A navigator can be an individual or an entity that supervises or employs an individual who performs any activities and duties related to the navigator program on behalf of the federal exchange and who receives funding to perform such functions on behalf of the federal exchange. An individual navigator does not include a person acting as an insurance intermediary; however, an insurance intermediary may apply to be licensed as a navigator provided the intermediary complies with federal restrictions.
No natural person or entity may act as a navigator in Wisconsin unless licensed or registered as a navigator. [s. 628.91, Wis. Stat.]
Licensure Requirements [s. 628.92, Wis. Stat.]
Individuals must apply to become licensed to act as a navigator in Wisconsin. In order to become a licensed individual navigator, individuals must:
- Be at least 18 years of age
- Reside in or maintain his/her principal place of business in Wisconsin
- Complete any training and course of study mandated by the exchange
- Complete 16 hours of prelicensing training
- Successfully pass a written examination
- Successfully complete a regulatory and criminal background investigation
- Pay the applicable licensing fee
Additionally, navigators who are not affiliated with a navigator entity must furnish and maintain a minimum bond no less than $100,000 from an authorized insurer or provide other evidence of financial responsibility.
Approved Prelicensing Courses [s. 628.92 (7), Wis. Stat.]
Candidates for an individual navigator license must complete at least 16 hours of prelicensing training before applying for an individual navigator's license. An overview of the topics covered during the prelicensing training is available in the Prelicensing Course Outline (opens in new window).
There are vendors offering training courses across the state. Fees and offerings may vary depending on the vendor. To view a list of approved courses visit www.sircon.com. Select "Look Up Education Course/Credits;" select "Approved Courses Inquiry;" select "Wisconsin;" click "Submit;" select an "Education Type" of "Pre-Licensing Education" and a "Course Category" of "Navigator PE;" and click "Submit."
Candidates must also successfully pass a written examination that tests the individual's knowledge of the duties and responsibilities of a navigator, the insurance laws and regulations of Wisconsin, and state public assistance programs and eligibility. An overview of the topics upon which the examination is based is available in the Examination Content Outline (opens in new window).
It is highly recommended that candidates take the prelicensing training before sitting for the examination.
Navigator Study Materials
Candidates for an individual navigator license must successfully pass a written examination before applying for a license. The examination tests the candidate's knowledge of the duties and responsibilities of a navigator, the insurance laws and regulations of Wisconsin, and state public assistance programs and eligibility. To assist candidates in preparing for the examination, the Office of the Commissioner of Insurance (OCI) has assembled the following materials:
These materials are prepared for individuals who are preparing for the navigator examination. They are brief summaries of select laws and rules and are not a complete summary. Each person taking an examination will be responsible for knowing the material covered in these materials. They should be read carefully and completely.
These materials are not intended to be a complete summary of the statutes and rules about which navigators should be aware. As such, candidates may also want to review additional materials available from the following sources:
- The Center for Consumer Information & Insurance Oversight
- Kaiser Family Foundation
- Commonwealth Fund
- Robert Wood Johnson Foundation
Initial Application Process
Individuals wishing to obtain an individual navigator license must complete the prelicensing training, complete any federally mandated exchange training, submit a full set of fingerprints to OCI, and successfully pass the examination before applying for a license. Once this has been done, the candidate must send a properly completed application to OCI.
Documentation to support the successful completion of the prelicensing training, examination, and fingerprint results will be electronically sent directly to OCI. The applicant must include with the application documentation to support completion of the federally mandated exchange training requirements and provide documentation related to any affirmative answers to the background questions contained on the application.
Detailed instructions on the examination, fingerprinting, and application process are contained in the Wisconsin Licensing Handbook (opens in new window).
Continuing Education Requirement
Once licensed, individual navigators must complete annually at least 8 hours of continuing education and pay the annual licensure fee when due.
Business Entity Navigators
Registration Requirement [s. 628.92 (2), Wis. Stat.[
Entities functioning as, or intending to function as, navigators, supervising individual navigators or receiving funds to perform such activities must register with OCI and pay the applicable registration fee. Additionally, navigator entities must furnish and maintain a minimum bond no less than $100,000 from an authorized insurer or provide other evidence of financial responsibility capable of protecting all persons against the wrongful acts, misrepresentations, errors or omissions, or the negligence of the navigator.
Initial Registration Process
To register as a navigator business entity, the entity must:
- Submit a properly completed registration formNavigator Business Entity Registration Application (OCI 11-091) (opens in new window
- Pay the applicable non-refundable application fee of $100.00
- Submit evidence of financial responsibility
- Identify an individually licensed Designated Responsible Licensed Navigator
- Provide a list of all individual navigators that it employs, supervises, or is affiliated with
Ongoing Reporting Requirements
After initial registration, navigator entities must provide OCI with monthly updates, if any, to the list of individual navigators it employs, supervises, or is affiliated with.