Navigators,

LDCAA has created this page to help you find important information about the Navigator Program.

Please visit this page when you are needing information concerning the:

Oklahoma Insurance Department.

Please read this information:

The Contact Information tracking:

You will have two files. There will be a file to keep consumer information in. Which we are required to keep by law. The other file which will only show the names of the consumers who agree to share their information. The information is to be locked up in a filing cabinet for 6 years. We will keep this information on the Contact sheet. That is protected by a password. The contact sheet is to be emailed to Bethani Lewis at immediately upon entering consumer information. The contact sheet to be used will be named Ld356 104 Navigator Spreadsheet used to record contact information by OK Ins Dept. The form is cumulative. Each time that you record consumer information keep adding to the same contact sheet. You should have only one contact sheet. Each time you assist a consumer add them to the same contact sheet.

Expect to be inspected by OID. You are responsible for your own personal compliance. Know the rules and follow them.

If you are inspected by the OID you can create a copy of your contact information tracking file. In the second copied file you may delete the rows of the consumers who refused to share their information with OID.

You may create you a filter to filter out the yes/no to help you find the ones you want to copy.

The consent Form:

Ld357 131 Navigator Consent Form 2014 2015

Each Navigator will need to personalize their own information onto this form. You must insert your name throughout the form. Only use LDCAA consent form.

The Disclosure Form:

Ld357 132 Oklahoma Disclosure of Personal Information is for a consumer to either refuse or to share their information with OID. This form is due to LDCAA within 3 days. Please be sure to have the consumer print and sign their names and have the date on the form. Only if a consumer refuses to share their information are navigators allowed to fax to LDCAA. Please only check the yes or the no box. Do not check both boxes.

Keep the yes/no disclosure forms in separate folders between those who agreed/refused to share their contact information with OID. Keep these forms locked in a filing cabinet. There will be a time that LDCAA may them and will call to ask you to email them to LDCAA. Please email these forms to of fax to 580/326/0556.

The Disclaimer Form:

Ld356 106 LDCAA Navigator Disclaimer Forms by OID 2014. You are required by law to sign, date, and hand to the consumer at each visit for the consumer to keep. You must personalize this form you’re your information. Navigator name and registration number. LDCAA information to include on the form is date registered 11/6/2014 Registration number 0100207210. You are responsible for adding all the information to you own forms. If you assist a consumer over the phone you must read the entire disclaimer to the consumer over the phone and gather the consumer information. Mail a copy of the disclaimer to the consumer.

Definition of assist.

(a) Facilitating the application for or enrollment of an individual or employer group in a QHP (qualified health plan) on the exchange, either through an in-person meeting, telephone conversation, video conference, mail, or any other electronic means, regardless of whether the individual or employer group completed final enrollment in a QHP, or assisting in determining an individual’s eligibility for premium tax credits and cost sharing reductions available for QHP’s, including but not limited to receiving an individual’s financial information for the purpose of determining said eligibility.

(b)Assist shall not include answering general questions about the exchange such as the website address or phone number of the exchange.

(c)If an individual navigator obtains authorization to provide assistance to an individual or employer group pursuant to 45 CFR~155.201(e)(6)(ii), the navigator shall provide a disclaimer to the individual or employer group on a form provided (disclaimer form). If the navigator assists an individual or employer group via telephone, the navigator shall read the contents of the disclaimer to the to the individual or the employer group, confirm that the individual or employer understands the disclaimer, and shall send a signed copy of the disclaimer to the individual or employer group via certified mail, email, or facsimile.

(d)If an individual navigator obtains authorization to provide assistance to an individual or employer group pursuant to 45 CFR ~ 155.210(e)(6)(ii), the navigator shall record all the contact information and the date of contact for the individual or employer group and provide such information to the navigator entity within 3 business days after the date of contact. Contact information shall mean, but not limited to, an individual or employer group’s name, mailing address, phone number, and e-mail address. A navigator shall only be required to record an individual or employer group’s contact information which is available.

(e)Any individual or employer group receiving assistance from a navigator may refuse, in writing to allow the individual or employer group’s contact information from being disclosed to the OID. Provided, however, that no individual navigator shall instruct, coerce, or otherwise direct the individual or employer group to make suck a refusal. An individual navigator shall provide a copy of the written refusal to the navigator entity within 3 business days after the date of refusal.

Required reports:

Ld357 126 Navigator Weekly Reporting numbers in excel template, is due on Thursdays of each week regardless if you have any numbers to report. You may send in an email stating there was no consumer contact for the dated week. But if you have an event, upcoming event, promotional event or promotional completion you will have to complete the report. Please pay attention to these reports they are very important to this program. I have to look your reports over and correct them if they are not right. If you add an event please add the event to the completed event page. Also, when we are doing promotional activities we will have to start calculating by dividing the number of days the ad ran by the estimated number of viewers/readers. We are reporting to many consumers reached. By just adding the numbers of every week each week. So we will only count the promotional activities once with the number that we get by the calculation. But we will add that promotional activity each week but leave out the consumers reached. The report is to be sent to by email to every Thursday by 4:00. Only report the numbers for that week. Also, if you are having any problems with the Marketplace, please add it to the report. That is the only way that we can share with them if the Marketplace is being rude, the website is slow, and having problems with staying connected by phone.

Promotional Items:

Please see page 23 number 15 of the grant under HHS Policy on the Prohibited Uses of Funds. We are allowed to use the CMS ordering site to order free printed material in English and Spanish. Please see this link to create you an account. Feel free to order at any time. .

See the Health Insurance Marketplace Branding Guide, to get permission to use their Logo.

Attending Conferences:

When attending conferences please let LDCAA know in advance. All navigators must have approval from Federal to attend a conference. LDCAA will have to submit a grant note to get the approval. Submit all required information to LDCAA 30 days prior to the conference date. The required information to submit to LDCAA, would be a detail of cost including food and beverages, hotel,a description of the purpose of the trip, the number of people attending, the cost of audio-visual services for conference, travel, per-diem. You will need to attach the agenda, conference registration. You will need to discuss the methodology used to determine which cost relate to a conference. Please refer to the grant under HHS Policy on Promoting Efficient Spending for Conferences and Meetings page 11.

Advertising and Events:

When you are making Flyers, placing Newspaper ads, Radio ads, Television ad, or brochures, please remember to add the Disclaimer to everything that you do. The Disclaimer is:

The project described was supported by Funding Opportunity Number CA-NAV-14-002 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

You are required to submit all ads to LDCAA. We have to keep all publications in an electric files. Please always keep copies of all the things that you do. And submit to Bethani Lewis.

The Statement of Compliance:

Federal law requires Navigator Entities, in this case, LDCAA, to submit a written attestation that Navigator Staff are in compliance with Federal Law. In order make sure all Navigators are in compliance. Please read it, print it, and if you are in compliance, sign it, and mail it back to me by regular mail. Or you can certainly scan it and e-mail a signed copy to me. Please note. The signature line describes your compliance “as it applies to Navigators”.