Skip to main content
Renewal pathways

Learn about available plan year 2025 renewal pathways

A
Written by Amber Dotson
Updated over a week ago

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:


Active & passive renewals

Active renewals

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:

  • They need to update their application to ensure their subsidy eligibility remains accurate

  • Formulary changes may have taken place for the upcoming plan year

  • Net premiums may be increasing

  • The crosswalk plan may offer a different network of providers

  • Health insurance needs and frequency of use may have changed

Passive renewals

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

  • They have an active policy for the current plan year

  • They have not opted out of BAR

  • They have provided relevant tax return access to CMS

  • They are enrolled in a plan that will be continued for the upcoming plan year or have a crosswalk plan available

  • AND they have not already actively renewed

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.


Agent-driven renewal pathways

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

Renewal Option 1: Renewal email

From your Clients dashboard, generate a customizable renewal email to clients who have not yet actively renewed by selecting the "Renewal email" button. Consumers who renew using this email link can actively renew their application without your assistance.

To send renewal emails, start on your Clients dashboard. Email options include:

  • Send renewal email in "bulk" to many clients at once

  • Use the filters to find consumers you wish to contact, then select the checkbox next to specific clients you wish to email, or

  • Send individual emails from a Client’s details page

By default, selecting the "Renewal email" button from your Clients dashboard will select all clients who have not yet actively renewed. Note: The "Renewal email" button only appears during the annual Open Enrollment Period (OEP).

Once the "Renewal email" button is selected, a Message Preview pop-up window will launch:

The Message Preview window allows you to customize your email prior to sending. You can edit the subject line and the body of the email, adjust the reply-to email address, and decide whether you'd like to include the renew online button.

Including the renew online button means the renewal email will include a 'Renew your plan online now' button as pictured above. This button allows your consumer to actively renew their application without your assistance. Note: Consumers who do not select the resume link (when the renew online button is included) will not be actively renewed via the renewal email pathway; active renewal is not an automatic function of the renewal email.

Some agents prefer to exclude the renew online button, opting instead to use the custom message to instruct their consumers to contact them directly to renew their application with agent assistance.

Your renewal email will come from no_reply@healthsherpa.com.

Upon selecting the renew link, the client will see the plan shopping page.

The client can choose a new plan, update their application as needed, and submit their active renewal.

When clients enroll through your renewal email, they will continue to be 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.

Note: The renewal email cannot be sent to the same client more than three times. We will not send renewal emails to clients who have received this email three times in the past seven days, have already renewed for the upcoming Plan Year, or unsubscribed from no_reply@HealthSherpa.com emails.

Renewal Option 2: Search Marketplace

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.

Renewal Option 3: Client's profile

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:

  • Selecting the “Renew” button will take you to renewal expectations page where you may shop for plans first

  • Selecting “Start with the application” will allow you to begin with application updates (you will land on the privacy page)

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.

Renewal Option 4: Renewals tab (New!)

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 your full client list, and dynamically updates when status changes take place. Here, you will find clients who are at risk of not renewing, losing their subsidy, are experiencing a significant crosswalk change, and even clients who have already renewed. Note: archived clients are not displayed within the 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


Consumer-driven renewal pathways

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

Renewal Option 1: Consumer Dashboard

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.

Renewal Option 2: Marketing link

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.


Frequently asked questions

What does "Crosswalk" mean?

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

  • The consumer's current plan is discontinued for the upcoming plan year and a close plan equivalent exists

  • OR When a carrier will no longer offer plans where the consumer resides for the upcoming plan year

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

What is BAR?

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.

How does CMS prioritize BAR for consumers?

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.

How do the new SSN requirements impact passive renewals?

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

Do passive renewals automatically display within my Clients dashboard?

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.

What does the “Do not auto-renew this plan for [upcoming plan year]” button within a Client’s details page do?

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.

  • An FFM application ID may be visible for the upcoming plan year if CMS has already performed BAR for the consumer.

  • If the agent checks the box after CMS has performed BAR for the consumer, a new FFM application ID for the upcoming plan year will be visible; however, the plan selected by CMS will be canceled once CMS processes the consumer’s decision to opt-out of BAR. CMS may take days or weeks to process a consumer’s decision to opt-out of BAR.

  • If an agent checks the box but cannot find an FFM application ID for the upcoming plan year, then the box was selected before CMS began BAR for the consumer.

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.

Will selecting the “Do not auto-renew this plan for [upcoming plan year]” button mean that I won’t encounter the Invalid Action error message?

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

If a consumer is passively renewed into a non-$0 premium plan effective January 1, does not make their binder payment, then actively renews into a $0 premium plan effective February 1, do they still need to pay the premium dollars owed for January?

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.

Do consumers with $0 premiums have to have a credit card on file with their 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.


Additional Resources

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.

Did this answer your question?