Siga las instrucciones aquí para traducir esta página a otro idioma usando Chrome.

The Enrollee Assistance Program (EAP) gives agents a way to partner with HealthSherpa on Affordable Care Act (ACA) enrollment submissions. When an enrollment is submitted using EAP, it is processed using HealthSherpa’s National Producer Number (NPN).

In this article we’ll cover:

The EAP is not available within carrier-specific account types.

The HealthSherpa Enrollee Assistance Program (EAP) gives agents a way to partner with HealthSherpa to help ensure consumers have a smooth Affordable Care Act (ACA) enrollment experience.

Applications submitted using EAP are processed using HealthSherpa’s National Producer Number (NPN). This can help agents support consumers across the full range of health plans available in a given market, including consumers seeking plans the agent’s Line of Authority may not allow them to sell.

HealthSherpa compensates participating agents at the time of enrollment, with additional compensation possible if consumers remain enrolled for a defined period. Payment is typically issued faster than standard carrier commission timelines.

Agents remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent state laws that require agents to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

EAP functionality is disabled in certain states, including Florida, Iowa, Michigan, New Hampshire, North Carolina, South Dakota, and Wisconsin, and not all carriers participate in the EAP.

The Enrollee Assistance Program (EAP) offers two Service Models: the Full-Service Model and the Shared-Service Model. Depending on the model selected, HealthSherpa may handle some or all of the Affordable Care Act (ACA) enrollment submission journey.

Both EAP models offer the same bonus payout amounts.

Agents may participate in both Service Models by maintaining separate HealthSherpa accounts. Each account may only be used by a single agent, and users cannot be logged into both accounts at the same time.

Steps to participate in the EAP are dependent on the Service Model selected.

Agents can track bonus payouts on the Bonuses page. Select the Enrollee Assistance Program tab to view the Track your program enrollments dashboard.

To receive bonus payouts, agents must complete additional steps on the Bonuses page so that payments can be processed.

HealthSherpa will pay agents for each enrollment processed through the Enrollee Assistance Program. Compensation is subject to change.

For OEP 2026, compensation is as follows:

For SEP 2026, compensation is as follows:

After your first EAP submission is completed, you'll be prompted to submit a W-9 and set up a payment method (if you haven't submitted a W-9 already). You can choose to get paid through Bill.com via direct deposit, or by check. Follow the steps outlined in the Complete program setup steps in your Bonus page to ensure you are properly set up to get paid.

We pay EAP compensation approximately 60 days after each milestone (e.g. enrollment & persistency). Note: There is a mandatory 45-day waiting period before HealthSherpa makes payment eligibility determinations & your payment may take more than 60 days to process.

For Enrollee Assistance Program (EAP) enrollments, the following must be true:

Agents are only required to have a resident license to transfer consumer relationships using the full service model in any state & receive payout.

In this video we'll show you how to set-up a Full-Service EAP HealthSherpa account.

In this video we'll show you how to enable the EAP Shared-Service Model within your HealthSherpa account, what to expect when completing EAP Shared-Service enrollments, and collecting EAP consent.

The HealthSherpa Enrollee Assistance Program is a program that offers agents the opportunity to work with HealthSherpa to ensure their clients have the best enrollment experience possible. Watch a recording of this training webinar here.

Once you have reviewed the available EAP Service Models, follow the steps outlined in this article to participate in whichever model you prefer.

Agents may also decide to create separate HealthSherpa accounts so they may participate in both models. Note: While multiple HealthSherpa accounts for a single user are allowed, there cannot be multiple people logging in to the same account, and multiple HealthSherpa accounts using the same FFM Credentials (such as the same FFM ID) cannot be logged in simultaneously.

Yes. You must be licensed in order to participate in either EAP option offered.

While the Full-Service Model only requires agents to have a resident license to transfer consumer relationships in any state & receive payout, the Shared-Service Model requires agents be licensed in the state where your consumer is seeking coverage.

Note: You remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent state laws that require you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

A resident license is your license in the state you file taxes as a resident. (e.g. Agent is an Ohio resident and files taxes in Ohio, Agent's resident license is Ohio)

You do not need to be FFM certified to participate in the Full Service Model; however, you do need to be FFM certified to participate in the Shared Service Model. Note: Georgia has their own State-based Marketplace (SBM) and therefore requires separate certification. Learn more here.

Note: You remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent state laws that require you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

You remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent state laws that require you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

Yes, depending on state insurance laws. You can enable EAP for any Carrier you'd like; however, you remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent any laws or regulations.

This depends on which EAP model you choose.

In the Full-Service Model (FSM), agents can only serve consumers by way of the EAP. In the Shared-Service Model (SSM), agents can service consumers according to the carrier settings in your HealthSherpa for Agents account (i.e. can be processed under the SSM, under your NPN, etc.).

If both the “Are you appointed” and “Enable Enrollee Assistance” boxes are toggled to ‘Yes’ for a carrier:

If the “Enable Enrollee Assistance” box is not toggled to ‘Yes’ for a carrier, policies written for that carrier will use your NPN (or Override NPN if applicable).

This depends on which EAP model you choose. Every Enrollee Assistance Program Account & HealthSherpa for Agent account comes with a free, customizable direct marketing link. When selected, your unique marketing link leads consumers to an enrollment website where consumers may quote to see available plans and even enroll. Learn more here.

In the Shared-Service Model (SSM), agents can service consumers according to the carrier settings within their HealthSherpa for Agents account (i.e. can be processed under the SSM, under your NPN, etc.). When clients enroll through the marketing link associated with your HealthSherpa for Agents account, the NPN applied will depend on the Carrier Settings you have in place for respective carriers. Note: Enrollments done using a Shared-Service EAP agent's marketing link will be blocked if the agent is not licensed in the consumer's state.

In the Full-Service Model (FSM), agents establish an Enrollee Assistance Program Account and can only serve consumers by way of the Full-Service Model. When clients enroll through the marketing link associated with your Enrollee Assistance Program Account, HealthSherpa will become the Agent of Record, and you will be eligible for EAP compensation. Enrollments done using a Full-Service EAP agent's marketing link will be blocked if the agent is not licensed in the consumer's state; however, applications will still be possible if completed using your personalized phone number associated with your EAP account. Note: Enrollments done using a Full-Service EAP agent's marketing link will be blocked if EAP functionality is disabled in the state or if the carrier selected does not participate in the EAP. Only consumers using your unique phone number will be able to proceed with enrollment in these instances.

Agents are able to enable EAP for carriers as they normally would, and will simply have the added option to select from an agency override NPN rather than processing the application as an EAP enrollment. Learn more about NPN override here.

No. You’ll notice the “Enable Enrollee Assistance” toggle within your carrier settings is disabled for carriers who do not participate in EAP. If the Enrollee Assistance Program (EAP) is disabled for a carrier, your own NPN (or Override NPN) will be applied to any applications submitted for that carrier.

EAP functionality is disabled in Florida, Iowa, Michigan, New Hampshire, North Carolina, South Dakota, and Wisconsin. Note: Enrollments done using a Full-Service EAP agent's unique link or marketing link will be blocked if EAP functionality is disabled in the state or if the carrier selected does not participate in the EAP. Only consumers using a Full-Service EAP agent's unique phone number will be able to proceed with enrollment in these instances.

If you choose the Full-Service Model, we’ll collect and document consent for you.

If you choose the Shared-Service Model, you’re responsible for collecting and uploading consent authorizing you and HealthSherpa to provide support before you proceed. Learn more about EAP consent guidelines here.

Agents are responsible for complying with all applicable state insurance laws regarding licensure and appointment and must attest that they are adhering to compliance requirements before proceeding. The Enrollee Assistance Program may not be used to circumvent state laws that require you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

Yes. The Full-Service Model is ideal for licensed agents who want to provide a personalized phone number or enrollment link with their consumers and let HealthSherpa provide full enrollment and post-enrollment support.

No. The EAP is only available for On-Exchange QHP enrollments.

The EAP is only available for states that utilize the Federally Facilitated Marketplace (FFM), as well as Georgia.

If you ever need to support consumers enrolled by way of the EAP (e.g. assistance contacting the carrier on behalf of the customer), please reach out to the HealthSherpa Agent Support team for assistance.

All EAP submissions require that documented consent be on file. If you see a payment status listed as “awaiting consent upload” your payment has been delayed due to lack of consent uploaded on a resubmission (this will likely be limited to submissions made under the old referrals program). HealthSherpa requires additional consent from the consumer to ensure they understand and are aware of application changes.

You manage your carrier settings and can opt in or out of using the SSM for any carrier at any time. Make sure to update your carrier settings throughout the year or each time you get a new appointment, get licensed in a new state, or a new carrier enters the market.

With consumer consent, you may assist consumers with updating their application at any point during the year. When reporting updates, if the consumer qualifies for a special enrollment period (SEP), they will have the option to update their plan selection. At this point, the NPN associated with their application would be updated according to your carrier settings.

When you initially enroll consumers using the EAP, HealthSherpa becomes the Agent of Record. When it comes time to renew, you have the option to actively renew consumers using your NPN or choose to process the active renewal using the EAP. Active renewals are eligible for EAP compensation, whereas passive renewals are not.

No, persistency compensation is based on a single policy year.

It is not possible to process an EAP enrollment using a 3-way calls with the Marketplace Call Center. EAP enrollments may only be processed using the HealthSherpa platform. If you experience CMS' Invalid Action error message, the enrollment must be submitted by the consumer using the Invalid Action resume link pathway in order for the enrollment to be eligible for EAP compensation.

For help using HealthSherpa or for other assistance, contact Agent Support. Agent Support is available by phone at (888) 684-1373, by email at Agent_Support@HealthSherpa.com, or by chat directly from your account.