Resources for Agents and Brokers in the Health Insurance Marketplaces

Welcome

Welcome to the Agents and Brokers Resources webpage. This page is the primary outlet for agents and brokers to receive information from CMS about working in the Health Insurance Marketplace and the Small Business Health Options Program (SHOP) Marketplace. The content on this page is updated regularly.

Click here for a roadmap on how to navigate the Agents and Brokers resources.

Background

To the extent permitted by states, licensed agents and brokers may assist consumers in determining their eligibility for insurance affordability programs, including advance payments of the premium tax credit and cost-sharing reductions, and enrolling in qualified health plans (QHPs).

Agents and brokers play a crucial role in educating consumers about the Health Insurance Marketplace, both during annual Open Enrollment and throughout the coverage year. Agents and brokers may also help employers understand their options for participating in the Small Business Health Options Program (SHOP) Marketplace and assist them and their employees through the SHOP Marketplace application and enrollment process.

Some states have set up their own State-based individual and small business Marketplaces, while the Federal Government runs the Health Insurance Marketplace and SHOP Marketplaces located on HealthCare.gov in other states. You can find out if your state is running its own Marketplace by visiting HealthCare.gov and selecting your state from the drop down. Agents and brokers can help consumers apply for and choose insurance options in any state in which the agents and brokers are licensed, regardless of whether the Marketplaces are operated by the state or Federal Government.

Agents and brokers who wish to assist consumers in the Health Insurance Marketplace and SHOP Marketplace on Healthcare.gov must first complete registration.

Latest News

Plan Year 2018 Registration and Training is Now Available

Marketplace registration and training for plan year 2018 is now live!

For more information and resources to help you get started, visit the Plan Year 2018 Registration and Training page.

Upcoming Webinars

CMS is hosting a webinar series from September 13 through December 13, 2017 to help agents and brokers prepare for the upcoming Open Enrollment period. Once you sign up for one of these webinars, you will automatically be registered for the entire series and can join the webinars at your leisure. This series will include the following webinars:

CMS Marketplace Update for Agents and Brokers

  • September 13, 1:00 PM – 2:00 PM ET

Marketplace Privacy and Security Requirements for Agents and Brokers

  • September 27, 1:00 PM – 2:00 PM ET

Preparing for Plan Year 2018 Open Enrollment

  • October 11, 1:00 – 2:00 PM ET

Complex Eligibility Cases: Calculating Back Premium Payments and Resolving Data Matching Issues

  • October 18, 1:00 – 2:00 PM ET

Making the Most of your Marketplace Participation During this Open Enrollment Period

  • October 25, 1:00 – 2:00 PM ET

Marketplace Open Enrollment Office Hours for Agents and Brokers

  • November 8 – December 13 every Wednesday, 1:00 – 1:30 PM ET

CMS is also hosting the following registration and training webinars:

PY2018 Registration and Training for New Agents and Brokers

  • Wednesday, September 20 - 1:00 PM to 2:00 PM ET

PY2018 Registration and Training for Returning Agents and Brokers

  • Wednesday, September 20 - 3:00 PM to 4:00 PM ET

Visit  REGTAP - Opens in a new window  - External Link Policy - Opens in a new window  for more details and to register for these webinars.

Upcoming Special Enrollment Period Pre-Enrollment Verification Process

Beginning in Summer 2017, new applicants who attest to certain types of SEP qualifying events will be subject to the special enrollment period pre-enrollment verification (SEPV) process. Eligible consumers must submit documents that confirm their SEP eligibility before they can enroll and start using their Marketplace coverage.

Click here - Opens in a new window  for more information about when the Marketplace needs documents to confirm an SEP.

  • On June 23, 2017 pre-enrollment verification started for two SEP types:
    • Loss of coverage
    • Permanent move
  •  On August 23, 2017, pre-enrollment verification starts for three additional SEP types:
    • Marriage    
    • Gaining or becoming a dependent through adoption, placement for adoption, placement in foster care, or a child support or other court order
    • Medicaid/CHIP denial

For more information, check out the following resources:

Manage your Email Preferences

Agents and brokers can now choose the types of emails they want to receive from the Marketplace by updating Subscriber Preferences - Opens in a new window  - External Link Policy - Opens in a new window . Click here to find out how. To get started:

  1. Log in to the Subscriber Preferences - Opens in a new window  - External Link Policy - Opens in a new window  webpage using the email address at which you receive emails from CMS and your password, if you’ve set one up
  2. Select the Email Frequency tab
  3. Next to Send Me Fewer Emails, select the Yes radio button
  4. Select the Save button 

Agent and Broker Newsletter

News for Agents and Brokers is an electronic source of information for agents and brokers assisting consumers in the Marketplaces on HealthCare.gov. Check out the latest edition here.