Virginia Code 38.2-3456: Prohibited activities.
A. A navigator shall not:
Terms Used In Virginia Code 38.2-3456
- Commission: means the State Corporation Commission. See Virginia Code 38.2-100
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Exchange: means either a (i) federal health benefit exchange established by the Secretary of the U. See Virginia Code 38.2-3455
- Insurer: means an insurance company. See Virginia Code 38.2-100
- Navigator: means an individual or entity described in Virginia Code 38.2-3455
- Qualified dental plan: means a limited scope dental plan that has in effect a certification that the plan meets the criteria for certification described in § 1311(d)(2)(B)(ii) of the Patient Protection and Affordable Care Act, P. See Virginia Code 38.2-3455
- Qualified health plan: means a health benefit plan that has in effect a certification that the plan meets the criteria for certification described in § 1311(c) of the Patient Protection and Affordable Care Act, P. See Virginia Code 38.2-3455
- Secretary: means the Secretary of the U. See Virginia Code 38.2-3455
- State: means any commonwealth, state, territory, district or insular possession of the United States. See Virginia Code 38.2-100
1. Engage in any activity that would require an insurance agent license under this title;
2. Offer advice about which qualified health plan or qualified dental plan is better or worse for a particular individual or employer;
3. Act as an intermediary between an employer and an insurer that offers a qualified health plan or qualified dental plan offered through an exchange;
4. Violate any unfair trade practice and privacy requirements in §§ 38.2-502, 38.2-503, 38.2-506, 38.2-509, 38.2-512, 38.2-515, 38.2-612.1, 38.2-613, and 38.2-614 to the extent such requirements are applicable to the activities of navigators; or
5. Receive compensation for services or duties as a navigator that are prohibited by federal law, including compensation from a health carrier.
B. An individual or entity shall not claim to be, or otherwise hold himself or itself out as, a navigator or conduct business as a navigator in the Commonwealth without:
1. Having been selected as a navigator in accordance with applicable federal or state law;
2. Having evidence of successful completion of all navigator requirements prescribed by the Secretary or the Exchange; and
3. Having met requirements established pursuant to § 38.2-3457.
C. If an individual or entity has engaged in the Commonwealth in one or more of the prohibited activities identified in this section, a complaint may be filed with the Commission. The Commission, upon investigation and verification of the prohibited activity or activities, may order such individual or entity to cease and desist such prohibited conduct.