CAC Organization Toolkit:
The Basics

What Is a Certified Application Counselor?

Certified Application Counselors (CACs) provide free, unbiased assistance to consumers applying for and enrolling in health coverage.

CAC duties include:

  • Helping consumers apply for and enroll in health coverage through marketplaces, Medicaid, and the Children’s Health Insurance Program (CHIP)
  • Working with consumers to help them understand their coverage
  • Working in the best interest of the consumer, without steering individuals to specific plans
  • Optional (but recommended!): Conducting outreach, in-reach, and education surrounding new health coverage options

Becoming a CAC: Training and Other Requirements

CACs exist in every state, but the rules and training requirements vary. In most states (including all states where the federal government operates the marketplace), individuals who want to become CACs must be affiliated with a CAC organization (an organization designated by the marketplace to oversee individual CACs). CAC organizations must have experience providing social services to the community and are responsible for ensuring their staff protect consumers’ personally identifiable information.

Individual CACs must complete a five-hour online training in states where the federal government operates the marketplace. Additional trainings may be available or required, depending on the state. Federal training for the 2015 open enrollment period is now posted on the CMS’ Training Site for Health Insurance Marketplace In-Person Consumer Assisters (available for account holders) and CMS’ technical assistance resource page (publicly available).

There is no fee to enroll in the federal CAC training program. States that run their own marketplaces have their own requirements for certifying and training CACs. However, regardless of marketplace type, states may require CACs or the CAC organization to cover the cost of additional state-level certification requirements (such as background checks and fingerprinting). Additional information on these state requirements can be found here.

Certain CAC organizations may also choose to supplement the online training and provide a more tailored and interactive experience for their CACs.

Working or Volunteering for a CAC Organization

Individuals interested in serving as CACs in states where the federal government operates the marketplace must be affiliated with a CAC organization. If you’re interested in learning more about CAC organizations near you, contact Enroll America at CACinfo@EnrollAmerica.org. Individuals interested in serving as CACs in states that operate their own marketplace can also contact the state’s marketplace directly.

Are CACs Paid or Volunteers?

Individual CACs can be paid by CAC organizations for their enrollment efforts, and the decision of whether and how to pay individual CACs is generally up to the CAC organization. CAC organizations can decide how to most effectively use their resources to compensate individual CACs (such as through hourly or annual salaries) or build out successful volunteer models. However, individual CACs in states where the federal government is operating the marketplace may not be paid based on the number of enrollments, applications completed, or individuals assisted. States that run their own marketplaces may make their own choices about how individual CACs can be paid.

How Do CACs Differ from Other In-Person Assisters?

There are some key differences between CACs and other certified in-person assisters such as Navigators. For example, unlike CACs, Navigators are funded directly through the marketplace. In states where the federal government operates the marketplace, Navigators receive grants based on the number of uninsured in their state. Navigators are also required to conduct outreach and education to consumers regarding their coverage options, in addition to helping consumers enroll in coverage. Navigators must follow strict weekly, monthly, and quarterly reporting requirements regarding their enrollment activities in states where the federal government operates the marketplace. Unlike Navigators, who are not permitted to have any conflicts of interest, CACs can still assist consumers if they disclose relevant conflicts of interest and act in the best interest of consumers. Lastly, while Navigators are required to provide culturally and linguistically appropriate services to fit the needs of the population and be able to help consumers with disabilities, CACs can choose to either assist such consumers or refer them to a Navigator or the marketplace call center.

Table 1: How Are CACs Different from Other In-Person Assisters?

 Characteristics and Requirements of Assisters
CACs*
Other In-Person Assisters
Funded by the marketplace X
Required to conduct outreach X
Required to submit reports to the marketplace X
Prohibited from having conflicts of interest X
Required to provide culturally/linguistically appropriate services X
Required to ensure access for people with disabilities X

*Many community health centers receive federal funding to provide enrollment assistance. These individuals are also sometimes referred to as CACs, but unlike other CACs, they are required to perform outreach and must adhere to reporting requirements.

The CAC program offers unique opportunities to organizations and individuals because of the flexibility related to funding sources, responsibilities, and performance metrics. While some organizations may find that conducting outreach and raising consumer awareness about health coverage options aligns with their current mission and focus in the community, other organizations may choose to more narrowly tailor their CAC efforts to focus strictly on enrollment, or partner with other organizations to conduct the outreach component.

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