Chapter 02. Individual Exchange Navigator Certification and Training Standards
Regulation .01 Scope.LinkCopy Citation
This chapter sets forth the qualifications, training, and certification standards for an individual who applies to receive an Individual Exchange navigator certification and is required under Insurance Article, §31-113(h)(1), Annotated Code of Maryland to hold an Individual Exchange navigator certification to provide the services listed under Insurance Article, §31-113(d)(1), Annotated Code of Maryland.
Regulation .02 Eligibility Requirements.LinkCopy Citation
To qualify for an Individual Exchange navigator certification, an applicant shall:
A.
Be of good character and trustworthy;
B.
Be at least 18 years old;
C.
Successfully complete and comply with any ongoing requirements of the training program set forth under regulation .04 of this chapter; and
D.
Comply with any applicable requirements of Maryland Department of Health.
Regulation .03 Application Procedures.LinkCopy Citation
A.
In order to obtain an Individual Exchange navigator certification, the applicant shall submit to the Exchange:
(1)
An application on the form provided by the Exchange;
(2)
An attestation that the applicant will notify the Exchange of any changes to information that the applicant provides or to which the applicant attests on the application form within 30 days of such change;
(3)
An application fee if permitted by law and in the manner specified by the Exchange;
(4)
Evidence of the written consent required under COMAR 31.03.12, if applicable; and
(5)
Evidence that the applicant has successfully completed the Individual Exchange navigator certification training program.
B.
The Exchange may not consider an application to be complete until it has received all required materials.
C.
If the application is not completed with all required materials within 45 days after the Exchange receives the signed application form, the Exchange may consider the application withdrawn.
Regulation .04 Training Standards.LinkCopy Citation
A.
Scope of Training. The training shall include information on:
(1)
Commercial health insurance;
(2)
The Medicaid and MCHP programs;
(3)
Eligibility, enrollment, renewal and disenrollment;
(4)
Advanced premium tax credits;
(5)
Consumer assistance and protection;
(6)
Quality assurance standards; and
(7)
Ethics.
B.
Conduct.
(1)
The Exchange shall conduct training in geographically diverse locations across the State.
(2)
The training shall be conducted in examination facilities equipped to provide access in accordance with the Americans with Disabilities Act of 1990 as amended under 42 USC §12101, et seq.
C.
Type of Training. The training shall be administered in-person and online.
D.
Examination.
(1)
The training shall include a final examination.
(2)
The examination shall be multiple choice.
(3)
The examination shall be scored and reported in accordance with a passing score established by the Exchange.
(4)
Applicants must successfully pass the examination within 45 calendar days of completing the training described under §A of this regulation.
(5)
Applicants are allowed three attempts to pass the examination in a 12-month period.
(6)
If the applicant does not pass the examination on the third attempt, they must wait 12 months before they are eligible to train and test again.
E.
Training Frequency. The Exchange shall conduct trainings:
(1)
At least monthly during all months; and
(2)
At least weekly for the 3 months immediately preceding the open enrollment period.
F.
Assessment. The Exchange, in consultation with the Maryland Department of Health and with the approval of the Commissioner, shall review, and as appropriate update, the content of the training on a schedule established by the Exchange.
Chapter annotations
Authority: Insurance Article, §§31-106 and 31-113, Annotated Code of Maryland
History: Effective date: April 15, 2013 (40:7 Md. R. 612)
History: Regulation .04D amended effective August 18, 2025 (52:16 Md. R. 848)
History: Regulation .04F amended effective June 15, 2020 (47:12 Md. R. 597)