You have several different pathways available within your HealthSherpa for Agents account when assisting consumers with plan year 2025 renewals. In this article we will cover:

An active renewal takes place when a consumer updates their Marketplace application during the annual Open Enrollment Period (OEP) and selects a new plan for the upcoming plan year. With consent, agents, brokers, and other authorized representatives may assist consumers with active renewals.

The National Producer Number (NPN) associated with the most recent version of a consumer's active application for the current plan year will automatically carry over to the new plan year. To ensure NPN accuracy, active renewals are encouraged.

OEP is your consumer's opportunity to make any necessary updates to their plan and ensure they have suitable coverage for the upcoming plan year. Consumers might need to update their plan selection for a number of reasons:

The renewals task view displays clients who are at risk of not renewing, losing their subsidy, or experiencing a significant crosswalk change. Minimally, we recommend you actively renew clients who display within your Renewals tab.

A passive renewal takes place by default for the upcoming plan year when all of the following items are true for the consumer:

Passive renewals are designed to ensure consumers have an opportunity to maintain uninterrupted coverage, even if they take no action during OEP. When a passive renewal takes place, the Federally Facilitated Marketplace (FFM) will automatically re-determine the consumer's subsidy eligibility and will re-enroll the consumer into their current plan or the closest equivalent (i.e. a crosswalk plan). Passive renewals are designed to be a “safety net” so that consumers can maintain coverage, but it is always best practice to reach out to your client and actively renew. Learn more about passive renewals here.

With consent, agents may assist a consumer with their active renewal one of three ways on HealthSherpa for Agents:

When assisting Clients who are not yet in your book of business, utilize the “Search Marketplace” button.

Searching for the consumer will retrieve their existing pre-filled subsidy application which you can update as needed. Agents will likely want to select the FFM application ID for the upcoming plan year if displayed within the search results. Learn more about understanding search results here.

After updating the subsidy application, you will see the consumer's crosswalked plan by default. You can continue with the crosswalked plan or change plans as desired prior to submitting the consumer’s active renewal.

Access your Client’s profile by selecting the “Renew” button from your Clients dashboard or by selecting the “Renew” button from their Client’s details page.

Note: Selecting a client’s name from the list of consumers displayed on your Clients dashboard will launch their Client’s details page.

You may shop for plans first or you may begin by updating the consumer's application:

After updating the subsidy application, you will see the consumer's crosswalked plan by default. You can continue with the crosswalked plan or change plans as desired prior to submitting the consumer’s active renewal.

You now have access to a Renewals tab within the Clients page of your HealthSherpa for Agents account. This renewals task view is designed to help you prioritize your renewal book so you can maximize efficiency during OEP.

The renewals task view displays clients who are at risk of not renewing, losing their subsidy, or experiencing a significant crosswalk change. You will likely wish to actively renew clients who display within your Renewals tab.

The Action column allows you start an active renewal directly from the Renewals tab. Selecting the “Renew now” button will allow you to shop for plans first; selecting “Start with the application” will allow you to begin with application updates instead (you will land on the privacy page). Learn more about the columns available within the Renewals tab here.

Note: the renewals task view may not currently display renewals in Georgia

Consumers may actively renew their coverage without agent assistance one of two ways on HealthSherpa:

Every client that's enrolled through HealthSherpa receives an invitation to create their own dashboard. Clients can sign into their Consumer Dashboard to actively renew their plan without assistance. Learn more about the Consumer Dashboard here.

Note: The National Producer Number (NPN) associated with the most recent version of a consumer's active application for the current plan year will automatically carry over to the new plan year. To ensure NPN accuracy, active renewals are encouraged.

Upon selecting the "Renew" button, the client will see a renewal expectations page:

Selecting the "Start my renewal" button will launch a plan list for the consumer with their existing plan highlighted. The client can choose a new plan, keep their current plan, update their pre-filled application as needed, and submit their enrollment. Overall, the Consumer Dashboard renewal experience is just like the experience you see as an agent when renewing a consumer from their Client's details page.

Consumer selects your marketing link to complete plan shopping and application renewal without agent assistance. Learn more about your direct marketing link here.

Your logo, name and NPN will be displayed as well as the image you have selected.

When clients enroll through your unique direct marketing link, they are associated with your account and will have your NPN automatically applied to any application submitted. Note: If you are participating in the Enrollee Assistance Program (EAP), the NPN applied will depend on your specific EAP and any alternative Carrier Settings you have in place for respective carriers.

The consumer will provide their basic information to view available plans, search the marketplace to claim and update their existing application, then proceed through their active renewal.

CMS automatically "crosswalks" consumers to new health plans when:

Consumers who have opted out of BAR will not be crosswalked and therefore will not passively renew.

BAR stands for Batch Auto Re-enrollment. BAR is a process used by Marketplaces to ensure consumers who are currently enrolled in Qualified Health Plans (QHPs) who do not engage in new plan selection by the end of OEP retain coverage for the upcoming plan year.

BAR is a behind-the-scenes process that CMS begins in October each year and continues through December. Consumers may be included in the BAR process at any point during this time. CMS creates a new FFM application ID and selects a plan for the consumer then sends this information to Carriers to passively renew the consumer.

Consumers may choose to opt out of BAR. Learn more about the BAR process here.

CMS prioritizes BAR for consumers based on enrollment effective dates.

Consumers with effective dates earlier in the year will likely be part of initial BAR waves, whereas consumers with effective dates later in the year may be part of CMS’ BAR processes in later waves.

CMS considers the most recent plan effective date for consumers during these waves.

Passive renewals will not be impacted by the new SSN requirement since passive renewals are handled by CMS.

No. With consumer consent, you will need to use the "Search Marketplace" button to search for the new FFM ID associated with your consumer's passive renewal to view this in your dashboard.

Because the OEP deadline for 1/1 effective dates does not end until 12/15, passive renewals are not visible to consumers or agents until after 12/15. You should wait to search for passive renewals until after 12/15 to ensure you are able to view passive renewal information.

If you search for consumers prior to 12/15 that you believe passively renewed and you see renewal data, this means the consumer actively renewed or someone else has actively renewed the consumer.

Selecting the “Do not auto-renew this plan for [upcoming plan year]” button within a Client’s details page indicates the consumer wishes to opt out of passive renewal (BAR) for the upcoming plan year.

Checking this box will not impact a consumer's coverage for the existing plan year.

Note: The “Do not auto-renew this plan for [upcoming plan year]” button only appears just before the annual Open Enrollment Period (OEP) and remains live through 12/31.

No. Selecting the “Do not auto-renew this plan for [upcoming plan year]” button will not impact whether the InvalidAction error message generates. Learn more here.

Consumers who do not make binder payments by January 1 for passive renewals will enter into a payment grace period.

If a consumer actively renews their coverage effective February 1 and, in the process, changes issuers or changes to a different product under the same issuer, then the consumer will likely not be required to pay the premium dollars owed for January in order to have coverage effectuate February 1.

If a consumer actively renews their coverage effective February 1 and, in the process, stays with the same issuer and remains in the same product line, then the consumer will likely be required to pay the premium dollars owed for January in order to have coverage effectuate February 1.

This may vary by carrier.

This may vary by carrier. Many carriers do not require consumers with $0 premium plans to have a credit card on file, but you’ll want to reach out to the carrier to be certain.

Have questions? Contact our Agent Support Team at (888) 684-1373 or agent_support@healthsherpa.com.

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