Agent Frequently Asked Questions

Basic Information

How does it work?

HealthSherpa is a drop-in replacement for Healthcare.gov designed specifically to meet the needs of agents. You get a branded website where customers can get quotes and enroll in as little as 5 minutes. You can help customers sign up, or share your link so that consumers can shop plans on their own.

Who is the broker of record?

You are! As long as you are either logged in or a customer visits your HealthSherpa link your NPN will be attached to the enrollment when it is transmitted to the carrier. When a customer visits your link, and then comes back to HealthSherpa, they’ll still see your logo, name, and contact information.

Does HealthSherpa work with State-Based Marketplaces?

Due to technical and guideline limitations with the state exchanges, HealthSherpa enrollments only work in the 37 Healthcare.gov states at this time.

How much does it cost?

During the 2016 Special Enrollment Period (SEP), all applications submitted through HealthSherpa are free of charge. There’s no monthly fee, no seat licensing fee, no minimum contract, and no hidden fees.

Can HealthSherpa help me with licensing or carrier contracting?

For licensing information please visit NIPR.com. For appointment information and general education, please contact fmo_support@healthsherpa.com.

How do I get FFM Certified?

To use HealthSherpa, you must be Marketplace certified. Here's how to check if you are set up correctly:

  1. Go to CMS Portal, click Login to CMS Secure Portal on the right, Accept the Terms and Conditions, and then log in.
  2. On the right you should see a button that says, "Request Access".
  3. On the right, you should see a box that says, "My Access". It should list, "FFM".

If you are still getting a notification on your HealthSherpa dashboard that your FFM username and password are invalid, please visit this link and make sure that you have completed steps 7 onwards on page 3. This includes logging into CMS Portal, completing identity verification, and requesting access to the "Agent/Broker" role.

Do you offer any training?

Absolutely! Check out our video tutorials to help get you started with HealthSherpa.

Quoting

What web browser and computer system work best with HealthSherpa?

HealthSherpa is accessible through all web browsers, but optimized for Google Chrome and Firefox. HealthSherpa is functional on both Macs and PCs.

What plans can clients choose from?

Clients can choose and enroll in the same plans that are displayed on Healthcare.gov.

Are off exchange plans available via HealthSherpa?

Not Yet. We currently do not offer off-exchange plans on our platform, however, we do plan to introduce additional products like dental and vision in the coming months.

What if the client is not applying for a tax credit? Do clients still have to go through the double redirect?

Yes. All clients need to go through the double redirect to Healthcare.gov, when applying for a Marketplace plan, regardless if a tax credit is being applied for or not.

How can I quote and send applications for California and other state based exchanges?

Currently, state based exchanges are unavailable for quoting and enrollment.

How can I quote and send applications for Marketplace Group Plans (SHOP)?

Marketplace Group or SHOP Plans are unavailable for quoting and enrollment.

How do I send quotes to my clients?

Before sending quotes, always be signed into your agent account or use your custom agent branded link, which is available under your consumer link tab. Once you have the list of quotes, there are 3 options to share quotes with your clients: email, link, or print. You’ll see these 3 buttons at the top of the page.

  • Email - send an email with the quoting link to your intended clients
  • Link - surfaces the url link to the page so you can copy and paste accordingly. Popular for agents that want to send links via chat or another email address.
  • Print - prints a copy of the quote. Your client can then review it in person.

How can I control which insurance carriers are displayed with my agent branded link?

You can select which insurance carriers are pre-filtered on your agent branded link on your insurers tab. When you email or share your agent branded link with clients, your selected insurance companies will be displayed first. However, please note that other insurance companies are accessible to your clients, as CMS guidelines state that all plans available on Healthcare.gov need to be displayed.

Applications

During OEP 2016, there were no double redirects. Now every application has a double redirect during SEP 2016. What happened?

Due to a notice from CMS and Healthcare.gov, all applicants are required to go through the double redirect with Healthcare.gov. The double redirect will likely be active during SEP 2016 and the upcoming OEP 2017. Any changes to this will be communicated to agents immediately.

Can all of my clients enroll through HealthSherpa?

Most clients can submit applications and enroll with HealthSherpa, but there are a few exceptions. Due to guidelines from CMS and Healthcare.gov, these cases cannot be handled by HealthSherpa and need to be enrolled directly with Healthcare.gov.

  • Dependent only applications, where only dependents in the household are seeking coverage.
  • Catastrophic plans
  • American Indians and Alaska natives, who are part of a federally recognized tribe.

When redirected back to HealthSherpa, the client’s application cannot be enrolled. The final enrollment page on HealthSherpa says that no one on the application is eligible for coverage. Why can’t HealthSherpa enroll them?

If redirected back to HealthSherpa to finalize the enrollment and the client is then told that no one on the application can be covered, that generally means that the client is ineligible. Based on what the client filled out on the application when redirected to Healthcare.gov, the client may not have entered a valid Special Enrollment Period reason. At that point, if the application cannot be enrolled, we provide the FFM application ID number on the final enrollment page and advise the agent and the client to call Healthcare.gov to look into the exact cause behind non-enrollment.

What other errors can lead to non-enrolled, pending applications?

Because of the re-direct to Healthcare.gov, the number of errors that can pause applications is much lower. However, one common error is a mismatch between quoted county and the client’s actual physical county.

For example, let’s say a zip code has 2 counties: Smith County & Jones County. The client’s physical address is in "Smith County", but the plan selected was for "Jones County".

This may pause an application because the plan selected is unavailable in the actual physical county. These types of applications cannot be submitted. The client needs to fill out a new application with the plan from the actual county.

When my client is redirected back to HealthSherpa, an error "oops" page or a red banner on the HealthSherpa enrollment page says that this application could not be enrolled at this time. Why did this happen? What should we do?

The error page and red banners occur due to a technical issue at HealthSherpa and/or Healthcare. gov. To help us pinpoint the issue, please reach out to agent_support@healthsherpa.com with the applicant’s first and last name and any details that may help us identify and resolve the issue.

Important action: If an application has not been able to process for longer than 24 hours, or you are approaching a deadline, archive the application by clicking the trashcan icon, go directly to Healthcare.gov or call the Marketplace at 1-800-318-2596 to complete the enrollment.

Post-Enrollment

Where can I track all of my enrollments?

You can track your enrollments on your HealthSherpa agent account under the enrollments tab.

During OEP 2016, eligibility letters were stored on the agent dashboard and were emailed to clients. Now there are no more eligibility letters. What happened?

Due to updated guidelines from CMS, our system can no longer store the eligibility letter or attach them in enrollment confirmation emails. Eligibility letters must be downloaded directly from Healthcare.gov by you or the client.

Where can I export my enrollment information?

Exports can be retrieved on the enrollments tab by clicking the export button on the right hand side. If the export file is small enough, the csv file will automatically download to your downloads folder. If the export file is too large, the csv file will be emailed to the email address on the HealthSherpa account. Please check your junk and spam folders. If no export file is sent in 30 minutes, please email agent_support@healthsherpa.com with the first and last name on your agent account.

How can I import information into my HealthSherpa account?

Import functionality is unavailable at this time.

My client submitted an application and received a confirmation email. However, the client does not appear on my agent dashboard. Why did this happen and am I the AOR?

If the client was enrolled and their application is not displayed on your agent dashboard, it could mean one of the following:

  • The client’s application was not submitted using your agent branded link
  • You were not logged in while completing the application.
  • If the client was enrolling remotely, their cookies were not enabled.

If the client does not appear in your agent dashboard, it means that you are not attached as the AOR.

My client submitted an application, but it appears as yellow on the dashboard. What does this mean? Can you enroll the client?

The application is yellow because the client is not enrolled. The reason for non-enrollment depends on the application. Please see the Applications FAQs for specific issues that can lead to non-enrollment. In most cases, due to the way HealthSherpa is set up with Healthcare.gov for these double redirect applications, we cannot enroll or push through applications if the customer did not complete the process.

Please feel free to reach out to agent_support@healthsherpa.com with the applicant's first and last name and any details to help identify the problem.

Important action: If an application has not been able to process for longer than 24 hours, or you are approaching a deadline, archive the application by clicking the trashcan icon, go directly to Healthcare.gov or call the Marketplace at 1-800-318-2596 to complete the enrollment.

My client's application is yellow and has the trashcan icon. What does that mean?

Yellow means that the application is not enrolled. The trashcan icon is to archive an application. When clicking the trashcan icon, the application is not actually deleted, it is simply placed into your archive. If an application is pending and you or the client decide to go to Healthcare.gov directly to complete an enrollment, we recommend clicking the trashcan icon to prevent trigerring duplicate enrollments. Archived applications can be retrieved by switching "Deleted?" to "Yes" and clicking "Submit".

My client's application is yellow and has a green play button. What does that mean?

Yellow means that the application is not enrolled. The green play button is to resume the enrollment, after a client’s application is redirected back to HealthSherpa from Healthcare.gov.

When I look up my archived applications on my enrollments tab, the archived applications have a refresh icon and/or a green play button. What are those for?

The refresh button is for reactivating an archived application. Clicking this button will move the application from the archive to active enrollments. The green play button is for resuming enrollments.

Important note: If the application was originally pending due to a technical error or if the client is not eligible to apply, the refresh button and the green play button will not enroll the client.

After enrollment, a blue access button is displayed. What is that for?

The blue access button gives agents a backend log-in to Healthcare.gov. Agents can look up applications, upload documents, and pay premiums. Payment of premiums is available via Healthcare.gov, if the insurance carrier permits this option. The blue access button is not for updating client information or reporting life changes.

For my double redirect applications, the blue access button does not auto populate my FFM username and I cannot log into Healthcare.gov. What can I do to log into Healthcare.gov?

Because of the way Healthcare.gov has set up their system, you may experience this specific issue.

Solution: You could try starting a new application on HealthSherpa to gain access to Healthcare.gov. (ie, log into HealthSherpa agent account, start a new application, log into Healthcare.gov with your agent FFM username, then look up any of your client applications).

Important: Do not use the Access button from a different client's account. If you do this, when you work on your current client, it will over write that client's information on return.

I am unable to log in to Healthcare.gov to locate a client’s application by starting a new application on HealthSherpa. What can I do to help manage my client’s applications?

There are two options available to you - we recommend doing both.

  1. Have your client create a Healthcare.gov consumer account to administer online functions like paying premiums or uploading documents.
  2. Perform 3 way calls with the Federal Marketplace to report life changes and make updates.

Important note: If you or your client calls the Marketplace, please be sure your agent NPN is attached to the application. There is an issue at CMS with all online applications submitted through all web based entities. If an application is opened up to report changes or update client information, the agent's information may be stripped away.

I looked up my client's application via the blue access button to report a life change/ update client information. I completed the life change, downloaded the eligibility letter, but when I try to "return to enrollment site", I am unable to select a new plan. How can I do this?

The blue access button is only for uploading documents or payment of premiums. If you downloaded an eligibility letter, please complete a 3 way call with the Marketplace to do plan selection (agent, client, and Marketplace representative).

Important note: If you or your client calls the Marketplace, please be sure your agent NPN is attached to the application. There is an issue at CMS with all online applications submitted through all web based entities. If an application is opened up to report changes or update client information, the agent's information may be stripped away.

How do I report life changes or update client information?

To report a life change or update client information, you must make a 3 way call with the Marketplace (agent, client, and Marketplace representative).

Important note: If you or your client calls the Marketplace, please be sure your agent NPN is attached to the application. There is an issue at CMS with all online applications submitted through all web based entities. If an application is opened up to report changes or update client information, the agent's information may be stripped away.

I or my client misspelled the name or entered incorrect information on the application. How can I get this corrected?

To edit incorrect client information, you must make a 3 way call with the Marketplace (agent, client, and Marketplace representative).

Important note: If you or your client calls the Marketplace, please be sure your agent NPN is attached to the application. There is an issue at CMS with all online applications submitted through all web based entities. If an application is opened up to report changes or update client information, the agent's information may be stripped away.

Agent of Record

I recently tried calling Healthcare.gov, but the Marketplace representative said that I am not an authorized user. I thought I was the Agent of Record. What happened?

This can be confusing. To the Marketplace, there is a difference between being the agent of record on the enrollment that is sent to the insurance company and an authorized user on the Healthcare.gov account. An authorized user doesn't need to be an agent. It can be any friend or family member that is authorized by the applicant to speak on their behalf. This authorization is typically done over the phone between the all three parties: Healthcare.gov, the authorized user (or in your case, you, the agent), and the applicant. Once this is taken care of, you can speak on behalf of your client to the Marketplace. However, you do not need this to speak with us or the carrier.

Additionally, you can access your client's entire application on the Federal Marketplace by using the "access" button on your HealthSherpa dashboard without going through the process of becoming an authorized user on the account. There you can submit payment and verification documents.

  1. Log in to your HealthSherpa dashboard.
  2. Click on a submitted (white) application.
  3. Click "ACCESS ACCOUNT" for the completed application.
  4. Log in to Healthcare.gov.
  5. Look up the application.

My client's application appears on my agent dashboard. However, when I call the insurance company, they do not have any agent on the application. Why did this happen?

Healthcare.gov and carriers communicate via what is called an 834 form. Think of this as a standard form that Healthcare.gov fills out and sends to the carrier. When HealthSherpa submits an enrollment to Healthcare.gov, we always attach your agent NPN to the application, and Healthcare.gov puts that on the 834 form. Other information (e.g. your Marketplace login, or your carrier writing number) is not included on the 834.

If the application is in your HealthSherpa Dashboard, we put your NPN on the application with Healthcare.gov. If the application is in yellow/beige, the application is pending and not fully enrolled. If it is in white, it has been successfully submitted to the Marketplace and then to the carrier with your NPN.

There are a few common issues that can cause errors with 834s - most of these happen after HealthSherpa has transmitted the application to Healthcare.gov.

Healthcare.gov sometimes fails to transmit 834s correctly to the carriers. They then send a reconciliation file to the carriers, and sometimes carriers discover old enrollments in that reconciliation file that they never received an 834 for. NPNs (and entire enrollments) are sometimes lost this way. HealthSherpa has no control over the communication between Healthcare.gov and the carrier, so we can't provide a resolution. You can however re-submit applications through HealthSherpa, and you won't be charged again for the same person or family.

Carriers sometimes incorrectly process 834s once they receive them from Healthcare.gov. This can result in agent attribution and/or enrollment errors as well.

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