That insurance companies are wealthy does't mean they pay lots of money to low-level phone workers, unless their activities are a profit center. Now if the government was paying them extra $ for everybody they convinced to get preventative checkups, the callers might be on commission....
Your wealthy insurance companies sound analogous to our wealthy airlines, when their ticket prices were regulated by the government. That regulation ended here, eventually. Most think it great in that prices fell sharply, though service levels fell as well....
The $48/hr figure for ACA navigators was the top of the initial salary estimate released, of $20 to $48/hr. As you'd expect in lean budget times, the lower end of the range predominates. This salary reporting gadget says the average wage for ACA navigators in the city of Indianapolis is $39,000 on a yearly basis, less than $20.00/hr;
http://www.indeed.com/salary?q1=Aca+...anapolis%2C+IN
I also plugged Baltimore, MD into it and got $49,000 on the higher-cost east coast. The $48/hr salary would translate into about $100,000 a year. BTW, the ACA navigators, by law, cannot take any money from insurance companies. They are employed by non-profits.