What are health insurance leads?
Health insurance leads are US consumers who have asked about health coverage, usually for themselves or their family, and agreed to be contacted. For offshore floors the main market is ACA marketplace plans for people under 65. Leads are sold as web records, inbound calls or live transfers to licensed agents, and their value rises sharply during open enrollment.
The ACA, or Affordable Care Act, created the marketplace where people without employer coverage can buy plans, often with a premium tax credit that lowers the monthly cost. Licensed agents and brokers help people enroll, and many of them buy leads or transfers to keep their phones busy. That demand is what floors in Pakistan and India are serving when they run an ACA campaign.
If you are new to the vertical, our ACA campaign explainer covers the basics of how the campaign is set up on a floor.
Where do ACA leads come from?
Most ACA leads start online. A consumer searches for affordable health insurance, sees an ad, and fills in a form with their ZIP code, household size and income. The form passes the record to a lead generator, which sells it in real time, sells it later as aged data, or calls the consumer and transfers them. We cover this chain in detail in how ACA leads are made.
Other sources include inbound calls from TV, radio and social ads, and outbound calling on data where the consumer has given consent. Each source has a different level of intent. A person who called a number during open enrollment is usually ready to talk. A person who clicked a social ad promising a low monthly price may not have read what they agreed to.
Price follows the calendar. Leads and transfers cost the most in the weeks of open enrollment, when every agency wants volume at once, and fall sharply afterwards. Buying early, before the season starts, and agreeing volumes in advance usually gets better pricing than buying at the peak.
Real-time leads cost the most and convert best, as long as you dial within seconds. Aged leads are cheaper and work better during open enrollment, when people who looked at coverage months ago may be ready to enroll. Live transfers cost the most per unit, because the vendor has already done the calling, and agencies that do not want to run their own fronting buy those. Shared leads are common in ACA, so assume you are racing other floors unless the vendor guarantees exclusivity in writing.
How do open enrollment and SEP change the work?
ACA campaigns follow the enrollment calendar. During open enrollment, which starts on November 1 each year, anyone eligible can enroll or change plans. Demand for leads and transfers peaks, buyers want volume, and prices rise. End dates have changed in recent years and differ between HealthCare.gov and state-run exchanges, so check the current window with your buyer before you plan staffing.
Outside open enrollment, people can only enroll through a special enrollment period, or SEP. SEPs follow qualifying life events such as losing other coverage, moving, getting married or having a baby, and usually last 60 days from the event. Rules for some income-based SEPs have changed, so let the licensed agent confirm eligibility rather than the fronter.
For a floor, this means two different campaigns in one year. Open enrollment is a volume game where speed and closer capacity matter most. The rest of the year is a qualification game where the fronter must find people who actually have a qualifying event. Our post on what changes for a fronting floor during ACA season has a staffing plan for the switch.
Are all health insurance leads ACA leads?
No. The term covers several products, and buyers usually want only one or two of them, so be clear about what you are generating.
- ACA marketplace leads: people under 65 looking for an individual or family plan, often with a premium tax credit. The main market for offshore floors.
- Short-term and supplemental health leads: people interested in short-term medical, hospital indemnity, accident or critical illness cover. Rules on short-term plans have changed several times, so check with the buyer.
- Small group leads: employers looking for staff coverage. Longer sales cycles and usually handled by US-based brokers.
- Medicare leads: people 65 and over. A separate vertical with its own calendar and rules, covered in how to get Medicare leads.
What should a fronter ask before the transfer?
Take the exact criteria from your buyer, but most ACA buyers want these facts confirmed on the call.
- The person is under 65 and not on Medicare
- They do not have health coverage through an employer, or are losing it
- They are not on Medicaid, or are no longer eligible
- Household size and an estimate of annual household income, for the tax credit estimate
- State and ZIP code, so the call reaches an agent licensed there
- During SEP months, whether they have had a qualifying life event and roughly when
- That they are willing to speak with a licensed agent now
What should a fronter never say on an ACA call?
ACA marketing has had real problems in recent years, with consumers enrolled or switched without their knowledge and agents paid commissions on plans people never chose. Regulators have responded with stricter rules and enforcement, and buyers are under pressure to prove that every enrollment was consented to. Your floor's scripts need to reflect that.
Fronters should not promise free health insurance, a $0 plan or a cash card. They should not quote premiums or tell the person what tax credit they will get. They should not imply they are calling from the government or from HealthCare.gov. And they should never collect information to enroll someone who has not clearly agreed. Leave plan details, pricing and enrollment to the licensed agent, who must follow the marketplace's own rules.
Write the transfer line carefully. The consumer should know they are being connected to a licensed agent, what the agent will help with, and that they can say no. A line like "I'm going to connect you with a licensed agent who can go through the plans available in your area. Is that okay?" is clear and easy to defend if a transfer is ever reviewed.
How do you judge health insurance lead quality?
Track every source separately and compare the same numbers each week.
- Contact rate: how often a real person answers
- Eligibility rate: the share of contacts who are under 65, not on Medicare or Medicaid and without employer coverage
- Transfer rate: qualified callers who agree to speak with an agent
- Billable rate: transfers the buyer accepts after the minimum call duration
- Complaint and "I never asked" rate: the clearest sign of poor consent behind the data
- Cost per billable transfer: lead cost plus seat and dialing cost, divided by billable transfers
Consent and compliance on ACA campaigns
Consent is the first thing to check on any ACA lead. The consumer should have agreed, on a clear form, to be contacted by your company or the buyer you transfer to, and you should be able to produce that record. Under the TCPA, calls to mobile numbers using an autodialer or an artificial or prerecorded voice need the right prior consent. Many buyers now require consent proof for every transfer.
Scrub every list against the national DNC registry, any applicable state lists and your internal list, and record opt-outs immediately. Call within allowed hours in the consumer's time zone. If anything in your process depends on a vendor's word rather than a record you can show, fix that before open enrollment, not during it.
Keep recordings of every transfer and make them easy to find by phone number and date. When a buyer or a consumer questions a call, you want to be able to pull the recording in minutes and show exactly what was said, including the consumer agreeing to speak with an agent.
How do bots help an ACA floor?
Open enrollment is short and the volume swings hard from day to day, which makes it difficult to staff with humans alone. The B3 Voice ACA bot runs on your existing dialer, asks your buyer's eligibility questions from your own script and warm-transfers qualified consumers to your licensed closers. You can add bots for the season without hiring and training a second shift.
Each Fronter bot is $40 per month with unlimited calls, with a minimum of 15 bots and a 3-day free trial. Outside open enrollment, the same bots can screen for qualifying life events on SEP campaigns, where most calls end early and human fronters burn out fastest. You see every transcript and disposition in the client dashboard, so your QA team can check that the script is followed word for word.
Planning your ACA lead budget
Start planning before open enrollment, not on November 1. Agree volumes, criteria and pricing with your buyers early, test lead sources in the weeks before the season, and drop those with weak consent or high complaint rates. Make sure your closers or your buyer's closers have the capacity to take the transfers you plan to send.
During the season, review the numbers daily: contact rate, transfer rate, billable rate and cost per billable transfer by source. Shift budget to the sources that hold up and cut those that do not. After the season, look back at what worked so next year's plan starts from your own data.
Do not forget the closer side. An ACA transfer is only worth money if a licensed agent answers it quickly. If your buyer's agents are overloaded in the first weeks of open enrollment, extra transfers just turn into abandoned calls. Agree hourly caps with the buyer, watch how long transfers wait in the queue, and slow your dialer before the queue backs up rather than after.
