Wis. Admin. Code Office of the Commissioner of Insurance Ins 6.95

Current through October 28, 2024
Section Ins 6.95 - Registration of certified application counselors, nonnavigator assisters and nonnavigator assister entities
(1g) REGISTRATION REQUIREMENT. Certified application counselors and other nonnavigator assisters shall be employed or supervised by a registered nonnavigator assister entity, or be affiliated with a registered nonnavigator assister entity.
(1r) ELECTRONIC REGISTRATION FOR A NONNAVIGATOR ASSISTER ENTITY. An entity registering as a nonnavigator assister entity shall provide all of the following information to the commissioner in the form prescribed by the commissioner:
(a) The nonnavigator assister entity's name and current mailing address.
(b) The name and contact information for the nonnavigator assister entity.
(c) The name, business address, and type of nonnavigator assister for each nonnavigator assister it employs, supervises, or is affiliated with.
(d) An attestation that each nonnavigator assister is in compliance with applicable state law including any nonnavigator assister who is a certified application counselor and who has complied with s. 628.96(2), Stats.
(e) The nonnavigator assister entity's agreement to provide to the commissioner all supporting documents as requested by the commissioner.
(2) CERTIFIED APPLICATION COUNSELORS AND OTHER NONNAVIGATOR ASSISTERS.
(a) Certified application counselors under, and other nonnavigator assisters, are eligible to be registered by a nonnavigator assister entity if either of the following apply:
1. The application counselor or other nonnavigator assister is designated by the federal government to provide consumer assistance; that designation is not withdrawn; and the person has completed the training and examination requirement under ss. 628.92(7) and 628.96(2), Stats.
2. The application counselor or other nonnavigator assister is an insurance agent who hold an active resident license with the accident and health line of authority and is in compliance with continuing education requirements; complies with s. 628.96(3), Stats., including competence and trustworthiness, and satisfactorily completes 4 hours of navigator training specific to public assistance programs, including Medicaid, in addition to the completion of any federally required nonnavigator assister training and compliance with federal restrictions and requirements. An insurance agent who meets the requirements of this subdivision is not required to complete prelicensing training or the navigator licensing examination under ss. 628.92(7) and 628.96(2), Stats.
(b) The nonnavigator assister entity shall maintain records that each certified application counselor and other nonnavigator assister registered under par. (a) has completed the annual continuing education training. The nonnavigator assister entity shall provide an attestation of compliance with such requirement to the commissioner in a form prescribed by the commissioner by October 1 of each year. The commissioner will provide guidance on the topics for the continuing education training required under this subsection.
(c) The commissioner may deny registration for a certified application counselor and other nonnavigator assisters, for any of the following:
1. Failure to possess requisite character, integrity, competency and trustworthiness. In addition to the requirements set forth in s. 628.04, Stats., and s. Ins 6.92(3)
2. Commission of any act that would warrant the denial, suspension, or revocation of an insurance license or registration including any of the acts delineated in s. Ins 6.92(3).
3. Failure to fully provide required or requested information, to complete requisite training including continuing education, to maintain certification from the federal government as a certified application counselor or nonnavigator assister entity.
(3) ENTITY REPORTING OF UPDATES. A nonnavigator assister entity shall comply with s. 628.96(1), Stats., reporting in an electronic format as prescribed by the commissioner, any updates to the list of nonnavigator assisters that the nonnavigator assister entity provided when it first registered with the commissioner, including additions, deletions, or modifications. The information shall be provided within 30 days of the addition, deletion, or modification to the list of nonnavigator assisters.
(4) ENTITY LIABILITY. A nonnavigator assister entity assumes legal responsibility, in accordance with s., Stat., for the acts of the nonnavigator assisters, on behalf of the entity, that the entity employs, supervises or is formally affiliated with, that are performed in this state and that are within the scope of the apparent authority to act as a nonnavigator assister.
(5) REVOCATION OF ENTITY REGISTRATION. The commissioner may deny, suspend or revoke a nonnavigator assister entity registration if the nonnavigator assisters it employs, supervises or is affiliated with, fail to comply with s. Ins 6.92(3), or the nonnavigator assister entity fails to comply with any provision contained in this section or by failing to comply with requests of the commissioner.
(6) INVESTIGATION AND REVIEW.
(a) The commissioner, or designated examiner, may investigate and review all nonnavigator entities under ss. 601.43 and 601.44, Stats. The method and timing of the reviews shall be determined by the commissioner in each case and may consist of any of the following:
1. Consideration of information available from state, federal, or local agencies, private organizations or agencies, or interested persons.
2. Investigation upon receipt of a complaint from any person.
3. Any other information the commissioner deems relevant to the investigation.
(b) If, after the investigation the commissioner suspends, denies, or revokes the registration, written notification shall be given with reasons for such action. The suspension, denial or revocation constitutes an order pursuant to s. 601.62(3) (a), Stats., and the nonnavigator entity may request a hearing before the commissioner under that section.

Wis. Admin. Code Office of the Commissioner of Insurance Ins 6.95

EmR1314: emerg. cr. eff. 9-10-13; CR 13-113: cr. Register August 2014 No. 704, eff. 9-1-14; (1g) and (1r) renumbered from (intro.) and (1) under s. 13.92(4) (b) 1, Stats., (1g) (title) added under s. 13.92(4) (b) 2, Stats., correction in (2) (intro.) made under s. 13.92(4) (b) 7 Register August 2014 No. 704.