With HealthSherpa, agents and brokers can shop and enroll their clients in off-exchange plans.
This product is currently available for select carriers and states. As our off-exchange selection grows, we will keep this resource updated.
What are off-exchange plans?
The off-exchange plans available through HealthSherpa are ACA-compliant, and rates for plans can sometimes be cheaper outside the ACA’s exchanges.
However, these plans are not eligible for subsidies. If your client could be eligible for ACA subsidies, Medicaid or CHIP, you will want to check what they qualify for on-exchange first.
Who could benefit from off-exchange plans?
Clients who fall into these three categories are most likely to find value in off-exchange plans:
Households that make too much to qualify for subsidies on-exchange
Individual coverage HRA (ICHRA) folks who are offered a Cafeteria plan and want to use those dollars along with HRA to pay for premiums
HRA early retiree folks who prefer non-mirrored Off-ex plans to On-ex plans
Key reason for this would non-mirrored plans that have removed the silver loading premium amount (i.e. plans are less expensive off-exchange)
It’s important to note that many people who would’ve made too much money to qualify for subsidies before 2021 may now be eligible due to the American Rescue Plan Act (ARP).
What carriers offer off-exchange plans on the HealthSherpa Marketplace?
Off-exchange plans from the following carriers are available on the HealthSherpa Marketplace:
For Medical Plans:
United Healthcare (UHC)
Blue Cross Blue Shield Kansas City (Blue KC)
Blue Cross Blue Shield of South Carolina (BCBS SC)
Blue Cross Blue Shield of Arizona (BCBS AZ)
Ambetter (Centene)
Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas (HCSC)
Cigna
Molina Healthcare
For Dental Plans:
Blue Cross Blue Shield of Arizona (BCBS AZ)
United Healthcare (UHC)
Off-exchange plans on HealthSherpa
In this section, we’ll cover the key points to know before writing our first off-exchange policy on HealthSherpa:
Off-exchange is only accessible through an agent account on HealthSherpa. Your clients will not be able to see these plans if they go through your custom HealthSherpa website in your Marketing tab.
Off-exchange plans are currently only available for select carriers and states. Review the map below to see the number of carriers offering off-exchange medical plans on HealthSherpa for Plan Year 2025 Open Enrollment. We plan to add more options over time, so check your agent account to see new additions.
How to access off-exchange shopping and enrollment
Agents should update their carrier settings to include all states they hold an active license within. After updating your carrier settings, click the quote dropdown button in the top right corner of the agent dashboard as shown below:
If your client is eligible, make sure to add their ICHRA and cafeteria amounts when quoting. They’ll be applied to the premium prices, meaning the plan list will reflect the portion of the premium the applicant will need to pay.
After choosing an off-exchange plan, you will be directed to complete an application for off-exchange enrollment.
How to view your off-exchange clients and leads
In the ‘Clients’ and ‘Leads’ tabs, you will notice an on- and off-exchange toggle. Use this to view and track your off-exchange business.
How do my carrier settings work for off-exchange plans?
Agents should update their carrier settings to include all states they hold an active license within. The first time you utilize the off-exchange health quote button, we'll prompt you to acknowledge appointment requirements, then you will be able to proceed with off-exchange health applications.
What if I don’t see any available off-ex plans?
Off-exchange plans are an actively growing offering from HealthSherpa, and for now, agents will only see plans from select carriers in certain states.
If you toggle over to off-exchange and see no plans, that means we don’t yet have this capability with carriers in the selected state. If you are an ACA agent with a HealthSherpa account, we will send you email updates when we add more off-ex plans to states you are licensed in.