August 15th. CCIIO will be holding two informational calls for those interested in applying to become a navigator next week. It is important to note that health insurance agents and brokers do not need to become navigators to assist their clients with exchange-based coverage. In all states, agents and brokers will be able to work with their clients and then receive compensation through the health insurance carriers just as you do today.

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