Agent authorization tools

Your consumer will need to authorize you before you can access their application.

Beginning in plan year 2027, all consumers will need to authorize you as their agent before you can access, update, or submit their Marketplace application. With this new agent authorization step, you will be able to use HealthSherpa for all agent-assisted enrollments and application updates.

For Open Enrollment 2027 and beyond, CMS is sunsetting the three-way call for AOR changes. The Marketplace Call Center will no longer support enrollments or application updates with a broker’s NPN attached, except in certain special or complex situations.

HealthSherpa will make the agent authorization process as seamless as possible:

You send the request. Send the consumer an authorization link by email or text.
The consumer authorizes you. The consumer opens the link and completes a simple authorization step.
You access the application. Once authorization is complete, you can begin assisting with the application in HealthSherpa.

Agent authorization stays with the EDE platform

Authorization completed through HealthSherpa is valid only through HealthSherpa and does not transfer to another EDE platform. The authorization remains active for the plan year while you continue assisting the consumer through HealthSherpa.

If you move the consumer to a different EDE platform, the consumer will need to complete that platform’s authorization process using a new and different workflow.

Some consumers will need identity verification

CMS may require additional identity verification for certain higher-risk applications. A consumer may be asked to verify their identity when:

They submit a new Marketplace application, including an application in a different state
They have an active Marketplace enrollment with a monthly premium of $30 or less after APTC
They begin working with a new or different agent or broker

HealthSherpa’s identity verification experience will include multiple approved options, including the CMS-provided Experian Remote Identity Proofing process (RIDP), which happens in the background without impact to the user, ID.me, and other available methods.

Our goal is to help more of your consumers successfully complete identity verification without needing to complete the enrollment on their own using HealthCare.gov.

Consent documentation is still required

Agent authorization provides access to the application. It does not replace CMS’consent documentation requirements.

Agents will still be required to obtain and document consent from their consumers. This includes::

consent documentation before person search
Application review and consumer attestation
Any other applicable CMS documentation requirements

We’ll continue sharing updates as CMS finalizes additional details and HealthSherpa tools become available.

Review your consumer contact information now

Accurate phone numbers and email addresses will be essential once authorization goes live. This is how consumers will receive and complete their authorization requests. Starting now is the best way to avoid delays during Open Enrollment. Learn more about updating consumer contact information here.

Here's what happens if a consumer's contact info on file is outdated or invalid after this change goes live:

The consumer can update their own contact information by calling the Marketplace Call Center directly. This must be done by the consumer themselves, without the agent on the line.
Alternatively, the consumer can submit an application with their correct information through HealthCare.gov or another consumer-facing pathway.