The first open enrollment period made it clear that consumers applying for health coverage want in-person assistance and that those who receive it are nearly twice as likely to enroll in coverage compared to those who do not receive in-person assistance. The role of in-person assistance is even more pronounced among African-American and Latino communities, who are 43 percent more likely to seek in-person assistance than their white counterparts. Every state has Navigators and community health centers that receive funding to provide enrollment assistance, but there are often not enough assisters to meet consumer demand. The CAC program provides a pathway for other interested organizations and individuals to receive training and become certified to provide enrollment assistance.
Organizations that already devote their energy and resources to working with underserved communities can expand on their existing work, provide an additional service to the community they serve, and advance their overall mission by becoming a CAC organization.
- Who Can Become a CAC Organization?
Many types of organizations can become CAC organizations, including:
- Community health centers
- Faith-based organizations
- Community colleges
- Fraternities and sororities
- Health care providers
- City health departments
Note: A single CAC organization can have multiple locations within a given state.
- Who CANNOT Become a CAC Organization?
There are very few situations where federal law prohibits organizations from becoming a CAC organization (although states may have additional rules). Health insurance issuers cannot serve as CAC organizations. If an organization cannot ensure that individual CACs are able to fulfill their duties and protect consumer information, they cannot become a CAC organization.
CAC organizations and individual CACs cannot be paid by any health insurance issuer related to the enrollment of individuals into health plans. This means that a CAC organization cannot be paid by an issuer to motivate individuals to enroll in a specific plan; it does not prevent health care providers who receive payment from issuers for the care and services they provide from serving as CACs. Additional updates on who cannot become a CAC organization will be provided when new information is available.
- Taking the First Step: How to Become a CAC Organization
In states where the federal government operates the marketplace, organizations that want to become a CAC organization complete an online application that must be approved by the marketplace. In states where the state operates the marketplace, organizations and individuals should ask their marketplace about how to apply and gain approval.
CAC organizations must disclose potential conflicts of interest through the online application by answering some basic questions about the nature of their organization and who they work with. CAC organizations and individuals must also comply with privacy and security standards, such as protecting individuals’ personally identifiable information (PII; a tip sheet from CMS on how to access and use PII can be found here, and the federal template to receive consent from a consumer to collect PII can be found here).
Once approved, the CAC organization can find people within or outside their organization that are interested in helping work with consumers to enroll through the marketplace. The CAC organization can then help their staff or volunteers become certified as individual CACs. CAC organizations must have two agreements in place before assisting consumers:
- An agreement between the CAC organization and the Centers for Medicare and Medicaid Services (CMS)
- Agreement(s) between the CAC organization and individual CAC(s) (staff and/or volunteers)
There is no fee to become a CAC organization in federally facilitated marketplace (FFM) states, and CACs do not have to pay to participate in the federal CAC training. However, certain states require CAC organizations or CACs to cover the cost of additional state-level certification requirements (such as background checks and fingerprinting). A list of all state requirements and fees can be found here.