Illinois General Assembly - Full Text of SB1194
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Full Text of SB1194  98th General Assembly




State of Illinois
2013 and 2014


Introduced 1/30/2013, by Sen. William R. Haine


New Act

    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,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the
5Insurance 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
9or operating in this State, including any exchange established
10or operated by the United States Department of Health and Human
12    "Navigator" means a person selected to perform the
13activities and duties identified in 42 U.S.C. 18031(i) in this
14State. "Navigator" includes any person who receives grant funds
15from the United States Department of Health and Human Services
16to perform any of the activities and duties identified in 42
17U.S.C. 18031(i), including, but not limited to, in-person
18assisters and application counselors.
19    Section 10. License required.
20    (a) No individual or entity shall perform, offer to
21perform, or advertise any service as a navigator in this State
22or receive navigator funding from the State or an exchange



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1unless 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
15State 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
25make application to the Director on a form developed by the



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1Director and declare under penalty of refusal, suspension, or
2revocation of the license that the statements made in the
3application are true, correct, and complete to the best of the
4individual's knowledge and belief. Before approving the
5application, 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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1activities of individual navigators, or receives funding to
2perform such activities shall obtain a navigator license. An
3entity applying for a navigator license shall make application
4on a form containing the information prescribed by the
6    (c) The Director may require any documents deemed necessary
7to verify the information contained in an application submitted
8in accordance with subsections (a) and (b) of this Section.
9    (d) Entities licensed as navigators shall, in a manner
10prescribed by the Director, periodically provide the Director
11with a list of all individual navigators that it employs,
12supervises, or is affiliated with.
13    (e) The Director shall require that each navigator obtain a
14surety bond in an amount acceptable to the Director or
15otherwise demonstrate a level of financial responsibility
16capable of protecting all persons against the wrongful acts,
17misrepresentations, or negligence of the navigator. The
18Director may ask for a copy of the bond or other evidence of
19financial responsibility at any time.
20    (f) Prior to any exchange becoming operational in this
21State, the Director shall prescribe initial training,
22continuing education, and written examination standards and
23requirements 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
2license in a method prescribed by the Director and pay the
3renewal fee prescribed by the Director. Any navigator who fails
4to timely file for license renewal shall be charged a late fee
5in an amount prescribed by the Director.
6    (c) Prior to the filing date for application for renewal of
7a license, an individual licensee shall comply with ongoing
8training and continuing education requirements established by
9the Director. The navigator shall file with the Director, by a
10method prescribed by the Director, satisfactory certification
11of completion of the continuing education requirements. Any
12failure to fulfill the ongoing training and continuing
13education requirements shall result in the expiration of the
15    Section 25. Navigator referrals. On contact with a person
16who acknowledges having existing health insurance coverage
17obtained through an insurance producer, a navigator shall refer
18the person back to that insurance producer for information,
19assistance, and any other services.
20    Section 30. Grounds for placing on probation; refusal to
21issue or renew a license; revocation or suspension of a
23    (a) The Director may place on probation, suspend, revoke,
24or refuse to issue, renew, or reinstate a navigator license, or



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1may levy a fine for each violation, or any combination of
2actions, for any one or more of the causes set forth in this
3Act or for other good cause.
4    (b) In addition to imposing the penalties authorized by
5subsection (a) of this Section, the Director may require that
6restitution be made to any person who has suffered financial
7injury because of a violation of this Act.
8    (c) The Director shall have power to examine and
9investigate the business affairs and records of any navigator
10to determine whether the individual or entity has engaged or is
11engaging in any violation of this Act.
12    (d) The navigator license held by an entity may be
13suspended or revoked, or the renewal or reinstatement thereof
14may be refused, or a fine may be levied with or without a
15suspension, revocation, or refusal to renew a license, if the
16Director finds that an individual licensee's violation was
17known or should have been known by the employing or supervising
18entity and the violation was not reported to the Director and
19no 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
22within 30 calendar days after the final disposition of the
23matter any administrative action taken against him in another
24jurisdiction or by another governmental agency in this State.
25The report shall include a copy of the order, consent to order,



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1or other relevant legal documents.
2    (b) Within 30 days after the initial pretrial hearing date,
3a navigator shall report to the Director any criminal
4prosecution of the navigator taken in any jurisdiction. The
5report shall include a copy of the initial complaint filed, the
6order resulting from the hearing, and any other relevant legal
8    (c) An entity that acts as a navigator that terminates the
9employment, engagement, affiliation, or other relationship
10with an individual navigator shall notify the Director within
1130 days following the effective date of the termination, using
12a format prescribed by the Director, if the reason for
13termination is one of the reasons set forth in this Act or the
14entity has knowledge the navigator was found by a court or
15government body to have engaged in any of the activities
16prohibited by this Act. Upon the written request of the
17Director, the entity shall provide additional information,
18documents, records, or other data pertaining to the termination
19or activity of the individual.
20    Section 40. Other laws; rulemaking authority.
21    (a) The requirements of the Illinois Insurance Code, and
22any related rules, shall apply to navigators. The activities
23and duties of a navigator shall be deemed to constitute
24transacting the business of insurance.
25    (b) The requirements of this Act shall not apply to any



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1individual or entity licensed as an insurance producer in this
3    (c) Pursuant to the authority granted by this Act, the
4Director may adopt rules as may be necessary or appropriate for
5the administration and enforcement of this Act.
6    Section 97. Severability. The provisions of this Act are
7severable under Section 1.31 of the Statute on Statutes.
8    Section 99. Effective date. This Act takes effect upon
9becoming law.