Beginning with Open Enrollment for Plan Year 2023 (OEP PY23), HealthSherpa will include off-exchange dental plans (also known as non-qualified dental, or NQD) in the HealthSherpa Marketplace. Agents will be able to shop for and sell off-exchange dental plans alongside health plans within the HealthSherpa Marketplace and leverage the same CRM features like consumer marketing links for their dental business. Read on to learn more:
Q: What is Non-Qualified Dental?
A: Non-qualified dental plans are plans that are sold “off-exchange” directly from the plan issuer. These plans do not qualify for ACA Marketplace status and are not eligible for subsidies.
Q: Can agents sell off-exchange dental year-round, or only during Open Enrollment?
A: Off-Exchange Dental plans can be sold year-round and do not need a Qualifying Life Event (QLE) to be sold or effectuated.
Q: Does the HealthSherpa Marketplace include plans from all 50 states?
A: No. The HealthSherpa Marketplace currently includes off-exchange dental plans in AL, AK, AZ, AR, DE, FL, GA, HI, IL, IN, IA, KS, LA, MS, MO, NE, NH, NC, ND, OH, OK, OR, SC, SD, TN, UT, WI, WV, WY
Q: Does HealthSherpa include off-exchange dental plans from all carriers the same way they do for health plans?
A: Not yet. Additional state and plan offerings may expand in the future, but for now the HealthSherpa Marketplace only includes plans from UnitedHealthcare (UHC) and Blue Cross Blue Shield of Arizona (BCBSAZ) at this time.
Q: Do agents have to be appointed to sell off-exchange dental with UHC and BSBSAZ?
A: Yes. Instructions on how to become appointed with each issuer are below:
UHC: UHC has a single application for all UHC ancillary products. Agents and Brokers can apply at Broker Contracting & Appointment | UnitedHealthOne. Contracted/Appointed Agents and Brokers can call the UHC Broker Service Line at 800-474-4467.
Blue Cross Blue Shield of Arizona: Agents who are already appointed to sell Off-Ex Medical plans can also sell off-exchange dental plans. Agents/Brokers interested in getting appointed with BCBS of AZ can start here: AZBlue - Brokers: How to become contracted with BCBSAZ.
Q: How does an agent quote a customer?
A: To initiate an off-exchange dental quote, follow the steps outlined below:
Log into the Agent Dashboard
On the top right of the Agent Dashboard, click the drop down and select “Quote off-ex dental” (the default selection is “Quote on-ex”). You will land the Off-exchange Dental Plan List Page.
Enter the following customer information (spouse & dependent may be added if applicable):
Zip Code
Age
Sex
After customer information is entered, available off-exchange dental plans will populate
Q: Is quoting from the Agent Dashboard the only way to generate an off-exchange dental quote on HealthSherpa?
A: Yes, all quotes need to be initiated from the Agent Dashboard.
Q: Can I share a direct marketing link from the marketing page for off-exchange dental plans like I do for medical plans?
A: No, there is currently no support for an off-exchange dental marketing direct link but marketplace agents are able tosend a shopping link to consumers to view plans.
Q: What happens if an agent sells an off-exchange dental plan but is not appointed?
A: The Agent or Broker will not receive commission and the policy may be denied by the carrier.
Q: What sort of enrollment reporting is available at the Agent and Agency level?
A: There is currently no specific reporting for off-exchange dental, but Agents are able to break out leads and clients by NQD plans within the Agent Dashboard. Please feel free to reach out to your HealthSherpa account manager if there are specific reports you’re interested in - we love your input!
Q: Can consumers buy a stand alone dental plan?
A. Yes, Agents will be able to shop for and sell off-exchange dental plans using HealthSherpa. Consumers may also purchase their own off-exchange dental coverage; but this can only be done by reaching out to off-exchange dental providers directly. Off-exchange dental coverage is not tied to OEP and can be purchased at any time during the year.
Additionally, on-exchange dental plans are available to consumers and agents alike, but can only be purchased on HealthSherpa when purchased at the same time as a Marketplace health plan. When shopping for coverage through the Marketplace, consumers can choose from two types of dental coverage options:
On-exchange health plans with dental included
Some Marketplace health plans already include dental benefits. You’ll see these listed as “Health + Dental” or similar when comparing plans. If you enroll in one, your single monthly premium covers both health and dental services.
Standalone dental plans on-exchange
The Marketplace also offers separate dental plans that you can add to your cart while enrolling in a medical plan. These stand alone on-exchange dental plans are billed separately and provide coverage for routine cleanings and basic dental care.Since on-exchange dental plans must be purchased at the same time as a Marketplace medical plan, coverage ends when your medical plan ends (or at the end of the calendar year, whichever comes first).
If a consumer enrolls in a Marketplace Health plan then later decides they would like to add on-exchange dental, they must still be in their enrollment window to do so. To add on-exchange dental, select the "change plan" option (must still be in enrollment window for this option to appear) and add dental to the cart along with the Health plan then finalize the enrollment.