Texas Department of Insurance Proposes Navigator Rules for Health Exchange

December 3, 2013

The Texas Department of Insurance (TDI) has proposed rules relating to federal health insurance exchange navigators.

The rules propose criminal background checks, privacy training, proof of identity and evidence of financial responsibility for individuals providing the navigator assistance.

Commissioner of Insurance Julia Rathgeber said the “proposed rules address insufficiencies in federal regulations and make the training and qualifications of navigators in our state more readily apparent to consumers and service providers.”

Senate Bill (SB) 1795 passed by the 83rd Texas Legislature requires the Commissioner of Insurance to set standards ensuring that navigators can perform their required duties if federal standards are determined to be insufficient.

TDI posted an outline of concerns with federal regulation of navigators on Nov. 15, 2013, following an informal stakeholder meeting conducted on Sept.30, 2013.

Under the proposed rules, entities and individuals providing enrollment assistance in the federal health exchange would be required to register with TDI.

Requirements for navigator registrations would include:

  • Proof of U.S. citizenship or immigration status to obtain employment in U.S.
  • Documentation of compliance with education requirements
  • Fingerprinting and background check
  • Evidence of financial responsibility to protect individuals against wrongful acts

Navigators would be prohibited from the following:

  • Charging consumers for providing information about health coverage
  • Selling, soliciting, or negotiating health insurance coverage
  • Recommending a specific health benefit plan
  • Providing advice regarding substantive benefits or comparative benefits of different health plans
  • Engaging in electioneering activities or financing or otherwise supporting the candidacy of an individual for government positions

Under the proposed rules, Texas Insurance Code provisions related to privacy and protection of personal information would also apply to navigators.

The rules have been submitted to the Texas Register for publication on Friday, Dec. 6. A public hearing will be held on Dec. 20; public comments will be accepted through Jan. 6, 2014. To view the proposed rules, please visit: http://www.tdi.texas.gov/rules/2013/documents/navproposal.pdf.

Latest Comments

  • November 21, 2014 at 11:57 am
    Dean Bradshaw says:
    Where in SB 1795 does it state that I have to have $21,000.00 of life or whole life insurance in the state of Texas?
  • December 5, 2013 at 6:20 pm
    Strangle Them says:
    What will the navigators be able to do? NOT charge consumers for health insurance information NOT sell or solicit health insurance NOT recommend a specific plan NOT provide ad... read more
  • December 4, 2013 at 2:03 pm
    FFA says:
    Guess that's another reason for my Bro to move to Texas instead of giving it a go in Illinois. AA- did you catch the news on the "Pension Budget Fix". Seems like the temp incr... read more
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