Insurance navigator bill amended, advanced

Senators advanced a bill from select file May 31 that would register individuals and entities applying for and acting as navigators for the state’s health benefit exchange.

The exchange will be established in Nebraska under the Affordable Care Act (ACA), which requires that all exchanges include programs to assist individuals in navigating the new system.

Nebraska’s exchange must be operational by Oct. 1 and states have the authority to license and regulate navigators.

LB568, as introduced by Omaha Sen. Burke Harr, would have established a licensure and regulatory system within the state Department of Insurance for navigators in Nebraska.

During select file debate, Harr offered an amendment that would replace the bill’s provisions with a registration program rather than a licensure system. He said the amendment represents a compromise reached since the bill was debated on general file.

The amendment removed references in the bill to navigators’ duties and instead would authorize the department to register individuals and entities seeking to act as navigators in Nebraska.

The amendment also lowered the maximum registration fee from $50 to $25 for an individual and from $100 to $50 for an entity. Registration would be valid for one year and could be renewed for a fee.

Navigators would be prohibited from:
• engaging in any activities that would require an insurance producer license;
• violating Nebraska insurance licensure law;
• recommending or endorsing a particular health plan;
• advising consumers about which health plan to choose;
• accepting compensation dependent on whether a person enrolls in or purchases a qualified health plan; or
• failing to respond to an inquiry from the director.

Lincoln Sen. Danielle Conrad, who had opposed the bill during general file debate, supported the amendment, saying it was the best option available as a political compromise.

With the amendment, she said, the bill would not apply to social workers, volunteers, church or family members who attempt to assist individuals in navigating the health exchange computer program.

Instead, it would apply only to a small group that receives federal funding to act as official navigators for the exchange, Conrad said.

“This is no longer a regulatory act … but a state registration,” Conrad said. “I think the amendment is a step forward to this state’s eventual embrace of the Affordable Care Act.”

Norfolk Sen. Jim Scheer expressed concern that the amendment contained no recourse if navigators give individuals advice regarding policy selection or incorrect information regarding definitions.

“Where is the protection for the consumer?” Scheer said. “There is none.”

Harr said that because Nebraska chose to default to a federal exchange, the state is limited in its ability to punish violations of navigator restrictions, which are specified in federal law. The state legally cannot provide a more severe punishment than allowed under federal regulations, he said.

Lincoln Sen. Kathy Campbell supported the amendment and the bill, saying that involvement of the state Department of Insurance in the navigator oversight process
would be the primary benefit of the proposal.

Without the bill, she said, the only recourse for someone who believes that a navigator has acted in bad faith is to contact the federal government. Under LB568, individuals would have access to a local remedy, Campbell said.

Harr said the state Department of Insurance does not anticipate issues with navigators, but that having a local regulatory structure would be beneficial.

“If past performance is any [indication] …. we’re not going to have any problems,” he said.

Following adoption of the amendment 34-1, senators advanced the bill to final reading by voice vote.