Navigator License and Certified Application Counselor Registration

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

• 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.

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 the PSI website at PSI WI exams . Exam fee is $75.
   
   
4. Submit fingerprinting through fieldprintwisconsin.com . Use Fieldprint code FPWIOCIINSURANCE.
   
   
5. Apply online at nipr.com or via paper. Individual Navigator Application.
   
   

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. Renew online at nipr.com or via paper. Individual Navigator Application Renewal fee is $35.
   
   

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. Reinstate online at nipr.com or via paper. Individual Navigator Application Reinstatement fee is $70.
   

Initial Application Requirements

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

1. Apply online via nipr.com or complete a paper application form. Navigator Business Entity Registration. Please note: The Designated Responsible Licensed Navigator must first be submitted and approved prior to the submission of the business entity application.
   
   
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. Apply online via nipr.com or complete paper 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.

Navigator Entities are required by s. 628.92 (4), Wis. Stat. upon initial registration to OCI with a list of all individual navigators that it employs, supervises, or are affiliated with.

To look up individual navigators employed, supervised, or affiliated with each navigator entity click here . You must enter the Jurisdiction (Wisconsin), the Search Type (License), and Entity Type (Business Entity). Select Advanced Criteria, choose License Type (Navigator Business Entity) and License Status (Active, agree to the NAIC's Terms and Conditions and then select the Search button.

Select the navigator business entity name and you will find all individual navigators listed under the relationships section.

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 the PSI website at PSI WI exams . 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.
  

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.
  

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 non-navigator/CAC assistance, the non-navigator/CAC entity must;
   
   

   a. Set up a MyWisconsinID here: General Information & Assistance with MyWisconsinID​

   b. Register with OCI by using the Non-Navigator Business Entity Registration. Step by step instructions can be found here: Non-Navigator Data Entry Process.pdf ​
   

   
   
2. Provide a list of all individual CAC's and any other non-navigator assisters it employs, supervises, or it affiliated with. Individual non-navigator/CAC's can be added through the Non-navigator Business Entity Registration​. 
   
   
3. Provide monthly updates, if any, to the list of individual non-navigator assisters/CACs it employs, supervises, or is affiliated with. Individual non-navigator/CAC's can be updated through the Non-navigator Business Entity Registration.
   
   

Reporting Requirement for Non-navigator Assister Entities

By October 1 of each year, non-navigator assister/CAC entities must attest to OCI that their non-navigator assisters/CAC have completed the required training. Entities can attest to compliance through the Non-navigator Business Entity Registration. Additionally, non-navigator assister/CAC entities must maintain documentation verifying that the non-navigator assisters/CACs 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.
  

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.

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.

A licensed agent can keep their license active however, cannot have any active accident & health company agent appointments.

A licensed agent must have held the accident & health line of authority and be in good standing with our office.

Navigator Licensing Steps

1. Either complete the OCI-DHS Medicaid 1-day training course or annual enrollment conference. If neither are available, complete online Navigator prelicensing education.
2. Complete any federally mandated training required under the federal health care exchange.
3. Make a reservation with Fieldprint at fieldprintwisconsin.com for your digital fingerprinting. Fingerprinting information is valid for only 180 days. Use Fieldprint code FPWIOCIINSURANCE when scheduling your appointment.
   
4. Must be affiliated with a navigator entity.
5. Apply online via nipr.com or via paper Individual Navigator Application.

A licensed agent can keep their license active however, cannot have any active accident & health company agent appointments.

Complete any federally mandated training required under the federal health care exchange.

The affiliated entity only needs to submit the required attestation to our office of the new individual CAC added.

The affiliated entity only needs to submit the required attestation to our office of the termination of individual CAC.

No navigator exam is required.

Navigator Licensing Steps

1. Make a reservation with Fieldprint at fieldprintwisconsin.com for your digital fingerprinting. Fingerprinting information is valid for only 180 days. Use Fieldprint code FPWIOCIINSURANCE when scheduling your appointment.
2. Must be affiliated with a navigator entity.
3. Apply via paper application Individual Navigator Applicationand send directly to ociagentlicensing@wisconsin.gov.
   
4. No fee required.
   

The affiliated entity only needs to submit the required attestation to our office of the termination of individual CAC affiliation.

Individual must follow steps under resident licensing requirements.