HB1820.DOC

SECTION 1. In 2013, the Hawaii Health Insurance Exchange, also known as the Hawaii Health Connector, was established in response to the federal Patient Protection and Affordable Care Act, popularly known as "Obamacare." Under the federal Act, the federal government is awarding millions of dollars to community-based organizations to assemble and train so-called "community navigators" to help consumers understand and comply with the new law.

The legislature finds that these navigators will be

employed to help individuals and small businesses explore and purchase health insurance plans. The legislature further finds that licensing and regulation of such navigators to ensure that they are trained and knowledgeable in the subject matter of individual and group health insurance plans and insurance coverage is necessary to avoid substantial risk to the health, safety, and welfare of the residents of this state. This finding is based on reports that have surfaced nationwide exposing improper conduct by health insurance navigators, including, but not limited to, giving enrollees misinformation; failing to secure consumers' health information and confidential personal information such as social security numbers; encouraging consumers to commit tax fraud by underreporting income in order to qualify for federal health insurance subsidies; and accepting "kickbacks" for steering consumers toward particular health plans.

The purpose of this Act is to establish licensing, examination, and renewal requirements for health insurance navigators operating in conjunction with the Hawaii Health Insurance Exchange.

SECTION 2. Chapter 435H, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§435H-__ Community navigators; licensing and renewal. (a) No navigator shall provide advice, guidance, or other assistance with regard to health benefit plans as a navigator under the provisions of the federal act unless licensed in accordance with this section.

(b) The commissioner shall not issue a license to any applicant who does not meet or conform to the following qualifications or requirements:

(1) The applicant shall establish to the satisfaction of

the commissioner that he or she has the background,

experience, knowledge, and competency in the subject matter that will enable him or her to deliver accurate information and advice to individuals and groups in this state seeking to obtain health insurance coverage under the provisions of the federal act;

(2) The applicant shall have successfully completed not less than fifty hours of instruction in health benefit insurance, the exchange provisions of the federal act, the provisions of Hawaii's Prepaid Health Care Act as set out in Chapter 393, Hawaii Revised Statutes, protection of the privacy of consumers' personal and financial information, relevant provisions of the Hawaii insurance code, and any other subjects deemed necessary by the commissioner; provided further that the training program and materials are to be approved by the commissioner;

(3) The applicant shall pass an examination as required by the commissioner, unless such applicant is exempted by the commissioner based on the applicant's experience and qualifications and pursuant to the rules and regulations adopted by the department of commerce and consumer affairs;

(4) An applicant shall be not less than eighteen years of age and of good moral character, and must submit in a form approved by the commissioner such information, including without limitation criminal history and regulatory background information, as the commissioner may require; and

(5) An applicant for a renewal license shall have completed continuing education classes, as approved by the commissioner.

(d) No navigator shall receive any commission, compensation, or anything of value from any insurer, health benefit plan, business, or consumer for providing advice or services specifically authorized to be provided as a navigator pursuant to the provisions of the federal act. Navigators shall be compensated for advice or services rendered pursuant to the provisions of the federal act only as provided for by the federal act and any applicable state laws or rules.

(e) Navigators shall provide factually accurate information to uninsured persons and businesses regarding the availability of premium tax credits under Section 36B of the Internal Revenue Code of 1986 and cost-sharing reductions under Section 1402 of the federal act.

(f) Notwithstanding any other provision of law, licensing as a navigator pursuant to the provisions of this article shall not constitute licensing as an insurance agent or administrator as defined in state law; provided, however, that the provisions of this subsection shall not prohibit the holder of a license issued pursuant to another section of the Hawaii insurance code from being compensated for advice or services rendered as a licensee and not as a navigator. Navigators licensed pursuant to the provisions of this section shall not, except as specifically authorized by the provisions of the federal act:

(1) Engage in any activities that would require licensing pursuant to another section of the Hawaii insurance code;

(2) Provide advice concerning the benefits, terms, and features of a particular health benefit plan or offer advice about which health benefit plan is better or worse for a particular individual or business, in a manner inconsistent with the provisions of the federal act and any applicable state laws or rules; or

(3) Recommend a particular health benefit plan or advise individuals or businesses about which health benefit plan to choose, in a manner inconsistent with the provisions of the federal act and any applicable state laws or rules.

(g) Violation of any provision of this section or the

federal act, including any act or omission that would be a ground for denial, suspension, or revocation of an insurance agent's license pursuant to state laws or rules, shall be a ground for denial, suspension, or revocation of a navigator's license under this section."

SECTION 3. Section 435H-1, Hawaii Revised Statutes, is amended by adding three new definitions to be appropriately inserted and to read as follows:

""Exchange" means the Hawaii Health Insurance Exchange, also known as the Hawaii Health Connector, established pursuant to chapter 435H, Hawaii Revised Statutes.

"Federal act" means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and regulations or guidance issued thereunder.

"Navigator" means an individual, including assistors, application counselors, or other persons, authorized pursuant to the federal act to provide insurance advice and guidance to uninsured individuals and groups seeking health insurance coverage. For the purposes of this chapter, if an organization or business entity serves as a navigator, an individual performing navigator duties for that organization or business entity shall be considered to be acting in the capacity of a navigator."

SECTION 4. The department of commerce and consumer affairs shall adopt rules pursuant to chapter 91 to effectuate the purposes of this Act.

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.

INTRODUCED BY:

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HOUSE OF REPRESENTATIVES	H.B. NO.	1820
TWENTY-SEVENTH LEGISLATURE, 2014
STATE OF HAWAII