§ 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(7) [Repealed.]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.)