Certified Application Counselor Designated Organization (CDO) Application

Thank you for your interest in providing assistance to Maine consumers looking for affordable health insurance coverage.

  1. In order to participate in Maine’s Certified Application Counselor (CAC) Program, organizations must be designated by the State as a CDO. All organizations that want to be designated as a CDO must fill out the application form below.
  2. The organization must include in the application a listing of staff members who plan to obtain certification to help Maine residents enroll in coverage through Maine’s State-based Marketplace on the Federal Platform.
  3. Organizations must obtain designation by the Department of Health and Human Services and must ensure all staff/volunteers serving as CACs meet State and Federal requirements before providing assistance to consumers.

If you have any questions, please reach out to SBMAssisters.DHHS@maine.gov

Is your organization a current or past CDO?
Do one or more of the following apply to your organization?
A non-federal government entity
A health care delivery organization?
Designated as a Medicaid/CHIP application assistance program?
Organized under 501 (c) of the Internal Revenue Code?
How Can DHHS Contact Your Organization?
How Can the General Public Contact Your Organization?
Please note: this information will be made available to the public
(please include a brief summary of any additional key information for the public to know – e.g. specialty in serving immigrants, appointments required)
List of Current and Anticipated Certified Application Counselors
Please list the first and last name of the members of your team that will serve as CACs for the 2021 Plan Year, including during the upcoming Open Enrollment Period. List one name per line.
more items

If your organization plans to oversee more than 10 CACs, please email additional names to: SBMAssisters.DHHS@maine.gov

Privacy and Security
Does your organization already:
Screen the employees/volunteers it will certify as application counselors?
Handle Personally Identifiable Information (PII) and have processes in place to protect PII?
Comply with privacy and security standards adopted consistent with 45 CFR 155.260 (b), and applicable authentication and data security standards required by federal regulation?
Reporting to DHHS per 45 CFR 155.225
Organization will maintain a registration process and method to track the performance of Certified Application Counselors.
Organization will provide data and information to the DHHS regarding the number and performance of its Certified Application Counselors and regarding the consumer assistance provided by its Certified Application Counselors, upon request, in the form and manner specified by the Department.