OnlineNavigator Fair Use Agreement and Terms of Service

revised September 21, 2017

OnlineNavigator service offers personal professional support with health insurance reform information, health insurance exchanges and online enrollment support that is not typically available through other resources. Service is based on the following terms of use:

  • Use of OnlineNavigator service is not authorized without your prior acceptance of these terms of service.
  • Your use of any OnlineNavigator service presumes that you have read, understand and accept these terms of service.
  • If you do not understand or agree with the terms of service then please do not use OnlineNavigator service.

Services. We may offer services that include:

  • Health insurance search and pre-screening for eligibility, suitability and affordability
  •  Medicare and Medicaid eligibility and pre-planning
  • Supplemental support for issues related to health care or planning

Eligibility. Employees of contracted businesses and members of contracted groups are eligible for service under the terms of the group service agreement. Service is not longer offered to users of any formerly contracted insurance exchange.

Email service and Telephone service. Telephone service is limited by the adviser's schedule and offered on a 'first come first served' basis. Email service is available at any time. Telephone support is available as individually scheduled. Both services are free of charge to the user but offered at the sole discretion of the adviser. Email response typically includes direct links to specific resources that may address your issue; this option is not possible with telephone service. Telephone service requires a pre-scheduled appointment. Unless otherwise indicated, response time is less than one business day for either email or telephone service.

OnlineNavigator fees. There are no user fees at this time. OnlineNavigator fees may be paid by a health insurance plan, health insurance exchange, employer, employee benefit plan, association or government entity.

Written authorization may be required prior to any service. This applies to both free and expanded services. The authorization form will be provided when we accept a request for service. Simply reply to the following  the embedded instructions.

No overlap of commercial insurance service. OnlineNavigator is not intended to offer services that are available through commercial insurance companies, agents and online services. If your request involves an issue or service that is commonly offered by a commercial insurance company, agent or broker then we may refer you to that provider for fulfillment of your request.

English language only. At this time we are able to offer service only to English-speaking residents of the United States. We may be able to refer a similar Spanish language service on request.

Best efforts basis. OnlineNavigator service is offered on a "best efforts basis". Information provided is based on sources believed to be reliable, but cannot be guaranteed.

Criteria for acceptance of service request. OnlineNavigator screens incoming requests in order to maximize the benefits of our service and minimize wasted time. The quality control criteria includes consideration of: 1) completeness and accuracy of the request (Do we have enough information to reach you by phone and e-mail and is the contact information accurate?) , 2) an evaluation of the authenticity of the request and the person making the request (Are you a real person with a real need for help?). This evaluation may include a check of compiled information from various social media sources including Google, Facebook, LinkedIn and others, and 3) other criteria that are designed to maximize the value of the services that we are able to provide. We are likely to decline a request, for example, that includes a fake name, an invalid e-mail address or from a person who is not fluent in English language. If you accidently provided incorrect information on a service address, that may be corrected by making a new request or contacting us to manually correct the request.

Limited scope of service. OnlineNavigator service is limited in scope to the services which are determined by the navigator to best serve each situation. In other words, we might not offer service options that we do not feel are appropriate in your situation even if you may request that service option.

Limited availability of service. OnlineNavigator service is limited based on time availability of a qualified navigator. In periods of peak demand, OnlineNavigator may not be able to accept all requests for service. We may also limit the total amount of service time offered or decline to offer service for any reason.

No warranty for service. OnlineNavigator is offered only on a "best efforts" basis. No warranty is offered in connection with the service. Specifically, we cannot offer assurance that you or your employees will be satisfied with the service we provide or with any third party service. We provide no assurance that state or federal regulators will agree with the opinions that we provide.

Recourse. In the event of dissatisfaction with any service, your recourse is limited to cancellation of the service and dismissal of any unpaid invoice.

Navigator's opinion. Advice offered is only the personal opinion of the navigator. The navigator does not have the authority to speak for any other person, regulatory agency, government, plan sponsor, insurance exchange or insurance company.

Source of authority. In the event of a conflict between the information provided by OnlineNavigator and any insurance policy, the insurance policy will always prevail.

Compliance with U.S. Department of Health and Human Services regulations CFR 155, 156 and 157. OnlineNavigator intends to comply with the federal regulations for independent health insurance advisers who assist individuals who use a federal insurance exchange. In accordance with these regulations. the following additional conditions are placed on service:

  • Your social security number must be provided to the insurance exchange to determine eligibility for some programs
  • If you are a member of a group applying for coverage but you are not applying for coverage for yourself or your dependents then you are not required to provide your social security number to the insurance exchange.
  • You may request consideration of only qualified health plans or only plans that are not qualified health plans. However, if you do elect to see qualified health plans then the navigator is required to show all plans for which you are eligible. If you request a non-qualified health plan then the navigator may show only plans that are recommended for you.

Dispute resolution. Any disputes arising from OnlineNavigator service will be arbitrated under the terms of the dispute resolution procedures of the American Arbitration Association including binding arbitration. By agreeing to these Term of Service, the parties acknowledge in advance that they give up certain rights to bring a complaint in the civil courts.