What is a passive renewal?
“Passive renewal” refers to a process in which consumers with an existing plan year policy are automatically renewed into a new plan year policy, if the consumer had agreed to. It's designed to ensure that consumers maintain uninterrupted coverage, even if they don't actively renew their plan.
How do passive renewals work?
Beginning in October and continuing periodically through December, the Federally Facilitated Marketplace (FFM) does the following:
Redetermines consumer eligibility for Qualified Health Plans (QHP), Advance Premium Tax Credits (APTC), and Cost-Sharing Reductions (CSR).
Re-enrolls consumers into plans issued by their current carrier or the closest equivalent plan with another carrier. This is often referred to as a “crosswalk” plan.
Note: The FFM creates a new application for the new plan year.
How does this impact agents?
As an agent, most clients in your book of business will be automatically renewed into the next plan year without requiring any action on your part. However, there are some instances in which this is not the case. For this reason–and for several others–HealthSherpa strongly recommends you actively renew each client. These reasons include the following:
Net premiums can increase in the new plan year
Clients could lose their subsidies due to the FFM no longer having permission to review tax data
Clients may have opted out of automatic renewal the previous year (i.e. they won’t be renewed)
No equivalent plan exists in the new plan year (i.e. there’s no “crosswalk” plan)
Clients may have been actively enrolled by another agent
If you’re unable to actively renew your client, you should still search and claim their application.
Note: Search and Claimed applications before Dec 15th will not display the applicant’s policy. You’ll need to revisit the client’s details page after Dec 15th in order to view policy information.
What about my NPN?
If you have a National Producer Number (NPN) associated with the current plan year’s application, it will automatically carry over to the new plan year.
Why don’t I see a passively renewed client in my clients’ list?
When the FFM passively renews a client, they create a new application for that new plan year. HealthSherpa is unable to show that client without you, the agent, actively searching and claiming the client’s latest application.
I searched and claimed my client before Dec 15th. Why do I see a policy?
If you’re seeing a policy before Dec 15th, then it means the client was actively renewed, either on their own or by another agent.