Indiana § 27-19-4-3 - Requirements for navigator and application organization; violation

§ 27-19-4-3. Requirements for navigator and application organization; violation

Sec. 3. (a) A person that is a navigator or an application organization must meet all the following:

(1) Shall not provide incorrect, misleading, incomplete, or materially untrue information in an application for certification or registration.

(2) Shall not violate any of the following:

(A) An insurance law.

(B) A regulation.

(C) A subpoena of the commissioner.

(D) An order of the commissioner.

(E) A rule of a health benefit exchange operating in Indiana.

(F) A rule adopted under IC 27-19-3-3(d).

(G) PPACA or a federal regulation adopted under PPACA.

(3) Shall not intentionally misrepresent the terms of an actual or proposed insurance contract or application for insurance.

(4) Must not have had:

(A) an insurance producer or consultant license;

(B) a navigator certification or an application organization registration; or

(C) an equivalent to a license, certification, or registration described in clause (A) or (B);

denied, suspended, or revoked in any state, province, district, or territory.

(5) If the person is a navigator, shall not fail to satisfy the continuing education requirements established under section 12 of this chapter.

(6) Shall not obtain or attempt to obtain a license, certification, or registration through misrepresentation or fraud.

(7) Shall not fail to disclose a conflict of interest to the commissioner:

(A) in an application under this chapter; or

(B) arising after application is made under this chapter.

(8) If the person is a navigator, must not have been convicted of a felony or other crimes determined by the commissioner or secretary.

(9) Must not have admitted to committing or have been found to have committed an unfair trade practice or fraud in the business of insurance.

(10) Shall not use fraudulent, coercive, or dishonest practices, or demonstrate incompetence or untrustworthiness, in acting as a navigator or an application organization.

(11) Shall not improperly use notes or other reference material to complete an examination for certification under this chapter.

(12) If the person is a navigator, must not have failed, and shall not fail, to comply with an administrative or court order imposing a child support obligation.

(13) Must not have failed, and shall not fail, to pay state income tax or comply with any administrative or court order directing payment of state income tax.

(14) Shall not fail to timely inform the commissioner of a change in legal name or address.

(15) If the person is an application organization, shall not fail to verify that each navigator working for the application organization meets the following requirements:

(A) The navigator is certified under this chapter.

(B) The navigator has not committed an act that would be grounds for denial, suspension, or revocation of certification under this chapter.

(16) Shall not receive consideration from a health insurance issuer (as defined in Section 2791 of the federal Public Health Service Act (42 U.S.C. 300gg-91)) in connection with the enrollment of an individual in a health plan.

(b) The commissioner may:

(1) reprimand a navigator or an application organization;

(2) levy a civil penalty against a navigator or an application organization;

(3) place a navigator or an application organization on probation;

(4) suspend a navigator's certification or an application organization's registration;

(5) revoke a navigator's certification or an application organization's registration for a period of years;

(6) permanently revoke a navigator's certification or an application organization's registration;

(7) issue a cease and desist order to a navigator or an application organization; or

(8) take any combination of the actions described in subdivisions (1) through (7);

for a violation described in subsection (a).

As added by P.L.278-2013, SEC.27.