TDIC protects consumers on health exchange

Posted on Friday, September 27, 2013 at 3:20 pm

The Department of Commerce and Insurance (TDCI) issued emergency rules this morning aimed at protecting Tennesseans seeking health insurance coverage through the federally facilitated marketplace (FFM), or “exchange.”  The emergency rules implement Public Chapter 377 by establishing registration requirements for navigators and certified application counselors designated under the Affordable Care Act (ACA) with the responsibility to assist consumers access the FFM.  

Commissioner Julie Mix McPeak said, “Beginning October 1, many Tennesseans are expected to review health insurance options for 2014 through the federally run exchange. TDCI’s emergency rules will ensure that the people representing themselves to consumers as exchange experts have completed federal training courses and related examinations, where appropriate, and that they have passed a criminal background check.”  

“Navigators and certified application counselors will have access to consumers’ most personal information—including tax returns, social security numbers, and health history,” said McPeak.  “It is incumbent on us, working to implement the will of the General Assembly, to ensure that individuals who are not of good moral character cannot act as navigators or counselors in this State.”  

Commissioner McPeak said, “The Department designed the rules to protect consumers without obstructing individuals and entities planning to act as navigators and certified application counselors.  The rules erect a low barrier to entry, to be followed by continuing education on the part of navigators and certified application counselors, and protect consumers from unscrupulous dealers.” 

The emergency rules require navigators and certified application counselors to register annually with TDCI. Among other things, the rules require that a navigator or application counselor must be 18 years of age and must have successfully passed the federal training program.  The rules require navigator and certified application counselor applicants to successfully complete a criminal background check and prohibit convicted felons from acting as navigators or certified application counselors. Navigators and certified application counselors are also prohibited from acting as insurance producers under the rules, unless they are also licensed as insurance producers. 

The FFM open enrollment period for 2014 begins October 1, 2013, and ends March 31, 2014.  In future years, the open enrollment period is scheduled from October 15 through December 7.  Individuals may qualify for special enrollment periods if a qualifying event should happen outside of specified enrollment periods.

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