This article will cover:

Member Defense Network™ (MDN) is a partnership among industry leaders, like HealthSherpa, who are committed to fighting fraud so all Americans have secure, uninterrupted access to health coverage through the Affordable Care Act (ACA) Marketplace. MDN is an agent-first solution to fraud in the ACA marketplace.

Starting in Open Enrollment 2025, the MDN Registry will:

The MDN Registry works to combat Unauthorized Plan Switching (UPS) by using ‘smart’ two-factor authentication to validate member consent for each enrollment application and issue a “pay” or “don’t pay” recommendation to the insurance carrier.

Through the MDN Registry, agents will be notified when there is a change to their clients’ AOR no matter where that occurs. Notices will include clear, actionable instructions on how to protect clients across all enrollment channels. The MDN Registry acts as a central source to validate consent, remove financial incentives for fraud, and keep members safe.

As the front line of the ACA, agents understand better than anybody that fraud is a problem. HealthSherpa is committed to giving agents and brokers the comprehensive tools, robust training, and timely support they need to help the people they serve connect to quality, affordable health plans. Finding a solution to fraud & UPS is part of that commitment.

We know you work hard to maintain client relationships and we’ve heard your stories and concerns about UPS, especially those that lead to lapses in coverage, loss of access to preferred providers, and unexpected costs for consumers.

HealthSherpa is always working to build solutions to help you serve and protect your clients and make sure you get paid without sacrificing the streamlined, easy enrollment process on HealthSherpa for Agents. Since curbing fraud & UPS starts with validating member intent, HealthSherpa is partnering with MDN to provide you with seamless integration.

HealthSherpa’s integration with MDN means you can manage consent & enrollments directly on HealthSherpa for Agents, the information will automatically be sent to MDN for validation, and you can track your clients and your MDN commission recommendations without extra steps.

Seamlessly! HealthSherpa already has simple and efficient consent management tools built into the platform. HealthSherpa allows agents to document and manage consent in a variety of ways during the application flow as well as within their dashboard. Learn more about managing consent on HealthSherpa.

Our partnership with MDN will enhance the consent management functionality already in place. Because of this integration, consent uploaded on HealthSherpa for Agents will be automatically sent to MDN. Agents will be able to see MDN pay/don’t pay commission status for each enrollment and manage any disputes directly from their HealthSherpa account.

No. HealthSherpa is a participant in MDN; however, MDN is independent of HealthSherpa.

No. Fraud and UPS are industry-wide issues that happen across all EDE platforms and Healthcare.gov. Starting in OE 2025, carriers will begin relying on MDN to provide pay/don’t pay commission guidance.

MDN is an industry-wide solution that will cover a carrier’s entire book, including submissions from Healthcare.gov, HealthSherpa, and other EDE platforms.

HealthSherpa’s integration with MDN means you can manage consent & enrollments directly on HealthSherpa for Agents, the information will automatically be sent to MDN for validation, and you can track your clients and your MDN commission recommendation without extra steps.

MDN will be live for Plan Year 2025 enrollments.

No. MDN is currently available in Georgia & states utilizing the Federally-facilitated Marketplace (FFM).

Yes. We are currently working to incorporate MDN information into HealthSherpa for Agents and will provide live training on the new tools as well as FAQs and Agent Support as soon as detailed user flows become available. Watch for training announcements in our platform, newsletter, or register here for upcoming sessions once available.

For more information on MDN, visit MemberDefense.org and sign up to receive communications and training on their platform as it becomes available.