Under-65 insurance plans can be a rich and profitable addition to your portfolio.
Our ASG Podcast host, Sarah J. Rueppel, sat down with Under-65 Health Manager, Danica Stover, to discuss sales opportunities outside of the Open Enrollment Period (OEP).
We’ve compiled the best tips and pieces of advice from their conversation below. Keep reading to discover why adding Affordable Care Act (ACA) insurance options can be an excellent decision.
To hear the full interview and more about ACA sales opportunities, listen to the full episode:
What do we [agents] do during the time period that lasts from February to June when we’re not necessarily preparing, we’re not necessarily selling ACA?
It can be challenging to learn and pick up new skills during that busier time of year. Realistically, it’s not always going to be a good fit or feasible for you to be able to pick up new products. Starting anytime between February and June is a great starting point and a great way to use some of that time.
I like what you said about it being challenging to get started with something new. What does that look like?
The first tip I’m going to recommend to you is give yourself a goal and a deadline of when you want to have this new product line added to your portfolio and completed. So, if today’s May 1 and I say, “I want to be contracted and certified to sell ACA plans by June 1,” you can start working backwards from that date and give yourself a timeline.
Once you’ve given yourself a goal and a deadline to work towards, the next tip I would recommend is putting that time and blocking it off on your calendar. I think we can all relate to the fact that, if you don’t run your day, your day can run you. So, you have to be very intentional about the time that you set aside toward that. Scheduling it is a great way to make it happen.
The last tip on this topic I just want to remind you about is, typically, once we get into that June timeframe, there’s still time to pick up something new and enjoy your vacation before that busy season really starts to pick up. Take advantage of that opportunity and that time now, before it slips by.
What about those opportunities to sell under-65 plans? Can you give us some examples of how we might come across those opportunities in, just kind of, everyday sales, or how it might fit into our Medicare process?
We may continue to see people retiring before they’re eligible for Medicare, and they’re going to need to sign up for an individual health plan if they don’t have other credible coverage. Another great example is meeting with spouses and only one of those spouses is eligible for Medicare, but they both need coverage. Of course, if you sign a husband up for a Medicare Advantage plan and the wife needs individual health coverage, that’s a great way to build your Medicare pipeline and keep the entire household happy and covered.
What does that training look like on the ACA side? With Medicare, it’s a little more involved. Is the under-65 market similar?
I have some good news for you. If you’re used to selling Medicare Advantage and prescription drug plans and doing your annual AHIP and carrier certifications, it is simpler for ACA. You only need to complete one annual marketplace or state exchange training. There are not carrier-specific certifications. And in most cases, your recertification process is much shorter.
What do the enrollments look like for ACA coverage, specifically Special Enrollment Periods that can let us [agents] write business outside of those core enrollment timeframes in the fall?
Just like in Medicare, there are Special Enrollment Period (SEP) options for clients to enroll or change their individual health plan coverage with ACA outside of the Open Enrollment Period. Typically, those [SEPs] are triggered by a qualifying life event… You may change jobs; you may have a baby, or you may move to a new house in a new city. There are opportunities to help clients change or sign up for health plan coverage throughout the year. The other SEP I want to mention there is new – and hopefully you’ve heard about this, but if you’ve not, I’m happy to be sharing this with you now.
For individual health plans, there is a rolling Special Enrollment Period for consumers that are up to 150 percent of the federal poverty level (FPL). So, if you reside in a state that had Medicaid expansion, that means that somebody that’s between 133 percent and 150 percent of the federal poverty level at income now has a rolling Special Enrollment Period to sign up for or change their individual health plans.
And in the states that did not expand their Medicaid, that opportunity exists for consumers that are between 100 percent and 150 percent. So again, if you’re selling Medicare, I typically would compare that to the Low-Income Subsidy Special Enrollment Period. This is something new that was just created and an opportunity for even more people to review and sign up for coverage.
Let’s bring this all home and kind of summarize all these different steps that it takes for a new [ACA] agent to get started from start to finish…
So, first and foremost, reach out to your FMO (field marketing organization). If you’re interested in partnering with Ritter, you can reach out to your territory sales specialist, so we can help guide you in getting started.
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Your first step is going to be completing your certification. If you’re in a federal exchange state, you’ll do the FFM training. You would do the state-based exchange training if you’re in a state-based exchange state like Pennsylvania.
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The next step is to contract. You actually want to have your certification done before you start the contracting process because many carriers actually require that to be completed first.
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After you contract, train on your enrollment platforms and options. So, if you sell in a federal exchange state, we are partnered with HealthSherpa for agents to complete enrollments through their platform.
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Next up is marketing. You want to put yourself out there. If you’ve done your carrier contracting, you’ll get access to different carrier portals with some marketing pieces that are available, or you can go a more generic route as well.
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Lastly, you’ll want to quote your clients and then submit an enrollment for them.
And that is the full cycle of getting started to sell an ACA plan.
Is there anything else that you would like our listeners to know about here today, Danica?
Regardless of what product lines you’re specialized in, take advantage of the opportunity to learn a new product line or skill in that offseason. It’ll really round out your portfolio and make you a more trusted health advisor to the clients that you’re serving in your market.
Listen to the full podcast episode to hear more advice about selling ACA products outside the OEP. Register with Ritter to gain access to our sales support, innovative technology, and educational resources.
Editor’s Note: This post is based on an episode from our ASG Podcast. We have modified content from the original recording. To listen to the full episode, visit RitterIM.com/podcast.
Not affiliated with or endorsed by Medicare or any government agency.
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