Navigator Resource Guide on Private Health Insurance Coverage & the Health Insurance Marketplace

Updated Resource Guide Prepares Navigators for Enrollment Push Before March 31

Prepared by Georgetown University's Center on Health Insurance Reforms, this guide is intended to supplement the Navigator training available from HHS and help answer questions people may have about the private insurance reforms in the Affordable Care Act. This comprehensive resource addresses more than 230 enrollment questions about everything from tax credits and cost standards to enrollment periods, and more.

This resource is organized into sections that address how individuals may present themselves to Navigators, based on their insurance status and coverage options.

  • Section 1 covers enrollment issues for individuals, beginning with those who do not have coverage or an offer of group coverage, i.e., from an employer.
  • Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage—whether through an employer-sponsored plan, individual plan, high-risk pool, retiree plan, or student health plan—and want to understand their options, including eligibility for premium tax credits through the health insurance marketplace.
  • Section 3 covers enrollment issues for small employers who want to understand and compare their coverage options for their employees.
  • Section 4 covers post-enrollment issues, including questions that may arise as individuals use their coverage.

Information in this guide is current as of February 21, 2014. Future supplements will incorporate changes to federal rules. While we have made every effort to provide accurate information in this resource guide, navigators should contact their state’s marketplace, Department of Insurance, or Medicaid agency for guidance on specific circumstances.