(215 ILCS 121/10)
Sec. 10. Certificate required.
(a) No individual or entity shall perform, offer to perform, or advertise any service as a navigator in this State or receive navigator grant funding from the United States Department of Health and Human Services, the State of Illinois, or an exchange or private funds unless certified as a navigator by the Director under this Act.
(b) A navigator who complies with the requirements of this Act shall do the following:
(1) conduct public education activities to raise
awareness of the availability of qualified health plans;
(2) distribute fair and impartial information
concerning enrollment in qualified health plans offered within the exchange and the availability of the premium tax credits under Section 36B of the Internal Revenue Code of 1986, 26 U.S.C. 36B, and cost-sharing reductions under Section 1402 of the federal Patient Protection and Affordable Care Act;
(3) facilitate enrollment in qualified health plans;
(4) provide referrals to appropriate federal and
State agencies for any enrollee with a grievance, complaint, or question regarding their health plan or coverage or a determination under such plan or coverage;
(5) provide information in a manner that is
culturally and linguistically appropriate to the needs of the population being served by the exchange.
(c) A navigator may not:
(1) sell, solicit, or negotiate, as these terms are
defined in Section 500-10 of the Illinois Insurance Code, any of the classes of insurance enumerated in Section 4 of the Illinois Insurance Code;
(2) offer advice about which health plan is better or
worse for a particular individual or employer;
(3) recommend or endorse a particular health plan or
advise consumers about which health plan to choose;
(4) provide any information or services related to
health benefit plans or other insurance products not offered in the exchange, except for health care providers when furnishing information or services related to a patient's existing health benefit plan or other existing health insurance coverage; or
(5) accept any compensation or consideration,
directly or indirectly, from any issuer of accident and health insurance or stop-loss insurance that is dependent, in whole or in part, on whether a person enrolls in or purchases a particular private health benefit plan.
(d) Items (1), (2), (3), (4), and (5) of subsection (c) of this Section do not apply to navigators when assisting individuals with the enrollment process in the State Medicaid program or other public programs.
(Source: P.A. 98-524, eff. 8-23-13.)
Sections: Previous 1 5 10 15 20 25 30 35 40 45 97 99 Next
Last modified: February 18, 2015