Licensed Healthcare Agents That Consistently Outperform
Purpose-built for health plans that want to win on new member acquisition — and keep the members they earn, all year round.<!--
Ranked #1 by 6 of 7 health plan clients in the 2024 AEP/OEP season. Exceeded enrollment goals on 9 of 12 client lines of business.-->
States covered
Active licensure across all 50 states for Medicare Advantage and ACA programs
Effectuation rate
Major ACA marketplace insurer – scaled rapidly at maintained quality
QA & compliance quality
Sustained at scale across all CMS monitoring benchmarks
Conversion acceleration
Regional Blue Plan — stringent quality fully maintained
#1
Ranked by 6 of 7 health
plan clients, 2024 AEP/OEP
9/12
Client lines of business
exceeded enrollment goals
95%+
QA & CMS compliance
quality scores at scale
50%
Reduction in agent onboarding time
Licensed agents are your most knowledgeable advocates.
Most plans use them for 10 weeks a year.
- Compliance exposure from inconsistent seasonal offboarding and re-licensing every cycle
- Re-training costs compound annually - agents lose product literacy between AEP seasons
- Member care teams without plan literacy can't resolve - only respond - driving churn and hurting Star Ratings
- High cost-per-enrollment (CPE) from repeated ramp-up friction, QA drift, and slower conversion at scale
The Elite Licensed Agents Program
Purpose-built for health plans that want to win on acquisition and keep the members they earn.
Most Effective Cohort. Best Retention.
Persona-based training that creates advocates
A year-round model that pays for itself
AEP/OEP Acquisition
New member enrollment
CMS compliance
Effectuation
Activation follow-up
Revenue recognition
Member Care
Benefits navigation
FCR improvement
Retention
At-risk outreach
Loyalty building
Renewal Ready
Star Ratings lift
Next AEP advantage
Built for enrollment season.
Designed to deliver all year.
365-DAY VALUE
Year-round member care & retention program
-
Benefits navigation & effectuation follow-up
Newly enrolled members who don't activate are your highest churn risk. Our agents follow up, explain, and guide, driving effectuation rates that convert to revenue. -
Empathy-led member care (FCR-focused)
A licensed advocate understands coverage context. They resolve - not just respond. First-contact resolution improves, escalations drop, CSAT rises. -
Proactive retention & loyalty outreach
We identify at-risk members and deploy agents in outreach that combines plan literacy with genuine care, building loyalty that carries into renewal. -
Star Ratings & member satisfaction impact
Member experience is one of CMS's most heavily weighted Star Ratings dimensions. Every quality interaction builds a structural advantage in your ratings trajectory.
Annual Enrollment Period · Open Enrollment Period
When the season peaks, we're already ready
-
Rapid, compliant ramp at scale
Pre-licensed, pre-trained agents ready to handle CMS test calls from day one - state licensure, call audit compliance, and QA benchmarks maintained throughout the ramp. -
Persona-based AEP/OEP sales training
Consultative, needs-based enrollment conversations - not transactional ones. Agents understand the difference between a dual-eligible beneficiary and a first-time MA buyer, and are equally adept at guiding members through subsidy changes and plan discontinuations - the conversations that require the most trust and the clearest advocacy. -
QA scoring & CMS compliance at every call
Rigorous call audit programs, QA scoring frameworks, and CMS regulatory risk protocols protect your plan while maintaining member-first experience that builds trust. -
Operational efficiency drives CPE down
Agents who already know your products and quality standards mean faster ramp, fewer errors, and better conversion. CPE improves because quality doesn't degrade at scale.
DESIGNED FOR EVERY MARKET
Built for the complexity of every Health Plan market
Medicare Advantage
- Star Ratings member experience scores
- New member acquisition during AEP
- Year-on-year renewal rates
- Regulatory risk from CMS monitoring
#1
Ranked by the majority of our MA clients in the 2025 AEP/OEP season vs all competing vendors
9 of 12
Client lines of business exceeded their enrollment season goals with our MA licensed agent teams
ACA Marketplace
Marketplace buyers are often first-time insurance purchasers navigating a complex landscape of metal tiers, subsidies, and network constraints. Our agents are trained to simplify, not overwhelm – driving enrollment conversion while ensuring the member makes a decision that fits their life. The result: higher effectuation, lower churn, stronger retention.
- Enrollment conversion rate (OEP)
- Effectuation from first-time buyers
- Post-enrollment member confusion
- Early-year churn from poor plan fit
30%
86%
Medicare Traditional
Traditional Medicare beneficiaries navigating supplemental options need advisors, not sales agents. Our licensed advocates are trained to listen first, educate second, and connect members to the right choices – building loyalty to your plan before they ever have a claim. The result is a member base that trusts your plan enough to stay.
- Member trust and plan loyalty
- Supplemental plan understanding
- Member confusion on coverage gaps
- Escalations from uninformed members
50%
Medicaid
Medicaid members often face the greatest barriers to understanding and using their coverage. Our persona training is specifically calibrated for this population – with communication approaches that reduce confusion, support effectuation, and reduce the administrative burden on your plan through better-informed member interactions.
- Effectuation rates post-enrollment
- Member understanding of benefits
- Avoidable escalations and re-contacts
- Administrative cost from uninformed calls
86%
Effectuation rate achieved for a major marketplace insurer, a result driven by post-enrollment licensed agent follow-up
95%+
QA and compliance quality scores sustained at full seasonal scale, protecting plan regulatory risk
PROOF IN PRACTICE
What Elite Licensed
Agents deliver for Health Plans
ACA Marketplace - Effectuation
Effectuation rate sustained at 95%+ quality while scaling rapidly
A major ACA marketplace health insurer needed speed and quality simultaneously. Our licensed agents delivered an 86% effectuation rate while maintaining 95%+ compliance and QA scores throughout a demanding ramp.
Read Case Study
Regional Blue Plan - Conversion
Conversion acceleration with zero compromise on compliance standards
A regional Blue plan needed to convert faster without letting quality slip. Our program accelerated conversions by 30% while meeting every regulatory and quality benchmark — including stringent CMS compliance requirements.
Read Case Study
Health Plan - Operational Efficiency
Reduction in agent onboarding and offboarding time through intelligent automation
A leading health plan was absorbing the full operational cost of seasonal agent ramps. Our intelligent automation solution cut onboarding and offboarding time by 50%, making every enrollment season faster, less expensive, and fully compliant.
Read Case Study
Medicare Advantage - Seasonal Ramp
Largest seasonal ramp surpasses Medicare Advantage conversion goals
Our largest-ever MA seasonal deployment didn't just hit target; it surpassed the client's conversion goals. Scale and quality are not in tension when the program infrastructure is built correctly from the start.
Read Case Study
Your Licensed Agents Leave in December. Your Member Retention Problem Starts in January.
See what the right Licensed Agent Program does for your plan.
