“Navigator” is an individual or entity selected to perform activities and duties identified in 42 U.S.C. 18031 (i) in the Commonwealth. A “Navigator” can assist with the insurance application and enrollment processes through the Exchange, but is not permitted to sell, solicit, or negotiate contracts of insurance or annuity.
Navigator Grantee Requirements:
- Register as a navigator in Virginia by submitting an application.
- Submit to the Virginia Exchange a signed Grantee Contract that includes the Privacy and Security Agreement.
Individual Navigator Certification Requirements:
- Successfully complete assister training through the CMS Marketplace Learning Management System (MLMS). There is no additional state-specific training required.
- When accessing the training on the MLMS landing page, select “SBE-FP Assister” under the “Assister type” drop-down. For the “Organization Type” drop-down, select “State-based Exchange using the Federal Platform.”
- The MLMS system will not recognize the previously-issued assister IDs. However, an ID is not required to complete training.
- Register as a Navigator in Virginia by submitting an application. Attach the following to the application:
- Provide proof that you have passed all Virginia Exchange-approved certification examinations.
- Submit a Criminal History Record Report (CHRR) that is less than 90 days old.
- Virginia Residents will need to download form (SP-167) from the Virginia State Police and have the results mailed back to them.
- Non-residents will need a CHRR from their home state less than 90 days old and have the results mailed back to them.
- Pay Navigator Fees- $15 Application Fee and $8.55 Sircon Service Fee (approx.)
- When accessing the training on the MLMS landing page, select “SBE-FP Assister” under the “Assister type” drop-down. For the “Organization Type” drop-down, select “State-based Exchange using the Federal Platform.”
- The MLMS system will not recognize the previously-issued assister IDs. However, an ID is not required to complete the training.
Registered navigators are required to report any of the following to the Commission at Assisterprograms@scc.virginia.gov within 30 days:
- Any felony convictions (include facts and circumstances around conviction)
- Any administrative action taken against the navigator in another state or by another governmental agency in the Commonwealth
- Provide proof of completion of annual training to the Virginia Exchange
A navigator shall not:
- Engage in any activity that would require an insurance agent license
- Offer advice about which qualified health or dental plan is better or worse for an individual or employer
- Act as an intermediary between employer and insurer that offers qualified health or dental plans offered through an exchange
- Violate any unfair trade practice and privacy requirements applicable to the activities of navigators
- Receive compensation for services or duties as a navigator, including compensation from health carriers
An individual or entity shall not claim to be and/or conduct business as a navigator without:
- Being selected as such in accordance with federal or state law
- Having evidence of successful completion of all navigator requirements prescribed by the Virginia Exchange
- Meeting additional requirements outlined in §38.2-3457
If any individual or entity engages in one or more of the prohibited activities above, a complaint may be filed with the Commission. If the complaint is verified after investigation, the individual or entity may be ordered to cease and desist further prohibited conduct.