© 2018 National Association of Insurance Commissioners 28
Q 73: Will an insurance agent or broker show consumers all of the plan choices available through the [insert name of
state exchange]?
In [insert name of state], agents and brokers aren’t required to show consumers all available health plans. If the consumer is
using the [insert name of state exchange] website with the help of an agent or broker, all QHP choices will be displayed. If
the agent or broker goes through an insurance company portal, all plans available through the [insert name of state exchange]
may not be shown, but other plans available in the market outside the exchange—that aren’t eligible for the advance premium
tax credit—may be shown. Consumers should ask the insurance agent or broker if they’re being shown all of the plans
available through the [insert name of state exchange] and whether tax credits or cost-sharing reductions apply to the plans
they are looking at.
All agents and brokers must follow applicable [insert name of state] laws, regulations, and [insert name of state exchange]
requirements, including standards related to relationships or appointments with insurance companies.
[Insert name of state] expects that the insurance agent or broker will tell consumers if the information given is about health
plans with which the agent or broker has a business relationship and that consumers can always directly access the [insert
name of state exchange] website. They’ll find information about other available qualified health plans there. The [insert name
of state] expects that insurance agents and brokers will advise consumers to check with the [insert name of state exchange]
about available tax credits or cost-sharing reductions.
Drafting Note: States should modify this answer if agents and brokers are required to show consumers all options available
through the exchange.
Q 74: Will consumers have to share their personal information, including their tax returns, with an agent or broker,
navigator, in-person assistance personnel, or certified application counselor?
No. A consumer isn’t required to share personal information, including tax returns, with an agent or broker, navigator, in-
person assistance personnel, or certified application counselor. When consumers complete the application on the [insert name
of state exchange] website with the help of an agent or broker, navigator, or assister, they should be able to fill out and submit
their eligibility application without the agent, navigator or assister in direct view of the application. While consumers
applying for financial assistance are asked to enter income amounts, income figures from the IRS won’t be shown during the
application process, whether or not the consumer gets help filling out the application or does it independently. In [insert name
of state], after completing the registration and training, agents or brokers, navigators, in-person assistance personnel, and
certified application counselors must complete and comply with a privacy and security agreement and get a user ID to use
with the [insert name of state exchange].
Q 75: Will consumers have to share their account username and password with an insurance agent or broker,
navigator, in-person assister, or certified application counselor?
No. An agent or broker, navigator, in-person assistance personnel, or certified application counselor shouldn’t ask for a
consumer’s account username and password. If a consumer is asked to share a username or password, he or she should
contact the [insert name of state insurance department] at [insert phone number] and discuss this with the consumer
assistance representatives.
Q 76: What help should an insurance agent or broker, navigator, in-person assister, or certified application counselor
give consumers if they or their dependents are eligible for Medicaid or CHIP?
Agents or brokers, navigators, in-person assisters, and certified application counselors will work with all consumers who ask
for help with [insert name of state exchange] enrollment, including those eligible for Medicaid or CHIP. The [insert name of
state exchange] will send a notice to consumers who are eligible for Medicaid or CHIP. An agent or broker, navigator, in-
person assister, or certified application counselor working with these consumers is expected to refer consumers to the [insert
name of state agency]. Agent and broker, navigator, in-person assister, and certified application counselor training will
include information about where to direct Medicaid- or CHIP-eligible consumers.
Agents and brokers should be able to give consumers a referral to a navigator, in-person assister, certified application
counselor, or the [insert name of state Medicaid agency]. Navigators, in-person assisters, and certified application counselors
should help all consumers seeking assistance with completing an application through the [insert name of state exchange]. If
the [insert name of state exchange] assesses the consumer as Medicaid- or CHIP-eligible, the navigator, in-person assister, or