Vermont Statutes Title 33 Sec. 1807
Terms Used In Vermont Statutes Title 33 Sec. 1807
- Affordable Care Act: means the federal Patient Protection and Affordable Care Act, Pub. See
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- following: when used by way of reference to a section of the law shall mean the next preceding or following section. See
- Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by a health insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health services. See
- Person: shall include any natural person, corporation, municipality, the State of Vermont or any department, agency, or subdivision of the State, and any partnership, unincorporated association, or other legal entity. See
- State: when applied to the different parts of the United States may apply to the District of Columbia and any territory and the Commonwealth of Puerto Rico. See
§ 1807. Navigators
(a)(1) The Vermont Health Benefit Exchange shall establish a navigator program to assist individuals and employers in enrolling in a qualified health benefit plan offered under the Vermont Health Benefit Exchange. The Vermont Health Benefit Exchange shall select individuals and entities qualified to serve as navigators and shall award grants to navigators for the performance of their duties.
(2) The Vermont Health Benefit Exchange shall ensure that navigators are available to provide assistance in person or through interactive technology to individuals in all regions of the State in a manner that complies with the Americans with Disabilities Act.
(3) Consistent with Section 1311(i)(4) of the Affordable Care Act, health insurers shall not serve as navigators, and no navigator shall receive any compensation from a health insurer in connection with enrolling individuals or employees in qualified health benefit plans.
(b) Navigators shall have the following duties:
(1) conduct public education activities to raise awareness of the availability of qualified health benefit plans;
(2) distribute fair and impartial information concerning enrollment in qualified health benefit plans and concerning the availability of premium tax credits and cost-sharing reductions;
(3) facilitate enrollment in qualified health benefit plans, Medicaid, Dr. Dynasaur, VPharm, and other public health benefit programs;
(4) provide referrals to the Office of the Health Care Advocate and any other appropriate agency for any enrollee with a grievance, complaint, or question regarding his or her health benefit plan, coverage, or a determination under that 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 Vermont Health Benefit Exchange; and
(6) distribute information to health care professionals, community organizations, and others to facilitate the enrollment of individuals who are eligible for Medicaid, Dr. Dynasaur, VPharm, other public health benefit programs, or the Vermont Health Benefit Exchange in order to ensure that all eligible individuals are enrolled.
(7) [Repealed.] (Added 2011, No. 48, § 4; amended 2011, No. 171 (Adj. Sess.), § 2b; 2013, No. 79, §§ 22, 35h, eff. Jan. 1, 2014; 2019, No. 15, § 1, eff. May 6, 2019.)