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Senate of Pennsylvania
Session of 2015 - 2016 Regular Session


Posted: December 8, 2014 10:56 AM
From: Senator John H. Eichelberger, Jr.
To: All Senate members
Subject: Navigators and Health Exchange Assistors
I plan to re-introduce legislation to address consumer protection concerns resulting from the implementation of the Affordable Care Act. The Act, in large part, depends upon individuals, generally called “navigators,” to educate and enroll millions of uninsured Americans in either Medicaid or a private insurance plan. Although in many respects these navigators act like insurance agents, they have almost no qualifications or restrictions placed upon them.

The introduction of persons to assist with the health insurance exchange, rather than using existing licensed insurance agents, raises numerous consumer protection issues. First, these individuals, like licensed insurance brokers, will have access to confidential personal information. It is essential that we know who will have such access and ensure they will protect and use that information only for proper purposes. Second, it is essential for navigators to provide reliable information to consumers. Erroneous information could lead a consumer to choose a plan without understanding provider network limitations, cost-sharing, or benefits. Further, if a navigator does not correctly explain income reporting requirements, a consumer may get the wrong premium tax credit amount and have to repay some or all of the excess received in a later tax return.

My legislation would require individuals acting as health exchange assistors to register with the Department of Insurance, and to pass a criminal background check.

Last session's co-sponsors were: Senators, SCARNATI, ALLOWAY, ARGALL, WHITE,

Introduced as SB293