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<chapter num="02" heading="Individual Exchange Navigator Certification and Training Standards" title_num="14" subtitle_num="35">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>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.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Eligibility Requirements.">
    <text>To qualify for an Individual Exchange navigator certification, an applicant shall:</text>
    <paragraph num="A.">
      <text>Be of good character and trustworthy;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Be at least 18 years old;</text>
    </paragraph>
    <paragraph num="C.">
      <text>Successfully complete and comply with any ongoing requirements of the training program set forth under regulation .04 of this chapter; and</text>
    </paragraph>
    <paragraph num="D.">
      <text>Comply with any applicable requirements of Maryland Department of Health.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Application Procedures.">
    <paragraph num="A.">
      <text>In order to obtain an Individual Exchange navigator certification, the applicant shall submit to the Exchange:</text>
      <paragraph num="(1)">
        <text>An application on the form provided by the Exchange;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>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;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>An application fee if permitted by law and in the manner specified by the Exchange;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Evidence of the written consent required under COMAR 31.03.12, if applicable; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Evidence that the applicant has successfully completed the Individual Exchange navigator certification training program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Exchange may not consider an application to be complete until it has received all required materials.</text>
    </paragraph>
    <paragraph num="C.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Training Standards.">
    <paragraph num="A.">
      <text>Scope of Training. The training shall include information on:</text>
      <paragraph num="(1)">
        <text>Commercial health insurance;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The Medicaid and MCHP programs;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Eligibility, enrollment, renewal and disenrollment;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Advanced premium tax credits;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Consumer assistance and protection;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Quality assurance standards; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Ethics.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Conduct.</text>
      <paragraph num="(1)">
        <text>The Exchange shall conduct training in geographically diverse locations across the State.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Type of Training. The training shall be administered in-person and online.</text>
    </paragraph>
    <paragraph num="D.">
      <text>Examination.</text>
      <paragraph num="(1)">
        <text>The training shall include a final examination.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The examination shall be multiple choice.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The examination shall be scored and reported in accordance with a passing score established by the Exchange.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Applicants must successfully pass the examination within 45 calendar days of completing the training described under §A of this regulation.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Applicants are allowed three attempts to pass the examination in a 12-month period.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Training Frequency. The Exchange shall conduct trainings:</text>
      <paragraph num="(1)">
        <text>At least monthly during all months; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>At least weekly for the 3 months immediately preceding the open enrollment period.</text>
      </paragraph>
    </paragraph>
    <paragraph num="F.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Insurance Article, §§31-106 and 31-113, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: April 15, 2013 (40:7 Md. R. 612)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04D amended effective August 18, 2025 (52:16 Md. R. 848)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04F amended effective June 15, 2020 (47:12 Md. R. 597)</annotation>
  </annotations>
</chapter>