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Plan shopping allows agents to quote and compare plans and review plan results with a consumer. Agents can start plan shopping at any time by getting a quote or land on plan results after completing the subsidy application.

In this article we’ll cover:

Agents can start plan shopping at any time by clicking Quote On-Ex to open the quoter.

A drop down menu may display if Off-Exchange medical plans or Off-Exchange dental plans are available within the HealthSherpa account.

With consent, enter the consumer’s ZIP code, gender, date of birth or age, and household information into the quoter.

Add additional people to the quote if needed, then view estimated subsidy eligibility.

Review available plans with the consumer and narrow options based on the consumer’s needs.

Plan results display below the quoter after the consumer’s information is entered. Agents may also land on the plan results page after completing the subsidy application.

Plan results can be filtered to narrow options based on the consumer’s needs. Start by identifying the consumer’s priorities, such as provider preferences, prescription usage, budget, and how they expect to use coverage.

Common questions to understand needs include:

From plan results, agents can save a quote, share plan options with a consumer, or compare plans side by side.

Plan shopping and the subsidy application are distinct parts of the flow that culminate in an enrollment submission. Enrollment submission can begin with plan shopping or with completing the subsidy application.

Select Enroll or Enroll now on a plan card to continue with the enrollment submission flow.

Consumers who start plan shopping or start an application but have not submitted an enrollment display on the Leads page. After an enrollment is successfully submitted, the consumer moves to the Clients page.

During the Open Enrollment Period (OEP), use the available renewal pathways to assist consumers who are already on the Clients page. To assist consumers who are already on the Clients page and seeking a Special Enrollment Period (SEP), edit the application from the client's Details page.

Affordable Care Act (ACA) plans fall into four different categories referred to as metal levels. Metal levels include Bronze, Silver, Gold, and Platinum plans. The main difference between each metal level is how costs for covered services are shared between the carrier and the consumer.

Catastrophic plans are also available to certain consumers.

Catastrophic plans cover the same 10 essential health benefits as the other metal levels and typically have low monthly premiums coupled with high deductibles. Advance premium tax credit (APTC) and cost-sharing reductions (CSR) cannot be used toward Catastrophic plans.

No. Catastrophic plans are only available to consumers under 30 years old and to consumers who qualify for an exemption.

If a consumer is over 30 years old and wants to purchase a Catastrophic plan, the consumer must qualify for an exemption. Consumers who are under 30 years old do not need an exemption to purchase a Catastrophic plan.

There are two types of exemptions available to consumers over 30 years old seeking Catastrophic coverage:

To apply for an exemption, consumers should complete an exemption application form. Hardship exemptions based on being ineligible for APTC or CSR due to projected annual household income may also be automatically calculated during the subsidy application process. Note: This applies to consumers applying through the Federally Facilitated Marketplace (FFM) as well as consumers applying through Georgia Access.

The federal poverty level (FPL) is a measure of income updated each year that is used to determine eligibility for certain programs and benefits such as ACA subsidies, Medicaid, and the Children’s Health Insurance Program (CHIP).

The 2025 FPL chart will be used to determine subsidy eligibility during plan year 2026 Open Enrollment Period.

A health savings account (HSA) compatible health plan is a high deductible health plan (HDHP) that allows the consumer to open and contribute to an HSA. An HSA is a tax-advantaged savings account, typically offered by a bank or financial institution, that lets consumers save and use pre-tax money for qualified medical expenses such as deductibles, copayments, and coinsurance.

The health plan and the HSA are separate. The insurance plan covers medical care, while the HSA is a financial account the consumer chooses to open and manage independently.

Having an HDHP does not require the consumer to open or contribute to an HSA. It gives the consumer the option to do so. While HSA funds can be used at any time for eligible expenses, consumers can only contribute to an HSA while covered by an HDHP.

Effective January 1, 2026, all Bronze and Catastrophic plans automatically qualify as HDHPs.

A health savings account (HSA) lets consumers set aside pre-tax money to pay for qualified medical expenses, lowering taxable income. Funds can be used tax-free for eligible costs. Unused balances roll over year to year with no expiration. The consumer owns the account, so it stays with the consumer even if the consumer changes jobs or health plans.

An HSA is not an insurance plan. It is a personal savings account that works alongside an eligible health plan.

To open and contribute to an HSA, the consumer must be enrolled in an HDHP, have no other disqualifying coverage, and not be claimed as a dependent on someone else’s tax return.

A flexible spending account (FSA) is an employer-sponsored benefit that lets employees set aside pre-tax money to pay for qualified medical expenses such as doctor visits, prescriptions, dental care, and vision costs.

The employee chooses an annual contribution during enrollment. The contribution is deducted from the employee’s paycheck before taxes. The full amount is generally available at the start of the plan year, often through an FSA debit card.

FSAs are owned and managed by the employer and are tied to the employee’s job. FSAs typically must be used by the end of the plan year unless the employer offers a carryover or grace period. An FSA is a benefit tied to an employee’s job. It is not an insurance plan.

To see the coverage associated with a specific plan, click Plan details on the plan card, then select the Summary of benefits and coverages (PDF) link. The PDF is created by the carrier and outlines plan coverage details and coverage levels available to the consumer.

Yes. Use the browser search tool to find words or phrases on the page.

This opens a search bar to search for words or phrases on the page.

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.

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