HHS Final Rulings on Navigators

[RayNY]

http://newsmanager.commpartners.com/nahuw/downloads/2013_17125_PI.pdf

Full text.

The only interesting thing I saw was how clearly the defined what outside sources cannot compensate a navigator:

"In all Exchange models, entities ineligible to become Navigators include health insurance issuers and their subsidiaries, issuers of stop loss insurance and their subsidiaries, associations that include members of or that lobby on behalf of the insurance industry, and entities that receive any consideration directly or indirectly from any health insurance issuer or issuer of stop loss insurance in connection with the enrollment of any individuals or employees in a QHP or non-QHP insurance product."

No mention of DI, CI, LTD, STD, BOE, Whole/Term Life, Annuities, etc. There may be a big opportunity for ancillary sales generated by navigators.

 

[taterpeeler]

http://newsmanager.commpartners.com/nahuw/downloads/2013_17125_PI.pdf

Full text.

The only interesting thing I saw was how clearly the defined what outside sources cannot compensate a navigator:

"In all Exchange models, entities ineligible to become Navigators include health insurance issuers and their subsidiaries, issuers of stop loss insurance and their subsidiaries, associations that include members of or that lobby on behalf of the insurance industry, and entities that receive any consideration directly or indirectly from any health insurance issuer or issuer of stop loss insurance in connection with the enrollment of any individuals or employees in a QHP or non-QHP insurance product."

No mention of DI, CI, LTD, STD, BOE, Whole/Term Life, Annuities, etc. There may be a big opportunity for ancillary sales generated by navigators.

seems they would then have to have an insurance license and that may slam the brakes on it.

it also said "entities that receive any consideration directly or indirectly from any health insurance issuer" so any carrier that markets health insurance and pays a commission or "consideration"

Ray, I just don't see that happening by the navies


OH... I didn't read the article I just read your comments... sorry, im lazy

 

[stuy119]

Remember, they can only explain plan options, not offer advice.

 

[RayNY]

Navigators are certainly allowed to have the (relatively cheap, easy to obtain) Life/Accident/Health license, they just can't be CURRENTLY COLLECTING commissions from the specific entities I listed. My ancillary providers do not offer health insurance whatsoever.

I recognize they cannot provide advice on health plan selection, but I have heard nothing about them offering other products/services. Can they recommend a tax accountant? Recommend a bank so the "unbanked" can obtain an account? Can you suggest Coke over Pepsi? As written, the limitation stops at health plans.

What's to prevent them from "explaining" how an indemnity plan layered over a high deductible plan can limit their exposure and keep their premium lower than a comparable EPO? Why can't they explain options to someone wondering how they pay for rent while stuck in a hospital? If a client asks "what happens if I die?", are you disallowed from saying "nothing, but I have these Life products available if you would like coverage in that event."?

I don't see anything "slamming the brakes" on ancillary sales.

 

[houcoogster]

Does anybody really believe any of these rulings are in fact "final"?

 

[taterpeeler]

Navigators are certainly allowed to have the (relatively cheap, easy to obtain) Life/Accident/Health license, they just can't be CURRENTLY COLLECTING commissions specifically from the entities I listed. My ancillary providers do not offer health insurance whatsoever.

I don't see anything "slamming the brakes" on ancillary sales.

no.. your cool... my thought is they will be some mickey mouse angle they could try to block the navies from doing it.... IE: MAPD plans and selling anything other than "health products"

 

[RayNY]

Tater, I agree. I'm crossing my fingers that they are too busy trying to launch this thing and close all the loopholes to figure out how to block navigators from providing services above and beyond what is required.

 

[anonymous1]

Just my thoughts. But you have to have a health listener to sell ci di and by IRS rulings ltc is health insurance Now I agree that there are huge OPPURTUNITY here. Also a lot of grey area and with cms involved its going to be a head ache
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Just my thoughts. But you have to have a health listener to sell ci di and by IRS rulings ltc is health insurance Now I agree that there are huge OPPURTUNITY here. Also a lot of grey area and with cms involved its going to be a head ache

Health license stupid auto correct

 

[RayNY]

It all comes down to where the lawmakers want to draw their line in the sand of what is and isn't healthcare, and whether they release additional regulation disallowing navigators from collecting commission or recommending non-health products.

Argument's sake, could a tax accountant be a navigator and offer to do tax returns? Could a bank teller be a navigator and refer clients to their bank (and get a finder's fee)?

Could the Nassau-Suffolk Health Council (recently named navigator for NY) refer clients with medical questions to their hospitals?

 

[AllenChicago]

ObamaCare advocates are now blaming Insurance Agent groups for instigating "fights across the nation" over Navigator legitimacy.

Story: ObamaCare advice program sparks fights across the nation - The Hill's Healthwatch

Democrats are preparing their "who to blame" lists and speeches in case ObamaCare sinks, like Hillarycare did.


Edit to add:

Illinois is one example. The Obamacare Advocacy groups here have pressured the Governor into reviewing the state-specific navigator law. They're saying that it's too restrictive and was pushed through by Insurance Agent groups who fear that their commissions will be "eaten away by the online exchange".

Story: http://www.chicagobusiness.com/arti...ance-exchange-bill-could-hamper-consumer-info

-ac