The federal exchange navigators will have a lot of work ahead of them, and a few at the very top will get paid up to $48 an hour.
According to newly released projections from the Centers for Medicare & Medicaid Services, the federal navigators hired to help Americans buy insurance on the coming exchanges will provide 1.7 million "help" sessions a year.
A navigator will likely spend an average of one hour per client, with about 10 minutes of each hour being devoted to recordkeeping. The exchanges are at first expected to generally serve uninsured individuals buying coverage, rather than employers.
In its latest word on how the system should work, CMS said a client-level navigator/caseworker should be paid about $20 per hour, while the time of a mid-level project leader will be about $29 per hour. Senior-level executives will earn $48 per hour.
The Patient Protection and Affordable Care Act requires each PPACA health insurance exchange to hire navigators -- who are not paid by health insurers -- to help consumers understand how to use the exchange system.
Navigators will be hired in the 34 states in which the federal government is running the coming Obamacare marketplaces or where the state is engaged in a partnership with the federal government. In those states, the Department of Health and Human Services is making available $54 million.
The administration has said that navigators do not have to be licensed agents or brokers and may not be paid by insurance companies, a move that angered many in the industry. Republicans have slammed the navigator programs, and stood up for brokers and agents, arguing they are trained professionals who have the experience and requirements to guide consumers in their health plan options.
The new CMS navigator reporting system would affect only navigators in states with all-federal, "federally facilitated exchanges," and the states with federal-state "state partnership exchanges."
CMS prepared the navigator activity projections when estimating the cost of the CMS-10463 navigator reporting program. CMS came up with the cost estimates to comply with federal Paperwork Reduction Act of 1995 requirements.
The agency is expecting to provide federal exchange navigator organization grants for 264 organizations, with each organization employing an average of seven "caseworkers," or staff navigators.
At a typical navigator organization, officials said, seven caseworkers will spend about 1,078 hours per year on navigator help session recordkeeping.
If total help session time amounts to six times session recordkeeping time, then the caseworkers would be spending 8,124 hours per year on help sessions. That would be enough time to provide 8,124 one-hour help sessions.
CMS put the navigator recordkeeping system through a 60-day public comment period that began April 12.
"Several commenters suggested navigator awardees reporting requirements be expanded to include demographics and [other] standards, specifically sexual orientation and gender identity," officials said.
CMS decided against including information about clients' sexual orientation or gender identity, such as whether consumers are transsexual, in the navigator reporting program. Complying with that kind of requirement would be impractical, because navigators will not be retaining personal information on a consumer other than a consent form that will let the navigator help the consumer, officials said.
"The only demographic information associated with a consumer is the information provided by the consumer in their application for coverage through the marketplace," officials said. "Navigators will not retain copies of the application."