2027 OEP Enrollment & Compliance
What agents need to know before November 1, including enrollment rules, consumer authorization, verification, documentation, deadlines, and CMS requirements.
How to use this guide:
Click any topic below to expand it and view the details, requirements, and agent guidance.
Agents must be properly registered for 2027
Before assisting with a federal Marketplace enrollment, the agent needs to have the required CMS
Marketplace registration and an active Exchange Agreement.
CMS says Plan Year 2027 registration and training is currently available for returning agents and brokers who completed 2026 registration and training.
Agents need to:
Complete 2027 Marketplace registration.
Complete required 2027 training.
Maintain an active CMS Exchange Agreement.
Make sure their NPN is correctly associated with their registration.
Maintain the appropriate state health insurance license/Line of Authority.
Verify that their registration appears on CMS's Registration Completion List when applicable.
CMS specifically states that agents without an approved health-related Line of Authority, as determined by their resident state, do not have access to Marketplace systems and cannot assist consumers with Marketplace enrollment.
New-agent registration is restricted for 2027
This is a major 2027 change.
CMS announced a temporary moratorium on registering agents and brokers for 2027 who did not have an active Exchange Agreement for Plan Year 2026.
Practical implication
An agent cannot simply assume:
"I have a health license, so I'll register with the Marketplace for 2027."
That is no longer sufficient for an agent who did not have the required 2026 Exchange Agreement.
Agency owners should check every agent's 2026 CMS status before OEP.
Identity proofing is becoming a bigger part of the enrollment process
CMS has required existing agents and brokers to re-identity proof through Login.gov or ID.me.
Separately, CMS's 2027 EDE requirements require consumer identity proofing and agent/broker authorization to be systematically enforced for applications submitted through the EDE agent/broker pathway.
Agents should be prepared for:
Consumer identity verification.
Agent identity verification.
Failed identity verification.
Consumers needing to provide additional documentation.
EDE systems requiring authorization before the agent can proceed.
This is one area where agents should not try to work around the system if verification fails.
Consumer authorization is mandatory
This is one of the biggest compliance areas.
Agents assisting consumers through the federal Marketplace need documented consumer consent before assisting with the application/enrollment process.
CMS maintains a model consent form and has established requirements for documenting consumer consent and application review.
For 2027, CMS is also implementing electronic consumer authorization in the EDE agent/broker pathway.
The agent needs to be able to prove:
The consumer authorized the agent.
The consumer understood the agent's role.
The consumer reviewed the application information.
The consumer confirmed the information was accurate.
The agent was authorized to perform the enrollment-related action.
The consumer must review and confirm application information
This is different from simply obtaining a signature.
The agent has an obligation to ensure the consumer reviews and confirms the accuracy of the eligibility application information before submission.
CMS specifically maintains documentation requirements around both consumer consent and review/confirmation of application information.
Agents should review:
Name
Date of birth
SSN
Immigration information where applicable
Address
Household members
Tax household
Expected income
Employer coverage
Medicaid/CHIP eligibility
Current coverage
Coverage-loss information when relevant
Other eligibility information
Plan selection
Do not treat "I have their information from last year" as sufficient.
Keep the documentation for 10 years
CMS says agents, brokers and web-brokers must maintain documentation of consumer consent and review/confirmation of application information for at least 10 years following the enrollment or application submission. CMS can request that documentation during that period.
That requirement can continue even if:
The client leaves the Marketplace.
The client changes agents.
The client rescinds consent.
The agent stops working with the client.
The client moves to coverage outside the Marketplace.
Agents should have a retention system before OEP starts. Don't rely on email searches six years from now.
SSNs and immigration information matter
CMS announced that applications involving an agent or broker must include Social Security numbers or immigration document numbers that CMS can verify for all non-newborn applicants.
This is particularly important because CMS specifically identified missing SSNs and unresolved citizenship/immigration verification as areas associated with problematic enrollments.
Agent rule:
Don't knowingly submit incomplete or inaccurate identifying information simply to get an application through.
Don't create duplicate Marketplace applications
This is an existing CMS requirement that agents absolutely need to remember during OEP.
Before creating an application, agents should search for the consumer's existing Marketplace application.
If an application already exists, update it rather than creating another one.
Duplicate applications can create problems with:
Coverage
APTC
Household members
Plan enrollment
Application updates
Potential cancellation of coverage
CMS specifically warns that duplicate applications can result in consumers losing coverage or tax credits.
Don't add yourself to a consumer's application improperly
CMS has specifically prohibited agents and brokers from being added to applications that consumers should be completing on their own through HealthCare.gov.
This is part of CMS's response to unauthorized agent activity.
Translation for agents:
Don't insert yourself into a consumer's Marketplace account or application unless the process and consumer authorization permit you to do so.
Unauthorized plan switching is a serious issue
CMS's new identity and authorization requirements are specifically designed to address unauthorized enrollments and unauthorized plan switching.
An agent should never:
Move someone to another plan without authorization.
Change household information without authorization.
Change the application simply to generate a different eligibility result.
Assume a prior client wants the same agent to make changes for the new year.
Treat an existing client relationship as perpetual authorization.
SEP verification is not something agents should "work around"
Special Enrollment Periods remain an important source of compliance risk.
CMS currently has updated September 2026 SEP Verification and Complex Case Scenario guidance.
Agents need to determine:
What qualifying event occurred.
When it occurred.
Whether the consumer qualifies for the particular SEP.
Whether documentation is required.
Whether the consumer must provide verification.
What plan-category restrictions apply.
Don't manufacture an SEP.
If a consumer doesn't have a qualifying event, OEP is the appropriate enrollment window unless another legitimate enrollment pathway applies.
Data Matching Issues need to be monitored
CMS continues to use data matching to verify Marketplace eligibility.
Current CMS resources specifically address:
Income discrepancies
Medicaid/CHIP coverage
Citizenship/immigration status
Other eligibility inconsistencies
CMS released a Medicaid/CHIP Coverage Data Matching Issue Checklist in September 2026.
Agents need a process for:
Reading the consumer's Marketplace notice.
Identifying the discrepancy.
Determining what documentation is requested.
Helping the consumer understand what needs to be submitted.
Meeting the applicable deadline.
Confirming the issue was resolved.
Medicaid/CHIP overlap needs attention
CMS specifically identified dual enrollment in Medicaid/CHIP and Marketplace coverage as a program-integrity concern.
During OEP, agents should not simply assume that a client losing or having Medicaid issues automatically qualifies for Marketplace financial assistance.
The agent needs to determine the person's actual eligibility and current coverage status.
Income must be handled carefully
For Marketplace financial assistance, the application uses projected household income for the coverage year.
That means an agent needs to ask about changes such as:
Employment changes
Self-employment
Variable income
Bonuses
Commissions
Household changes
Marriage/divorce
Dependents
Retirement income
Other taxable income
Do not simply copy the client's previous year's income into a 2027 application without reviewing whether it is still a reasonable projection.
APTC creates a tax reconciliation issue
This is one of the most important client conversations.
The premium tax credit is based on eligibility information reported to the Marketplace. If the consumer receives too much advance premium tax credit during the year, the difference can be reconciled on the federal tax return.
Agents should therefore avoid telling clients:
"Your subsidy is guaranteed."
It isn't.
The agent should explain that the amount of financial assistance depends on the consumer's circumstances and that income changes can affect the final tax outcome.
Tax advice should be referred to a qualified tax professional.
Review the entire household, not just the person buying coverage
Marketplace eligibility can depend on the tax household, not simply who wants insurance.
Agents need to review:
Spouse
Dependents
Household income
Other household coverage
Employer-sponsored coverage
Medicaid/CHIP
Marketplace coverage
A change affecting one household member can affect eligibility for others.
Employer coverage can affect Marketplace eligibility
Agents need to ask whether the client or household members have access to employer-sponsored coverage.
Don't assume:
"Marketplace plan is cheaper, so they can just take the subsidy."
Employer coverage eligibility and affordability rules can affect premium-tax-credit eligibility.
For 2027, this needs to be reviewed as part of the application rather than treated as an afterthought.
Compare the actual 2027 plan, not the 2026 plan
This sounds obvious, but it is one of the biggest practical OEP issues.
Agents need to review:
2027 premium
Deductible
Out-of-pocket maximum
Copays
Coinsurance
Network
Prescription formulary
Drug tiers
Specialist access
Hospital participation
Urgent care
Emergency care
Referral requirements
Prior authorization
Covered services
Exclusions
Plan changes
A client's current plan automatically renewing does not mean it is still the right plan for that client.
Don't sell based solely on premium
CMS itself provides agent resources addressing plan selection and cost comparisons, including Silver vs. Bronze scenarios.
Agents should help consumers compare total potential cost, not just monthly premium.
That means looking at:
Premium + deductible + copays/coinsurance + out-of-pocket exposure + expected healthcare usage.
Advertising and marketing have their own compliance rules
CMS published updated Agent, Broker, and Web-broker Guidelines for Compliant Marketplace Advertising and Marketing in August 2026.
This matters for:
Websites
Landing pages
Social media
Digital advertising
Lead forms
Direct mail
Text messaging
Enrollment promotions
Agents should review the current CMS marketing guidance before OEP rather than relying on old ACA advertising practices.
Don't imply you're the Marketplace
An agent's website, advertising, lead form, or social content should not create confusion about whether the agent is:
CMS
The federal government
A state Marketplace
An official government enrollment center
This is especially important with paid search, lead generation, and "free ACA enrollment" advertising.
Don't make misleading claims about savings or subsidies
Avoid blanket claims such as:
"Everyone qualifies for $0 coverage."
"Get free health insurance."
"Guaranteed subsidy."
"Everyone's premiums are going down."
"The government will pay your entire premium."
"You have to enroll through us."
Claims need to accurately reflect the actual consumer's eligibility and the applicable Marketplace rules.
Be extremely careful with lead generation
For agents using:
Lead vendors
Call centers
Websites
Forms
Purchased leads
Facebook/Google leads
Referral partners
The agent still needs to ensure the enrollment process complies with Marketplace requirements.
A lead source's compliance does not eliminate the agent's own obligations.
Protect consumer information
Agents handle extremely sensitive information, including:
SSNs
Dates of birth
Income
Immigration documentation
Tax information
Health coverage information
CMS maintains cybersecurity resources for agents and brokers and has specifically published 2026 materials addressing Marketplace scams and cybersecurity.
Agents should have secure procedures for collecting, transmitting, storing, and disposing of client information.
Know which Marketplace you're dealing with
Not every state uses the federal Marketplace platform.
Agents need to know whether the client is enrolling through:
FFM: Federally Facilitated Marketplace
SBM-FP: State-Based Marketplace on the Federal Platform
SBM: State-Based Marketplace
CMS publishes the Marketplace structure and agent resources accordingly.
Federal CMS rules do not automatically tell you every state-specific requirement.
State licensing, appointment, advertising, consent, enrollment, and OEP rules can add requirements.
Don't confuse Marketplace rules with off-Marketplace rules
The federal Marketplace consumer-consent requirements apply specifically to agents assisting with FFM/SBM-FP Marketplace enrollment.
CMS says agents assisting with off-Marketplace enrollment may be subject to consent requirements under applicable state law or regulation.
That's important for an agent selling both:
ACA Marketplace
Off-exchange major medical
Short-term medical
Fixed indemnity
Accident
Critical illness
Hospital indemnity
Other supplemental products
You cannot automatically apply one set of rules to every product.
Agents need a pre-OEP compliance checklist
Before November 1, an agent should be able to answer yes to all of these:
2027 CMS registration completed
Required 2027 training completed
Active Exchange Agreement
Correct NPN
Appropriate state health LOA
Identity proofing completed
EDE platform access confirmed
Consumer consent process established
Application-review process established
10-year documentation retention process established
Duplicate-application procedure established
SEP verification procedure established
DMI/documentation follow-up process established
Secure client-data process established
Marketing reviewed for current CMS requirements
State-specific OEP dates confirmed
State-specific licensing/advertising requirements confirmed
2027 carrier/product information loaded
2027 provider networks checked
2027 formularies checked
2027 premiums and benefits checked
Renewal clients scheduled for review
Application and consent records being retained
2027 OEP Enrollment & Compliance
What agents need to know before November 1, including enrollment rules, consumer authorization, verification, documentation, deadlines, and CMS requirements.
How to use this guide:
Click any topic below to expand it and view the details, requirements, and agent guidance.
Agents must be properly registered for 2027
Before assisting with a federal Marketplace enrollment, the agent needs to have the required CMS
Marketplace registration and an active Exchange Agreement.
CMS says Plan Year 2027 registration and training is currently available for returning agents and brokers who completed 2026 registration and training.
Agents need to:
Complete 2027 Marketplace registration.
Complete required 2027 training.
Maintain an active CMS Exchange Agreement.
Make sure their NPN is correctly associated with their registration.
Maintain the appropriate state health insurance license/Line of Authority.
Verify that their registration appears on CMS's Registration Completion List when applicable.
CMS specifically states that agents without an approved health-related Line of Authority, as determined by their resident state, do not have access to Marketplace systems and cannot assist consumers with Marketplace enrollment.
New-agent registration is restricted for 2027
This is a major 2027 change.
CMS announced a temporary moratorium on registering agents and brokers for 2027 who did not have an active Exchange Agreement for Plan Year 2026.
Practical implication
An agent cannot simply assume:
"I have a health license, so I'll register with the Marketplace for 2027."
That is no longer sufficient for an agent who did not have the required 2026 Exchange Agreement.
Agency owners should check every agent's 2026 CMS status before OEP.
Identity proofing is becoming a bigger part of the enrollment process
CMS has required existing agents and brokers to re-identity proof through Login.gov or ID.me.
Separately, CMS's 2027 EDE requirements require consumer identity proofing and agent/broker authorization to be systematically enforced for applications submitted through the EDE agent/broker pathway.
Agents should be prepared for:
Consumer identity verification.
Agent identity verification.
Failed identity verification.
Consumers needing to provide additional documentation.
EDE systems requiring authorization before the agent can proceed.
This is one area where agents should not try to work around the system if verification fails.
Consumer authorization is mandatory
This is one of the biggest compliance areas.
Agents assisting consumers through the federal Marketplace need documented consumer consent before assisting with the application/enrollment process.
CMS maintains a model consent form and has established requirements for documenting consumer consent and application review.
For 2027, CMS is also implementing electronic consumer authorization in the EDE agent/broker pathway.
The agent needs to be able to prove:
The consumer authorized the agent.
The consumer understood the agent's role.
The consumer reviewed the application information.
The consumer confirmed the information was accurate.
The agent was authorized to perform the enrollment-related action.
The consumer must review and confirm application information
This is different from simply obtaining a signature.
The agent has an obligation to ensure the consumer reviews and confirms the accuracy of the eligibility application information before submission.
CMS specifically maintains documentation requirements around both consumer consent and review/confirmation of application information.
Agents should review:
Name
Date of birth
SSN
Immigration information where applicable
Address
Household members
Tax household
Expected income
Employer coverage
Medicaid/CHIP eligibility
Current coverage
Coverage-loss information when relevant
Other eligibility information
Plan selection
Do not treat "I have their information from last year" as sufficient.
Keep the documentation for 10 years
CMS says agents, brokers and web-brokers must maintain documentation of consumer consent and review/confirmation of application information for at least 10 years following the enrollment or application submission. CMS can request that documentation during that period.
That requirement can continue even if:
The client leaves the Marketplace.
The client changes agents.
The client rescinds consent.
The agent stops working with the client.
The client moves to coverage outside the Marketplace.
Agents should have a retention system before OEP starts. Don't rely on email searches six years from now.
SSNs and immigration information matter
CMS announced that applications involving an agent or broker must include Social Security numbers or immigration document numbers that CMS can verify for all non-newborn applicants.
This is particularly important because CMS specifically identified missing SSNs and unresolved citizenship/immigration verification as areas associated with problematic enrollments.
Agent rule:
Don't knowingly submit incomplete or inaccurate identifying information simply to get an application through.
Don't create duplicate Marketplace applications
This is an existing CMS requirement that agents absolutely need to remember during OEP.
Before creating an application, agents should search for the consumer's existing Marketplace application.
If an application already exists, update it rather than creating another one.
Duplicate applications can create problems with:
Coverage
APTC
Household members
Plan enrollment
Application updates
Potential cancellation of coverage
CMS specifically warns that duplicate applications can result in consumers losing coverage or tax credits.
Don't add yourself to a consumer's application improperly
CMS has specifically prohibited agents and brokers from being added to applications that consumers should be completing on their own through HealthCare.gov.
This is part of CMS's response to unauthorized agent activity.
Translation for agents:
Don't insert yourself into a consumer's Marketplace account or application unless the process and consumer authorization permit you to do so.
Unauthorized plan switching is a serious issue
CMS's new identity and authorization requirements are specifically designed to address unauthorized enrollments and unauthorized plan switching.
An agent should never:
Move someone to another plan without authorization.
Change household information without authorization.
Change the application simply to generate a different eligibility result.
Assume a prior client wants the same agent to make changes for the new year.
Treat an existing client relationship as perpetual authorization.
SEP verification is not something agents should "work around"
Special Enrollment Periods remain an important source of compliance risk.
CMS currently has updated September 2026 SEP Verification and Complex Case Scenario guidance.
Agents need to determine:
What qualifying event occurred.
When it occurred.
Whether the consumer qualifies for the particular SEP.
Whether documentation is required.
Whether the consumer must provide verification.
What plan-category restrictions apply.
Don't manufacture an SEP.
If a consumer doesn't have a qualifying event, OEP is the appropriate enrollment window unless another legitimate enrollment pathway applies.
Data Matching Issues need to be monitored
CMS continues to use data matching to verify Marketplace eligibility.
Current CMS resources specifically address:
Income discrepancies
Medicaid/CHIP coverage
Citizenship/immigration status
Other eligibility inconsistencies
CMS released a Medicaid/CHIP Coverage Data Matching Issue Checklist in September 2026.
Agents need a process for:
Reading the consumer's Marketplace notice.
Identifying the discrepancy.
Determining what documentation is requested.
Helping the consumer understand what needs to be submitted.
Meeting the applicable deadline.
Confirming the issue was resolved.
Medicaid/CHIP overlap needs attention
CMS specifically identified dual enrollment in Medicaid/CHIP and Marketplace coverage as a program-integrity concern.
During OEP, agents should not simply assume that a client losing or having Medicaid issues automatically qualifies for Marketplace financial assistance.
The agent needs to determine the person's actual eligibility and current coverage status.
Income must be handled carefully
For Marketplace financial assistance, the application uses projected household income for the coverage year.
That means an agent needs to ask about changes such as:
Employment changes
Self-employment
Variable income
Bonuses
Commissions
Household changes
Marriage/divorce
Dependents
Retirement income
Other taxable income
Do not simply copy the client's previous year's income into a 2027 application without reviewing whether it is still a reasonable projection.
APTC creates a tax reconciliation issue
This is one of the most important client conversations.
The premium tax credit is based on eligibility information reported to the Marketplace. If the consumer receives too much advance premium tax credit during the year, the difference can be reconciled on the federal tax return.
Agents should therefore avoid telling clients:
"Your subsidy is guaranteed."
It isn't.
The agent should explain that the amount of financial assistance depends on the consumer's circumstances and that income changes can affect the final tax outcome.
Tax advice should be referred to a qualified tax professional.
Review the entire household, not just the person buying coverage
Marketplace eligibility can depend on the tax household, not simply who wants insurance.
Agents need to review:
Spouse
Dependents
Household income
Other household coverage
Employer-sponsored coverage
Medicaid/CHIP
Marketplace coverage
A change affecting one household member can affect eligibility for others.
Employer coverage can affect Marketplace eligibility
Agents need to ask whether the client or household members have access to employer-sponsored coverage.
Don't assume:
"Marketplace plan is cheaper, so they can just take the subsidy."
Employer coverage eligibility and affordability rules can affect premium-tax-credit eligibility.
For 2027, this needs to be reviewed as part of the application rather than treated as an afterthought.
Compare the actual 2027 plan, not the 2026 plan
This sounds obvious, but it is one of the biggest practical OEP issues.
Agents need to review:
2027 premium
Deductible
Out-of-pocket maximum
Copays
Coinsurance
Network
Prescription formulary
Drug tiers
Specialist access
Hospital participation
Urgent care
Emergency care
Referral requirements
Prior authorization
Covered services
Exclusions
Plan changes
A client's current plan automatically renewing does not mean it is still the right plan for that client.
Don't sell based solely on premium
CMS itself provides agent resources addressing plan selection and cost comparisons, including Silver vs. Bronze scenarios.
Agents should help consumers compare total potential cost, not just monthly premium.
That means looking at:
Premium + deductible + copays/coinsurance + out-of-pocket exposure + expected healthcare usage.
Advertising and marketing have their own compliance rules
CMS published updated Agent, Broker, and Web-broker Guidelines for Compliant Marketplace Advertising and Marketing in August 2026.
This matters for:
Websites
Landing pages
Social media
Digital advertising
Lead forms
Direct mail
Text messaging
Enrollment promotions
Agents should review the current CMS marketing guidance before OEP rather than relying on old ACA advertising practices.
Don't imply you're the Marketplace
An agent's website, advertising, lead form, or social content should not create confusion about whether the agent is:
CMS
The federal government
A state Marketplace
An official government enrollment center
This is especially important with paid search, lead generation, and "free ACA enrollment" advertising.
Don't make misleading claims about savings or subsidies
Avoid blanket claims such as:
"Everyone qualifies for $0 coverage."
"Get free health insurance."
"Guaranteed subsidy."
"Everyone's premiums are going down."
"The government will pay your entire premium."
"You have to enroll through us."
Claims need to accurately reflect the actual consumer's eligibility and the applicable Marketplace rules.
Be extremely careful with lead generation
For agents using:
Lead vendors
Call centers
Websites
Forms
Purchased leads
Facebook/Google leads
Referral partners
The agent still needs to ensure the enrollment process complies with Marketplace requirements.
A lead source's compliance does not eliminate the agent's own obligations.
Protect consumer information
Agents handle extremely sensitive information, including:
SSNs
Dates of birth
Income
Immigration documentation
Tax information
Health coverage information
CMS maintains cybersecurity resources for agents and brokers and has specifically published 2026 materials addressing Marketplace scams and cybersecurity.
Agents should have secure procedures for collecting, transmitting, storing, and disposing of client information.
Know which Marketplace you're dealing with
Not every state uses the federal Marketplace platform.
Agents need to know whether the client is enrolling through:
FFM: Federally Facilitated Marketplace
SBM-FP: State-Based Marketplace on the Federal Platform
SBM: State-Based Marketplace
CMS publishes the Marketplace structure and agent resources accordingly.
Federal CMS rules do not automatically tell you every state-specific requirement.
State licensing, appointment, advertising, consent, enrollment, and OEP rules can add requirements.
Don't confuse Marketplace rules with off-Marketplace rules
The federal Marketplace consumer-consent requirements apply specifically to agents assisting with FFM/SBM-FP Marketplace enrollment.
CMS says agents assisting with off-Marketplace enrollment may be subject to consent requirements under applicable state law or regulation.
That's important for an agent selling both:
ACA Marketplace
Off-exchange major medical
Short-term medical
Fixed indemnity
Accident
Critical illness
Hospital indemnity
Other supplemental products
You cannot automatically apply one set of rules to every product.
Agents need a pre-OEP compliance checklist
Before November 1, an agent should be able to answer yes to all of these:
2027 CMS registration completed
Required 2027 training completed
Active Exchange Agreement
Correct NPN
Appropriate state health LOA
Identity proofing completed
EDE platform access confirmed
Consumer consent process established
Application-review process established
10-year documentation retention process established
Duplicate-application procedure established
SEP verification procedure established
DMI/documentation follow-up process established
Secure client-data process established
Marketing reviewed for current CMS requirements
State-specific OEP dates confirmed
State-specific licensing/advertising requirements confirmed
2027 carrier/product information loaded
2027 provider networks checked
2027 formularies checked
2027 premiums and benefits checked
Renewal clients scheduled for review
Application and consent records being retained