Zane Benefits Publishes New Information on Navigator Final Rule

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New Final Rule on Navigators and non-Navigator assistance programs for the health insurance marketplaces. The new rule clarifies roles and training.

Today, Zane Benefits, the online alternative to group health insurance, published new information on navigator final rule.

According to Zane Benefits’ website, the Department of Health and Human Services (HHS) released the final rule on health insurance marketplace Navigators and non-Navigator assistance programs on July 12, 2013. Navigators and non-Navigator assistance personnel will be trained to assist consumers about health insurance, using the health insurance marketplaces, qualified health plans, and public programs such as Medicaid and CHIP.navigator final rule assistors

There are no significant changes to the proposed Navigator rule released in April. Rather, the final rule finalizes roles, training, and certification standards for Navigators and non-Navigator assistant programs.

In the final rule, HHS detailed the four different roles to assist consumers in the marketplace:

1. Navigators

Navigators will:

-Help consumers determine if they qualify for insurance affordability programs (including a premium tax subsidy, cost sharing reductions, Medicaid, and the Children’s Health Insurance Program).

-Help consumers enroll.

-Provide outreach and education to consumers to raise awareness about the marketplace.

-Refer consumers to ombudsmen and other consumer assistance programs when necessary.

2. Non-Navigator Assistance Personnel

Non-Navigator assistance personnel (also referred to as in-person assisters) will perform generally the same functions as Navigators but will only exist in either a state-based marketplace or a state-partnership marketplace.

Non-Navigator assistance personnel will serve as a part of an optional program. States can set up non-Navigator programs before its marketplace is economically self-sustaining, and before its Navigator program is fully functional.

3. Certified Application Counselors

Certified application counselors will perform many of the same functions as Navigators and non-Navigator assistance personnel, including:

-Educating consumers, and

-Helping consumers complete applications for coverage.

4. Agents and Brokers

To the extent permitted by a state (and if all marketplace requirements are met), the final rule states that licensed health insurance agents and brokers may enroll individuals, small employers, and employees in health insurance coverage through the marketplace.

Agents and brokers will be compensated by the issuer or by the consumer to the extent permitted under state law. Federal and state training and certification requirements will apply to agents and brokers who enroll or assist consumers in the marketplace.

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About Zane Benefits

Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit http://www.zanebenefits.com.

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Christina Merhar
Zane Benefits
800-391-9209 6725
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