Indiana navigator Test Questions With Correct Answers

Who must apply to become IN Navigators - Answer • 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: - Answer • Federal Navigators get grant funding from HHS (feds) • IN Navigator does not get federal funding Who cannot be an IN Navigator - Answer An individual who gets paid to sell health insurance IN Navigators Must - Answer • 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: - Answer • Change in name, address • Any change in Conflict of Interest Application Organization = AO - Answer = organization that employs an IN Navigator​ An AO will not be published if it requests not to be published/listed AO must submit an annual application to IDOI Changes AO must report to IODI: - Answer • Addition or removal of staff • Changes in name, address • Staff failure to pay child support Role of IN Navigator - Answer to provide confidential, unbiased enrollment assistance to consumers Navigators CAN: - Answer • 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: - Answer • 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 - Answer be paid by the consumer Federal CACs CANNOT - Answer be paid by the consumer IN Navigators MAY BE - Answer paid by the consumer IDOI can issue penalties to IN Navigators but cannot get people fired, jailed, or have their driver's license revoked. - Answer In the event a consumer has a complaint about an insurance company - Answer 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 - Answer CAN'T be IN Navigators if they are being paid for enrolling. A state cannot - Answer establish a waiting list or limit enrollment. *A state can: - Answer • 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 - Answer 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