Enrollment assisters may be paid staff or volunteers, sometimes called non-navigator assisters or Certified Application Counselors, who help eligible consumers by guiding them through their enrollment process to buy insurance on the Health Insurance Marketplace. Some can also help people enroll in BadgerCare+, Wisconsin’s public health insurance program. They provide information about all the Qualified Health Plans (QHPs) and discounts or tax subsidies for which consumers may be eligible.
Enrollment assisters do not recommend a plan. Instead, they help consumers by answering questions about the Marketplace, instructing how to enroll, and explaining terms.
The Federal Government has issued guidance and definitions about responsibilities and duties of Enrollment Assisters. Wisconsin’s Office of the Commissioner of Insurance has also issued guidance and definitions about Enrollment Assisters. Enrollment Assisters in Wisconsin must comply with the Wisconsin rules.
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Certified Application Counselors
Some Enrollment Assisters, through trainings and testing, choose to become Certified Application Counselors (CACs). CACs, must by definition, work for an organization that has been designated by, and registered with, Centers for Medicare and Medicaid Services as a Certified Application Counselor. Staff and volunteers who have taken the CMS and State of Wisconsin training and passed the test are designated Certified Application Counselors. You may want to consider this certification if you do any of these activities:
- Explain the essential health benefits to someone seeking coverage
- Provide financial or benefits counseling at a healthcare provider or organization
Under the Wisconsin insurance laws Certified Application Counselors are also required to meet the 16-hour prelicensing training requirement in addition to federal training for CACs. An overview of the topics covered during the prelicensing training is available in the Prelicensing Course Outline and more detailed information about the course and exam can be found on the Prelicensing/Continuing Education Provider Information page.
Additionally, there are state continuing education requirements.
Complete information from the State of Wisconsin for Certified Application Counselors can be found on the Nonnavigator Assisters/Certified Application Counselors page.