The Centers for Medicare & Medicaid Services (CMS) established Certified Application Counselors (CACs) as a type of assistance personnel trained to provide information to consumers and to help facilitate consumer enrollment in health insurance and insurance affordability programs through the Federally-facilitated Marketplaces (FFMs). In the FFMs, Certified Application Counselor Designated Organizations (CDOs) oversee CACs.
CDOs are a vital component of the assister community.
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Which organizations can be a CDO?
The FFMs will only designate certain types of organizations that, based on the functions of the organization:
- Have processes in place to screen their staff members and volunteers who are CACs to ensure that they protect personally identifiable information (PII) and do not have any conflicts of interest;
- Engage in services that position them to help those they serve with health coverage issues;
- Have experience providing social services to the community; and
- Agree to make sure individual CACs complete required training, comply with privacy and security laws, and meet other program standards.
Thus, organizations that the FFMs may designate could include, for example, community health centers such as federally-qualified health centers (FQHCs); hospitals; health care providers (including Indian Health Services, Indian tribes, and Urban Indian organizations that provide health care); Ryan White HIV/AIDS providers; behavioral health or mental health providers; agencies that have experience providing social services to the community such as Supplemental Nutrition Assistance Program (SNAP) outreach, energy assistance, or tax assistance, which are either non-federal governmental entities or organized under section 501(c) of the Internal Revenue Code; and other local governmental agencies that have similar processes and protections in place such as other health care providers, health departments, and libraries.
Organizations that wish to become CDOs designated by CMS to serve in an FFM must apply to become a CDO and enter into an agreement with CMS.
Who can be a CAC?
To serve as a CAC in an FFM, the individual must be affiliated with a CDO. Individuals can find CDOs in their area by searching our online Find Local Help directory. If you have questions, please contact us at [email protected].
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• Not sure what the difference between a State Navigator and Certified Application Counselor is? Click here.
For further assitance or enquiries please contact Jenny Walden, IPHCA Outreach and Enrollment specialist
