Illinois Navigator Grant Program Plan Year 2027

Illinois Navigator Grant Program Plan Year 2027

For Plan Year 2027 the Illinois Navigator Grant opportunity is only available to the five grantees that were awarded the Plan Year 2025 Illinois Navigator Grant. The Merit Based Review has been completed.

The Illinois Department of Insurance (DOI) and Get Covered Illinois (GCI) are jointly posting this Non-Discretionary Funding Information (NDFI) for the Illinois Navigator Grant Program Plan Year 2027. The purpose of this NDFI is to provide grant funding to support a robust, statewide Illinois Navigator program. States running their own State Based Marketplace are responsible for performing all marketplace functions for the individual market. Customers in these states apply for and enroll in coverage through marketplace websites established and maintained by the state. This funding opportunity targets organizations seeking to assist eligible Illinois residents in enrolling in health coverage options and affordability programs made available through Get Covered Illinois, the state’s official Health Insurance Marketplace. Grant proposals that identify and serve populations currently without health insurance and are expected to benefit from the Affordable Care Act’s (ACA) provision of financial assistance for the purchase of Qualified Health Plans (QHPs) on Get Covered Illinois and the Illinois Medicaid program will be favored by DOI and GCI. The State is particularly focused on serving individuals who would have difficulty enrolling in coverage without the help of an Illinois Navigator, including (but not limited to) individuals with low literacy, limited English proficiency, low- income individuals, people with disabilities, people who are or at risk of experiencing homelessness and other hard-to-reach populations.

Eligible Illinois residents will be able to enroll in or make changes to their current Marketplace health coverage through Get Covered Illinois throughout the Open Enrollment period (and through any potential extensions). Enrollment must occur during this period unless an individual experiences a loss of other health coverage or another qualifying life event which triggers a special enrollment period (SEP).

Enrollment will occur 24 hours a day, 7 days a week during the entire open enrollment period. Medicaid eligible individuals will be able to enroll in coverage at any time throughout the year.

Through this NDFI, the State is seeking to award funding to eligible organizations to perform the following duties prior to, during, and after the Open Enrollment period:

• Maintain expertise in eligibility, enrollment, and program requirements through the Get Covered Illinois Learning Management System (LMS), Get Covered Illinois State Based Marketplace platform, technical training, and other Navigator-specific professional development trainings.

• Conduct daily outreach and public education activities through two or more out of office events at a physical location weekly with one or more navigators present, social media posts, and community stakeholder engagement to raise awareness about Get Covered Illinois, Illinois Medicaid and utilization of health coverage.

• Provide information and services in a fair, accurate, ethical, and impartial manner, which includes providing information that assists customers with submitting the eligibility application; clarifying distinctions among health coverage options, including QHPs; and helping customers make informed decisions during the health coverage selection process.

• Facilitate selection of a QHP or, when appropriate, a public insurance plan.

• Provide referrals to the Illinois Department of Insurance, or any other appropriate State agency, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage.

• Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by Get Covered Illinois at no cost to those individuals, including individuals with limited English proficiency, and ensure accessibility and usability of Illinois Navigator tools and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act; and

• All funded navigators maintain a physical presence in the Marketplace service area, so that face-to-face assistance in a private location to protect Personally Identifiable Information (PII) can be provided to applicants and enrollees.

Details

• Awarding Agency: Illinois Department of Insurance
• CSFA Number: 446-00-3995
• Announcement Type: Renewal
• Award Type: Non Competitive
• Total Funding Available: $0.00
• Expected Number of Awards: 5
• Funding Sources: State
• Capital Grant: No
• Indirect Costs Allowed: No
• Posted Date: 2026-04-28
• Award Period: 2026-07-01 – 2027-06-30

Funding Source Description

Funding Information

Cost Sharing or Matching:

There is no cost sharing or matching for this program.

Funding for the 2027 Illinois Navigator Grant Program will be determined by service area, the number of Illinois Navigators proposed, and the associated costs, as outlined in Appendix I.

Applicants are required to submit information for each service area in which they would like to perform activities under the Illinois Navigator program. Applicants may apply as a single organization or as a partnership of organizations; each organization in the partnership may operate in one or more counties.

Applicants applying as a partnership of organizations must designate a Lead Grantee. Funding and reimbursements will be paid by the Illinois Department of Insurance (DOI) through the Lead Grantee. Lead Grantees will be responsible for remitting payment to all partnership organizations and that the proposed service area is covered as outlined in the original application.

• Total amount of funding to be awarded: $7,000,000
• Anticipated number of state awards: 3-5
• Amount of individual awards: (can be range) $500,000 - $2.5 M
• Anticipated start date: July 1, 2026
• Periods of performance for new state awards: July 2026 through June 2027

Allowable costs:

Grant funding is intended to support the provision of in-person and virtual/remote application assistance to Illinois customers eligible for enrollment into QHPs, premium tax credits and cost-sharing reductions, and/or Medicaid. Grant funding will also be used to provide outreach and education to eligible populations and provide post-enrollment support to individuals served by the grantee organization.

Examples of eligible expenses include, but are not limited to

hiring new staff to perform grant activities,

paying current staff for performing grant activities,

expenses associated with travel to and from locations at which grant activities are performed,

production of materials to promote awareness of the specific organization’s services as an Illinois Navigator entity (example: event flyers).

Educational and marketing materials describing features of the Illinois Marketplace, eligibility requirements, enrollment processes, common features of health insurance products, and other materials not specific to promoting awareness of individual Illinois Navigator entities will be produced by the State. Applicants should therefore not apply for funding for the production of such materials.

The grant funds may not be used:

For institutional, organizational, or community-based overhead costs not directly related to grant objectives, indirect costs, or levies.

To cover the costs to provide direct health care services to individuals.

To match any Federal funds.

To provide services, equipment, or support that are the legal responsibility of another party under Federal or State law (such as vocational rehabilitation or education services) or under any civil rights laws. Such legal responsibilities include, but are not limited to, modifications of a workplace or other reasonable accommodations that are a specific obligation of the employer or other party.

To support existing State, local, or private funding of infrastructure or services such as staff salaries, etc.

To cover any pre-award costs.

To assist customers residing in a State other than Illinois. Grantees may provide these customers with basic information about Health Insurance Marketplaces, but should refer them to other state Navigators, the Get Covered Illinois Call Center, and other resources within the State where the customer resides for more in-depth assistance.

For any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before the Congress or any state government, state legislature or local legislature or legislative body. Grant recipients may lobby at their own expense if they can segregate federal funds from other financial resources used for that purpose.

To purchase gifts, gift cards, or to provide cash gifts.

To cover the cost of food or beverage

Funding Restrictions

See Funding Source Description

Administrative and National Policy Requirements

Statutory Requirements:

Grantees must comply with all legal requirements related to procurement, environmental concerns, labor standards, and other requirements. Failure to comply with any legal requirement or other requirement specified in the grant agreement may result in suspension or termination of the grant agreement, grant funds being repaid by the Grantee, the withholding of future grant payments by DOI, or other remedy provided by law. In addition to the below requirements, Grantees must comply with all rules, regulations, and laws applicable to the grant program, as may be listed in this NOFO.

Reporting

Reporting, Monitoring, and Audit Requirements:

Grantees must complete multiple reports during the term of the grant and potentially after the grant has ended. This will include, but is not limited to, financial and performance reports, closeout report, and labor hour reports. Grantee is subject to the audit rules and policies set forth by the Governor’s Office of Management and Budget as found in 30 ILCS 708/65(c) and 44 Ill. Admin. Code 7000.90. Deadlines for any required reports may be extended at the discretion of DOI and Get Covered Illinois. Extensions shall be issued only in extraordinary circumstances not in control of the grantee.

Grantee must complete weekly performance metrics on a form provided. See example of weekly metrics Appendix III.

Grantee must report out of office events on a form or platform provided by Get Covered Illinois.

Grantee must complete periodic financial reporting at least quarterly using the State grant management system.

More frequent or additional reporting may be required in the grant agreement based on the successful applicant’s risk assessments.

In addition to required reporting, grantees are subject to fiscal and programmatic monitoring visits by Get Covered Illinois in accordance with 2 CFR 200.336. Grantees must have an open-door policy allowing periodic visits by Get Covered Illinois to evaluate the progress of the project and must provide documentation upon request. Get Covered Illinois staff will also maintain contact with the participants and will monitor progress and performance under the terms of the agreement(s). DOI and Get Covered Illinois may modify grants based on performance.

Grantees shall be subject to Illinois’ statewide Audit Report Review requirements. Terms of the Single Audit Act Amendments of 1996 (31 USC 7501-7507), Subpart F of 2 CFR Part 200, and the audit rules set forth under the Grant Accountability and Transparency Act shall apply. (See 30 ILCS 708/65).

Reporting:

Grantees will be required to participate in regular calls and meetings with the state and other organizations providing application assistance and outreach services to share best practices and coordinate activities within common geographic regions.

Grantees will be required to abide by the grant agreement, submit Periodic Performance Report and Periodic Financial Report, progress reports on a quarterly basis, expenditure reports every month, and communicate performance data to Get Covered Illinois on a regular basis. In addition, individual navigators will be required to submit events and weekly enrollment metrics as determined by Get Covered Illinois.

Additional Information

https://getcovered.illinois.gov/

Program Requirements Activities:

Organizations awarded funding through this grant opportunity will be required to provide in-person assistance to eligible individuals seeking to enroll in QHP (including advanced premium tax credits and cost-sharing reductions) or Medicaid coverage, particularly with federal eligibility changes due to HR1.

The list of required duties includes those referenced in Appendix I of this application. In addition, outreach and education activities must be performed by all granted partners to raise awareness and knowledge of coverage options in Illinois.

Examples of required outreach and educational activities include but are not limited to:

Canvassing local communities and small businesses

Developing community contacts

Educational presentations

Visibility and tabling events

Using social channels to promote educational and enrollment activities

Stakeholder engagement

IDOI and Get Covered Illinois are committed to engaging the communities that we are serving at times that are most beneficial to the public. Grantees and Illinois Navigators must be regularly available for client services during evening and weekend hours.

Due to the condensed open enrollment period, granted organizations and Illinois Navigators will limit the period of office closure, not to exceed four days throughout the Open Enrollment period (and through any potential extensions). Grantees must review their plan for enrollment coverage during emergency closures with Get Covered Illinois.

It is an expectation of this grant funding that Illinois Navigators will conduct daily outreach. Examples of this are public education activities outside of the grantee offices through two or more events at a physical location weekly with one or more navigators present, social media posts, and community stakeholder engagement to raise awareness about Get Covered Illinois, Illinois Medicaid and utilization of health coverage. This requirement will be demonstrated through the weekly event reporting.

Organization Structure and Staffing Requirements:

Lead Grantees of the Illinois Navigator Grant Program coordinate all operational and administrative matters for any/all sub-granted organizations in addition to directly fulfilling the Outreach and Enrollment requirements stated in the Illinois Navigator grant. All Lead Grantees will appoint a Program Director responsible for managing all Illinois Navigator grant activities. Duties may include but are not limited to the following:

Manage partnership organizations within all service areas to ensure that project goals are being met.

Take responsibility for metrics and reporting requirements set by the Get Covered Illinois team.

Ensure that hours of operation and activities requirements are being met in all service areas.

Participate in calls, webinars, email communication, as needed.

Ensure that certification requirements are met by all individuals expected to be certified under the grant (all Navigators and Program Managers).

Engage and serve as the point of contact for Get Covered Illinois.

Lead Grantees must also have a Project Supervisor who will directly manage their sub-contracted partners in regard to Illinois Navigator grant. For Lead Grantee organizations with 5 or more sub-grantees, a Project Supervisor may be dedicated to each group of 5 or more sub-grantees and be available full time to oversee the activities of the organization, per review and approval by Get Covered Illinois during budget review.

Manage the Lead Grantee organization’s sub-contracted partners in regard to Illinois Navigator outreach and enrollment activities.

Monitor submission of fiscal reporting and performance reporting.

Participate in calls, webinars, email communication, as needed.

Support activities related to grant and metrics reporting.

Support outreach / enrollment event planning and reporting.

Serve as point of contact for Navigators.

The lead organization must also designate an individual to serve as a Fiscal Manager for the grant program to support program activities. (Please see Appendix I for further detail on staffing requirements). The Fiscal Manager will oversee all financial and grant management activities for the Illinois Navigator program. Duties may include but are not limited to the following:

Fulfill all reporting requirements on a timely basis as required by Get Covered Illinois.

Establish and manage grant oversight program for Lead Grantee organization and any sub-grantees.

Coordinate with Get Covered Illinois, as necessary, on grant procedures, processes, and requirements.

Establish and implement appropriate tracking controls to ensure compliance with grant guidelines and requirements.

Participate in calls, webinars, email communication, as needed.

Each Lead Grantee will also have a Lead Navigator. Lead Navigators will be dedicated to performing enrollment and outreach functions within the service area on a full- time or part-time basis. If a sub-grantee has only one navigator, being the Lead Navigator, this position must be full-time. The Lead Navigator will be responsible at the sub-grantee level for the day-to-day operations of the Illinois Navigator Program and will serve as back up when there are Navigator staff absences and/or when enrollment activities are high. Lead Navigator duties include the following:

Complete and maintain certification for the duration of employment under this position.

Serve as back up when there are Navigator staff absences and/or when enrollment activities are high.

Maintain expertise in eligibility, enrollment, and program requirements.

Help Marketplace applicants who may be more apprehensive about completing a QHP enrollment due to cost and are typically confronted with more options than customers under other programs.

Follow-up appointments with Marketplace applicants may be required to complete the QHP enrollment process.

Attendance is required for all Get Covered Illinois trainings, webinars and in-person.

Provide in-person and virtual assistance to eligible individuals seeking to enroll in QHP (including advanced premium tax credits (APTC) and cost-sharing reductions (CSR).

Virtual assistance must include the ability to visually compare Marketplace Qualified Health Plans (QHP) with the customer.

As necessary Navigators may help facilitate enrollment for individuals eligible for Medicaid and other Illinois programs.

Schedule, attend and report events.

Examples of required outreach and educational activities include but are not limited to:

(1) Canvassing local communities and small businesses
(2) Developing community contacts
(3) Educational presentations
(4) Tabling events
(5) Using social channels to promote educational and enrollment activities
(6) Stakeholder engagement

Conduct public education activities to raise awareness about Get Covered Illinois, Marketplace QHPs, Illinois Medicaid, and utilization of health coverage.

Provide information and services in a fair, accurate and impartial manner, such information must acknowledge all health benefit programs.

Provide referrals to the Illinois Department of Insurance, or any other appropriate State agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage.

Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by Get Covered Illinois at no cost to those individuals, including individuals with limited English proficiency, and ensure accessibility and usability of Illinois Navigator tools and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act.

Maintain a work schedule that meets the needs of the population being served.

Report required information to necessary staff related to enrollment numbers, appointment, outreach activities, and other metrics as necessary.

Each Navigator staff member’s time must be dedicated fully to the performance this grant’s detailed activities (e.g., no job sharing or adding navigator duties to an existing role).

Navigator duties include the following:

Complete and maintain certification for the duration of employment under this position.

Maintain expertise in eligibility, enrollment, and program requirements.

Help Marketplace applicants who may be more apprehensive about completing a QHP enrollment due to cost and are typically confronted with more options than customers under other programs.

Follow-up appointments with Marketplace applicants may be required to complete the QHP enrollment process.

Attendance is required for all Get Covered Illinois trainings, webinars and in-person.

Provide in-person and virtual assistance to eligible individuals seeking to enroll in QHP (including advanced premium tax credits (APTCs) and cost-sharing reductions (CSRs).

Virtual assistance must include the ability to visually compare Marketplace Qualified Health Plans (QHP) with the customer.

As necessary Navigators may help facilitate enrollment for individuals eligible for Medicaid and other Illinois programs.

Schedule, attend and report events.

Examples of required outreach and educational activities include but are not limited to:

(1) Canvassing local communities and small businesses
(2) Developing community contacts
(3) Educational presentations
(4) Tabling events
(5) Using social channels to promote educational and enrollment activities
(6) Stakeholder engagement

Conduct public education activities to raise awareness about Get Covered Illinois, Marketplace QHPs, Illinois Medicaid, and utilization of health coverage.

Provide information and services in a fair, accurate and impartial manner. Such information must acknowledge all health benefit programs.

Provide referrals to the Illinois Department of Insurance, or any other appropriate State agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage.

Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by Get Covered Illinois at no cost to those individuals, including individuals with limited English proficiency, and ensure accessibility and usability of Illinois Navigator tools and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act.

Maintain a work schedule that meets the needs of the population being served.

Report required information to necessary staff related to enrollment numbers, appointment, outreach activities, and other metrics as necessary.

Organizations may be allowed an Additional Position exclusively focused on program operations and customer education and outreach strategy. The Lead Grantee will be required provide a clear job description for this position. This is an optional position; if included, the position must be employed by the Lead Grantee and may be dedicated to the Illinois Navigator grant project on a full-time or part-time basis depending on the needs of the applicant. This position must be reviewed and approved by Get Covered Illinois.

Target Populations:

Grantees are expected to engage with all individuals seeking health coverage, regardless of the coverage program they ultimately enroll in. Using the Get Covered Illinois website, Illinois Navigators are expected to work with customers to apply for coverage through either the Marketplace or Medicaid. Illinois Navigators will conduct referrals to experts for other health programs, such as Medicare, or to agents or brokers as requested by customers. Grantees are expected to refine their messages and outreach activities in order to reach the Marketplace-eligible population including but not limited to African American, Hispanic or Latino, LGBTQIA and Asian American/Pacific Islander customers. It is expected that Illinois Navigators and grantees expend the necessary effort to reach these populations.

Certification:

All Illinois Program Directors, Project Supervisors, Lead Navigators and Navigators designated in the proposal and participating in grant activities through successful applicant organizations will be required to be certified by completing online training through Get Covered Illinois and in person trainings (when offered). Upon completion of the training, trainees will be required to demonstrate their knowledge of coverage options, eligibility rules, enrollment procedures, the needs of underserved and vulnerable populations, customer assistance rules, conflict of interest standards, and privacy and security considerations through testing on the Get Covered Illinois LMS System. Training will be free of charge for grantees. Certified individuals are required to pass a criminal background check, conducted by the Illinois State Police through a process designated by the State. The cost of the background check is an eligible grant expenditure—see Section 6.8 of the Grant Application Instructions. For prospective Illinois Navigators who are currently certified by the Illinois Department of Insurance as of Plan Year 2025, a new background check would not be required.

For prospective Illinois Navigators who are new employees, background checks must be submitted within 2 weeks of the hiring date.

Equipment:

Organizations must have sufficient infrastructure to facilitate online submission of enrollment applications through the Marketplace or Medicaid, including computers and internet access to facilitate online enrollment; scanners to assist potential enrollees with uploading copies of documents to the Marketplace and Medicaid online web portals; and printers. Except in rare instances, all enrollment applications assisted through the Illinois Navigator program will be electronically submitted through the appropriate eligibility and enrollment system or state Application for Benefits Eligibility (ABE) online portal. New equipment purchases must be reviewed and approved by Get Covered Illinois.