Ultimate Guide to Selling ACA Health Insurance

Written by Lexi Williams

May 3, 2021

Originally signed into law in 2010 by President Barack Obama, the Affordable Care Act (ACA) is a list of healthcare policies intended to extend health coverage to millions of Americans. It expanded Medicaid eligibility, created health insurance exchanges, prohibited companies from denying coverage (or charging more) for those with preexisting health conditions, and allowed children to stay on their parent’s plans until age 26.

Note: In 2021, as part of the American Rescue Plan, subsidies for coverage purchased through the Marketplace have increased, and eligibility for these subsidies has been extended to higher income levels.

When selling ACA insurance, it is essential to note that plans are divided into the “metal tiers” based on how costs are split between the insurance company and the client. The four tiers are as follows:

  • Bronze
    • The company pays 60%
    • The beneficiary pays 40%

This plan is an appropriate choice for clients who want to protect themselves from worst-case medical situations such as sickness or injury. The monthly premium will be low, and they will have to pay for most routine care out-of-pocket.

  • Silver
    • The company pays 70%
    • The beneficiary pays 30%

This plan is a good choice for clients who qualify for cost-sharing reductions or tax credits. They can save hundreds to thousands of dollars annually. The premium will be slightly higher than bronze, but more routine care will be covered.

  • Gold
    • The company pays 80%
    • The beneficiary pays 20%

This plan is a great choice for clients willing to pay more for their monthly premium to have more costs covered for medical treatment. These are a good option for clients who use a lot of care.

  • Platinum
    • The company pays 90%
    • The beneficiary pays 10%

This plan is an excellent choice for clients who use a lot of care and are willing to pay a high monthly premium to know their other costs will be covered.

Recent Changes to the ACA

On January 28, 2021, President Biden not only opened a special enrollment period but signed an executive order that ordered federal agencies to examine and focus on “rules and other policies that limited Americans’ access to health care.” These included:

  • Protections for those with preexisting conditions, including COVID-19 complications
  • Limitations such as work requirements to access the ACA and Medicaid
  • Policies that undermine the health insurance markets, including the Health Insurance Marketplace
  • Policies that increase the difficulty of enrollment into Medicaid or the ACA
  • Policies that reduced financial assistance or affordability for recipients or dependents

So, what is the Ultimate Strategy for Selling?

Now, let’s talk about some ways that are proven to improve your ACA marketing strategies this year.

  1. Target People Turning 26.
    Prospects who are turning 26 are aging off of their parent’s health insurance. These are often known as the “young invincible” who are often very healthy. You can find and target these prospects by identifying lists of people turning 26 and living with their parents – don’t limit yourself to this, but it is a good start.
  2. Target New Movers to Your State.
    Like the T-26 crowd, those moving into your state will qualify for a SEP. So, targeting this market can yield effective campaigns.
  3. Clean Your Marketing Data.
    While this is not unique to ACA marketing, it is always a way to improve your marketing results. Always use the most advanced data cleaning techniques. Remove duplicates and take your current clients out of your prospecting lists. Take this seriously, or the responses to your marketing could suffer greatly.

For more tips, ideas, and access to the latest ACA products, contact Agent Pipeline today at 800.962.4693


T-26 Social Media Marketing Pieces

Agent Pipeline is here to help you market to those turning 26 and coming off of their parent’s plans! Our free social media marketing pieces will help you connect with your target demographic. Click here to find out how you can gain access to the T-26 social media marketing pieces!

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