Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 6 - General › Section Ins 6.92 - Individual navigators

Current through June 24, 2024
(1) PURPOSE. This section protects insurance
			 consumers by establishing procedures for the licensing of navigators when
			 transacting the business of insurance, prescribing minimum standards and
			 requirements to ensure timely and reliable information will exist and be
			 available to the commissioner. This section implements and interprets ss.
			 628.095,
			 628.097,
			 628.10,
			 628.90 to
			 628.95,
			 Stats., as applicable.
(2)
			 PROCEDURE.
(a)
Application for
			 navigator license.
An individual applying for a navigator license
			 shall submit an application to the office in the form prescribed by the
			 commissioner. A completed application shall include: the navigator's name; the
			 navigator's residence; contact email address; mailing and business addresses;
			 confirmation of successful completion of prelicensing training; fingerprints
			 provided in a format specified by the commissioner to complete; an electronic
			 confirmation of criminal history from the Wisconsin department of justice,
			 crime information bureau, and the federal bureau of investigation completed not
			 more than 180 days prior to the licensing examination date; payment of the
			 nonrefundable fees to the testing vendor; an electronic photograph of the
			 applicant taken by the test vendor at the time of testing; confirmation of
			 previous navigator licensure in another state, if applicable; payment of the
			 fee under s.
			 601.31(1)
			 (nm), Stats.; proof of financial
			 responsibility under sub. (7); and any documentation required in answer to
			 questions on the application.
Note:
A copy of the navigator license application
				form OCI 11-090, required in par. (a), may be obtained at no cost from the
				Office of the Commissioner of Insurance at 125 S. Webster Street, Madison WI
				53703, or at the Office's web address: oci.wi.gov.
(b)
Prelicensing Training.
An individual seeking a navigator license, in addition to any training
			 requirements of the federal government, shall complete at least 16 hours of
			 commissioner-approved navigator prelicensing training. Training required under
			 this subsection must be approved by the commissioner and provided by an
			 education provider that is approved by the commissioner.
(c)
Scheduling the navigator
			 licensing examination.
An applicant must schedule an examination with
			 the testing vendor at least twenty-four hours prior to the desired navigator
			 licensing examination date. The written examination will test the applicant's
			 knowledge of the duties and responsibilities of a navigator; the insurance laws
			 and regulations of this state; and the state's public assistance programs and
			 eligibility. The written examination shall be approved by the commissioner and
			 offered through a commissioner-approved testing vendor.
(d)
Exception.
1. An insurance agent who holds an active
			 resident license with the accident and health line of authority and is in
			 compliance with continuing education requirements may apply to be licensed as a
			 navigator if the currently licensed insurance agent demonstrates all of the
			 following:
a. Compliance as set forth in s.
			 628.92(1),
			 Stats., including competence and trustworthiness.
b. Satisfactory completion of 4 hours of
			 navigator training specific to public assistance programs, including Medicaid,
			 in addition to the completion of any federally required navigator training and
			 compliance with federal restrictions and requirements including those set forth
			 in
			 45 CFR
			 155.205(d),
			 155.210,
			 155.215(b)
			 and (c), and
			 155.260(b),
			 as amended. The state training required under this subsection must be approved
			 by the commissioner and provided by an education provider that is approved by
			 the commissioner.
2. A
			 currently licensed insurance agent who is in compliance with subd. 1. is exempt
			 from passing the navigator examination and photograph requirements described in
			 par. (a). The currently licensed insurance agent shall provide new fingerprints
			 unless the office has received current, valid fingerprint results provided in a
			 format specified by the commissioner and an electronic confirmation of criminal
			 history from the Wisconsin department of justice, crime information bureau, and
			 the federal bureau of investigation that were completed not more than 180 days
			 prior to the date of the application. The currently licensed insurance agent
			 shall submit a completed application as described in par. (a) and pay the
			 licensing fee in accordance with s.
			 601.31(1)
			 (nm), Stats., to the
			 commissioner.
(e)
Issuance of license.
The commissioner shall issue a navigator
			 license to an applicant who completes and satisfies the requirements in pars.
			 (a) and (b), in addition to any federal training or requirements including the
			 requirements set forth in
			 45 CFR
			 155.205(d),
			 155.210,
			 155.215(b)
			 and (c), and
			 155.260(b),
			 as amended, has passed the commissioner-approved written examination with a
			 satisfactory grade, and meets the standards of competence and trustworthiness
			 as described in sub. (3). Examination scores are valid for 180 days. Failure to
			 apply for a license within 180 days will require the applicant to re-take the
			 examination. Determination of the acceptance or rejection of a completed
			 application shall be made within 90 days of receipt by the commissioner of the
			 completed application, which is tolled until receipt of any additional required
			 or requested documentation.