An Act To Comply with the Health Insurance Exchange Provision of the Patient Protection and Affordable Care Act
Maine Legislature, Session 125, LD 1497
Committee Amendment CA_A_H840 (House)
Amends: 24-A MRSA §2188

COMMITTEE AMENDMENT "A" to H.P. 1098, L.D. 1497, Bill, "An Act To 
Comply with the Health Insurance Exchange Provision of the Patient Protection and 
Affordable Care Act" 
Amend the bill by striking out the title and substituting the following: 
'An Act Relating to Navigators under Health Benefit Exchanges' 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 24-A MRSA §2188 is enacted to read: 
§2188. Permitted activities of insurance producers; navigators; requirements 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Exchange" means a health benefit exchange established or operated in this State, 
including a health benefit exchange established or operated by the Secretary of the 
United States Department of Health and Human Services, pursuant to Section 1311 of 
the federal Affordable Care Act. 
B. "Navigator" means a person selected to perform the activities and duties identified 
in Section 1311 (i) of the federal Affordable Care Act. 
2. Permitted insurance producer activities. Only a person licensed as an insurance 
producer in this State in accordance with chapter 16 may: 
A. Sell, solicit or negotiate health insurance; 
B. Confer with or offer advice to purchasers, enrollees or prospective purchasers or 
enrollees concerning the substantive benefits, terms or conditions of health plans; or 
C. Enroll an individual or employer in a qualified health plan offered through an 
exchange or facilitate enrollment of an individual or employer in a qualified health 
plan offered through an exchange. 
COMMITTEE AMENDMENT 
.~-' 
COMMITTEE AMENDMENT·A "to H.P. 1098, L.D. 1497 
3. Certification of navigators. Prior to any exchange becoming operational in this 
State, the superintendent shall: 
A. Develop criteria for use by any exchange for the selection of a navigator pursuant 
to Section 1311 (i) of the federal Affordable Care Act and state law; 
B. Adopt rules to establish a certification and training program for a prospective 
individual navigator that includes initial and continuing education requirements and 
an examination; and 
C. Adopt rules that require a navigator to carry and maintain errors and omissions 
insurance to cover all activities contemplated or performed pursuant to this section 
and Section 1311 (i) of the federal Affordable Care Act. 
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
4. Navigator requirements. An individual, other than a licensed insurance producer 
under chapter 16, may not act in the capacity of a navigator unless the individual: 
A. Is at least 18 years of age; 
B. Has completed and submitted a disclosure fonn, which must be developed by the 
superintendent and which may include such information as the superintendent 
determines necessary, and has declared under penalty of refusal, suspension or 
revocation ofthe navigator certification that the statements made in the form are true, 
correct and complete to the best of the individual's knowledge and belief; 
C. 
Has submitted to fingerprinting and a criminal history record check and 
regulatory background check in a manner prescribed by the superintendent; 
D. Has not committed any act that would be a ground for denial, suspension or 
revocation of a producer license as set forth in section 1420-K; 
E. Has successfully completed the certification and training requirements adopted by 
the superintendent in accordance with subsection 3; and 
F. Has paid any fees required by the superintendent. 
5. Unfair practices. The provisions of this chapter and chapter 24 and any rules 
adopted pursuant to those chapters apply to navigators. For purposes of this section and 
the application of other provisions of this Title, the duties of a navigator are deemed to 
constitute the business of insurance. 
6. Denial, suspension or revocation. The superintendent may deny, suspend or 
revoke the authority of a navigator certified pursuant to this section for good cause. I 
SUMMARY 
This amendment replaces the bill and changes the title. The amendment requires that 
only licensed insurance producers may sell, solicit or negotiate health insurance or enroll 
an individual or employer in a qualified health plan offered through an exchange 
established or operated in this State pursuant to state or federal law. 
COMMITTEE AMENDMENT 
I 
COMMITTEE AMENDMENT "A" to H.P. 1098, L.D. 1497 
The amendment also requires the Superintendent of Insurance to develop criteria for 
the selection and certification of navigators prior to the establishment of any exchange in 
this State pursuant to state or federal law and prohibits individuals from acting as 
navigators without certification from the superintendent unless the individuals are 
licensed insurance producers. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/22/12 
~ac 
LD 1497 
LR 1081(02) 
An Act To Comply with the Health Insurance Exchange Provision of the Patient Protection and 
Affordable Care Act 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment '14" (~-B4o") 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Minor revenue increase - Other Special Revenue Funds 
Additional costs and revenue to the Bureau of Insurance in the Department of Professional and Financial Regulation 
are expected to be minor and can be absorbed within existing budgeted resources. 
LR1081 (02) - Fiscal Note - Page 1 of 1