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<chapter num="16" heading="SHOP Exchange Navigators — Licensing" title_num="31" subtitle_num="03">
  <regulation prefix="Regulation" num=".01" heading="Purpose.">
    <text>The purpose of this chapter is to establish certain requirements that must be satisfied in order to qualify for a SHOP Exchange navigator license.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Applicability.">
    <text>This chapter applies to any person seeking to act as a SHOP Exchange navigator.</text>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meaning indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Administration” means the Maryland Insurance Administration.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Applicant” means a person who is applying for a SHOP Exchange navigator license.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Application” means a written request for a license in a form approved by the Commissioner.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Commissioner” means the Maryland Insurance Commissioner.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Effective Date” means the date on which a license takes effect.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Examination” means the written pre-licensing examination given under the authority of the Commissioner pursuant to Insurance Article, §31-112(d), Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“License” means a SHOP Exchange navigator license.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Licensee” means a SHOP Exchange navigator.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Maryland Health Benefit Exchange” means the public corporation established under Insurance Article, §31-102, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“SHOP Exchange” has the meaning set forth in Insurance Article, §31-101(w), Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(11)">
        <text>“SHOP Exchange navigator” has the meaning set forth in Insurance Article, §31-101(x), Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(12)">
        <text>“SHOP Exchange navigator license” has the meaning set forth in Insurance Article, §31-101(y), Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(13)">
        <text>“Training Program” means the educational program offered to an applicant by the SHOP Exchange that must be completed subject to Insurance Article, §31-112(c)(2)(v), Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Licensing Requirements.">
    <paragraph num="A.">
      <text>Before a person may act as a SHOP Exchange navigator in the State, the person shall obtain a license issued by the Commissioner.</text>
    </paragraph>
    <paragraph num="B.">
      <text>To qualify for a license, an applicant:</text>
      <paragraph num="(1)">
        <text>Shall be at least 18 years of age;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Shall successfully complete the training program;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Shall complete and pass both sections of the examination;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Shall submit an application and any additional information the Commissioner deems necessary to the Administration;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Shall pay to the Administration initial license and application fees if permitted by law;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Shall be of good character and trustworthy; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>May not have committed any act the Commissioner finds would warrant suspension or revocation of a license under Insurance Article, §31-112(e), Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Examination.">
    <paragraph num="A.">
      <text>To qualify to take the examination, an applicant must submit evidence of successful completion of the training program.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The examination shall be:</text>
      <paragraph num="(1)">
        <text>Divided into a State-specific section and a general section;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Based on a content outline that is approved by the Commissioner in consultation with the Maryland Health Benefit Exchange;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Reviewed by the Commissioner on a periodic basis, in consultation with the Maryland Health Benefit Exchange, to ensure that it accurately measures an applicant’s competency in the required areas of knowledge;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>In writing, but may be administered electronically to an applicant;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Conducted in specified locations throughout the State which have been approved by the Commissioner;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Conducted in facilities that comply with the Americans with Disabilities Act of 1990 as amended by 42 U.S.C. §12101, et seq.; and</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Administered quarterly, or more frequently if deemed appropriate by the Commissioner.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Each section of the examination shall be scored separately.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The Commissioner shall establish a minimum passing score, in consultation with the Maryland Health Benefit Exchange, for each section of the examination.</text>
    </paragraph>
    <paragraph num="E.">
      <text>An applicant who fails a single section of the examination may retake the failed section of the examination within 1 year of the initial examination date. If the applicant does not pass the failed section within that time, the applicant must retake both sections of the examination to be eligible to pass the examination. The examination may be taken no more than three times in a 6-week period.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Changes to Information in the Application.">
    <paragraph num="A.">
      <text>Within 30 days after a change to any information in an initial or renewal application, a licensee shall file with the Commissioner, in a form required by the Commissioner, the change in information.</text>
    </paragraph>
    <paragraph num="B.">
      <text>If a licensee fails to timely file with the Commissioner a change to the information specified in §A of this regulation, the licensee is in violation of Insurance Article, §31-112(e)(1)(i), Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="License Term.">
    <paragraph num="A.">
      <text>An initial license expires on the last day of the licensee’s birth month following the second anniversary of the effective date of the initial license.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A renewal license expires on the second anniversary of its effective date.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="License Renewal.">
    <paragraph num="A.">
      <text>To qualify to renew a license, a licensee:</text>
      <paragraph num="(1)">
        <text>Shall submit to the Commissioner a renewal application approved by the Commissioner;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Shall pay a license renewal fee if permitted by law;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Shall submit to the Commissioner any additional information the Commissioner deems necessary;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Shall complete the continuing education requirements as set forth in §A(7) of this regulation;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Shall be of good character and trustworthy;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>May not have committed any act the Commissioner finds would warrant suspension or revocation of a license under Insurance Article, §31-112(e), Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Shall complete 16 credit hours of continuing education during the prior license period as approved by the Administration in consultation with the Maryland Health Benefit Exchange. The credit hours shall include the following:</text>
        <paragraph num="(a)">
          <text>A minimum of 9 credit hours in health insurance; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A minimum of 3 credit hours in ethics;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>Shall have paid all undisputed taxes and unemployment insurance contributions payable to the Comptroller of Maryland and the Secretary of Labor or have provided for payment in a manner satisfactory to the unit responsible for collection; and</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Shall have paid any amount in arrears on an applicant’s child support obligation, if any, or have provided for payment in a manner satisfactory to the unit responsible for collection.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A renewal application is considered timely filed if:</text>
      <paragraph num="(1)">
        <text>The application contains all of the required information;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The renewal license fee, if permitted by law, has been received by the Administration; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The application is:</text>
        <paragraph num="(a)">
          <text>Mailed and postmarked on or before the expiration date of the license; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Submitted electronically and received by an information processing system that the Administration has designated for the purpose of receiving electronic applications prior to the expiration date of the license.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>If, at least 2 calendar weeks before a license expires, the licensee makes sufficient application for renewal of the license, the license shall not expire until:</text>
      <paragraph num="(1)">
        <text>The Administration takes final action on the renewal application; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The time for seeking judicial review of the action expires or any judicial stay of the Administration’s final action expires.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Expired License Reinstatement.">
    <paragraph num="A.">
      <text>An individual whose license has expired:</text>
      <paragraph num="(1)">
        <text>Is prohibited from acting as a SHOP Exchange navigator in the State; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>For up to 1 year after the expiration date of the license, may obtain reinstatement of the expired license by:</text>
        <paragraph num="(a)">
          <text>Submitting to the Commissioner a reinstatement application approved by the Commissioner;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Meeting all of the renewal requirements under Regulation .08(A) and (B) of this chapter; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Paying to the Administration the reinstatement fee, if permitted by law.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>An individual who does not qualify for reinstatement under §A(2) of this regulation may apply for an initial license as described in Regulation .04 of this chapter.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The Commissioner may waive the reinstatement procedures for a SHOP Exchange navigator who is unable to comply with the renewal and reinstatement procedures due to:</text>
      <paragraph num="(1)">
        <text>Military service; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Other extenuating circumstances, including a long-term medical disability.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Insurance Article, §§2-109 and 31-112, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: March 4, 2013 (40:4 Md. R. 348)</annotation>
  </annotations>
</chapter>