Navigator License and Certified Application Counselor Registration

Last Updated: January 19, 2017

Individual Navigators

In Wisconsin, a navigator can be an individual who performs any activities and duties related to the navigator program on behalf of the federal exchange and who receives funding to perform such functions on behalf of the federal exchange.

An individual navigator does not include a person acting as an insurance intermediary; however, an insurance intermediary may apply to be licensed as a navigator, provided the intermediary complies with federal restrictions.

An individual who meets the definition of a navigator under the Wisconsin insurance law must obtain an individual navigator license.

Navigator Frequently Asked Questions

Navigator Study Materials

To assist candidates in preparing for the examination, the Office of the Commissioner of Insurance (OCI) has assembled the following materials:

Intermediary Study Guide

State Public Assistance Programs

Please note: These materials are not intended to be a complete summary of the statutes and rules about which navigators should be aware. As such, candidates may also want to review additional materials available from the following sources:

Initial Application Requirements

  1. Complete 16 hours of accident and health prelicensing. See list of courses offered.
  2. Complete any federally mandated training required under the federal health care exchange.
  3. Schedule and pass a navigator exam through www.Prometric.com. Exam fee of $75.
  4. Submit fingerprinting through www.fieldprintwisconsin.com. Use Fieldprint code FPWIOCIINSURANCE.
  5. Submit Individual Navigator Application.

Renewal Requirements

  1. Complete 8 hours of accident-and-health-specific continuing education. See list of courses offered.
  2. Complete any federally mandated training required under the federal health care exchange.
  3. Verification of individual affiliation to a navigator entity.
  4. Submit evidence of financial responsibility. Navigator entity bond must be no less than $100,000 from an authorized insurer.
  5. Submit Individual Navigator Application along with renewal fee of $35.

Reinstatement Requirements

A navigator whose registration has been expired for less than 12 months must complete the following:

  1. Satisfy all training requirements. Both accident and health and federally mandated training.
  2. Verification of individual affiliation to a navigator entity.
  3. Submit evidence of financial responsibility. Navigator entity bond must be no less than $100,000 from an authorized insurer.
  4. Submit Individual Navigator Application along with a reinstatement fee of $70.

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Navigator Entities

Entities functioning as, or intending to function as, navigators, supervising individual navigators or receiving funds to perform such activities must register with OCI.

Initial Application Requirements

To register as a navigator business entity, the entity must:

  1. Complete application form Navigator Business Entity Registration.
  2. Identify an individually licensed Designated Responsible Licensed Navigator.
  3. Submit evidence of financial responsibility. Minimum bond must be no less than $100,000 from an authorized insurer.
  4. Provide a list of all individual navigators that it employs, supervises, or is affiliated with.
  5. Pay initial application fee of $100.

Renewal Requirements

  1. Complete application form Navigator Business Entity Registration.
  2. Submit evidence of financial responsibility. Minimum bond must be no less than $100,000 from an authorized insurer.
  3. Provide a list of all individual navigators that it employs, supervises, or is affiliated with.
  4. Pay renewal application fee of $100.
  5. Navigator entities must provide OCI with monthly updates, if any, to the list of individual navigators it employs, supervises, or is affiliated with.

Navigator Entities are NOT eligible for reinstatement. Entities must follow initial application requirements above.

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Wisconsin Licensed Individual Navigators and Navigator Entities

Licensed Navigator Entities and Affiliated Licensed Navigators

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Individual Certified Application Counselors/Nonnavigator Assisters

Individuals working in settings such as federally qualified health centers, hospitals, health care providers, social service agencies, local health departments and Indian Health Services who do the following must be registered with OCI:

  • Help consumers fill out electronic and paper applications to establish eligibility for the federal exchange and public assistance programs; and
  • Help consumers enroll in coverage on the federal exchange.

Certified Application Counselor Frequently Asked Questions

Certified Application Counselor (CAC) Study Materials

To assist candidates in preparing for the examination, OCI has assembled the following materials:

Intermediary Guide

State Public Assistance Programs

Registration Requirements

  1. Complete 16-hour prelicensing training requirement which can be in accident and health or navigator-specific training. See list of courses offered. CACs should retain a copy of the documentation demonstrating successful completion of the prelicensing requirement for their own records.
  2. Complete any federally mandated training required under the federal health care exchange for CACs.
  3. Schedule and pass a navigator exam through www.Prometric.com. Exam fee of $75.
  4. Provide evidence of certification with an organization(entity) designated by the federal exchange as a CAC organization.
  5. Organization CAC is affiliated with will notify OCI with your name.
  6. Certified application counselors must be registered with OCI by contacting ocialdocuments@wisconsin.gov.

Ongoing Training Requirement

  • CACs must complete 8 hours of continuing education training each year. See CE Guidance Memo.

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Certified Application Counselors/Nonnavigator Assister Entities

CAC entities in a federal exchange will be federally qualified health centers, hospitals, health care providers, social service agencies, local health departments and Indian Health Services. CAC entities, with the help of individual CACs, will:

  • Help consumers fill out electronic and paper applications to establish eligibility for the federal exchange and public assistance programs; and
  • Help consumers enroll in coverage on the federal exchange.

Certified Application Counselor Entity Frequently Asked Questions

Please note: Any government entity or anyone working on behalf of a governmental entity is exempt from the state registration requirements.

Registration Requirements

  1. Once authorized by the federal exchange to provide CAC assistance, the CAC entity must register with OCI by using the Nonnavigator Business Entity Initial Registration form.
  2. Provide a list of all individual CACs and any other nonnavigator assisters it employees, supervises, or is affiliated with.  
  3. Completed application and list of CACs should be e-mailed to ocialdocuments@wisconsin.gov.
  4. Provide monthly updates, if any, to the list of individual CACs and any other nonnavigator assisters it employs, supervises, or is affiliated with.

Reporting Requirement for Nonnavigator Assister Entities

By October 1 of each year, nonnavigator assister entities must attest to OCI that their nonnavigator
assisters have completed the required training by submitting the Nonnavigator Business Entity Continuing Education Training Attestation and submitting the form via e-mail to ocialdocuments@wisconsin.gov. Additionally, nonnavigator assister entities must maintain documentation verifying that the nonnavigator assisters working for or with the entity have completed the continuing education requirement.

This documentation shall consist of the following and is subject to audit by OCI:

  • A summary record for each individual listing the course title, date of completion, course hours, mode
    of delivery (classroom, webinar, etc.) and location of class.
  • Certificates of completion or verification of attendance for each course with a signature of the
    instructor or monitor verifying attendance.
  • Course summary, outline or agenda describing the content of the course.

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Wisconsin Registered Certified Application Counselors

Registered Certified Application Counselors

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Tribal-Certified Application Counselors

OCI recognizes tribal sovereignty over foreign persons, activities, and land within each tribal nation. As such, OCI clarifies that CAC entities operating on a reservation or within sovereign jurisdictions are not subject to ch. 628, Wis. Stat., or ss. Ins 6.91 to 6.99, Wis. Adm. Code.

OCI will handle complaints regarding the activities of a CAC acting on behalf of a tribal CAC entity on a case-by-case basis. OCI intends to only regulate CAC and CAC entity activity that occurs outside of tribal sovereign jurisdictions.

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Licensed Agents Participating as Navigators on the Federal Exchange

Agents that hold an active resident license with the accident and health line of authority and complete the Wisconsin and federal training to be a navigator may apply to be licensed as a navigator.

Agents cannot have active company appointments with a health insurance company and cannot receive commission from the health insurance company.

Agents must be certified by the federal exchange as a navigator and be affiliated with one of the entities that received a federal navigator grant.

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Licensed Agents Selling on the Federal Exchange

The following FAQ is for agents wanting to sell on the federal exchange. Agents must complete federal training and be registered on the exchange.

Frequently Asked Questions For Insurance Agents Regarding Navigators, Certified Application Counselors, and Participating on the Federal Health Insurance Exchange

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