Navigator Regulation: Enacted Laws & Regulations

The Affordable Care Act (ACA) requires States to establish Navigator programs to help enroll individuals in health plans on state health benefits exchanges.  The role of Navigators includes outreach and education efforts, providing unbiased and accurate information, and helping individuals apply for coverage.  The ACA also requires Navigators to operate in those States that declined to establish their own exchange and instead deferred to the federal exchange. 
 
In early 2014, NAIFA Staff learned that some States had enacted laws to regulate the activity of Navigators.  Many of these new laws require that Navigators obtain a license from the State prior to assisting consumers shopping for health insurance policies through a state or federal exchange.   Other States have enacted laws requiring Navigators to register with the Department of Insurance, pass a background check, and which limit or state permissible Navigator duties. 
 
To date, 16 States have enacted licensure/registration laws for Navigators:  AZ, AR, GA, IL, IN, ME, MO, MT, NE, NM, OH, PA, TX, UT, VA, and WA
 
In early 2014, after evaluating the legislative, legal, and political dynamics on Navigator regulation, the NAIFA Board of Trustees approved the following policy statement on Navigators developed by the Government Relations Committee:   
 
“NAIFA believes that states should require any Navigator that recommends a policy, or sells, solicits or negotiates insurance to be licensed on the same basis as insurance producers.  NAIFA also believes that all Navigators should be instructed as to what constitutes selling, soliciting, and negotiating insurance, and informed that if they engage in such activities, they must be licensed as insurance producers.”
 
NAFIA Government Relations staff has communicated this policy statement in comment letters to both State regulators at the National Association of Insurance Commissioners (NAIC) and federal officials at the Department of Health and Human Services (HHS).  The NAIC amended several of its guidance publications for state insurance departments to emphasize that Navigators cannot engage in activities exclusive to licensed insurance agents, and HHS broadly distributed a notice from the Arkansas Department of Insurance that holds Navigators to all state insurance licensing requirements.