What is a Navigator? An individual or entity that conducts community outreach activities to raise public awareness about new health insurance exchange or “marketplace” options and facilitates enrollment of eligible individuals and small businesses into Qualified Health Plans (QHPs) through the health insurance marketplace.
What is required of Navigators? Navigators must have expertise in eligibility, enrollment rules and procedures for Tenncare, CoverKids, and marketplace tax credits, must be capable of facilitating enrollment of Qualified Health Plans, provide fair, accurate and impartial information and be able to provide referrals for grievances.
Who are Navigators in Knoxville? Knoxville Area Project Access (KAPA) is the Knox County and surrounding counties Navigator program.
What is a CAC (Certified Application Counselor) entity? A community based organization, medical provider, or other 501c organization with expertise in social service program that will assist Navigators in educating the public on the health insurance exchange and facilitate enrollment in qualified health plans on the marketplace and for Tenncare and CoverKids.
When does the health insurance exchange take place? Open enrollment for the health insurance exchange takes place October 1st 2013- March 31st 2014. After that point, consumers only can get health coverage for 2014 through a special enrollment period. A special enrollment period occurs if a consumer has a qualifying life event such as move to a new state, change in income, or change in family size.
How will I afford health insurance plans? Premium tax credits and cost-sharing reductions may be available through the Marketplace. Premium tax credits can lower consumers’ monthly premiums right away for enrollment in a qualified health plan (QHP) through the Marketplace. If consumers are eligible, the value of the tax credit may either be paid directly to the health insurance company or given to consumers as a refund at the end of the year when they file their federal income taxes.
To be eligible consumers must:
File federal income taxes annually
Have household incomes of at least 100% but not more than 400% of the federal poverty level
Enroll in a qualified health plan through the Marketplace
Be ineligible for minimum essential coverage through either public programs or their employers
What if I don’t sign up for a qualified health plan and remain uninsured? If consumers decide not to enroll during an open enrollment period, the consumer will have to pay a fee under the individual responsibility requirement. The fee in 2014 is $95 per adult or 1% of annual family income, whichever is higher. The first fee will be due when consumers file their 2014 federal income tax returns in 2015.
How do I reach KAPA to speak with a Navigator?* You can call into KAPA’s office at 531-2766 to request to speak with a Navigator.
How do I get more information regarding the Affordable Care Act?* You can visit www.healthcare.gov or call KAPA at (865) 531-2766.
*Please direct all media inquiries to Jules Morris at 865-805-8345
*Information Updated 9/25/2013
Our Tennessee Navigator line is live! Calling (866) 720-1711 is an excellent solution for any after hours questions. You can leave messages that will be sent directly to KAPA representatives.
The best way to protect yourself from fraud in the Health Insurance Marketplace is to be informed ---> read more here