The U.S. Department of Health and Human Service awarded three organizations navigator grants in Wisconsin in 2014. These organizations are responsible for:
- Maintaining expertise in eligibility, enrollment, and program specifications;
- Conducting public education activities to raise awareness about the Marketplace;
- Providing information and services in a fair, accurate, and impartial manner, including information that acknowledges other health programs such as Medicaid and CHIP;
- Facilitating selection of a Qualified Health Plan;
- Providing referrals for enrollees with questions, complaints, or grievances about their health plan, coverage, or a determination under such health plan or coverage to any applicable office of health insurance consumer assistance or health insurance ombudsman or any other appropriate state agency or agencies;
- Providing information in a culturally and linguistically appropriate manner, including to persons with limited English proficiency;
- Ensuring accessibility and usability of Navigator tools and functions for persons with disabilities.
2016-2019 Navigator awardees
Covering Wisconsin (CWI) plans to build upon their 2014-15 Navigator region, and expand into targeted contiguous areas where gaps exist and substantial vulnerable populations remain underserved. This includes is but not limited to uninsured, underinsured, farmers, small business owners and their employees, migrant workers, racial and ethnic minorities, including Latino and Hmong consumer, and those who have limited English proficiency or financial and health literacy skills.
Northwest Wisconsin Concentrated Employment Program, Inc.
The Northwest Wisconsin Concentrated Employment Program, served as a 2013 and 2014 Navigator grantee and will continue to lead a Navigator project in their region to promote accessibility to health insurance Marketplace and the health care system in Wisconsin. They will conduct education and enrollment events at Job Center offices and at rural outreach sites, including libraries, schools, 44 | Page community centers, partner entity worksites and hospitals. They will also provide direct assistance for either face-to-face or phone contact for either enrollment, re-enrollment or other related services, including assistance with filing for exemptions, handling grievances, applying for Medicaid or CHIP, making changes to their application and working with tax forms.
Forest County Potawatomi Community
Forest County Potawatomi Community served as a 2014 Navigator grantee and will continue providing Tribal consumers with direct access to culturally competent Navigator assistance. Navigators will be trained and housed within each tribal community. This project will provide Tribal governments in Wisconsin and Michigan with sustainable access to information about and assistance with enrollment in Qualified Health Plans (QHP) and state Medicaid programs through Federally-Facilitated Marketplaces. Forest County Potawatomi Community will also serve as a Navigator grantee in Michigan.
State Regulation and Training of Navigators
Wisconsin Office of the Commissioner of Insurance (OCI), Navigator Information page
Navigator Resource Guide from Robert Wood Johnson Foundation