How to Become a Certified Application Counselor Designated Organization

Get Covered Illinois, a division of the Illinois Department of Insurance (IDOI), administers the Get Covered Illinois CAC Program for organizations to become a Certified Application Counselor Designated Organization (CDO) in Illinois.

A Certified Application Counselor Designated Organization (CDO) is any organization designated by Get Covered Illinois to certify its staff members or volunteers to act as certified application counselors and includes those organizations described in 45 CFR 155.225 (Apr. 27, 2023) (no later editions or amendments).

• Organizations seeking to help eligible Illinois residents enroll in health insurance and affordability programs may apply to become a CDO in Illinois.
• Email DOI.GCI.Outreach@illinois.gov to receive a copy of the CDO Application.
• Return the completed CDO application via email to DOI.GCI.Outreach@illinois.gov by 5:00 PM Central Time on October 25, 2024, to participate as a CDO during Plan Year 2025.
• Organizations must agree to meet all training and licensing requirements.
• CDOs will be selected by Get Covered Illinois staff.
• CDOs will not receive grant funding.

Get Covered Illinois will only designate organizations that meet certain requirements (including, but not limited to):

• The organization must have experience in serving individuals who would have difficulty enrolling in coverage without the help of a CAC or Illinois Navigator.
  • Examples of experience include, but are not limited to: individuals with low literacy, individuals with limited English proficiency, individuals with disabilities, individuals with low income people who are or at risk of experiencing homelessness and other hard-to-reach populations
• The organization must have processes to screen its CAC staff members and volunteers and ensure that they do not have any conflict of interest.
• The organization must agree to enforce completion of all required training for individual CACs, comply with privacy and security laws, and meet other program standards.
  • The CDO is directly responsible for supervising its CAC program and must designate a CAC Lead that will complete CAC training and licensing through the Illinois Department of Insurance. Oversight will include ensuring training completion, daily management, and monitoring CAC activities, especially in relation to the protection of consumer Personal Identified Information (PII) which is any information that can directly or indirectly identify a consumer.
  • CACs will be certified and licensed by the State of Illinois, through IDOI, to support consumers applying for health coverage options and affordability programs.

NOTE: Agents, brokers and other individuals and organizations who receive direct or indirect consideration from a health insurance issuer or stop loss insurance issuer in connection with the enrollment of an individual into a qualified health plan (QHP) or non-QHP are not eligible to apply to become a CDO.

Email DOI.GCI.Outreach@illinois.gov to receive a copy of the CDO Application.

All CDO applications must be submitted via email to DOI.GCI.Outreach@illinois.gov by 5:00 PM Central Time on October 25, 2024, to participate as a CDO during Plan Year 2025. Applications received after the deadline will not be considered.

CDOs selected by Get Covered Illinois must sign the Get Covered Illinois CDO agreement for Plan Year (PY) 2025 by October 25,2024. The agreement will be renewed each year in October.

A GCI Certified Application Counselor (CAC) can be any employee or volunteer from a Certified Application Counselor Organization (also known as a Certified Application Counselor Designated Organization) that enters into an agreement with Get Covered Illinois.

The agreement requires the organization to train its employees or volunteers to assist eligible individuals with:

• Information about insurance affordability programs and qualified health plan coverage options.
• Comparing qualified health plans side by side and answering questions about health coverage.
• Enrolling in qualified health plans and insurance affordability programs.

CACs play a critical role in educating and enrolling uninsured Illinois residents, especially those in underserved communities. Services are free to consumers.

My organization is a currently CDO with Centers for Medicare and Medicaid Services (CMS). Do I need to reapply with Get Covered Illinois for plan year 2025?
Yes, Illinois is transitioning to a State-based Marketplace using the federal platform for plan year 2025 and CMS will terminate CDO agreements in August 2024.
 

I am a current CAC, and I received an email from CMS that says my CAC ID number will be discontinued. Can I still complete training for plan year 2025?
Yes, the organization must enter into a new CDO agreement with Get Covered Illinois. Once the agreement is in place, your organization will receive a welcome email with instructions on how to complete training for plan year 2025.
 

What is the final day for applying to be a CDO in Illinois for Plan Year 2025?
October 25, 2024, at 5PM, Central Time.
 

If you have any question about the CAC or the CDO process, please contact the help desk at DOI.GCI.Outreach@illinois.gov