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The Enrollee Assistance Program (EAP) gives agents a way to partner with HealthSherpa on Affordable Care Act (ACA) enrollment submissions. When an enrollment is submitted using EAP, it is processed using HealthSherpa’s National Producer Number (NPN).

In this article we’ll cover:

Enrollee Assistance Program at a glance
Available Service Models
How to participate
Tracking bonus payouts
Training videos
Frequently asked questions

The EAP is not available within carrier-specific account types.

Enrollee Assistance Program at a glance

The HealthSherpa Enrollee Assistance Program (EAP) gives agents a way to partner with HealthSherpa to help ensure consumers have a smooth Affordable Care Act (ACA) enrollment experience.

Applications submitted using EAP are processed using HealthSherpa’s National Producer Number (NPN). This can help agents support consumers across the full range of health plans available in a given market, including consumers seeking plans the agent’s Line of Authority may not allow them to sell.

HealthSherpa issues bonus payouts at the time of enrollment, with additional bonus payouts possible if consumers remain enrolled for a defined period. Bonus payouts are typically issued faster than standard carrier commission timelines.

Agents remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent state laws that require agents to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

EAP functionality is disabled in certain states, including Florida, Iowa, Michigan, New Hampshire, North Carolina, South Dakota, and Wisconsin, and not all carriers participate in the EAP.

Available Service Models

The Enrollee Assistance Program (EAP) offers two Service Models: the Full-Service Model and the Shared-Service Model. Depending on the model selected, HealthSherpa may handle some or all of the Affordable Care Act (ACA) enrollment submission journey.

Full-Service Model (FSM)

In the Full-Service Model (FSM), agents transfer the consumer relationship to HealthSherpa using a personalized FSM phone number or link. When a consumer calls or uses the link, HealthSherpa completes a full needs analysis and manages consent, the enrollment submission, and the ongoing consumer relationship.

FSM enrollment submissions are only available through the HealthSherpa Enrollee Assistance Full-Service account type. This account type processes all enrollment submissions using HealthSherpa’s National Producer Number (NPN).

Agents may choose the FSM if the agent:

Is licensed but not licensed in the state(s) where consumers are seeking coverage
Is not certified with the Federally Facilitated Marketplace (FFM) or a supported State-based Marketplace (SBM)
Prefers HealthSherpa collect and document consent
Does not want involvement in the enrollment or ongoing consumer relationship

Shared-Service Model (SSM)

In the Shared-Service Model (SSM), agents maintain a shared responsibility with HealthSherpa for the consumer relationship. The agent completes a full needs analysis and manages EAP consent and the enrollment submission.

SSM enrollment submissions are only available through the HealthSherpa for Agents account type. This account type processes enrollment submissions based on the agent's carrier settings, or an agency override NPN.

Agents may choose the SSM if the agent:

Is licensed in all states where consumer(s) are seeking coverage
Is certified with the FFM or a supported SBM
Prefers to collect and document consent
Wants to manage the enrollment and ongoing consumer relationship
Is part of an agency using an NPN override

In some states, agents must be appointed with carriers to discuss their plan benefits.

Both EAP models offer the same bonus payout amounts.

Agents may participate in both Service Models by maintaining separate HealthSherpa accounts. Each account may only be used by a single agent, and users cannot be logged into both accounts at the same time.

How to participate

Steps to participate in the EAP are dependent on the Service Model selected.

Steps to participate in the Full-Service Model (FSM)

Step 1: Access the HealthSherpa account

Go to HealthSherpa.com/Enrollee_Assistance and log in to the HealthSherpa Enrollee Assistance Full-Service account.

To create a new HealthSherpa Enrollee Assistance Full-Service account, follow the steps outlined here.

Step 2: Generate a unique FSM phone number & link

From the dashboard, click Share my link in the top right corner.

A pop-up window opens with the personalized FSM phone number & link associated with the HealthSherpa Enrollee Assistance Full-Service account.

Step 3: Share the FSM phone number or link

From the Share my link pop-up:

Type a consumer’s email address in the To field to have the FSM phone number & link sent directly from HealthSherpa, or
Select Copy link to clipboard to share the information another way, such as email, social media, or printed advertisements.

Agents can also provide the unique FSM phone number & link to consumers who may be interested in ACA coverage.

Step 4: Understand the application experience

When a consumer uses the FSM phone number or link, HealthSherpa completes a full needs analysis and manages consent, the enrollment submission, and the ongoing consumer relationship.

All enrollment submissions are processed using HealthSherpa’s National Producer Number (NPN).

Important notes:

Consumers who contact HealthSherpa using the agent's FSM phone number or link will be linked to the agent's account; the agent does not need to be present for the communications.
If the agent is not licensed in the consumer’s state, EAP functionality is disabled for the state, or a carrier does not participate in the EAP:
- The consumer will only be able to proceed using the FSM phone number.
  - Consumers who select a plan with a carrier that does not participate in the EAP may display on the Bonuses page, but will not be eligible for EAP bonus payouts.
- The enrollment will not be possible using an FSM link or marketing link.

Steps to participate in the Shared-Service Model (SSM)

Step 1: Access the HealthSherpa account

Go to HealthSherpa.com and log in to the HealthSherpa for Agents account.

To create a new HealthSherpa for Agents account, follow the steps outlined here.

Step 2: Go to the Bonuses page

The Enrollee Assistance Program tab is the default view when an agent selects the Bonuses page.

Step 3: Turn on the Enrollee Assistance Program (EAP)

Select Turn on program settings to open the terms and conditions of the Enrollee Assistance Program (EAP).

Review & agree to the terms and conditions. Once the EAP is enabled for the account, a success message displays.

Step 4: Manage EAP carriers

The agent can select which carriers use the Enrollee Assistance Program (EAP) by state on the Carriers page. Choose Select carriers to manage EAP carriers.

Enrollments submitted using EAP are processed using HealthSherpa’s National Producer Number (NPN). The agent’s NPN, or override NPN, is automatically applied to any enrollment submissions for a carrier that does not have Enrollee Assistance enabled.

Step 5: Understand the application experience

When the agent starts an enrollment submission for an EAP-enabled carrier, HealthSherpa asks the agent to confirm how they want to proceed.

The agent can decide to:

Update carrier settings so that the agent’s NPN, or override NPN, is applied to the enrollment submission instead of HealthSherpa's.
- Select Edit carrier settings
Proceed with the EAP enrollment using the SSM.
- Review the conditions and select the checkboxes to agree
- Select Continue
Process the EAP enrollment using the FSM instead.
- Select Create a Full-Service Enrollee Assistance Program account
- A pop-up window will appear that displays next steps

Step 6: Understand EAP consent guidelines

When the agent completes an EAP enrollment submission, the agent is responsible for managing consent.

EAP consent must:

Authorize the agent and HealthSherpa to provide support to the consumer.
Be uploaded to HealthSherpa.
Meet all EAP consent guidelines.

Tracking bonus payouts

Agents can track bonus payouts on the Bonuses page. Select the Enrollee Assistance Program tab to view the Track your program enrollments dashboard.

To receive bonus payouts, agents must complete additional steps on the Bonuses page so that payouts can be processed.

HealthSherpa issues bonus payouts for each enrollment processed through the Enrollee Assistance Program.

Bonus payout amounts

Payout amounts are subject to change.
For Special Enrollment Period (SEP) 2026 enrollments, payout amounts are as follows:
- Enrollment payout: Up to $50
During Open Enrollment Period (OEP) 2026, payout amounts were as follows:
- Enrollment payout: Up to $100
- Persistency payout (consumer stays with their plan for 6 months): Up to $50
  - To receive persistency payout, the enrollment must remain active and in good standing, aligned with HealthSherpa’s book of business, and with the same carrier for the entire duration of the persistency payout requirement.

Eligible EAP bonus payouts are processed approximately 60 days after each milestone (for example, 60 days after enrollment, 60 days after persistency). Review additional information about payout timing as desired.

For Enrollee Assistance Program (EAP) enrollments, the following must be true to be eligible for payout:

Appropriate EAP consent documentation must be included with the application.
The consumer must be eligible as a new EAP enrollment for the plan year.
The consumer must have an active policy.
HealthSherpa must be the Agent of Record (AOR) for the EAP enrollment.

Training videos

Participating in the Full-Service Model (FSM)

This video shows how to set up a Full-Service Enrollee Assistance Program HealthSherpa account.

Participating in the Shared-Service Model (SSM)

This video shows how to enable the SSM in the HealthSherpa for Agents account, what to expect when completing SSM enrollments, and how to collect Enrollee Assistance Program (EAP) consent.

HealthSherpa Enrollee Assistance Program (EAP) training webinar

This webinar recording covers how agents can work with HealthSherpa through the EAP to support consumers through the enrollment submission journey. Watch a recording of this training webinar here.

Frequently asked questions

What is a resident license?

A resident license is the agent’s license in the state the agent files taxes as a resident. For example, if an agent is an Ohio resident and files taxes in Ohio, the agent’s resident license is in Ohio.

Can an agent use the EAP for carriers the agent is not appointed with?

Can an agent enable EAP for carriers the agent is appointed with?

This depends on which Service Model the agent uses. In the FSM, agents can only serve consumers by way of the EAP. In the SSM, agents can serve consumers according to carrier settings in the HealthSherpa for Agents account.

Can an agent use the EAP for some carriers but not others?

This depends on which EAP model the agent chooses.

In the FSM, agents can only serve consumers by way of the EAP. In the SSM, agents can serve consumers according to the carrier settings in your HealthSherpa for Agents account.

What happens if both the You are appointed and Enable for Enrollee Assistance checkboxes are selected for a carrier within a state?

If both checkboxes are selected for a carrier within a state, enrollments submitted for that carrier using the agent’s marketing link are submitted using the EAP. If the agent is completing the enrollment for the consumer, the agent is prompted to confirm whether the agent wants to proceed using EAP or adjust carrier settings before proceeding with the enrollment.

How does EAP impact enrollments completed through a marketing link?

This depends on which EAP model the agent chooses.

In the SSM, the NPN applied depends on carrier settings in the HealthSherpa for Agents account. Enrollments completed using a SSM marketing link will be blocked if the agent is not licensed in the consumer’s state.

In the FSM, all enrollment submissions made using the HealthSherpa Enrollee Assistance Full-Service account are processed using HealthSherpa’s NPN. Enrollments completed using a FSM marketing link will be blocked if the agent is not licensed in the consumer’s state, EAP functionality is disabled for the state, or a carrier does not participate in the EAP.

How does EAP work if an agency uses NPN override?

This depends on which EAP model the agent chooses.

In the SSM, agents can enable the EAP for carriers as usual and will have the option to select an agency override NPN rather than submitting the enrollment submission using EAP.

In the FSM, agency NPN override is not available. All enrollment submissions made using the HealthSherpa Enrollee Assistance Full-Service account are processed using HealthSherpa’s NPN.

Can an agent join the EAP if health insurance is not the agent’s primary business?

Yes. The FSM may be a good fit for licensed agents who want to transfer consumer relationships to HealthSherpa using a personalized FSM phone number or link. When a consumer calls or uses the link, HealthSherpa completes a full needs analysis and manages consent, the enrollment submission, and the ongoing consumer relationship.

Can the EAP be used for off-exchange enrollments?

No. The EAP is only available for on-exchange qualified health plan (QHP) enrollments.

Can the EAP be used for State-Based Marketplace (SBM) enrollments?

The EAP is only available for Georgia Access and states that use the Federally Facilitated Marketplace (FFM).

What if a consumer contacts the agent for assistance after enrolling through EAP?

If an agent needs to support a consumer enrolled by way of EAP (for example, help contacting the carrier on behalf of the consumer), contact Agent Support.

Can an agent use the SSM for an enrollment submission and change their mind later?

Agents manage carrier settings and can opt in or out of using the SSM for any carrier at any time.

How do renewals work with the EAP?

Active renewals are eligible for EAP bonus payout. Passive renewals are not.

Does persistency include renewal periods?

No. Persistency payout is based on a single policy year.

If CMS' Invalid Action error message displays when completing an EAP enrollment submission?

EAP enrollment submissions may only be processed using the HealthSherpa platform. If a CMS Invalid Action error message displays, the enrollment must be submitted by the consumer using the Invalid Action resume link pathway for the enrollment to be eligible for EAP bonus payout. EAP enrollment submissions cannot be processed using a 3-way call with the Marketplace Call Center.

Additional resources

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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