Lesson 5: Getting Started with ACA
Hi, everyone. It’s Brandon again. Welcome to our last lesson of ACA 101, How to Get Started Selling. In this lesson, we will go over the steps you need to take to start selling ACA plans, best practices for serving your clients, and tips on how you can retain those same clients.
There’s a few things you need to do before you are ready to start selling. The first step to get started in the ACA market is the ACA certification, also known as the Federal Facilitated Marketplace Certification, which certifies you in all 30 federal Marketplaces. Now, if you are selling in a state that requires the state-based exchange, you must go through the state certification process. So now let’s talk about how to complete the process for the Federal Facilitated Marketplace, FFM. Certification can be completed by visiting CMS website which is portal.CMS.Gov. You’ll need to create your profile and then log in. Next, you’ll click the drop down menu and select Federal Facilitated Marketplace requesting MLMS training access. For a new agent getting certified for the first time. The certification typically takes two to 5 hours to complete the training modules. Once you have completed that initial FFM training, the annual certification renewal usually takes less than an hour to complete. I do want to add you can complete this certification at no-cost, and this is the only education requirement for selling ACA plans in the marketplace. There are no specific training or certifications required by the carriers.
Now, as I mentioned before, there are several states that do not recognize the Federal Marketplace certification. Remember, each state has an independent process for certification. For example, you are only certified to sell ACA in California and Nevada. You have to do the California State Exchange certification and you also have to do Nevada’s State based exchange. They are not the same, they are completely separate. So, once you’ve completed your certification, you’re ready to start selling and serving your clients.
Next, I’m going to talk about how to find the best fit plan to meet your clients medical and financial needs. So, typically you have two types of ACA clients. The ones that are looking for the cheapest plan possible. They do not care who the primary doctor is, they don’t care about the network they are in, and they might not even go see a doctor regularly. They simply want coverage for those what if moments. Example you have a 25-year-old that makes $25,000 a year. They don’t go to the doctor, they just want to have something just in case they have to go to the emergency room. That is your what if moment. They’re looking for that cheap zero-dollar premium. They do not care about their network or hospitals.
On the other hand, you’ll have clients that are typically families or with higher incomes or even preexisting conditions. These clients have specific needs, such as a specific network, doctor specialist or hospital. They are willing to pay a higher premium with a zero dollar or zero low deductible plan as long as they know their needs are being met. I’ll give you an example. You have a client that has cancer. They have a specific specialist or hospital they need to go to. It is your job to find that carrier that is in that specialist and hospitals network to help out that client. Either way, both types of clients need your help to navigate the healthcare options.
When it comes to finding a plan that best fits your needs, you’re going to have a couple of different options as well. In the ACA marketplace, you typically have three metal tier plans a bronze, silver, and gold. Typically, the bronze plans have a zero-dollar premium with high deductibles. $8,600 $9,100 this is the type of plan you would want to offer the first type of ACA client we talked about clients with a lower income that really need the coverage for those what if moments. Silver plans generally have a higher monthly premium with low deductibles. Some plans occasionally even having a zero-dollar deductible. Gold plans have the lowest deductibles available in the market. However, that comes with a higher monthly premium. These are the plans you want to offer. The clients that have those pre-existing conditions or have particular specialists, hospitals, or even networks they need to stay with. They’ll also have the higher income support to provide those monthly premiums.
Another conversation or question that should be mindful of when helping a client find their health care coverage is whether or not they have or have been offered a Cobra plan. For example, if your client is offered a Cobra plan due to change of employment or retirement or currently on a Cobra plan, there’s a couple of things you need to discuss with them. If you have been offered a Cobra plan but have not accepted, you are eligible for ACA subsidies. If you are currently on a Cobra plan you are not eligible for the subsidy until the plan’s maturity date ends, it’s important to note that clients can still qualify for an ACA plan. However, they will not receive the subsidy, meaning they would have to pay full price for that plan.
So now that you know how to get started selling, how to find the best plans for your clients, let’s take a look at some tips on retaining those very clients. ACA retention comes down to two things keeping in touch with your clients and knowing what is going on in the marketplace. Year to year. You may see network changes from carriers different premium rollouts which vary from carrier to carrier. Many individuals are newly eligible for subsidies or premium tax credits due to changes in household income or size. ACA carriers expanding markets, adding or subtracting networks being aware of these types of changes in the marketplace gives you the leverage to help give your clients the opportunity to roll in a plan that fits their changing needs. Keep in touch with your clients to keep top of mind awareness. Send holiday cards, birthday cards, keep a physical and virtual presence. Host and attend those community events. Post and interact on social media. The goal here is to show the boots on the ground approach. Many of your clients will love the feel of that personal touch.
Keep in mind, doing these things not only benefits your clients, but you as well. In most cases, commissions on renewals pays the same as the first time you sold the policy, which is per member per month, up to five members. For example, if you write a policy this year for a family of four in Florida, let’s say the plan pays $20 per member per month. You’ll make $960 for the year in commission. The following year, this family is still happy with their current plan. They can renew that plan, and you will continue to earn that $20 per member per month. That means you have made $1,920 from that one policy in two years just by keeping up with your client and the market. Keep in mind, commissions are only paid up to five members per policy, meaning that if you have a family of six, seven or even eight, you will still only be paid on the first five members. Also, they are only paid as earned, meaning there is no advancing in ACA as you can leave the policy at any time.
This wraps up the entire ACA course. By now, you should have a better understanding on the history of the Affordable Care Act, the parts of ACA and what it looks like today, identifying the market and your target audience, enrollment tools, and also how to start selling, finding those best fit plans and how you can retain those clients. I hope you’ve enjoyed this course and found the information valuable. Now it’s time to test your knowledge and take your final exam. Good luck. This is Brandon from Agent Elevate signing off.