Section 760IAC4-3-7. Duties

   (a) An application organization or navigator shall carry out, at a minimum, the following duties:

(1) Maintain expertise in eligibility, enrollment, and program specifications related to QHPs available on the health benefit exchange and public health insurance programs.

(2) Provide information and assistance to an individual in a fair, accurate, and impartial manner. Information provided regarding QHPs must acknowledge all QHPs available to the individual on the health benefit exchange.

(3) Provide referrals to the department for any person who has a grievance, complaint, or question regarding a navigator, application organization, program, provider, or the certification, registration, or renewal procedures provided in this article or IC 27-19.

(4) Provide referrals to the appropriate person for any individual who has a grievance, complaint, or question regarding their QHP or public health insurance program coverage.

(5) Provide assistance in a manner that is culturally and linguistically appropriate to the needs of the individuals being assisted and ensure accessibility to individuals with disabilities in accordance with the federal Americans with Disabilities Act and Section 504 of the federal Rehabilitation Act.

  (b) An application organization or navigator shall comply with the conflict of interest policy and privacy and security agreements pursuant to 760 IAC 4-5.

  (c) If a navigator or application organization does not comply with the requirements of this rule, the commissioner may initiate an enforcement action against the navigator or application organization under 760 IAC 4-7. (Department of Insurance; 760 IAC 4-3-7; filed Jun 10, 2016, 1:21 p.m.: 20160706-IR-760150033FRA)