Siga las instrucciones aquí para traducir esta página a otro idioma usando Chrome.
Agents have access to reporting within the HealthSherpa account to help prioritize renewal work during Open Enrollment Period (OEP) and increase efficiency.
HealthSherpa will announce plan year 2027 renewal reporting functionality once available.
In this article we’ll cover:
Renewals reporting is not applicable for HealthSherpa Enrollee Assistance Full-Service account types.
Renewals tab
Agents can access a Renewals tab within the Clients page of the HealthSherpa account. The Renewals tab is designed to help agents prioritize their renewal book to maximize efficiency during OEP.
The Renewals tab displays a full client list and dynamically updates when changes take place. The list includes clients who are at risk of not renewing, losing their subsidy, experiencing a significant crosswalk change, and more.
At the top of the tab, callouts calculate the number of enrollments in each renewal status. These callouts can also be used to quickly filter the list to show only clients with that status.
Agents can use dropdown filters and the search bar to review specific data. The search bar allows searching by first or last name.
Columns in the Renewals tab include:
Client: The primary applicant’s name. At this time, the Renewals tab does not include enrollments with multiple enrollment groups.
Renewal status: Indicates the status of the consumer's renewal associated with the selected plan year. Renewal statuses that display include:
Coverage at risk: If the consumer takes no action, they may lose coverage for the upcoming plan year.
Subsidy at risk: If the consumer takes no action, they may lose all or part of their advance premium tax credit (APTC) for the upcoming plan year.
Coverage changes: If the consumer takes no action, they may see a change to their coverage for the upcoming plan year.
Premium changes: If the consumer takes no action, they may see an increase in their premium for the upcoming plan year.
Same coverage/premium: If the consumer takes no action, they will have the same coverage and premium for the upcoming plan year.
Actively Renewed: This consumer has been actively renewed.
Renewal follow-ups: These are factors that expand on the renewal status listed for the consumer. Renewal factors include:
Auto-renewal turned off: The consumer opted out of Batch Auto Re-enrollment (BAR) and will not renew passively.
Carrier change: The consumer is being crosswalked to a new plan with a new carrier.
Failure to reconcile APTC: Centers for Medicare & Medicaid Services (CMS) indicated the consumer did not reconcile their APTC.
Income near 400% FPL: The consumer's application displays a household income near 400% of the Federal Poverty Level (FPL).
Loss of $0 premium: The consumer has a $0 premium plan and will experience a premium increase if the consumer’s income and household are the same as last year’s.
No plan: The consumer’s current plan is no longer being offered and a crosswalk plan is not available. The consumer will not renew passively.
No plan change: The consumer will remain on the same plan with the same carrier, although benefits, network, and formulary may still adjust.
Plan change: The consumer is being crosswalked to a new plan with their current carrier.
Premium increase: The consumer does not have a $0 premium currently and will experience a premium increase if the consumer’s income and household are the same as last year’s.
Tax return access denied: CMS does not have access to the appropriate Internal Revenue Service (IRS) documents. Tax documents could also be missing or expired for the consumer, which will result in a loss of subsidy.
Will not file taxes: Within the application, the consumer indicated they do not intend to file taxes.
$0 premium plan: The consumer has a $0 premium plan.
State: The primary applicant's state.
Action: This column allows an agent to start an active renewal directly from the Renewals tab. Agents can also view the consumer’s details or hide or unhide the consumer from view. Once an agent begins a renewal application for a consumer, the Renew now button will no longer be available. To resume a renewal application that has already begun, go to the client's Details page.
Agents can use the Bulk email clients button to send renewal quote review emails to multiple consumers at once. Agents can use filters on the Renewals tab to select which consumers to share the renewal with prior to selecting the Bulk email clients button.
Exporting the contact list
Agents can export renewals at any time by selecting the Export contacts list button.
The export reflects any filters that are in place within the tab.
Fields included in this export include the consumer’s name, contact information, and Federally Facilitated Marketplace (FFM) application ID.
Frequently asked questions
What is an active renewal?
An active renewal takes place when a consumer updates their Marketplace application during the annual Open Enrollment Period (OEP) and selects a new plan for the upcoming plan year. With consent, agents can assist consumers with active renewals.
What is a passive renewal?
Passive renewals are designed to help consumers maintain uninterrupted coverage, even if they take no action during OEP. Passive renewals are designed to be a safety net so consumers can maintain coverage, but reaching out to the client and completing an active renewal is recommended.
What does "Crosswalk" mean?
CMS automatically crosswalks consumers to new health plans when:
The consumer’s current plan is discontinued for the upcoming plan year and a close plan equivalent exists, or
A carrier will no longer offer plans where the consumer resides for the upcoming plan year
Consumers who have opted out of Batch Auto Re-enrollment (BAR) will not be crosswalked and therefore will not passively renew.
What is BAR?
Batch Auto Re-enrollment (BAR) is a process used by Marketplaces to ensure consumers who are currently enrolled in Qualified Health Plans (QHPs) and do not engage in new plan selection by the end of OEP retain coverage for the upcoming plan year.
BAR is a behind-the-scenes process that CMS begins in October each year and continues through December. Consumers may be included in the BAR process at any point during this time. CMS creates a new FFM application ID and selects a plan for the consumer, then sends this information to carriers to passively renew the consumer.
Consumers may choose to opt out of BAR.
How does CMS prioritize BAR for consumers?
CMS prioritizes BAR for consumers based on enrollment effective dates. Consumers with effective dates earlier in the year will likely be part of initial BAR waves, whereas consumers with effective dates later in the year may be part of later waves.
CMS considers the most recent plan effective date for consumers during these waves.
What does the "Auto-renew this plan for [upcoming plan year]" checkbox within a client's Details page do?
Unchecking the Auto-renew this plan for [upcoming plan year] checkbox within a client’s Details page indicates the consumer wishes to opt out of passive renewal (BAR) for the upcoming plan year. If CMS has already started BAR for this consumer, the passive renewal will be canceled by CMS.
Unchecking this box will not impact a consumer’s coverage for the existing plan year.
An FFM application ID may be visible for the upcoming plan year if CMS has already performed BAR for the consumer:
If the agent unchecks the box after CMS has performed BAR for the consumer, a new FFM application ID for the upcoming plan year will be visible. However, the plan selected by CMS will be canceled once CMS processes the consumer’s decision to opt-out of BAR. CMS may take days or weeks to process a consumer’s decision to opt-out of BAR.
If an agent unchecks the box but cannot find an FFM application ID for the upcoming plan year, then the box was unchecked before CMS began BAR for the consumer.
The Auto-renew this plan for [upcoming plan year] checkbox only appears just before the annual OEP and remains live through December 31.
Additional resources
For help using HealthSherpa or for other assistance, contact Agent Support. Agent Support is available by phone at (888) 684-1373, by email at Agent_Support@HealthSherpa.com, or by chat directly from your account.