Illinois Navigator Grant Program Plan Year 2027

Who can apply

Small Businesses, Others, Government Organizations, Education Organizations, Public Housing Organizations, Nonprofit Organizations, For-Profit Organizations Legally recognized organizational entities based within Illinois (including local chapters of national organizations). The minimum eligibility requirements for entities responding to this NDFI are consistent with the final regulations issued by the U.S. Department of Health & Human Services on March 27, 2012, April 3, 2013, and May 16, 2024 (45 CFR 155.210 and 45 CFR 155.215). An entity may not apply for a grant until the entity has registered and pre-qualified through the Grant Accountability and Transparency Act (GATA) Grantee Portal. Pre-Registration: An entity may not apply for a grant until the entity has registered and pre-qualified through the Grant Accountability and Transparency Act (GATA) Grantee Portal, www.grants.illinois.gov/portal. Registration and pre-qualification are required. Pre-Qualification: During pre-qualification, verifications are performed including a check of federal SAM.gov Exclusion List and status on the Illinois Stop Payment List. The Grantee Portal alerts the entity of “qualified” status or informs how to remediate a negative verification (e.g., missing UEI- Unique Entity Identifier assigned in sam.gov, not in good standing with the Secretary of State). Inclusion on the SAM.gov Exclusion List cannot be remediated. Eligible Applicants: Get Covered Illinois will only accept letters of intent through an application in Euna from current Navigator grantees who are legally recognized organizational entities; applications from individual persons will not be considered. Only organizations based within Illinois (including local chapters of national organizations) are eligible for these funds. The minimum eligibility requirements for entities responding to this NDFI are consistent with the final regulations issued by the U.S. Department of Health & Human Services on March 27, 2012, April 3, 2013, and May 16, 2024 (45 CFR 155.210 and 45 CFR 155.215). Pursuant to these regulations and the Affordable Care Act (ACA), organizations eligible to apply for funding include the following: - Community and customer-focused nonprofit groups. - Trade, industry, and professional associations. - Commercial fishing industry organizations, ranching and farming organizations. - Chambers of commerce. - Unions. - Resource partners of the Small Business Administration. - Other public or private entities that meet the requirements of this section. - Other entities may include but are not limited to Indian tribes, tribal organizations, urban Indian organizations, and State or local human service agencies and other government entities, including local Public Health Departments. To receive a grant, an applicant must: - Be capable of carrying out duties described in CFR:: 45 CFR Part 155 Subpart C Section F, "Program Requirements" (see Appendix II for a web link to this regulation). - Demonstrate to Get Covered Illinois that the entity has existing relationships, or could readily establish relationships, with Illinois customers (including uninsured and underinsured customers) likely to be eligible for enrollment in a QHP or Medicaid – with a plan to target those eligible for QHPs. - Meet the certification standards prescribed within this application. - Agree to use and actively maintain platform find help tool. - Provide a complete employee roster by August 31st of each plan year and update within 2 days, if changes are made. - Not have a conflict of interest during the term as grantee defined in the section below; and - Comply with the privacy and security standards adopted by the US Department of Health and Human Services (HHS), IDOI, GCI, and HFS, including those found in 45CFR 155.260 (see Appendix II for a web link to this regulation). Organizations receiving consideration from health insurance issuers for reasons other than enrollment in insurance products (e.g., reimbursement for the provision of medical services, or grant funding for educational activities related to community health) are ineligible to apply for this grant. To receive a grant or participate in the grant program, an applicant or grantee may not: - Be a health insurance or stop-loss insurance issuer. - Be a subsidiary of a health insurance or stop-loss insurance issuer. - Be an association that includes members of, or lobbies on behalf of, the insurance industry; or, - Receive any consideration directly or indirectly from any health insurance or stop- loss insurance issuer in connection with the enrollment of any individuals or employees in a QHP or a non-QHP, though no health care provider shall be ineligible for participation in this grant program solely because it receives consideration from a health insurance issuer for health care services provided. - Charge any applicant or enrollee, or request or receive any form of remuneration from or on behalf of an individual applicant or enrollee, for application or other assistance related to Illinois Navigator program duties. - Provide gifts, including gift cards or cash, unless they are of nominal amount, or provide promotional items that market or promote the products or services of a third party, to any applicant or potential enrollee as an inducement for enrollment. Gifts, gift cards, or cash may exceed nominal amount for the purpose of providing reimbursement for legitimate expenses incurred by a customer in effort to receive application assistance, such as, but not limited to, travel or postage expenses. - Use grant funds to purchase gifts or gift cards, or promotional items that market or promote the products or services of a third party that would be provided to any applicant or potential enrollee. - Solicit any customer for application or enrollment assistance by going door-to-door or through other unsolicited means of direct contact, including calling a customer to provide application or enrollment assistance without the customer initiating the contact, unless the individual has a pre-existing relationship with the Navigator or Navigator entity and other applicable State and Federal laws are otherwise complied with. Outreach and education activities may be conducted by going door-to-door or through other unsolicited means of direct contact, including calling a customer. - Initiate any telephone call to a customer using an automatic telephone dialing system or an artificial or prerecorded voice, except in cases where the Navigator or Navigator entity has a relationship with the customer and so long as other applicable State and Federal laws are otherwise complied with. Conflict of Interest: All applicants and grantees must have a signed conflict of interest form on file for each Administrator, Program Manager and Navigator attesting the adherence to the following conflict-of-interest disclosure requirements: - Certain conflicts of interest, while not a bar to serving as an Illinois Navigator, must be disclosed to Get Covered Illinois and to each customer receiving application assistance (which includes pre-enrollment and post-enrollment services, but does not include outreach and education assistance). Disclosures include: - Any lines of insurance business, other than health insurance or stop loss insurance, which the Navigator intends to sell while serving as a Navigator. - Any existing and former employment relationships they have had within the last five years with any issuer of health insurance or stop loss insurance, or subsidiaries of such issuers. - Any existing employment relationships between any health insurance issuer or stop-loss insurance issuer, or subsidiary of such issuers, and the individual’s spouse or domestic partner. - Any existing or anticipated financial, business, or contractual relationships with one or more issuers of health insurance or stop loss insurance or subsidiaries of such issuers. - Upon request, all Illinois Navigator entities must submit a written plan to remain free of conflicts of interest during their term as Illinois Navigators. Applicant organizations may also apply for and receive funding through other programs providing funding for ACA enrollment assistance efforts. However, applicant organizations that are selected for the Illinois Navigator grant program may not use other funding sources designated for outreach, education, or enrollment through the Marketplace to pay staff working as Illinois Navigators under this grant program. Each Illinois Navigator staff member’s time must be dedicated fully to the performance of this grant’s detailed activities (e.g., no job sharing or adding navigator duties to an existing role). Additional outreach and enrollment staff may be certified to support the funded program staff with other funding streams. Organizations that receive funding through another program must demonstrate that activities performed under the Illinois Navigator program will be distinct from those performed under the other program and maintain separate accounting and financial records for each program. If an organization is applying for funding for the same activities through this NDFI and another program, please include an attachment that clearly identifies areas of overlap. If the organization receives an award in any of these areas, it will not be eligible for funding through this NDFI for overlapping activities or program staff. If an organization receives funding from another source, it should submit the Project Narrative or similar document submitted with that application.