Why agencies move to pay per call
For years, most health agencies bought form leads and worked them by phone. It works, but it is a grind. Many leads never answer, some were sold to several agencies, and agents spend more time dialing than selling. Pay per call flips that. The shopper calls you, the conversation starts right away, and you only pay when the call meets the rules you set.
That does not make every call a sale. It does mean your agents spend their day talking, quoting and enrolling instead of chasing voicemail. For small agencies with a few strong closers, that alone can change the math of a season.
What makes a call billable
The single most important detail in any pay-per-call deal is the definition of a billable call. Get it in writing before launch. It usually includes:
- A minimum duration. The call must last past an agreed number of seconds. Short calls, hang-ups and misdials are not charged.
- Targeting rules. The caller must be in a state and ZIP code you accept, during hours you accept.
- Duplicate rules. If the same person calls twice in a short window, only the first call counts.
- Product fit. The caller should be looking for under-65 Marketplace coverage, not Medicare or something unrelated.
Duration is a trade-off. A very short duration means you pay for conversations that never got going. A very long one means the publisher takes on all the risk and may not want to send you their best traffic. Most buyers settle somewhere that matches how long it takes their agents to confirm a shopper is real and interested.
What affects the price of a call
Rather than quoting a single number, it helps to understand what moves price up or down:
- Season. Calls during open enrollment cost more because every agency wants them.
- States. Large, competitive states usually cost more than smaller ones.
- Call type. Inbound calls, direct transfers and warm transfers are priced differently. Read about ACA live transfer leads for how transfers compare.
- Hours. Taking calls in evenings and weekends gives you access to more volume and sometimes better prices.
- Billable duration. Longer durations usually come with a higher price per call.
- Source. Search traffic, TV, radio and social all carry different costs.
Pricing is confirmed with each buyer before launch, based on these factors. Be wary of any vendor that quotes a rock-bottom price without asking about your states, hours or duration.
How to work out what a call is worth
The question is not "how cheap can I buy a call?" but "how much can I afford to pay per call and still make money?" You can answer that with three numbers you probably already know: your average commission per enrollment, your close rate on live calls, and how many enrollments stay active after the first premium.
Say an effectuated enrollment earns your agency an amount we will call C. If your agents enroll 1 in every 5 billable calls, and 4 out of 5 of those enrollments pay their first premium, each billable call produces 0.16 lasting enrollments.
Your break-even call price is 0.16 × C. Anything below that is profit before payroll and overhead. Plug in your real numbers, not ours.
Run this by state and by hour of day once you have a few weeks of data. You may find some states or time slots are worth paying more for, and others are not worth buying at all.
Pay per call compared with form leads
Form leads still have a place, and some agencies run both. The difference is mostly about where the work happens. With forms, your team does the work of reaching the shopper. With calls, the shopper does that work by dialing in.
| Form leads | Pay-per-call leads | |
|---|---|---|
| How it starts | Your agent calls the shopper back | The shopper calls your agent |
| Contact rate | Often low, and falls fast with time | Every billable call is a live conversation |
| Exclusivity | Often shared with other buyers | One caller, one buyer at a time |
| Price per unit | Lower | Higher |
| Staff needed | Dialers plus closers | Closers ready to answer |
A higher price per unit is not a higher cost per sale. When you compare the two, always compare cost per effectuated enrollment, not cost per lead.
Setting up your first campaign
A clean start saves money. Before the first call arrives, confirm these details:
- Every agent who will take calls is licensed in each target state and, if they use HealthCare.gov, has completed the current plan year's Marketplace registration.
- Your phone line can handle the volume, with a backup number if the main line is busy.
- Your hours and daily cap match real staffing, including lunch breaks.
- Agents know how to document consumer consent and review application details, as CMS expects.
- You have a simple way to mark outcomes and flag calls that missed the rules.
Start with a modest cap, watch the first week closely, and raise volume only after your agents are converting at the rate you expected.
Handling calls that miss the rules
Even well-run campaigns send the occasional wrong call: a Medicare shopper, someone out of state, or a caller who dialed by mistake but stayed on the line. Every call should be recorded and tagged with an outcome, so these can be reviewed fairly. Flag them promptly with the recording, explain which rule was missed, and expect a clear answer. Good partners welcome this feedback because it helps them clean up traffic.