✅ What agents can do:
Agents and brokers are permitted to assist consumers during the enrollment process in the Marketplace, as long as they have clear, informed, and verifiable consent. This includes:
- Explaining plan options and subsidy eligibility.
- Guiding consumers as they enter personal data.
- Helping clarify forms and application stages.
🎯 Consent must be verifiable — through electronic signature, written authorization, or documented recording.
🚫 What is not allowed (even with consent):
According to Marketplace operational policies and the CMS Privacy and Security Agreement:
- Agents must not create HealthCare.gov accounts on behalf of consumers.
- Agents are prohibited from logging in, creating usernames, or accessing consumer passwords.
- These actions are forbidden even if the consumer gives verbal or written permission.
⚖️ Why this distinction matters:
The CMS Final Rule (CMS-9884-F, 2025) enforces penalties for agents who act without consumer consent, but does not authorize activities that violate Marketplace operational rules. In short:
- Account creation by agents is explicitly prohibited.
- Doing so — even with consent — can still result in penalties for violating CMS agreements.
📝 Best practices for agents:
- Never request or input login credentials on behalf of consumers.
- Assist in real time while the consumer completes their account setup.
- Ensure your team understands that consent does not override regulatory boundaries.
- Utilize consumer-facing educational tools to guide the process while ensuring compliance.
Useful links:
- Fedreal Register: Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability
- The Do’s and Don’ts of Assisting Consumers on HealthCare.gov
- FAQs for Marketplace Agents and Brokers
ℹ️ Informational Disclaimer
This article was generated with the assistance of 360X IA (artificial intelligence) and is intended for informational purposes only. It does not constitute legal, regulatory, or commercial advice. Please consult official sources such as CMS or HealthCare.gov before implementing any practices.
Last update: July 2025