The Affordable Care Act (ACA) – otherwise known as Obamacare – specifically included parameters under which properly certified individuals could assist the general public with the enrollment process into the Marketplace/Exchange. These individuals were referred to as Navigators.
While Navigators are required to successfully complete the Centers for Medicare & Medicaid Services (CMS) certification process, these individuals were not required to be licensed agents or even be covered by Professional Liability or Errors & Omissions (E&O) insurance. When I read this portion of the new law, I became deeply concerned over the misconceptions that were likely to happen due to the lack of insurance knowledge these Navigators would possess.
Having been employed in the health insurance industry for nearly 25 years, I knew all too well how complex benefit plans can be. (I thought this was the reason I was required to be licensed and also required to maintain continuing education to renew my license.) I was certain that the lack of knowledge of available health insurance plans; the narrowing of provider networks; and overall ignorance of benefit structure within plans was sure to prove to be a detriment as time goes on for those who enrolled into the Marketplace with a Navigator. Some of these confused buyers have already contacted us to see if we could “fix” it for them or explain to them just exactly what they bought.
When choosing a professional to help with you with some task or process that you are not comfortable tackling yourself, it is best to try to get help from someone that has experience and knowledge in the subject at hand. Choosing an agent or broker to assist you in enrolling in the Marketplace provides you with the ability to work with someone who lives and breathes health insurance. Generally speaking, agents and brokers invest the time to study the differences between carriers, networks, and plan designs, in order to make effective recommendations based upon your needs. When working with a Navigator, the experience is likely to be reduced to just picking a plan that has the lowest premium – and seeing what happens from there.
Choosing an agent or broker to assist you with enrollment in the Marketplace doesn’t cost you anything. But what you gain from the experience and future relationship you will be sure to have with that agent or broker, could be priceless!