Full Text of SB1194 98th General Assembly
SB1194 98TH GENERAL ASSEMBLY |
| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014 SB1194 Introduced 1/30/2013, by Sen. William R. Haine SYNOPSIS AS INTRODUCED: |
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Creates the Insurance Navigator Licensing Act. Provides that no individual or entity shall perform, offer to perform, or advertise any service as a navigator in this State or receive navigator funding from the State or an exchange unless licensed as a navigator by the Director of Insurance under the Act. Sets forth provisions concerning prohibited activities; applications for licensure; license renewal; referrals; probation, the refusal to issue or renew a license, and the revocation or suspension of a license; reporting requirements; and the Act's relationship to other laws and rulemaking authority. Contains a severability clause. Effective immediately
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| 1 | | AN ACT concerning insurance.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 1. Short title. This Act may be cited as the | 5 | | Insurance Navigator Licensing Act. | 6 | | Section 5. Definitions.
As used in this Act: | 7 | | "Director" means the Director of Insurance. | 8 | | "Exchange" means any health benefit exchange established | 9 | | or operating in this State, including any exchange established | 10 | | or operated by the United States Department of Health and Human | 11 | | Services. | 12 | | "Navigator" means a person selected to perform the | 13 | | activities and duties identified in 42 U.S.C. 18031(i) in this | 14 | | State. "Navigator" includes any person who receives grant funds | 15 | | from the United States Department of Health and Human Services | 16 | | to perform any of the activities and duties identified in 42 | 17 | | U.S.C. 18031(i), including, but not limited to, in-person | 18 | | assisters and application counselors.
| 19 | | Section 10. License required.
| 20 | | (a) No individual or entity shall perform, offer to | 21 | | perform, or advertise any service as a navigator in this State | 22 | | or receive navigator funding from the State or an exchange |
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| 1 | | unless licensed as a navigator by the Director under this Act. | 2 | | (b) A navigator may not: | 3 | | (1) engage in any activities that would require an | 4 | | insurance producer license; | 5 | | (2) provide advice concerning the benefits, terms, and | 6 | | features of a particular health plan or offer advice about | 7 | | which health plan is better or worse for a particular | 8 | | individual or employer; | 9 | | (3) recommend or endorse a particular health plan or | 10 | | advise consumers about which health plan to choose; or | 11 | | (4) provide any information or services related to | 12 | | health benefit plans or other products not offered in the | 13 | | exchange. | 14 | | (c) Only a person licensed as an insurance producer in this | 15 | | State may: | 16 | | (1) sell, solicit, or negotiate health insurance; | 17 | | (2) provide advice concerning the benefits, terms, and | 18 | | features of a particular health plan or offer advice about | 19 | | which health plan is better or worse for a particular | 20 | | individual or employer; or | 21 | | (3) recommend a particular health plan or advise | 22 | | consumers about which health plan to choose.
| 23 | | Section 15. Application for license.
| 24 | | (a) An individual applying for a navigator license shall | 25 | | make application to the Director on a form developed by the |
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| 1 | | Director and declare under penalty of refusal, suspension, or | 2 | | revocation of the license that the statements made in the | 3 | | application are true, correct, and complete to the best of the | 4 | | individual's knowledge and belief. Before approving the | 5 | | application, the Director shall find that the individual: | 6 | | (1) is at least 18 years of age; | 7 | | (2) resides in this State or maintains his or her | 8 | | principal place of business in this State; | 9 | | (3) is not disqualified due to having committed any act | 10 | | that would be grounds for denial, suspension, or revocation | 11 | | of an insurance producer license under the Illinois | 12 | | Insurance Code; | 13 | | (4) has completed the pre-licensing training and | 14 | | course of study prescribed by the Director; | 15 | | (5) has successfully passed the written examination | 16 | | prescribed by the Director; | 17 | | (6) when applicable, has the written consent of the | 18 | | Director pursuant to 18 U.S.C. 1033, or any successor | 19 | | statute regulating crimes by or affecting persons engaged | 20 | | in the business of insurance whose activities affect | 21 | | interstate commerce; | 22 | | (7) possesses the requisite character and integrity; | 23 | | (8) has identified the entity with which it is | 24 | | affiliated and by which it is supervised; and | 25 | | (9) has paid the fees prescribed by the Director. | 26 | | (b) An entity that acts as a navigator, supervises the |
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| 1 | | activities of individual navigators, or receives funding to | 2 | | perform such activities shall obtain a navigator license. An | 3 | | entity applying for a navigator license shall make application | 4 | | on a form containing the information prescribed by the | 5 | | Director. | 6 | | (c) The Director may require any documents deemed necessary | 7 | | to verify the information contained in an application submitted | 8 | | in accordance with subsections (a) and (b) of this Section. | 9 | | (d) Entities licensed as navigators shall, in a manner | 10 | | prescribed by the Director, periodically provide the Director | 11 | | with a list of all individual navigators that it employs, | 12 | | supervises, or is affiliated with. | 13 | | (e) The Director shall require that each navigator obtain a | 14 | | surety bond in an amount acceptable to the Director or | 15 | | otherwise demonstrate a level of financial responsibility | 16 | | capable of protecting all persons against the wrongful acts, | 17 | | misrepresentations, or negligence of the navigator. The | 18 | | Director may ask for a copy of the bond or other evidence of | 19 | | financial responsibility at any time. | 20 | | (f) Prior to any exchange becoming operational in this | 21 | | State, the Director shall prescribe initial training, | 22 | | continuing education, and written examination standards and | 23 | | requirements for navigators.
| 24 | | Section 20. License renewal.
| 25 | | (a) A navigator license shall be valid for 2 years. |
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| 1 | | (b) A navigator may file an application for renewal of a | 2 | | license in a method prescribed by the Director and pay the | 3 | | renewal fee prescribed by the Director. Any navigator who fails | 4 | | to timely file for license renewal shall be charged a late fee | 5 | | in an amount prescribed by the Director. | 6 | | (c) Prior to the filing date for application for renewal of | 7 | | a license, an individual licensee shall comply with ongoing | 8 | | training and continuing education requirements established by | 9 | | the Director. The navigator shall file with the Director, by a | 10 | | method prescribed by the Director, satisfactory certification | 11 | | of completion of the continuing education requirements. Any | 12 | | failure to fulfill the ongoing training and continuing | 13 | | education requirements shall result in the expiration of the | 14 | | license.
| 15 | | Section 25. Navigator referrals.
On contact with a person | 16 | | who acknowledges having existing health insurance coverage | 17 | | obtained through an insurance producer, a navigator shall refer | 18 | | the person back to that insurance producer for information, | 19 | | assistance, and any other services.
| 20 | | Section 30. Grounds for placing on probation; refusal to | 21 | | issue or renew a license; revocation or suspension of a | 22 | | license.
| 23 | | (a) The Director may place on probation, suspend, revoke, | 24 | | or refuse to issue, renew, or reinstate a navigator license, or |
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| 1 | | may levy a fine for each violation, or any combination of | 2 | | actions, for any one or more of the causes set forth in this | 3 | | Act or for other good cause. | 4 | | (b) In addition to imposing the penalties authorized by | 5 | | subsection (a) of this Section, the Director may require that | 6 | | restitution be made to any person who has suffered financial | 7 | | injury because of a violation of this Act. | 8 | | (c) The Director shall have power to examine and | 9 | | investigate the business affairs and records of any navigator | 10 | | to determine whether the individual or entity has engaged or is | 11 | | engaging in any violation of this Act. | 12 | | (d) The navigator license held by an entity may be | 13 | | suspended or revoked, or the renewal or reinstatement thereof | 14 | | may be refused, or a fine may be levied with or without a | 15 | | suspension, revocation, or refusal to renew a license, if the | 16 | | Director finds that an individual licensee's violation was | 17 | | known or should have been known by the employing or supervising | 18 | | entity and the violation was not reported to the Director and | 19 | | no corrective action was undertaken on a timely basis.
| 20 | | Section 35. Reporting to the Director.
| 21 | | (a) Each licensed navigator shall report to the Director | 22 | | within 30 calendar days after the final disposition of the | 23 | | matter any administrative action taken against him in another | 24 | | jurisdiction or by another governmental agency in this State. | 25 | | The report shall include a copy of the order, consent to order, |
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| 1 | | or other relevant legal documents. | 2 | | (b) Within 30 days after the initial pretrial hearing date, | 3 | | a navigator shall report to the Director any criminal | 4 | | prosecution of the navigator taken in any jurisdiction. The | 5 | | report shall include a copy of the initial complaint filed, the | 6 | | order resulting from the hearing, and any other relevant legal | 7 | | documents. | 8 | | (c) An entity that acts as a navigator that terminates the | 9 | | employment, engagement, affiliation, or other relationship | 10 | | with an individual navigator shall notify the Director within | 11 | | 30 days following the effective date of the termination, using | 12 | | a format prescribed by the Director, if the reason for | 13 | | termination is one of the reasons set forth in this Act or the | 14 | | entity has knowledge the navigator was found by a court or | 15 | | government body to have engaged in any of the activities | 16 | | prohibited by this Act. Upon the written request of the | 17 | | Director, the entity shall provide additional information, | 18 | | documents, records, or other data pertaining to the termination | 19 | | or activity of the individual.
| 20 | | Section 40. Other laws; rulemaking authority.
| 21 | | (a) The requirements of the Illinois Insurance Code, and | 22 | | any related rules, shall apply to navigators. The activities | 23 | | and duties of a navigator shall be deemed to constitute | 24 | | transacting the business of insurance. | 25 | | (b) The requirements of this Act shall not apply to any |
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| 1 | | individual or entity licensed as an insurance producer in this | 2 | | State. | 3 | | (c) Pursuant to the authority granted by this Act, the | 4 | | Director may adopt rules as may be necessary or appropriate for | 5 | | the administration and enforcement of this Act.
| 6 | | Section 97. Severability. The provisions of this Act are | 7 | | severable under Section 1.31 of the Statute on Statutes.
| 8 | | Section 99. Effective date. This Act takes effect upon | 9 | | becoming law.
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