The establishment of health insurance exchanges is one of the most significant reforms contained in PPACA. Exchanges are transforming our nation's private healthcare marketplace for individuals and small businesses buying coverage. Since it is the professional role of health insurance agents and brokers to provide consumers with accurate information about their health coverage options, we believe that exchange participation is a natural fit. However, as health insurance exchanges are operated by both the states and federal government, we must ensure that they allow individuals and business owners to utilize traditional agent and broker services. Exchange consumers will need agent and broker access not only during the annual enrollment process, but also to handle their policy service needs on an ongoing basis.
States were given the opportunity to choose between three different exchange models to help Americans gain access to health insurance coverage. No matter what exchange model a state chose, it is clear that exchange implementation will be no easy task. In an attempt to transition the country to this new health reform structure, PPACA provides a role for navigators and assistors. While navigators and assistors are prohibited by law from actually enrolling consumers in health insurance plans, they will serve as a resource for consumers looking to purchase coverage through the exchanges. NAHU has been working with state and federal and policy makers on exchange implementation to ensure that consumers are able to continue to benefit from the services of licensed health insurance agents and brokers
Additionally, PPACA created a separate, unique exchange for small businesses called Small Business Health Options Program (SHOP). Small businesses often find it incredibly challenging to find affordable health insurance for their employees. To make coverage more affordable for small businesses, the SHOP exchange sets up a separate state- based insurance market exclusively for small businesses.
NAHU’s Recommendations for the State-Based Regulation of Navigators
This principles statement, developed by NAHU’s National Legislative Council and Exchange Working Group outlines NAHU’s recommendations for state regulation of navigators.
NAHU’s White Paper on State Regulation of Navigators
This paper summarizes state regulation of navigators in a health insurance exchange.
NAHU has developed an FAQ document on the FLSA exchange notification to employees.