Section 6.96. Prohibited business practices.

  In addition to the prohibited acts contained in s. 628.95 (2) , Stats., navigators, navigator entities, nonnavigator assisters and nonnavigator assister entities are prohibited from all of the following:

(1)  Providing enrollment or other specific information regarding a health benefit plan that is not offered in the federal exchange.

(2)  Providing a recommendation comparing health benefit plans that may be better or worse for the consumer or employer.

(3)  Making misleading statements to a consumer or employer regarding or otherwise misrepresenting one's qualifications or services.

(4)  Offering a recommendation directly to a consumer or employer regarding a particular health benefit plan concerning deductible, coinsurance, or any substantive benefits, terms, or conditions of the contract.

(5)  Asking or urging a consumer to apply for a particular health benefit plan from a particular insurance company.

(6)  Distributing cards, documents or advertisements regarding a particular health insurer.

(7)  Recommending a particular health benefit plan or insurer.

(8)  Receiving consideration directly or indirectly from any health insurer in connection with the enrollment of individual or employees into a qualified health plan as defined 45 CFR 155.20 , as amended.

(9)  Using a single appointment for selling, soliciting or advising a consumer or employer about a product other than health benefit plans by a navigator or nonnavigator assister who is also a licensed insurance agent. Insurance agents shall make a separate appointment with the consumer or employer for selling, soliciting, or advising about a product other than a health benefit plan.

History: EmR1314 : emerg. cr. eff. 9-10-13; CR 13-113 : cr. Register August 2014 No. 704 , eff. 9-1-14; correction in (8) made under s. 13.92 (4) (b) 7. Register August 2014 No. 704 .