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'Navigators' of State Health Insurance Exchanges Prepare to Help Applicants

In the 16 states and the District of Columbia that have set up their own exchanges, there will also be navigators — but they may not be fully operational right away. That’s because of a funding quirk in the law. Those states receive what are known as federal exchange establishment grants, and that money can’t be used to pay for navigator programs.

So, HHS created the “in-person assister” program for those states, to help them beef up their consumer assistance in their first year of operation. States can apply for and use exchange establishment grants for these assister programs as well as state funds. The assisters probably will do many of the same things as navigators.

There is a third category of helpers called “certified application counselors.” They are not paid by the government but instead work for community health centers, hospitals or similar institutions, and they would be certified to help with exchange enrollment in those places.

How will navigators and other government-paid helpers be trained? How much will they be paid? What are their qualifications?

Both navigators and assisters will have to complete a Web-based training program that will take up to 30 hours, and they will be certified by passing exams approved by HHS. They’ll be trained on respecting people’s privacy and on customer service. And they have to pledge to stay free of conflicts of interest.

Those who apply to be navigators will be asked to provide information on their track records of developing and maintaining relationships with employers, employees, consumers, the uninsured and self-employed people, especially those who are low income. They’ll also be asked about public education they’ve conducted in the past.

Applicants for navigator grants are also supposed to demonstrate that they will be able to reach out to people with disabilities and that their services will be accessible to them.

It’s not clear what the pay will be, but HHS estimated in a proposed rule that it would average $29 an hour for all staff, from higher-paid senior executives on down. Similarly, it is not yet known how many navigators or assisters there will be, but the number is expected to be in the tens of thousands.

How will people who don’t have insurance find advice on how to sign up?

The idea is the helpers will be out in the community actively looking for people to sign up at church meetings, in barbershops, even knocking on doors, according to recent congressional testimony. In addition, the federal government, the states and private advocacy groups such as Enroll America are expected to roll out education programs in July, August and September that will publicize how to find help. Enrollment begins Oct. 1.

Will the helpers be fluent in languages other than English?

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