What is the typical role of a Navigator or Certified Application Counselor (CAC) in the FFM?

What is the typical role of a Navigator or Certified Application Counselor (CAC) in the FFM?

• A. They can override eligibility determinations
• B. They help consumers complete applications, compare plans, understand subsidies, and enroll in QHPs while adhering to program rules and privacy requirements
• C. They manage employer contributions
• D. They provide legal counsel for tax fraud

Answer: (B)

Navigators and Certified Application Counselors guide consumers through the Marketplace enrollment process. Their main role is to help people complete applications, compare plans, understand available subsidies (like premium tax credits and cost-sharing reductions), and enroll in Qualified Health Plans, all while following program rules and protecting privacy. They assist by explaining plan options, helping gather and verify the information needed for the application, and supporting enrollment during open enrollment or special enrollment periods. They don’t make or override eligibility decisions themselves—the Marketplace determines eligibility based on the information provided. They also don’t handle employer contributions or provide legal counsel for tax fraud; their focus is on helping individuals and families navigate enrollment and subsidies in a compliant, consumer-friendly way.

Navigators and Certified Application Counselors guide consumers through the Marketplace enrollment process. Their main role is to help people complete applications, compare plans, understand available subsidies (like premium tax credits and cost-sharing reductions), and enroll in Qualified Health Plans, all while following program rules and protecting privacy.

They assist by explaining plan options, helping gather and verify the information needed for the application, and supporting enrollment during open enrollment or special enrollment periods. They don’t make or override eligibility decisions themselves—the Marketplace determines eligibility based on the information provided. They also don’t handle employer contributions or provide legal counsel for tax fraud; their focus is on helping individuals and families navigate enrollment and subsidies in a compliant, consumer-friendly way.