VOLUME 1
Enroll Prime Presents
What to Expect When You’re Expecting...
to Sell Smart Health Plans.
Your quick guide to the new application experience.
A simple overview for agents on what has changed, what to watch for, and what to expect when submitting Smart Health Plan applications.
Before you begin your next Smart Health Plan application, take a minute to review the key updates below.
What to Expect
- Submit your application with complete details. You will notice that the new application asks for additional information about your prospective member and any family members applying for coverage. Please answer all questions accurately and be sure to complete all additional detail sections.
- These are not automatic knockout questions. Historically, these programs used a simple "Yes" or "No" application with a simplified questionnaire. The new questions allow the Plan to evaluate each prospective participant individually, with the goal of approving more applicants whenever possible.
- After the application is submitted. You and your member will receive an email within 24 hours confirming that the application has been received by underwriting. If additional information is needed, those questions will be sent directly to the member to complete.
- Application status and review timing. For a "clean" application with no medical conditions or medications requiring additional review, a status determination is generally expected within 24 to 48 hours. If the member has medical details that require further review, AI-assisted underwriting is expected to make a determination within approximately 24 to 72 hours.
- Once approved. Your member will be billed on the next available billing date: the 5th, 10th, 15th, 20th, or 25th, depending on when the application is approved.
Tip: The key to a successful enrollment is completing the application thoroughly and accurately. Providing complete information up front can help reduce unnecessary back-and-forth with underwriting. If additional information is requested, encourage your member to respond to the email as quickly as possible to help avoid delays.