INDIANA NAVIGATOR TEST QUESTIONS & ANSWERS
Who must apply to become IN Navigators - Answers- • Federally funded Navigators
• CACs
• Medicaid Enrollment Center staff
• Licensed insurance producer who do not sell insurance
• Staff or volunteers to who help complete insurance affordability program applications
Difference between Federal Navigator and IN Navigator: - Answers- • Federal
Navigators get grant funding from HHS (feds)
• IN Navigator does not get federal funding
Who cannot be an IN Navigator - Answers- An individual who gets paid to sell health
insurance
IN Navigators Must - Answers- • Submit application for certification annually
• Pay a fee
• Complete a Conflict of Interest disclosure form
• Do criminal background check
• Attend a precertification course
• Pass the certification test
Changes IN Navigators Must Report within 30 days: - Answers- • Change in name,
address
• Any change in Conflict of Interest
Application Organization = AO - Answers- = organization that employs an IN Navigator
An AO will not be published if it requests not to be published/listed
AO must submit an annual application to IDOI
Changes AO must report to IODI: - Answers- • Addition or removal of staff
• Changes in name, address
• Staff failure to pay child support
Role of IN Navigator - Answers- to provide confidential, unbiased enrollment assistance
to consumers
Navigators CAN: - Answers- • Provide consumer assistance
• Be paid by their employer
• Explain which plans a provider accepts
• Securely dispose of ppi without notifying the consumer
Navigators CAN'T: - Answers- • Choose/select health plan for consumer
• Get paid by an insurance company for the enrollment
• Get paid by a "stop loss" insurance company for enrollment
• Provide incorrect information on an IN Navigator application
, • Violate insurance law
Federal Navigators CANNOT - Answers- be paid by the consumer
Federal CACs CANNOT - Answers- be paid by the consumer
IN Navigators MAY BE - Answers- paid by the consumer
IDOI can issue penalties to IN Navigators but cannot get people fired, jailed, or have
their driver's license revoked. - Answers-
In the event a consumer has a complaint about an insurance company - Answers- 1.
Direct them to take their complaint to their insurance company first.
2. If their complaint is not resolved by their insurance company, direct them to take
complaint to IDOI.
Insurance Agents, Brokers or Producers CAN'T - Answers- CAN'T be IN Navigators if
they are being paid for enrolling.
A state cannot - Answers- establish a waiting list or limit enrollment.
*A state can: - Answers- • Set eligibility
• Set income and category guidelines
• Require consumer to be a US citizen
▪ Undocumented = "not lawfully present"
▪ Legal immigrants qualify after 5 years
IHCP - Answers- IN Health Coverage Programs
IN Medicaid Programs are part of IHCP
IN Medicaid covers all mandatory and most optional services
IHCP administered by OMPP which is under FSSA
FSSA
-OMPP
-IHCP
-IN Medicaid Pro grams
Hoosier Healthwise (HHW) - Answers- covers pregant women, low income children and
families
Care Select - Answers- Covers consumers with chronic illness who need case
management services to coordinate care
Optional Program
List of qualifying diagnoses
replaced by hoosier care connect
MED Works - Answers- Covers disabled people who work
Who must apply to become IN Navigators - Answers- • Federally funded Navigators
• CACs
• Medicaid Enrollment Center staff
• Licensed insurance producer who do not sell insurance
• Staff or volunteers to who help complete insurance affordability program applications
Difference between Federal Navigator and IN Navigator: - Answers- • Federal
Navigators get grant funding from HHS (feds)
• IN Navigator does not get federal funding
Who cannot be an IN Navigator - Answers- An individual who gets paid to sell health
insurance
IN Navigators Must - Answers- • Submit application for certification annually
• Pay a fee
• Complete a Conflict of Interest disclosure form
• Do criminal background check
• Attend a precertification course
• Pass the certification test
Changes IN Navigators Must Report within 30 days: - Answers- • Change in name,
address
• Any change in Conflict of Interest
Application Organization = AO - Answers- = organization that employs an IN Navigator
An AO will not be published if it requests not to be published/listed
AO must submit an annual application to IDOI
Changes AO must report to IODI: - Answers- • Addition or removal of staff
• Changes in name, address
• Staff failure to pay child support
Role of IN Navigator - Answers- to provide confidential, unbiased enrollment assistance
to consumers
Navigators CAN: - Answers- • Provide consumer assistance
• Be paid by their employer
• Explain which plans a provider accepts
• Securely dispose of ppi without notifying the consumer
Navigators CAN'T: - Answers- • Choose/select health plan for consumer
• Get paid by an insurance company for the enrollment
• Get paid by a "stop loss" insurance company for enrollment
• Provide incorrect information on an IN Navigator application
, • Violate insurance law
Federal Navigators CANNOT - Answers- be paid by the consumer
Federal CACs CANNOT - Answers- be paid by the consumer
IN Navigators MAY BE - Answers- paid by the consumer
IDOI can issue penalties to IN Navigators but cannot get people fired, jailed, or have
their driver's license revoked. - Answers-
In the event a consumer has a complaint about an insurance company - Answers- 1.
Direct them to take their complaint to their insurance company first.
2. If their complaint is not resolved by their insurance company, direct them to take
complaint to IDOI.
Insurance Agents, Brokers or Producers CAN'T - Answers- CAN'T be IN Navigators if
they are being paid for enrolling.
A state cannot - Answers- establish a waiting list or limit enrollment.
*A state can: - Answers- • Set eligibility
• Set income and category guidelines
• Require consumer to be a US citizen
▪ Undocumented = "not lawfully present"
▪ Legal immigrants qualify after 5 years
IHCP - Answers- IN Health Coverage Programs
IN Medicaid Programs are part of IHCP
IN Medicaid covers all mandatory and most optional services
IHCP administered by OMPP which is under FSSA
FSSA
-OMPP
-IHCP
-IN Medicaid Pro grams
Hoosier Healthwise (HHW) - Answers- covers pregant women, low income children and
families
Care Select - Answers- Covers consumers with chronic illness who need case
management services to coordinate care
Optional Program
List of qualifying diagnoses
replaced by hoosier care connect
MED Works - Answers- Covers disabled people who work
