HealthSherpa

After completing an enrollment, HealthSherpa makes it easy for agents to make binder payments with their clients through the ‘Pay Now’ button at the top of the Client’s Profile page.

HealthSherpa is able to offer this convenient link so long as an issuer has set up a payment integration with the federally facilitated Marketplace (FFM). 

Below is a list of common circumstances where the ‘Pay Now’ button will be missing from a Client’s Profile: 

Issuer does not have a payment integration with the FFM. In other words, the issuer has not shared a link for making binder payments. For these cases, agents will need to pay directly with the carrier. 

The effective date is in the past. In this case, HealthSherpa does not receive a working payment link from the FFM, and agents will need to pay directly with the carrier.

The application does not have Enhanced Direct Enrollment (EDE) permission. The ‘Pay Now’ button only appears for agents who have turned on EDE. <a href="https://faq.healthsherpa.com/en/articles/5160248-how-do-i-get-approved-to-use-ede">Click here for instructions on how to enable it for your account</a>. If an agent has lost EDE permission, they will need to reclaim the application to regain the ‘Pay Now’ functionality.   

You’re updating an application. If there’s only a change in circumstance happening on the application, a binder payment is not required, so there is no ‘Pay Now’ button. In these cases, the client will continue paying their premium as they were before the update.

The application has a pending SEP verification issue (SVI). This situation should only occur during a Special Enrollment Period where a client needs to experience a qualifying life event to enroll in coverage. After resolving the SVI, the agent will need to check that the letter of coverage document has been processed. In this situation, it is recommended to make the binder payment directly with the carrier. 

- Issuer does not have a payment integration with the FFM. In other words, the issuer has not shared a link for making binder payments. For these cases, agents will need to pay directly with the carrier. 
   
- The effective date is in the past. In this case, HealthSherpa does not receive a working payment link from the FFM, and agents will need to pay directly with the carrier.
   
- The application does not have Enhanced Direct Enrollment (EDE) permission. The ‘Pay Now’ button only appears for agents who have turned on EDE. <a href="https://faq.healthsherpa.com/en/articles/5160248-how-do-i-get-approved-to-use-ede">Click here for instructions on how to enable it for your account</a>. If an agent has lost EDE permission, they will need to reclaim the application to regain the ‘Pay Now’ functionality.   
   
- You’re updating an application. If there’s only a change in circumstance happening on the application, a binder payment is not required, so there is no ‘Pay Now’ button. In these cases, the client will continue paying their premium as they were before the update.
   
- The application has a pending SEP verification issue (SVI). This situation should only occur during a Special Enrollment Period where a client needs to experience a qualifying life event to enroll in coverage. After resolving the SVI, the agent will need to check that the letter of coverage document has been processed. In this situation, it is recommended to make the binder payment directly with the carrier. 