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Indiana Navigators are individuals who help Hoosier insurance consumers complete health coverage applications on the federally-facilitated Marketplace (healthcare.gov) or state-based insurance affordability program applications (such as Medicaid, the Children's Health Insurance Program ("CHIP"), or the Healthy Indiana Plan ("HIP") - dfrbenefits.in.gov).
An individual that meets the definition of “navigator” under Indiana Code 27-19-2-12 must become certified as an Indiana Navigator with the Indiana Department of Insurance ("IDOI"). An Indiana Navigator may be associated with an Application Organization ("AO"), but does not have to be in order to be an Indiana Navigator. Once certified as an Indiana Navigator, the Indiana Navigator must follow all reporting requirements with the IDOI and complete the annual renewal process.
An Application Organization ("AO") is an organization that has employees and/or volunteers helping Hoosier insurance consumers complete applications for health coverage on the federally-facilitated Marketplace (healthcare.gov) or state-based insurance affordability program applications (such as Medicaid, the Children's Health Insurance Program ("CHIP"), or the Healthy Indiana Plan ("HIP") - dfrbenefits.in.gov). Organizations meeting the definition of "application organization" under Indiana Code 27-19-2-3 must be registered with the Indiana Department of Insurance. Examples of possible AOs include: hospitals, health centers, community-based social service agencies, and Medicaid enrollment centers.
There are some organizations that assist consumers with health coverage applications that are not required to become Application Organizations. This may be the case if the organization only provides general information about health coverage applications or if the organization receives compensation from health insurance issuers for consumer enrollment into health plans. For example, social service agencies that provide consumers with information on where to go to assess eligibility and enroll in health plans are not required to register as Application Organizations. Hospitals that only perform presumptive eligibility ("PE") activities are also not required to register as Application Organizations. Likewise, health insurance agencies that receive compensation from health issuers when enrolling consumers into health insurance plans, are not eligible to serve as Application Organizations.
IDOI Navigator Contact – Navigator@idoi.in.gov