Navigator Background Check Act

Navigator Background Check Act

Summary

This bill creates registration and reporting procedures for health care insurance navigators in {insert state}.

Model Policy

Section 1. Title. This Act shall be known as the “Navigator Background Check Act.”

Section 2. Definitions.

“Health care insurance navigator” means a person who is selected to perform in {insert state} the activities and duties identified in 42 United States Code Section 18031(i) and includes any person who receives grant monies from the United States Department of Health and Human Services, state or a health care exchange or private monies to perform any of the activities or duties identified in 42 United States Code Section 18031(i).

Section 3. Health care insurance navigator registration and reporting

(A) A person shall not act as or hold himself out to be a health care insurance navigator in {insert state} unless that person registers with the {insert state department of insurance} and meets all of the following requirements:

(1) Submits application and registration fees in the amounts prescribed by the Department.

          (2) Has received a high school diploma or general equivalency diploma.

(3) Successfully completes all federally required training programs.

(4) The {insert state department of insurance}shall submit a full set of fingerprints to the {insert state department of public safety} for the purpose of obtaining a state and federal criminal records check pursuant to {insert relevant state criminal history records statute} and Public Law 92-554. The {insert state department of insurance} shall not issue the registration if the person has been convicted of a felony offense or a misdemeanor offense involving fraud or dishonesty.

(B) The {insert state department of insurance} may deny, suspend or revoke the registration of a Health care insurance navigator if:

(1) The health care insurance navigator is charged with a felony offense.

(2) The health care insurance navigator is charged with a misdemeanor offense involving fraud or dishonesty.

(3) The {insert state department of insurance} receives credible reports that the Health care insurance navigator has provided false or fraudulent information to consumers.

(4) The health care insurance navigator has engaged in intentional or negligent conduct that has resulted in the release of a consumer’s personally identifiable information.

(C) Upon any criminal conviction the navigator’s registration shall be revoked.

(D) An organization employing a health care insurance navigator shall report to the {insert state department of insurance} any event that results in the unauthorized release of a consumer’s personally identifiable information. The organization shall attempt to report this unauthorized release of personally identifiable information to the affected individual whose personal information was released within twenty-four hours after discovering the breach. The Department of Health and Human Services shall submit a report on or before February 1 of each year to the Speaker of the House of Representatives and the President of the Senate detailing the number of breaches reported to the {insert state department of insurance} pursuant to this subsection and the circumstances of each breach.

(E) Notwithstanding any other law, a health care insurance navigator shall not sell, solicit, or negotiate insurance in {insert state} for any class or classes of insurance when assisting individuals with enrollment or any other insurance navigator activities or duties through any health care exchange established or operating in {insert state}, including any exchange established or operated by the United States Department of Health and Human Services.

(F) All personal health information shall be secured by all navigators and their administrative staff in accordance with health care industry standards. Failure to do so shall result in revocation of the navigator’s registration.

(G) The {insert state department of insurance} shall maintain a website for the purpose of providing the public with a complete list of all currently registered health care insurance navigators in {insert state}.

Section 4.  Current health care insurance navigators

(A)  A person who is acting as a health care insurance navigator pursuant to 42 United States Code section 18031 (i) on the effective date of this act shall register within ninety days after the effective date of this act with the {insert state department of insurance} pursuant to {insert state law} as added by this section, in order to continue performing the duties and activities of a Health care insurance navigator in {insert state} after the effective date of this act.

Section 5. {Insert civil and criminal penalties.}

Section 6. {Severability clause.}

Section 7. {Repealer clause.} 

Section 8. {Effective date.}

Approved by the ALEC Board of Directors January 9, 2014.

Keyword Tags: 2013 SNPS, Health and Human Services Task Force