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Referrals Program Frequently Asked Questions
Referrals Program Frequently Asked Questions

Find answers to some of our most frequently asked questions about the HealthSherpa Referrals Program

Emily Duffee avatar
Written by Emily Duffee
Updated over a week ago

Quick Links:

How do I sign up for the HealthSherpa Referrals Program?

To sign up for the Referrals Program, visit the Bonuses tab of your HealthSherpa for Agents account and choose “Referrals” then toggle the switch to “on” and proceed to adjust your carrier settings.

Can I join if health insurance is not my primary business?

Yes. The Referrals Program is ideal for agents who want to provide health plan options for their clients but who are not focused on ACA Marketplace business.

Can I refer to carriers with which I am not appointed?

Yes. However, you are responsible for complying with applicable state insurance laws regarding appointment. The Referrals 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.

Can I choose to which carriers I refer? What if I change my mind later?

Yes. You manage your carrier settings and can opt in or out of referring to 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.

Do all carriers participate in the Referrals Program?

No. Some carriers have the Referrals Program disabled. You’ll notice in your carrier settings that these carriers’ “refer” button is disabled.

What happens if I check both the “appointed” and “refer” buttons for a carrier when I sign up?

If BOTH the “appointed” and “refer” boxes are checked for a carrier, applications for that carrier will be referred. If the “refer” box is not checked for a carrier, policies written for that carrier will use your NPN (or Override NPN if applicable).

What if my client needs support from the carrier after I enroll them?

Since HealthSherpa is AOR on the policy, if you ever need assistance contacting the carrier on behalf of the customer, HealthSherpa Agent Support can assist as needed.

Do I have to collect Active Consent when I refer a client?

Yes. In order to comply with CMS requirements around receiving and documenting consent, we require each referral to be accompanied by documented consent that include the following elements:

  1. a clear statement that the consumer is consenting to allow you and, through referral to HealthSherpa, HealthSherpa to assist with the consumer’s enrollment and/or application for advance payment of the premium tax credit and cost-sharing reductions for QHPs;

  2. a description of the scope, purpose, and duration of the consent;

  3. the date consent was given;

  4. the name of the consumer or their authorized representative;

  5. your name and HealthSherpa’s name listed as the agent and web-broker, respectively, being granted consent; and

  6. a description of the process through which the consumer or their authorized representative may rescind the consent.

HealthSherpa may require the consent to be in a specific form or format, which will be communicated to you through your agent dashboard. Per CMS regulations, you must appropriately secure and maintain such documented consent for 10 years. To learn more about our consent tools and see our referrals-specific consent form, read our Active Consent FAQ.

Once I submit a referral, where can I see my client?

Once enrolled, the client will appear on your Bonuses tab so you can track your referral bonus payments. The client will also appear on your Clients page along with your non-referral clients.

How do renewals work with the Referrals Program?

The first time you refer a client to HealthSherpa, our NPN is applied. When it comes time to renew, you have the option to enroll using your NPN as long as you’re appointed to write their policy since the client belongs to you. If you choose to refer again, active renewals are eligible for another referral bonus. There is no referral bonus for auto renewals.

Are Off-Exchange enrollments eligible for referrals?

No. The HealthSherpa Referrals Program applies only to On-Exchange enrollments.

How much will I get paid for each referral?

You’ll be able to see the exact referral bonus amount set for the OEP or SEP period in your Bonuses tab:

  • During the current Special Enrollment Period, HealthSherpa will pay you $50 for each referral.

  • There are a handful of Carriers who don't pay any commission. For these carriers, we'll pay you a $25 referral bonus per enrollment. You can see a list of these carriers on the Broker Bonus tab.

When will I get paid?

We pay each bonus 60 days after each milestone. The 4-month persistency bonus will be paid out after HealthSherpa has verified with the carriers that the policy has been active and aligned with HealthSherpa’s book of business for the consecutive 4 months.

Full terms and conditions for payment are set forth in your Joint Marketing Agreement with HealthSherpa

How do I get paid?

After you've submitted your first referral, you'll be prompted to submit a W-9 and set up a payment method on the Bonus tab. Without a W-9, we can’t pay you. You can choose whether to get paid through Bill.com direct deposit, or check. If you choose to be paid by check, the address you input on your W-9 is where your check will be sent.

ℹ️ For much more detail about getting paid, see the article: Referrals & Bonuses: Getting Paid

Why is my referral payment status “awaiting consent”?

All referrals require active consent from consumers. If your payment status is “awaiting consent upload” your payment has been delayed due to lack of consent uploaded on a resubmission. When you resubmit, HealthSherpa requires additional consent from the consumer to ensure they understand and are aware of application changes.

What happens when I switch my client into a new policy mid year?

To receive persistency bonus, the policy must remain active and aligned with Healthsherpa’s book of business, with the same carrier for the duration of the persistency bonus requirement (4 consecutive months).

Does persistency include renewal periods? For example, if I enroll a member during SEP and their policy is shorter than 4 months, am I eligible for the bonus?

No, the persistency bonus is based on a single policy year. Your client must be active for 4 months during the same plan year for your to receive the bonus.

How do referrals work with self-enrolling clients?

Every HealthSherpa for Agents account comes with a free Marketing & Enrollment website you can use to allow clients to self-enroll. In general, your NPN is applied to every self-enrollment done through your site. However, if you have Referrals turned on, then self-enrollments submitted for Carriers you've set to “refer” will be submitted as Referrals—they'll have our NPN, will appear on your Bonuses tab, and you'll receive the referral bonus.

Can I refer all of my clients to HealthSherpa?

Yes. However, if you want HealthSherpa to handle all of your ACA enrollments we have a separate account type called a "Referrals Account". For these accounts, our team does full-service enrolling: from plan selection and enrollment to servicing and renewal. You still get paid the referral bonus when using a Referrals Account. Learn more about full-service Referrals Accounts

Still have questions?

Give us a call at (888) 684-1373 or email agent_support@healthsherpa.com.

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