Quote and Enroll ACA Customers
A practical, step-by-step call flow for licensed agents who turn live ACA calls into completed, paid enrollments. Clear enough for new agents, useful as a refresher for veterans.
Buying good calls is only half the job. The other half happens in the few minutes after your agent says hello. Agencies with the same traffic can see very different results, and the gap almost always comes from the call itself.
This guide lays out an eight-step flow for quoting and enrolling ACA customers on the phone. It follows the order most successful agents use, keeps compliance inside the conversation rather than bolted on at the end, and focuses on the moment that actually pays: the first premium.
Use it to train new agents, to build or refresh your script, or to review recorded calls. Adapt every sample line to your agency and have your compliance team approve it.
Have these ready before you start
- Active license in each state you take calls from
- Current plan year Marketplace registration, if using HealthCare.gov
- Quoting and enrollment tools logged in
- Approved consent process and wording
- Note template for household, income and needs
- Direct callback number for follow-up
Prepare before the phone rings
Live ACA calls do not wait for you to find a password. Before your hours start, make sure the basics are ready.
Confirm your health license is active in every state you take calls from. If you enroll through HealthCare.gov, check that your Marketplace registration and training for the current plan year are complete. Log in to your quoting and enrollment tools, have your consent process ready, and keep a simple note template open so details are captured once, not three times.
Open the call and set the frame
The first thirty seconds decide whether the shopper relaxes or gets defensive. Introduce yourself, say you are a licensed agent, confirm the call is recorded, and tell them what will happen next. People are far more patient when they know where the conversation is going.
If the call came through a transfer, the shopper has already answered some questions. Acknowledge that rather than starting from zero.
Sample wording (adapt with your compliance team)
"Hi, this is Maria. I'm a licensed health insurance agent with [Agency]. This call is recorded for quality. I understand you're looking at Marketplace health plans. I'll ask a few quick questions, show you the options you qualify for, and you can decide what's right. Sound good?"
Confirm the eligibility basics
Gather the information that shapes every quote: state and ZIP code, who in the household needs coverage, ages, whether anyone has an offer of job-based coverage, and an estimate of expected household income for the year.
If it is outside open enrollment, ask what changed recently. Losing other coverage, moving, getting married or having a baby can qualify someone for a Special Enrollment Period. If nothing qualifies, explain that honestly and note when they can enroll.
Document consent before you help
CMS expects agents and brokers to document a consumer's consent before helping them apply for Marketplace coverage. Do this clearly and early, using the method your agency has approved, and keep the record. It protects the shopper from unauthorized changes and it protects you.
Explain it simply. Most people appreciate knowing their information will not be used without their agreement.
Sample wording (adapt with your compliance team)
"Before I look anything up, I need your permission to help you with your Marketplace application. That means I can search plans and help submit an application for you. Do I have your permission to do that today?"
Learn what matters to them
A good quote starts with a short conversation, not a plan list. Ask about the doctors they want to keep, the prescriptions they take, how often they use care, and what monthly budget feels comfortable. Ask whether they would rather pay more each month and less when they see a doctor, or the other way around.
Write the answers down. You will use them to narrow dozens of plans to two or three that actually fit.
Quote and compare plans clearly
Show the shopper what they qualify for, including any premium tax credit. Then compare a small number of plans side by side, explaining the trade-offs in everyday words: monthly premium, deductible, out-of-pocket maximum, and network type.
If their income is in the range that qualifies for cost-sharing reductions, point out that this extra help applies only to Silver plans and can lower deductibles and copays a lot. Check their doctors and prescriptions against each plan before they choose. Never promise a price until you have run the real numbers.
Sample wording (adapt with your compliance team)
"Here are the two plans that keep Dr. Patel in network. The first has a lower monthly cost but a higher deductible. The second costs a bit more each month, but your office visits are a flat copay. Which feels more like how you use care?"
Review the application and submit
Before you submit, walk through the application with the shopper. CMS expects agents to review the eligibility application details with the consumer, and it is good practice anyway. Read back names, dates of birth, household members, income and coverage choices. Small mistakes here cause big problems later, such as wrong subsidy amounts or verification requests.
Explain that the Marketplace may ask for documents to verify details like income or citizenship, and that they need to respond by the deadline to keep their coverage and savings.
Confirm the first payment and follow up
An enrollment only becomes active coverage, and usually a commission, once the first premium is paid. Before the call ends, explain how to pay, how much, and by when. If you can, help them make the payment on the call or set a reminder.
Then schedule a short follow-up. Check that the payment went through, that their ID cards arrived, and that any document requests are handled. Customers who hear from their agent after the sale stay longer, refer friends and come back at renewal.
Sample wording (adapt with your compliance team)
"Your plan is submitted. The first payment of $[amount] needs to be made by [date] for coverage to start. I'll call you on [day] to make sure it went through and your cards arrived. Here is my direct number if anything comes up."
Mistakes that cost enrollments
- Quoting before you know the household. A price based on guesses has to be walked back later, and trust goes with it.
- Skipping the doctor check. The best price means nothing if their doctor is out of network.
- Showing too many plans. Choice overload leads to "let me think about it." Two or three well-chosen options is enough.
- Rushing the review. A wrong birth date or income figure can create verification problems that cancel coverage.
- Ending the call without a payment plan. Unpaid first premiums are the most common reason enrollments never become customers.
Fixing these is usually worth more than any change to lead price. If you are still deciding where your calls should come from, our guides to ACA Live Transfer Leads and Pay-Per-Call Health Insurance Leads explain the options, and Health Insurance Call Center Leads covers running this flow across a whole team.
Frequently asked questions
How long does it take to enroll an ACA customer by phone?
Do I need the customer's consent before helping with an application?
What if the customer is not sure about their income?
When does ACA coverage start after enrollment?
More guides for ACA lead buyers
Put this playbook to work
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