The HealthSherpa Enrollee Assistance Program (EAP) is a new program that offers agents the opportunity to work with HealthSherpa to ensure their consumers have the best enrollment experience possible.

In this article we will cover:

Participating in the Enrollee Assistance Program allows agents to give their consumers access to the full range of health plans available in a given market. It also allows them to serve consumers who want to purchase health plans where their Line of Authority may not allow them to sell.

HealthSherpa compensates participating agents at the time of enrollment, and additional compensation may occur when consumers stay with the plan for a defined period of time (usually, 3, 6, or 9 months). This allows agents to receive compensation earlier than they would typically receive commissions from the carrier.

To help you enroll as many consumers as possible – and earn as much as possible – the HealthSherpa Enrollee Assistance Program (EAP) gives you two options to connect consumers to HealthSherpa so we can help them enroll when you aren’t able to write the policy yourself.

Agents can choose to participate in either the Full-Service Model or the Shared-Service Model to meet the needs of their consumers and their business.

In either EAP model, agents can track their consumers’ progress from their account and receive up to $150 for each enrollment. Note: You 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 you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

Agents may have two accounts – a HealthSherpa for Agents account and an Enrollee Assistance Program account – so they can participate in both models. While having two accounts is allowed, each account is for use by a single agent. Users cannot be logged into both at the same time.

The HealthSherpa Enrollee Assistance Full-Service Model gives you the freedom to share a personalized phone number or enrollment link with your consumers and let HealthSherpa provide full enrollment and post-enrollment support like walking your consumer through available local QHPs and selecting the best plan plan for them.

You must be licensed if you wish to transfer consumer relationships. Because you do not need to be FFM certified to participate in the Full-Service Model, you can only serve consumers by way of the EAP using this option. Note: If you are FFM certified and wish to service consumers using your own NPN (or Override NPN if applicable), consider leveraging the Shared-Service Model. Agents are only required to have a resident license to transfer consumer relationships using the full service model in any state; however, agents must be licensed in the consumer's state to receive payout.

Follow these steps to participate in the FSM:

Share your link and/or phone number with any consumers interested in ACA coverage to connect people to HealthSherpa. When someone calls your personal number or clicks your link to complete their enrollment:

To check on your consumers working with HealthSherpa and track your compensation, visit the ‘Enrollee Assistance Program’ tab located within the Bonuses page of your dashboard.

The HealthSherpa Enrollee Assistance Shared-Service Model allows you to maintain a strong relationship with your consumers throughout the year and partner with HealthSherpa to provide ACA application assistance, enrollment assistance, and ongoing support for your consumer’s ACA health plan.

This model is fully integrated into your HealthSherpa for Agents account, so you’re able to choose which carriers you’d like help with and track your consumers’ progress in the same place you’re already working every day. Remember, in some states you may need to be appointed in order to discuss plan benefits.

If you choose the Shared-Service Model, you’re responsible for collecting and uploading consent authorizing you and HealthSherpa to provide support before you proceed. Learn more about EAP consent guidelines here.

Follow these steps to participate in the Shared-Service Model:

When initiating an application for a carrier you’ve enabled the SSM, you will be prompted to confirm that you wish to proceed with the EAP enrollment.

When completing an application for a carrier you’ve enabled the EAP Shared-Service Model, you’re responsible for collecting and uploading both Consumer Consent & Eligibility Application Review. EAP consent must authorize you (the agent) and HealthSherpa to provide support to the consumer. Learn more about EAP consent guidelines here.

All SSM applications require you to upload both Consumer Consent & Eligibility Application Review prior to submission.

Should you attempt to proceed without uploading required consent documentation, you will be given the option to go back to upload the necessary documentation or Create a Full-Service Enrollee Assistance Program account (e.g. create or log into an existing EAP-specific Account).

When you enroll consumers using the EAP Shared-Service Model, HealthSherpa becomes the Agent of Record, and you’ll receive up to $150 for each enrollment.

To check on your SSM consumers and track your compensation, visit the ‘Enrollee Assistance Program’ tab located within the Bonuses page of your dashboard.

HealthSherpa will pay agents up to $150 for each enrollment processed through the Enrollee Assistance Program. Compensation is subject to change.

For OEP 2025, compensation is as follows:

After your first EAP submission is completed, you'll be prompted to submit a W-9 and set up a payment method (if you haven't submitted a W-9 already). You can choose to get paid through Bill.com via direct deposit, or by check. Learn more about getting paid here.

We pay EAP compensation approximately 60 days after each milestone (e.g. enrollment & persistency). Note: There is a mandatory 45-day waiting period before HealthSherpa makes payment eligibility determinations & your payment may take more than 60 days to process.

Once you have reviewed the available EAP Service Models, follow the steps outlined in this article to participate in whichever model you prefer.

Agents may also decide to create separate HealthSherpa accounts so they may participate in both models. Note: While multiple HealthSherpa accounts for a single user are allowed, there cannot be multiple people logging in to the same account, and multiple HealthSherpa accounts using the same FFM Credentials (such as the same FFM ID) cannot be logged in simultaneously.

Yes. You must be licensed in order to participate in either EAP option offered.

A resident license is your license in the state you file taxes as a resident. (e.g. Agent is an Ohio resident and files taxes in Ohio, Agent's resident license is Ohio)

While you do not need to be FFM certified to participate in the Full Service Model, you do need to be licensed in any states in which you wish to transfer consumer relationships. Note: Agents are only required to have a resident license to transfer consumer relationships using the full service model in any state; however, agents must be licensed in the consumer's state to receive payout.

The Shared Service Model, requires that you be FFM certified and licensed in the state where your consumer is seeking coverage. Georgia has launched their own State-based Exchange for plan year 2025 applications and therefore requires separate certification. Learn more here.

Note: You 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 you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

Yes, depending on state insurance laws. You 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 you to be appointed with a carrier in order to discuss that carrier’s plans with a consumer.

Yes, depending on state insurance laws. You can enable EAP for any Carrier you'd like; however, you remain responsible for complying with all applicable state insurance laws regarding licensure and appointment. The EAP may not be used to circumvent any laws or regulations.

This depends on which EAP model you choose.

In the Full-Service Model (FSM), agents can only serve consumers by way of the EAP. In the Shared-Service Model (SSM), agents can service consumers according to the carrier settings in your HealthSherpa for Agents account (i.e. can be processed under the SSM, under your NPN, etc.).

If both the “Are you appointed” and “Enable Enrollee Assistance” boxes are toggled to ‘Yes’ for a carrier:

If the “Enable Enrollee Assistance” box is not toggled to ‘Yes’ for a carrier, policies written for that carrier will use your NPN (or Override NPN if applicable).

This depends on which EAP model you choose. In the Full-Service Model (FSM), agents establish an Enrollee Assistance Program Account and can only serve consumers by way of the Full-Service Model. When clients enroll through the marketing link associated with your Enrollee Assistance Program Account, HealthSherpa will become the Agent of Record, and you will be eligible for EAP compensation. Note: Enrollments done using a Full-Service EAP agent's marketing link will be blocked if the agent is not licensed in the consumer's state.

In the Shared-Service Model (SSM), agents can service consumers according to the carrier settings within their HealthSherpa for Agents account (i.e. can be processed under the SSM, under your NPN, etc.). When clients enroll through the marketing link associated with your HealthSherpa for Agents account, the NPN applied will depend on the Carrier Settings you have in place for respective carriers.

Every Enrollee Assistance Program Account & HealthSherpa for Agent account comes with a free, customizable direct marketing link. When selected, your unique marketing link leads consumers to an enrollment website where consumers may quote to see available plans and even enroll. Learn more here.

No. You’ll notice the “Enable Enrollee Assistance” toggle within your carrier settings is disabled for carriers who do not participate in EAP.

If you choose the Full-Service Model, we’ll collect and document consent for you.

If you choose the Shared-Service Model, you’re responsible for collecting and uploading consent authorizing you and HealthSherpa to provide support before you proceed. Learn more about EAP consent guidelines here.

Agents are responsible for complying with all applicable state insurance laws regarding licensure and appointment and must attest that they are adhering to compliance requirements before proceeding. The Enrollee Assistance 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.

Yes. The Full-Service Model is ideal for licensed agents who want to provide a personalized phone number or enrollment link with their consumers and let HealthSherpa provide full enrollment and post-enrollment support.

No. The EAP is only available for On-Exchange QHP enrollments.

If you ever need to support consumers enrolled by way of the EAP (e.g. assistance contacting the carrier on behalf of the customer), please reach out to the HealthSherpa Agent Support team for assistance.

All EAP submissions require that documented consent be on file. If you see a payment status listed as “awaiting consent upload” your payment has been delayed due to lack of consent uploaded on a resubmission (this will likely be limited to submissions made under the old referrals program). HealthSherpa requires additional consent from the consumer to ensure they understand and are aware of application changes.

You manage your carrier settings and can opt in or out of using the SSM for 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.

With consumer consent, you may assist consumers with updating their application at any point during the year. When reporting updates, if the consumer qualifies for a special enrollment period (SEP), they will have the option to update their plan selection. At this point, the NPN associated with their application would be updated according to your carrier settings.

When you initially enroll consumers using the EAP, HealthSherpa becomes the Agent of Record. When it comes time to renew, you have the option to actively renew consumers using your NPN or choose to process the active renewal using the EAP. Active renewals are eligible for EAP compensation, whereas passive renewals are not.

No, persistency compensation is based on a single policy year.

The EAP may not be utilized during 3-way calls with the Marketplace Call Center. Because of this, you may wish to pursue the Invalid Action resume link pathway first.

If you are having any technical issues using HealthSherpa, please contact our Agent Support team at (888) 684-1373, at agent_support@healthsherpa.com, or via chat from within your account.

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