# 50 Ill. Adm. Code 45150.4515.20: Section 4515.20 Definitions

> Illinois · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_20

## Section

- **Citation:** 50 Ill. Adm. Code 45150.4515.20
- **Heading:** Section 4515.20 Definitions
- **Jurisdiction:** Illinois
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Illinois Administrative Code / Title 50  /  / Part 45150  / Section 4515.20 Definitions

## Text

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER ww: HEALTH CARE SERVICE PLANS
PART 4515 NAVIGATOR, IN-PERSON COUNSELOR AND CERTIFIED APPLICATION COUNSELOR CERTIFICATION
SECTION 4515.20 DEFINITIONS
Section 4515.20
Definitions
"Act"
means the Navigator Certification Act [215 ILCS 121].
"Certification"
means the issuance by the Director of an authorization pursuant to this Part.
"Certified
Application Counselor" means any employee or volunteer of a Certified
Application Counselor Organization that enters into an agreement with the
Marketplace to have its employees or volunteers provide information to
individuals and employees about insurance affordability programs and qualified
health plan coverage options; assist individuals and employees to apply for
coverage in a qualified health plan through the Marketplace and for insurance
affordability programs; and help to facilitate enrollment of eligible
individuals in qualified health plans and insurance affordability programs.
"Certified
Application Counselor Organization" means any organization designated by
the Marketplace to certify its staff members or volunteers to act as certified
application counselors and includes those organizations described in 45 CFR
155.225 (Apr. 27, 2023) (no later editions or amendments).
"Code" means the Illinois Insurance Code
[215 ILCS 5].
"Course"
means any course of study certified to the Director that meets the requirements
of this Part, including, but not limited to, seminar, classroom, and self-study
formats.
"Department" means the Illinois Department
of Insurance.
"Director"
means the Director of the Department or anyone to whom the Director's responsibilities
and authority are lawfully delegated.
"Federal
training curriculum" means the curriculum implemented by the United States
Department of Health and Human Services under 45 C.F.R. 155.215(b) (Apr. 25,
2019) (no later editions or amendments)
"Department" means the Illinois Department
of Insurance.
"Director"
means the Director of the Department or anyone to whom the Director's responsibilities
and authority are lawfully delegated.
"Federal
training curriculum" means the curriculum implemented by the United States
Department of Health and Human Services under 45 C.F.R. 155.215(b) (Apr. 25,
2019) (no later editions or amendments).
"In-Person
Counselor" means any individual or entity who receives grant funds from
the State of Illinois to perform the activities and duties identified in 45 CFR
155.205 (Apr. 15, 2024) (no later editions or amendments) or is described or
designated by a Marketplace, the State, or the United States Department of
Health and Human Services, or could reasonably be described or designated as
"non-Navigator assistance personnel" as described in 45 CFR 155.215.
An In-Person Counselor would engage in the activities and meet the standards
described in 45 CFR 155.215, including, but not limited to:
conduct
public education activities to raise awareness of the availability of qualified
health plans;
distribute
fair and impartial information concerning enrollment in qualified health plans,
and the availability of premium tax credits under 26 U.S.C. 36B and
cost-sharing reductions under 42 U.S.C. 18071;
facilitate enrollment in qualified health plans;
provide
referrals to any applicable office of health insurance consumer assistance or
health insurance ombudsman established under section 2793 of the Public Health Services
Act (42 U.S.C. 300gg-93), or any other appropriate State agency or agencies,
for any enrollee with a grievance, complaint, or question regarding his or her
health plan, coverage, or a determination under a plan or coverage; and
provide
information in a manner that is culturally and linguistically appropriate to
the needs of the population being served by the Marketplace
Public Health Services
Act (42 U.S.C. 300gg-93), or any other appropriate State agency or agencies,
for any enrollee with a grievance, complaint, or question regarding his or her
health plan, coverage, or a determination under a plan or coverage; and
provide
information in a manner that is culturally and linguistically appropriate to
the needs of the population being served by the Marketplace.
"Marketplace"
means any health benefit exchange authorized under the federal Patient
Protection and Affordable Care Act and established or operating in this State,
including any exchange established or operated by the United States Department
of Health and Human Services.
"Navigator"
means any individual or entity who is certified as a "Navigator"
under the federal Patient Protection and Affordable Care Act, and means any
individual or entity, other than an insurance producer licensed by the
Department, who receives grant funds from the United States Department of
Health and Human Services to perform any of the activities and duties
identified in 42 U.S.C. 18031(i)(3) or is described or designated by a
Marketplace, the State, or the United States Department of Health and Human
Services, or could reasonably be described or designated, as Navigators, as
described in 45 CFR 155.210 (Apr. 27, 2023) (no later editions or amendments).
A Navigator would engage in the activities and meet the standards described in
45 CFR 155.210 and 45 CFR 155.215, including, but not limited to:
conduct
public education activities to raise awareness of the availability of qualified
health plans;
distribute
fair and impartial information concerning enrollment in qualified health plans,
and the availability of premium tax credits under 26 U.S.C. 36B and
cost-sharing reductions under 42 U.S.C
t the standards described in
45 CFR 155.210 and 45 CFR 155.215, including, but not limited to:
conduct
public education activities to raise awareness of the availability of qualified
health plans;
distribute
fair and impartial information concerning enrollment in qualified health plans,
and the availability of premium tax credits under 26 U.S.C. 36B and
cost-sharing reductions under 42 U.S.C. 18071;
facilitate enrollment in qualified health plans;
provide
referrals to any applicable office of health insurance consumer assistance or
health insurance ombudsman established under section 2793 of the Public Health
Services Act (42 U.S.C. 300gg-93), or any other appropriate State agency or
agencies, for any enrollee with a grievance, complaint, or question regarding his
or her health plan, coverage, or a determination under a plan or coverage; and
provide
information in a manner that is culturally and linguistically appropriate to
the needs of the population being served by the Marketplace.
"Qualified
health plan" or "QHP"
has
the meaning given that term in 42 U.S.C. 18021(a).
"Successful
completion" means passing an examination with a score of 80% or above in
no more than three attempts.

## Nearby sections

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- [50 Ill. Adm. Code 45150.4515.50 Section 4515.50  Application for Certification](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_50.md)
- [50 Ill. Adm. Code 45150.4515.60 Section 4515.60  Certification Renewal](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_60.md)
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- [50 Ill. Adm. Code 45150.4515.100 Section 4515.100  Education Responsibilities of the Applicant for the Navigator, In-Person Counselor or Certified Application Counselor Certification or Renewal](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_100.md)
- [50 Ill. Adm. Code 45150.4515.110 Section 4515.110  State-Provided Education Course Curriculum](https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_110.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IL_IAC_T50_P45150_S4515_20. Check the current official text before relying on it. Not legal advice.
