HealthSherpa is a tool designed to help consumers shop, compare, and choose an ACA healthcare marketplace plan. HealthSherpa is a more user-friendly alternative to the original Healthcare Marketplace website. For 2022, they have enrolled 5 million individuals in healthcare plans.
What is HealthSherpa for?
HealthSherpa was created primarily to help consumers. However, they also provide services to healthcare carriers and agents. Since they function as a healthcare enrollment platform, carriers are given the opportunity to publish their plans on the HealthSherpa portal. This also provides room for agents to work with HealthSherpa; many cite that HealthSherpa has helped them enroll significantly more clients than on the original Healthcare Marketplace website.
HealthSherpa for Consumers
HealthSherpa is a user-friendly website for healthcare consumers who have difficulty choosing and enrolling in an affordable healthcare plan that also meets their needs. It is important to note that HealthSherpa is entirely integrated with the federal Healthcare Marketplace website. It functions as a private partner to the Healthcare Marketplace and, as a result, has the same plans and prices the marketplace offers.
HealthSherpa is free for consumers and can provide custom plan options based on zip code, income, household size, number of dependents, and healthcare needs. HealthSherpa also allows you to compare different plans side-by-side and minimizes healthcare jargon making it easier to use than the Marketplace website.
Besides comparing and enrolling in a plan, HealthSherpa can also tell you which plans your doctors or health facilities accept and how much your prescription medications will cost under each plan.
HealthSherpa for Carriers
HealthSherpa has opportunities for health insurance carriers as well. HealthSherpa aims to streamline not only the enrollment process for consumers but can also work as a platform for carriers to promote their care plans. Since the ACA health exchange plans are shared with HealthSherpa, carriers can specifically promote their products on the HealthSherpa portal. By doing so, these plans will show up as recommended for consumers contributing to more customers. Since HealthSherpa also has a portal for agents, carriers can connect directly with top-performing agents to maximize enrollment and efficiently manage their businesses.
Additionally, HealthSherpa allows carriers to have more control over their businesses. They provide tailored tools for carriers to help track growth, revenue, and market share. Carriers can also use insights and data provided by HealthSherpa to build the most efficient enrollment strategy. Unlike the original Healthcare Marketplace website, on HealthSherpa, carriers can have their own broker portal by running on Enhanced Direct Enrollment (EDE).
HealthSherpa for Agents
HealthSherpa also provides a portal for agents as well for no cost. Agents can use their platform to process client applications, submit follow-ups, and track enrollment status. Agents can also get additional payments from referring their clients to the HealthSherpa clients.
HealthSherpa provides streamlined quotes and allows agents to compare plans from different carriers. Additionally, clients can apply directly on HealthSherpa without using the Healthcare.gov portal.
HealthSherpa also provides agents with organizational resources to allow them to track their clients and monitor their application status. Agents can also view any changes and check the follow-up status with their clients. Agents can also have branded portals that they can send to their clients for self-enrollment.
How Does HealthSherpa Make Money?
HealthSherpa generates revenue in a few ways that align with how other insurance technology companies operate within the industry. Here are the primary means through which HealthSherpa may earn money:
1. Commissions from Insurance Carriers:
HealthSherpa, much like traditional insurance agents, earns commissions from health insurance carriers for each enrollee they sign up for a health insurance plan. Insurance carriers pay these commissions because platforms like HealthSherpa help them to reach more customers and streamline the enrollment process, thus reducing the carriers’ own marketing and sales costs. The commission structure usually involves a set fee for each new enrollee or a percentage of the premium.
2. Enhanced Direct Enrollment (EDE) Partnerships:
Operating under Enhanced Direct Enrollment (EDE) allows partners like HealthSherpa to essentially act as a storefront for insurance plans that are otherwise available via the federal Healthcare.gov platform. By offering a more user-friendly interface and customer support, HealthSherpa can guide users through the enrollment process, earning commissions as mentioned above without the consumer experiencing the sometimes more complex Healthcare.gov portal.
3. Enterprise Solutions for Agents and Brokers:
HealthSherpa provides enterprise solutions for insurance agents and brokers, which may involve subscription services or other fee structures for the use of HealthSherpa's tools and platforms. These services make the job of insurance agents easier by helping them manage clients, track applications, and improve their overall efficiency. This could potentially include a tiered pricing model depending on the level of service and number of users accessing the system.
4. Ancillary Products:
While providing ACA marketplace plans is HealthSherpa’s primary focus, they could also offer ancillary products such as dental or vision insurance. These additional products would provide extra options for consumers and additional commission revenue for HealthSherpa.
5. Carrier Advertising:
Although not a primary source of income, HealthSherpa may earn money through carrier advertisements on their platform. If insurance carriers want to highlight specific plans or promotions, they might pay additional marketing fees to HealthSherpa for increased visibility within the platform.
Is HealthSherpa right for me?
Whether you are a patient/consumer, carrier, or agent, HealthSherpa can be a helpful resource, especially if you are having trouble navigating the Healthcare.gov portal.
Pros of HealthSherpa
HealthSherpa is a much more user-friendly version of the Healthcare.gov website. HealthSherpa provides the following advantages:
- Complete integration with Healthcare.gov
- No extra cost
- Personalized plan recommendations
- Savings
- Prescription cost management
- Keep your current provider
Cons of HealthSherpa
Although HealthSherpa has helped out multiple individuals with enrolling in health insurance, the platform also has its problems:
- Not applicable for states with their own exchanges
- Have to verify premiums and subsidies
- Data quality issues
What are people saying about HealthSherpa?
HealthSherpa has received a lot of attention from consumers, agents, and carriers. As a result, several users have provided feedback on various platforms. Users are generally happy with how easy HealthSherpa is to use. Still, many individuals have complained about the lack of data consistency between HealthSherpa and the Healthcare.gov portal.
We have compiled examples of positive and negative feedback from consumers, agents, and carriers using HealthSherpa.
Bottom Line
HealthSherpa is a platform designed to work as an alternative to the original Healthcare.gov marketplace website. Based on user reviews, HealthSherpa has been successful in helping consumers enroll more efficiently in health insurance plans by providing custom recommendations and savings.
Like HealthSherpa, Mira works to make health insurance much more accessible and user-friendly. HealthSherpa works to help users enroll in health insurance plans; Mira ensures that you are provided essential care at an affordable cost. For an average of $45/month, you can access affordable urgent care, virtual primary care, lab testing, and discounted prescriptions. With no enrollment period, you can sign up for Mira today!