Indiana navigator test
Who must apply to become IN Navigators - Correct 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: - Correct Answers -• Federal
Navigators get grant funding from HHS (feds)
• IN Navigator does not get federal funding
Who cannot be an IN Navigator - Correct Answers -An individual who gets paid to sell
health insurance
IN Navigators Must - Correct 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
HIP Basic - Correct Answers -for members with household income less than or equal to
100% FPL
-meet min coverage standards
costsharing: must pay copayments for doc visits, hospital stays, and prescriptions
HIP state - Correct Answers -For individuals with complec medical or behavioral
conditions
( medically frail) or low-income parents/caretakers
•Benefits: Comprehensive, with some additional benefits including vision, dental, and
enhanced behavioral health services
•Cost-sharing: HIP Plus OR HIP Basic cost-sharing
Who else uses MAGI - Correct Answers --Hoosier healthwise
- Healthy Indiana Plan
, Changes IN Navigators Must Report within 30 days: - Correct Answers -• Change in
name, address
• Any change in Conflict of Interest
Application Organization = AO - Correct 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An AO will not be published if it requests not to be published/listed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: - Correct Answers -• Addition or removal of staff
• Changes in name, address
• Staff failure to pay child support
Role of IN Navigator - Correct Answers -to provide confidential, unbiased enrollment
assistance to consumers
Navigators CAN: - Correct 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: - Correct 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 - Correct Answers -be paid by the consumer
Federal CACs CANNOT - Correct Answers -be paid by the consumer
IN Navigators MAY BE - Correct 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. - Correct Answers -
In the event a consumer has a complaint about an insurance company - Correct
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 - Correct Answers -CAN'T be IN
Navigators if they are being paid for enrolling.
A state cannot - Correct Answers -establish a waiting list or limit enrollment.
Who must apply to become IN Navigators - Correct 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: - Correct Answers -• Federal
Navigators get grant funding from HHS (feds)
• IN Navigator does not get federal funding
Who cannot be an IN Navigator - Correct Answers -An individual who gets paid to sell
health insurance
IN Navigators Must - Correct 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
HIP Basic - Correct Answers -for members with household income less than or equal to
100% FPL
-meet min coverage standards
costsharing: must pay copayments for doc visits, hospital stays, and prescriptions
HIP state - Correct Answers -For individuals with complec medical or behavioral
conditions
( medically frail) or low-income parents/caretakers
•Benefits: Comprehensive, with some additional benefits including vision, dental, and
enhanced behavioral health services
•Cost-sharing: HIP Plus OR HIP Basic cost-sharing
Who else uses MAGI - Correct Answers --Hoosier healthwise
- Healthy Indiana Plan
, Changes IN Navigators Must Report within 30 days: - Correct Answers -• Change in
name, address
• Any change in Conflict of Interest
Application Organization = AO - Correct 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: - Correct Answers -• Addition or removal of staff
• Changes in name, address
• Staff failure to pay child support
Role of IN Navigator - Correct Answers -to provide confidential, unbiased enrollment
assistance to consumers
Navigators CAN: - Correct 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: - Correct 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 - Correct Answers -be paid by the consumer
Federal CACs CANNOT - Correct Answers -be paid by the consumer
IN Navigators MAY BE - Correct 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. - Correct Answers -
In the event a consumer has a complaint about an insurance company - Correct
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 - Correct Answers -CAN'T be IN
Navigators if they are being paid for enrolling.
A state cannot - Correct Answers -establish a waiting list or limit enrollment.
