For the 2019 Plan Year , approximately 95% of your clients will be able to submit applications and enroll directly through HealthSherpa. There are a few exceptions.

Due to guidelines from CMS and Healthcare.gov, the following rare cases cannot be handled by HealthSherpa and must be managed by Healthcare.gov.

  • American Indian and Alaskan Natives
  • Applicants with home addresses in a different state than where they are applying for coverage
  • Applicants with no home address
  • Applicants who are not planning to file a tax return
  • Married applicants who are not filing a joint tax return
  • Applicants responsible for a child 18 or younger who lives with them but is not included on tax return
  • Applicants who are offered coverage through their job, someone else’s job, or COBRA
  • Applicants with dependent children who are over 25 or who are married
  • Applicants with dependent children (under 21) who are not applying for coverage
  • Applicants with dependent children living with a parent not on their tax return applying for coverage



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