CACS/CDOS

CDOs are a vital component of the Assister community. They oversee Certified Application Counselors (CACs), who are trained and able to help consumers seeking health insurance coverage options through Virginia’s Insurance Marketplace. CDOs must be designated by the Virginia Health Benefit Exchange to operate in Virginia. CDOs designated by the Virginia Exchange certify CACs.

• The Virginia Health Benefit Exchange published rules to outline the designation requirements that CDOs will need to meet to be designated in Virginia. CDO and CAC regulations are found in 14 VAC 7-10: Rules Governing the Certified Application Counselor Program.

  CDO Designation Requirements are as follows:

  1. Submit a Virginia Certified Application Counselor Designated Organizations application through Assisterprograms@scc.virginia.gov.

     You will need to provide the following as part of the application:
           → Demographic and Operational Information
           → Completed List of Certified CACs Form
           → List of Counties and Cities in which the CDO intends to operate

  2. Execute a Virginia Health Benefit Exchange – Certified Application Counselor Designated Organization Agreement in accordance with 14 VAC 7-10-30 and submit the signed agreement and a sample of their CAC agreement to Assisterprograms@scc.virginia.gov.

     With this agreement CDOs attest to:
     a. Certifying individuals to serve as CACs and execution of an agreement with CACs pursuant to 14 VAC 7-10-50,
     b. Requiring application counselors complete required training,
     c. Maintaining a registration process and method to track the performance of CACs as specified in 14 VAC 7-10-40,
     d. Administration of a system to handle and protect personally identifiable information (PII) and provision of a PII authorization form attesting to adherence to all terms and conditions of privacy and security pursuant to 45 CFR 155.260(b),
     e. Provide data and information to the Exchange regarding the number and performance of its CACs in accordance with 45 CFR 155.225(b)(3).

• Once the CDO application is approved, the Exchange will create a CDO portal account on Virginia's Marketplace for your organization. Verify the information on this portal account is accurate.
  1. Require Assisters to complete required training through the Marketplace Learning Management System. Assisters will need to send a request for a new LMS account along with their name, unique email, unique cell number, and certification number (as applicable) to LMS@marketplace.virginia.gov.
  2. Create Assister portal accounts on the Marketplace Platform for all CACs that have completed training and been certified by your organization.
  3. Maintain a CAC registration process, a method to track the performance of CACs, and maintain procedures to withdraw certification from or refuse to recertify any individual certified application counselor upon a finding of noncompliance with the requirements for certification or a failure to perform duties as required in accordance with 14 VAC 7-10-40.
  4. Administer a system to handle and protect personally identifiable information (PII) and require a PII Authorization Form attesting to adherence to all terms and conditions of privacy and security pursuant to 45 CFR § 155.260(b)(2).

Beginning with PY 2024 Open Enrollment, each CDO must submit quarterly reports that include, at a minimum, data regarding the number and identifying information of individuals who have been certified by the organization; the total number of consumers who received application and enrollment assistance from the organization; and of that number, the number of consumers who received assistance in applying for and selecting a qualified health plan or qualified dental plan, enrolling in a qualified health plan or qualified dental plan, or applying for Medicaid or CHIP. The first quarterly report will be due 3/1 reporting on 11/1/23-1/31/24 and filed at Assisterprograms@scc.virginia.gov.

CDOs are required to renew their registration with the Virginia Exchange by 10/31 of every even-numbered year.

A CAC is an individual staff member or volunteer who is certified by a CAC Designated Organization (CDO) and trained to help consumers look for health coverage options through the Virginia Exchange and Virginia's Medicaid program. This includes helping consumers complete the eligibility and enrollment process. Their services are free to consumers.

1. Successfully complete assister training through Virginia’s Insurance Marketplace Learning Management System (LMS) required this year.
   • Current Virginia CACs will be eligible to complete a shorter training program for plan year 2025. You would have received an auto-generated email from no-reply@scc.virginia.gov providing your login ID. Visit https://marketplacelms.scc.virginia.gov/ to begin.
   • CACs new to the Virginia Exchange will take the full Marketplace training program for plan year 2025. Assisters without LMS accounts will need to send a request for a new LMS account along with their name, CDO name, unique email, unique cell number, and certification number (if applicable) to LMS@marketplace.virginia.gov.
2. Training will be completed at https://marketplacelms.scc.virginia.gov/.
3. To receive certification of training completion, you must receive a passing score of 80 on module tests. 
4. Execute privacy and security agreement with your CDO.
5. Receive certification from CDO.
6. Your CDO will create an assister portal account on the Marketplace Platform on your behalf at enroll.marketplace.virginia.gov/hix/account/user/login.

CACs are not required to register with the Virginia Exchange. CDOs will register and provide a list of CACs certified to operate through that organization.

• CAC/CDO Regulation: 14 VAC 7-10: Rules Governing the Certified Application Counselor Program
• CAC/CDO Certification FAQs
• Consumer Authorization Form (Spanish)
• Contact us with any questions at Assisterprograms@scc.virginia.gov