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Navigator and Agent Exchange Information


NAVIGATORS 

The insurance navigator program in Ohio will be run by the federally facilitated exchange and the U.S. Department of Health and Human Services (HHS). Therefore, HHS is responsible for the funding for each insurance navigator entity.  These entities were selected and announced August 15th, 2013. 
  
Business Entity Navigator:

The Ohio Department of Insurance will only accept business entity insurance navigator certification applications from those entities that were selected to receive funding from HHS. Click here for access to the Business Entity Insurance Navigator Certification application.
   
The list of entities that received funding was announced August 15, 2013. Once they are certified by the Department, they will be listed here:
   
 

The Ohio Association of Foodbanks  

Helping Hands Community Outreach Center

Carmella Rose Health Foundation

Cuyahoga Health Access Partnership
  
Toledo/Lucas County CareNet
  
The Community Action Program Corporation of Washington-Morgan Counties, OH

Ohio Association of Free Clinics

Community Action Committee of Pike County

Neighborhood Health Association

      
Individual Insurance Navigator:

An individual interested in becoming a certified individual insurance navigator in Ohio MUST be affiliated with an entity that received navigator funding from HHS. 

Individuals will need to apply for the certification only once they are affiliated with the business entity insurance navigator they will be operating under. The application to become an individual insurance navigator will be provided by the affiliated business entity.  

An individual applying for certification as an insurance navigator shall do all of the following:

(a) Complete pre-certification education requirements administered by HHS;

(b) Successfully complete a comprehensive exam administered by HHS;

(c) Complete state and federal criminal background checks; and

(d) Submit an application for individual insurance navigator certification to the Ohio Department of Insurance. (Applications are available from business entity navigators.)


AGENTS


In order to sell, solicit, or negotiate a qualified health plan through the Exchange, an agent must first complete an online training course developed by the Department of Health and Human Services (HHS) and then register with HHS. This course will also satisfy the requirements of the Ohio Department of Insurance as established in Ohio House Bill 3 and Ohio Administrative Code 3901-5-13.

Agent training for the Federally Facilitated Exchange in Ohio is now available. All training will occur online. To access the agent exchange training presentation, please visit Agent Training Webinar. To take the training now, visit http://Marketplace.MedicareLearningNetworkLMS.com. For more information about agent requirements to sell in the Exchange, visit: The Center of Consumer Information and Insurance Oversight (CCIIO).

In order to sell, solicit, or negotiate a qualified health plan through the Exchange, a licensed insurance agent must complete the following:

1. Complete the federally facilitated training

2. Complete the Federally Facilitated Marketplace Agreement(s)

3. Complete part II of the process by registering with the Federally Facilitated Marketplace (FFM)

4. Be a licensed insurance agent who is appointed with one or more of the following companies offering Qualified Health Plans:
    
Individual Market​
​Small Group Market
Community (Anthem)​ ​Community (Anthem)
​AultCare ​AultCare
​Buckeye Community Health Plan ​HealthSpan
​CareSource ​Kaiser
​Coventry ​Medical Health Insuring Corp. of Ohio
​HealthSpan ​SummaCare
​Humana Health Plan of Ohio
​Kaiser
​Medical Health Insuring Corp. of Ohio
Molina
​Paramount
​SummaCare

*Please note that this list was approved by ODI and submitted to HHS.


5. Once training and Exchange registration is complete, agents may submit proof of completion in the form of a completion certificate by fax or email to: 

Fax #:    614-387-0051
Email:    EducationDocs@insurance.ohio.gov
Agents will be awarded Ohio CE credit as follows:
There are three components offered through the federal exchange training program that count towards Ohio CE credit.   

Federal Exchange Components:
1) Affordable Care Act & Marketplace Basics
2) Individual Marketplace
3) Small Business Health Options Program (SHOP) Marketplace
    
Completion and passage of each course component's examination is worth 1 Ohio CE credit.
   
Ohio CE credit will ONLY be issued after proof of course completion is provided to the Department. (To avoid printing blank certificates, wait for the information to completely load before you print.) 
   
Please note: An agent can only receive a maximum of 3 "Exchange" credits each license renewal cycle.
Health Insurance Marketplace Training
Completion Certificates
Combined # of Approved Ohio CE Credits
Components of Curriculum
Ohio Approved Course Category
Individual Marketplace​ ​2
  1. Affordable Care Act & Marketplace Basics (1 credit)
  2. Individual Marketplace (1 credit)
​Exchange
SHOP Marketplace​ ​1
  1. SHOP Marketplace (1 credit)
​Exchange
​SHOP Marketplace (with proof of completing Basic exams) ​2
  1. Affordable Care Act & Marketplace Basics (1 credit)
  2. SHOP Marketplace (1 credit)
​Exchange
​Individual & SHOP Marketplace ​3
  1. Affordable Care Act & Marketplace Basics (1 credit)
  2. Individual Marketplace (1 credit)
  3. SHOP Marketplace (1 credit)
​Exchange
​Certified Application Counselor ​0 ​Not approved for Ohio CE credit ​n/a
​In-Person Assistance Personnel ​0 ​Not approved for Ohio CE credit ​n/a
Navigator​ ​0 ​Not approved for Ohio CE credit ​n/a
 

6. How to Add Federal Exchange Registration to Agent Record (Registration FAQs)

The Department’s agent/agency locator tool on the website now has the capability to search for agents that have completed the federal training to sell exchange plans.
 
If an agent wishes to be included in the search for licensed agents who have notified the Department that they have registered with the exchange, that agent must follow the below instructions. 
 
A) An agent must have a Gateway account, https://gateway.insurance.ohio.gov. For those agents that already have a gateway account, please skip to step 3.

B) For agents that need to obtain a gateway account, please use this document for step-by-step instruction on how to set up an account in gateway.

C) Once the gateway account set-up is complete and has been confirmed, return to https://gateway.insurance.ohio.gov and login using the User Name and password created for the Gateway.  Click the “Agent Health Insurance Exchange Registration” link.  When the “Locate Agent Record” page displays; enter your SSN, Last Name, First Name and NPN, EXACTLY as shown on your license, and select “Find Agent Record.”

D) Once your agent record populates, select the Action button on the far right of the record (blue arrow button).

E) Once you select action, an “Associate Agent Record” window will pop-up.  By selecting yes, you are attesting that you in fact are the agent on record, and that you agreeing to connect your agent record and this Gateway account. If you select no, you will return back to your record.

F) After the agent selects yes, they will see their detailed record.  Click the “Add Federal Health Insurance Exchange Registration” button.

G) After the agents selects add, a new window will pop-up, “Add Federal Health Insurance Exchange Registration to Agent Record.” The agent will need the following required information: 
   • MLN User ID
   • FFM User ID
   • Effective Year (which will then auto-populate the expiration year) 
   • Role Type (either individual, SHOP or both)

H) Once that information is included, select “Save” to move forward.  If the agent selects “Close,” they will return to their record detail.

I) After the agent selects “Save”, the agent detail will amend to show the new information entered and the Federal Health Exchange Registration designation will then display on their agent record detail.

J) Gateway will automatically update the agent/agency locator on the website to show that the agent is exchange registered.
 
CERTIFIED APPLICATION COUNSELOR:   
   
The Certified Application Counselor (CAC) program is administered by the Exchange.  Therefore, you must apply through the Exchange.  Only organizations can apply to be CACs, not specific individuals. For an organization to become a CAC, you must apply through the Exchange: http://marketplace.cms.gov/help-us/cac.html 
   
Organizations must enter into a written agreement with the Exchange in a form and manner determined by the Exchange. The agreement will contain the organization’s assurance that it will and all the staff and volunteers it certifies to be individual CACs will comply with the Exchange requirements. More information on CACs in federally facilitated exchanges can be found here: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CAC-guidance-7-12-2013.pdf OR http://marketplace.cms.gov/help-us/common-qandas-about-cac-designation.pdf.
   

ADDITIONAL INFORMATION

Link to HB3
Link to 3901-5-13
Link to HHS
Link to CMS
Link to CCIIO
    
   
     
Please direct inquiries regarding certified application counselors to:
http://marketplace.cms.gov/help-us/cac.html.
  
For agents experiencing technical trouble, please contact Medicare Learning Network (MLN) for training/registration technical difficulties: mln@cms.hhs.gov.


The State of Ohio is an Equal Opportunity Employer

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
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John Kasich, Governor | Mary Taylor, Lt. Governor / Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | OSHIIP Hotline: 800-686-1578