Montana Code 33-17-241. Navigator certification — duties — prohibitions
33-17-241. Navigator certification — duties — prohibitions. (1) An individual or an individual performing navigator duties on behalf of an organization serving as a navigator may not act in the capacity of a navigator unless the individual has met all of the following requirements, as applicable:
Terms Used In Montana Code 33-17-241
- Exchange: means a health benefit exchange established by the state of Montana or an exchange established by the United States department of health and human services in accordance with 42 U. See Montana Code 33-17-102
- Individual: means a natural person. See Montana Code 33-17-102
- Navigator: means a person certified by the commissioner under 33-17-241 and selected to perform the activities and duties identified in 42 U. See Montana Code 33-17-102
- Negotiate: means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms, or conditions of the contract if the person engaged in negotiation either sells insurance or obtains insurance from insurers for purchasers. See Montana Code 33-17-102
- Solicit: means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance. See Montana Code 33-17-102
(a)is at least 18 years of age;
(b)has completed and submitted the application form provided for in 33-17-242 and has declared, under penalty of refusal, suspension, or revocation of the navigator’s certification, that the statements made in the form are true, correct, and complete to the best of the applicant’s knowledge and belief;
(c)has completed a background examination as described in 33-17-220;
(d)has documentation of successful completion of the centers for medicare and medicaid services navigator certification training requirements or navigator recertification training requirements, as applicable; and
(e)has paid all fees required by 33-2-708.
(2)A navigator’s duties may include any of the following:
(a)conducting public education activities to raise awareness of the availability of qualified health plans;
(b)distributing fair and impartial general information concerning how to enroll in any qualified health plan offered within the exchange and the availability of the premium tax credits under 26 U.S.C. § 36B and the cost-sharing reductions provided under 42 U.S.C. § 18071;
(c)assisting consumers in understanding how to enroll in a qualified health plan through an exchange or appropriate public programs offering health care coverage, without suggesting that the consumer purchase any particular plan; and
(d)referring consumers to the commissioner’s office for assistance with complaints, appeals, or grievances or for general information about health insurance.
(3)A navigator may not do any of the following unless the navigator is otherwise licensed or authorized to do so under this chapter:
(a)sell, solicit, or negotiate health insurance;
(b)recommend, endorse, or offer opinions about the benefits, terms, or features of a particular health benefit plan or offer an opinion about which health benefit plan is better or worse for a particular individual or employer;
(c)provide any information or services related to a health benefit plan or another product not offered in the exchange;
(d)engage in any unfair method of competition or any fraudulent, deceptive, or dishonest act or practice; or
(e)enroll an individual or an employee in a qualified health plan offered through an exchange.