As you can probably tell, we’re pretty excited here at America’s Health Care Plan. We’re entering the fourth quarter, and very soon the busy time of the year in the Individual, Medicare, and Group Health markets will be upon us. It’s a time of great opportunity, especially this year, so we wanted to offer a few pointers to help you maximize your time and, therefore, your selling potential. We hope you can find a nugget or two in our words that will help your business.

Start and End Dates

While the open enrollment period for each market segment is a little different, there is a lot of overlap. As you sit down to map out your strategy to capture as much new business as possible (while continuing to hang on to your current clients), it’s helpful to know the start and end dates for each market.

Medicare: The Medicare Annual Election Period (AEP) starts Sunday, October 15 and ends Thursday, December 7. That means you have about seven-and-a-half weeks to sell as many Medicare Advantage and Medicare Part D plans as you can. The good news is that you can often sell these products in pairs as the spouses are usually both eligible for Medicare.

Individual: The open enrollment period for the individual market is only a month-and-a-half this year rather than the three months you’re used to. It starts November 1 and ends December 15. The bad news is that your clients and prospects have fewer options than they’ve had in the past as a number of carriers have pulled out of markets across the country.

Group: There’s no official selling season for small and large group products, but a large percentage of employers have December or January renewal dates. Since open enrollment for an employer group is usually the 30 days prior to the effective date, your clients will need to make a decision before that time—either by November 1 or December 1. You’ll also need to make sure they distribute the Summaries of Benefits and Coverage (SBCs) to their employees at least 30 days prior to renewal.


Keep in mind that you’ll need to get certified with the various Medicare Advantage and Medicare Part D plans that you’d like to market, and that will take some time. If you haven’t completed the certification process, you need to hurry.

You have a couple additional weeks before the start of the individual open enrollment period, but remember that there’s also a certification process if you want to sell Marketplace plans. If you haven’t completed that process, it should be near the top of your to-do list.

Finally, the small (not sold on the SHOP)  and large group markets don’t require an annual certification process. The carriers, though, do require that you be appointed to get a quote or place business with them. Be sure to finish up any required paperwork as soon as possible.

Your Product Portfolio

Each year, some vendors enter the market while others make the decision to exit. As an insurance advisor, you want to make sure you’re set up to sell any promising new option. A good place to start is the AHCP Carriers page. There, you can scroll through the various health, dental, vision, life, and supplemental health insurance carriers we work with. You can also search specifically for health insurance or Medicare solutions.

While most clients will be focused on their health insurance needs at this time of the year, you’ll want to make sure that you’re appointed with a wide range of ancillary vendors and are familiar with their products. During your conversations with your group, individual, and Medicare clients, you’ll certainly uncover some needs other than health insurance—and you’ll want to be able to offer solutions when you do.

Plan Ahead

Though some of your clients will want to talk about dental, life, or supplemental coverage at the same time they’re talking with you about health insurance, others won’t be in the mood. Until they make a decision about their health coverage, it will be difficult for them to focus on anything else.

Keep in mind that there is no open enrollment period for these other products, so it’s certainly not essential that you talk with every single client about every single risk they’re exposed to during this very busy time.

That said, you should definitely mention their other insurance needs at the end of the meeting and try to schedule a follow-up meeting, perhaps immediately following OEP or in the first quarter of 2018, to show them the other solutions that you have available. Just think how nice it will be if you can start off the new year not with an empty calendar but instead with dozens of pre-booked appointments. What a great way to start the year.

This Year’s Big Opportunities

We’ll finish up with a few ideas about the big opportunities that exist during this selling season. Here’s one for each market segment:

Group: If you sell group health, you probably know that CMS extended the deadline for transitional plans by one more year. As of right now, these non-ACA plans must end (and groups must move into metallic plans) no later than December 31, 2018. Sure, there’s always the chance that the government will kick the can a little further down the road, but for now that’s the rule. Either way, employers that have chosen to stay with their old plans and continue to play by the old rating rules tend to be younger, healthier groups since higher risk groups usually do better in ACA-compliant plans.

With that in mind, we know that these clients are great candidates for level-funded plans that are not subject to the modified adjusted community rating rules. And it just so happens, AHCP offers such a product. Think of it this way: grandmothered plans are great for your current clients – they can keep a plan they’re familiar with, and it’s a lot less work for you if they don’t want you to “shop the market” every year. But for prospects, you need them to move if you want them to become clients, and a level-funded plan is the perfect solution. In many cases, the worst-case scenario on a self-funded option is better than the fixed rates on their transitional plan.

Individual: There’s certainly a glass half full / glass half empty scenario in the individual market this year. A lot of agents will look at the shortened enrollment period, limited options, and reduced commissions and see nothing but bad news. There’s no doubt that fewer agents will be selling individual plans this year than in years past.

Other agents, though, will realize that, because of all of the turbulence, they’ll have less competition than in the past. More importantly, with the exodus of several carriers from the individual market, they’ll know that a lot of people will be looking for new coverage options. In other words, there’s plenty of business to be had, and agents who are willing to help people who don’t have a lot of good options could make a lot of money.

Medicare: There’s actually nothing special about 2017 that creates a bigger-than-normal opportunity in the Medicare market. That said, there’s always a huge opportunity for agents who sell Medicare products. Millions of seniors turn 65 every year, nearly all sign up for Medicare, a large percentage purchase additional coverage, and Medicare Advantage plans are guaranteed issue. If an agent can’t sell enough in the Medicare market, it might be time to find a different profession.

Best of Luck!

At AHCP, we’d like to wish you the best of luck this selling season. More importantly, we’d like to do whatever we can to make sure the next few months are a huge success. Please let us know how we can help.