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Standards set for ACA exchange enrollment navigators

NEWS IN BRIEF — Posted July 22, 2013

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The Centers for Medicare & Medicaid Services has finalized standards for health insurance exchange “navigators,” trained professionals who will assist individuals seeking coverage in the federally facilitated coverage marketplaces starting this fall.

“Navigators will be trained to play a vital role in fulfilling our commitment to help consumers learn about and apply for quality health insurance when open enrollment for consumers in the marketplaces begins Oct. 1,” CMS Administrator Marilyn Tavenner said in a statement. These professionals are charged with giving impartial and accurate guidance to shoppers of plans on the exchanges, providing specific assistance to those with disabilities and language barriers.

Navigators will be in-person assisters in marketplaces where the federal government either will be operating or partnering with a state on an exchange. Federal grants help support navigator programs in these types of exchanges, whereas state-based marketplaces are in charge of overseeing, awarding grants for and training personnel with similar functions as the navigators. State-run exchanges have the option of using the CMS final rule as guidance or developing their own standards for these professionals.

The final rule also sets training and qualification standards for certified application counselors, another type of professional that will help enroll consumers in the exchanges (link).

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