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What should I do if I suspect another agent has claimed my client?
What should I do if I suspect another agent has claimed my client?

Follow the steps below to follow up on an Agent of Record (AOR) dispute.

Emily Duffee avatar
Written by Emily Duffee
Updated over a week ago

If you suspect another agent has claimed your client, follow the steps below to ensure your client's policy in submitted and serviced only by the authorized agent:

  1. Assess the situation with the member. Confirm with the member they have not worked with a different agent. This includes submitting their information on any online form. Agents are required to document consent prior to working with a client; you can use HealthSherpa’s Consent Upload feature to store the documentation you receive from members all in one place.

  2. Reach out to the other agent. We recommend that you connect with the agent to try to resolve any issues. It may help to indicate to the other agent that you have received consent from the member to work on the member’s behalf going forward.

  3. Report to policy stakeholders. If the above steps reveal that another agent has worked on the member’s policy without their consent, then we advise reporting to the following entities:

    1. Reports of unauthorized submissions should be reported to the FFM Help Desk. You may send a report via email to

      1. In your report, provide as much detail as possible, but do not include any Personally Identifiable or Personal Health Information (PII and PHI) in your report.

      2. Only use identifiers such as National Producer Numbers and the FFM Application Number (found on the member’s eligibility letter and listed as the FFM App ID within the HealthSherpa platform) in your report.

  4. State Department of Insurance: You can use the National Association of Insurance Commissioners’ (NAIC) Online Fraud Reporting System (located here) to connect with the local Department of Insurance to file a report. Please do not include any PII or PHI in your report. Use identifiers such as application numbers or NPNs instead.

  5. Carrier: Contact the carrier to see how they may assist or advise. The Agent of Record that you may see in your HealthSherpa account may not reflect who the Agent of Record is at the carrier level. Each carrier may have their own rules on who they determine the agent of record to be.

HealthSherpa will review reports in the order that they were received; for more immediate action, we recommend taking the steps above but please refrain from sending HealthSherpa any member’s PII and PHI via an unsecured method.

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