Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges

Background
The Cooperative Agreement to Support Navigators in Federally-facilitated Exchanges (Funding Opportunity) will enable recipients to operate as Exchange Navigators in states with a Federally facilitated Exchange (FFE), as authorized by the Affordable Care Act (ACA). Each year, the Centers for Medicare & Medicaid Services (CMS) makes grant awards to organizations who serve as Navigators in FFE states. Navigators help consumers prepare applications to establish eligibility and enroll in coverage through the Exchanges, and help determine whether consumers potentially qualify for insurance affordability programs. They also provide outreach and education to raise awareness about the Exchanges. As trusted community partners, Navigators are required to provide targeted assistance to underserved and vulnerable populations within the Exchange service area, which is critical to improving access to health care coverage for communities that often experience a disproportionate burden of disease.

Grant Details
The purpose of this funding opportunity is to provide funding to eligible individuals or organizations to operate as Navigators in states with an FFE, as authorized by the Affordable Care Act (ACA). Organizations and individuals cannot serve as Navigators without receiving funding through this NOFO. The program requirements include conducting public education activities, providing information and services in a fair, accurate, and impartial manner, facilitating selection of a Qualified Health Plan (QHP), providing referrals to health insurance consumer assistance or health insurance ombudsman offices, complying with applicable training and conflict of interest standards, obtaining authorization of applicants for coverage available through an Exchange application prior to accessing their personally identifiable information (PII), assisting consumers with complex cases, coverage to care issues, general tax information related to the Exchange, exemptions, and appeals. Additionally, Navigators must provide targeted assistance to underserved or vulnerable populations within the Exchange service area.

Eligibility Requirements
Eligible applicants include government organizations such as state governments, county governments, city or township governments, special district governments, Native American tribal governments (federally recognized), Native American tribal organizations (other than federally recognized tribal governments), education organizations including independent school districts, public and state-controlled institutions of higher education, private institutions of higher education, nonprofit organizations having a 501(c)(3) status with the IRS or those that do not have a 501(c)(3) status with the IRS but are community and consumer-focused nonprofit groups. Other eligible entities include for-profit businesses, small businesses, individuals, and other entities capable of meeting the program requirements.

Period of Performance
The period of performance consists of five budget period increments of 12 months each over a five-year period.

Grant Value
Type: Cooperative agreement; Expected total funding for the program: $500M total over five years; Expected total awards: Up to 120; Funding range per FFE state for the period of performance: $6.25M to $84M over five years.