AOR at-risk reporting helps agents and agencies proactively identify current plan year enrollments within their book of business where the agent of record (AOR) status may be at risk (i.e. potential AOR swaps within HealthSherpa).
AOR at-risk Clients Export
Export reports are .csv files containing various pieces of information depending on the report you choose to generate. HealthSherpa offers agents and agencies an AOR at-risk Clients export to help identify submissions where the agent of record (AOR) status might be at risk - potentially indicating an AOR swap has taken place within HealthSherpa.
Accessing the export at the agent level
The agent-level version of this export is accessible in the Exports tab.
From the 'Quick exports' tab, agents will find the AOR at-risk clients section, and select the ‘Generate’ button to initiate the export process. Once the export is complete, it will be sent to their inbox for them to download and access.
If an agent does not see the Exports tab in their HealthSherpa account, it likely means their agency admin has disabled exports for their agents. HealthSherpa recommends reaching out to the agent's agency is this is believed to be a mistake.
Accessing the export at the agency level
The agency-level version of this export pulls all AOR at-risk clients for the agency, and any downline agency. The export may include enrollments that have transferred to another agent in your agency.
If you'd like to avoid AOR swaps within your agency while servicing clients, consider setting up a shared or full book model.
To generate the AOR at-risk export at the agency level, agency admins will go to the Agency page and select the Exports tab. From the AOR at-risk clients section, select the Generate button to initiate the export process.
Using the export
The export contains three columns:
Federal Exchange ID
Client Details Page URL
Archived Status
The agency version contains two additional columns:
Agency name
Agent name
Agent email address
If a Federal Exchange ID (also known as a FFM Application ID) is on the report, agents should click on the corresponding client details page URL. This will direct them to the client details page, triggering a sync with the CMS Marketplace. From there, agents will be able to lookup the associated plan(s) agent of record, and assess how they should proceed.
At-risk AOR tab
Agents have several reports they can view within the platform without needing to pull any exports. These agent-level reports are accessible from the Clients page.
The At-risk AOR tab is sorted with the most recent entry first and displays Client Name, Federal Exchange ID, and the date the client information was last synced (Last Synced At).
HealthSherpa also displays alert indicators that provide counts of new records in this tab since the agent last visited the list.
What to do if fraud is suspected?
Follow the steps outlined here if you suspect fraud. Additionally, CMS has issued the following guidance:
Agents and brokers who are aware of others conducting a search for consumer applications using approved DE/EDE websites, enrolling consumers, making unauthorized changes to consumer applications without their explicit consent, or inappropriately accessing CMS systems, should report it to the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.
Additional Resources
Have questions? Contact our Agent Support Team at (888) 684-1373 or agent_support@healthsherpa.com.
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