Frequently Asked Questions

Clients can make payments through their Oscar account or the Oscar app. They can also set up automatic payments.

Other options include paying by check or money order using the instructions on their bill, or calling their Care Team at (855) 672-2755.

Log in to the Oscar Broker Portal open your client’s Member Details page, and select Billing & Payments.

From there, you can review bills, balances, due dates, and payment history. You can also filter by outstanding bills, paid bills, or payments.

Need help? Contact Broker Support at brokers@hioscar.com.

During a grace period, your client’s coverage may remain active, but claims could be delayed or held until overdue premiums are paid.

If your client doesn’t pay by the deadline, their coverage may be terminated.

Grace periods and claim rules vary by plan. Check your client’s billing notice and plan documents for details.

It depends on your client’s plan and applicable grace period.

Log in to the Oscar Broker Portal and select Billing & Payments to check the amount due and payment deadline.

If you have questions, contact Broker Support at brokers@hioscar.com.

The premium shown generally reflects any Marketplace financial help applied to your client’s policy.

To see the full premium, subsidy amount, and balance due, log in to the Oscar Broker Portal and select Billing & Payments from your client’s Member Details page.

No, AHS’s Dental, Accident, Critical Illness, and Life plans are only available for members under 65 years old with Individual & Family Plans.

It does! AHS Agent Back Office is your one-stop business portal to see and search your book of business. Create your account when you get appointed. Once you have your account, just sign in.

• You can do so with an AHS appointment. But you can also sell without an AHS appointment. Here’s how to do both:
• I already have an AHS appointment, now what?
  • Keep doing what you’re doing! No need to change the way you’re currently selling.
  • That means no changes are needed to your appointment or how commissions are paid.

• Log in to your Broker account at business.hioscar.com (opens in new tab).
• Click on the ‘Payment preferences’ link on the My Account page.
• If you are a broker who will be receiving payments directly, then head to business.hioscar.com/account/payment/broker (opens in new tab).
• If you are a principal broker of an agency, you will need to update payment preferences on behalf of the agents appointed with your agency. You can do this at: business.hioscar.com/account/payment/agency (opens in new tab).
• You will be able to update your Tax ID Number, W-9, and payment method preference (ACH direct deposit or mailed check).
• Hit ‘Save Change’ on the screen once you have updated your information.

Log in here with your email address and password to access your Oscar Broker account, including enrollment tools, commission statements, and more.

Haven’t logged into your account before, or aren’t sure if you have one? Create an account here.

To get up to speed on all things portal, visit our Broker Training library for guides, or watch our Broker Portal video tour to see exactly how to navigate your new account.

• Sign into your Oscar Broker Account.
• Click the ‘sell supplemental plans’ button.
• It’ll take you to a login page that will automatically input your NPN. Note: If you see ‘NPN not found’, just click ‘Create Account’ and set up your account.
• Start selling! You can return to your Oscar Broker Account at any time to use the same link to quote and sell.

To update your agency affiliation: If you have not submitted an appointment yet, you can update your agency affiliation form here (opens in new tab).

• Click on ‘Update alignment’
• Select ‘Edit alignment’
• Remove states where you are no longer aligned with the agency
• Click Submit
• Click ‘Add agency’ and follow the prompts

If you have already submitted an appointment, please contact brokers@hioscar.com with the following details:

• Your Oscar writing number or NPN
• Current agency name
• Requested new agency
• Are you the principal of the new agency?
• Effective date of change

Please note that if the effective date of the change has passed, we will not be able to retroactively change any commission payments that have already been assigned and released.

To update your general agency affiliation: We allow general agency affiliation changes annually between August and October, taking into effect on January 1 of the following year. Please contact brokers@hioscar.com with the following details:

• Your Oscar writing number or NPN
• Current general agency name
• Requested new general agency
• Effective date of change

Please note that if the effective date of the change has passed, we will not be able to retroactively change any commission payments that have already been assigned and released. It takes two weeks to implement the change. During that time, we’ll notify the old GA and the new GA of the transition.

You can update your personal information in your Oscar Broker account.

• Log in to your Broker account at [business.hioscar.com][1]
• Go to the ‘Basic info’ section in [My Account][2]
• Edit your personal information as necessary
• Click ‘Save changes’

If you are changing your name: To ensure that commissions are processed accurately, please make sure that your name and NPN match what is listed in NIPR’s database. If you are unsure what your NPN is, please visit [www.nipr.com/PacNpnSearch.htm][3].

If you are the principal of your agency and wish to make a change to the agency’s address, you can make this change on your Agency details page at [business.hioscar.com/account/info/agency][4].

[1]: http://business.hioscar.com/ [2]: http://business.hioscar.com/account/info/broker [3]: https://www.nipr.com/PacNpnSearch.htm [4]: https://business.hioscar.com/account/info/agency

After entering your or your agency’s license number on the ‘Request appointment’ page, you may see an error message indicating that the license number is not valid or that there was an error. This could be for a few reasons:

• The license number does not match your NPN in NIPR. We check NIPR before finalizing appointments to ensure the information entered matches what is registered in NIPR.
• If you are unsure what your NPN is, please visit https://www.nipr.com/PacNpnSearch.htm (opens in new tab).
• The license number is in the wrong format. We include a helpful hint for every state as to what the license number should look like. If the number entered does not match the format for your state, you will see an error message.
• There is a technical issue with either NIPR or Oscar’s system. While rare, this could occur. In this instance, we advise that you try again in a few minutes. If the problem persists, please reach out to brokers@hioscar.com.

We currently send two different confirmation emails from your Oscar Broker account. Be sure to check your spam folder for emails from brokers@hioscar.com or commissions@hioscar.com. Otherwise refer to each specific email below:

Account activation email

This email is sent during the account creation process. If you are a broker who is already appointed with Oscar, we require you to activate your account via email. The email will have the subject line ‘Action Required: Complete your Oscar Broker account setup’ and will be sent from brokers@hioscar.com. If you did not receive the email, it may be because we have a different email on file for your account. Please reach out to brokers@hioscar.com to confirm the email on file.

Account verification email

This email is sent at the end of the account creation process. If you are not already appointed with Oscar, and you are creating your Broker account, you will be requested to verify that the email entered is valid. The email will have the subject line ‘Action Required: Verify your email address’ and will be sent from brokers@hioscar.com. If you did not receive the email, but you can login to your Broker account, click the ‘Resend email’ link on the red header on your My Account page.

If you cannot login it may be because we have a different email on file for your account. Please reach out to brokers@hioscar.com to confirm the email on file.

You can update your email address in your Oscar Broker account.

1. Log in to your Broker account at business.hioscar.com (opens in new tab)
2. Go to the ‘Basic info’ section in My Account (opens in new tab)
3. Enter your new email in the ‘email address’ field
4. Click ‘Save changes’

If you are the principal of your agency and wish to make a change to the agency’s email address, you can make this change on your Agency details page at business.hioscar.com/account/info/agency (opens in new tab).

You can update your name in your Oscar Broker account.

1. Log in to your Broker account at business.hioscar.com (opens in new tab)
2. Go to the ‘Basic info’ section in My Account (opens in new tab)
3. Edit your first and last name
4. Click ‘Save changes’

To ensure that commissions are processed accurately, please make sure that your name and NPN match what is listed in NIPR’s database. If you are unsure what your NPN is, please visit https://www.nipr.com/PacNpnSearch.htm (opens in new tab).

You can sell them in every state they’re offered. Here’s info on where each plan is available:

• AHS Select Dental PPO plans: AK, AL, AR, AZ, DE, FL, GA, IA, IL, IN, KS, KY, LA, MI, MN, MO, MS, ND, NE, NH, OH, OK, OR, PA, SC, SD, TN, TX, UT, WI, and WY.
• AHS Dental Indemnity plans: AK, AL, AR, AZ, CA, CO, CT, DC, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, OH, OK, PA, SC, SD, TN, TX, UT, VA, WA, WI, WV, and WY.
• AHS Plan Enhancer Accident Medical Expense (with Optional Riders) plans: AK, AL, AR, AZ, DE, FL, IA, IL, IN, LA, ME, MO, MS, MT, NC, ND, NE, NV, OH, OK, OR, SC, TX, UT, WI, WV, and WY. Cancer and Heart/Stroke rider is not available in IA and MO. Sickness Hospitalization rider is not available in MO, ME, MT and ND.
• AHS Plan Enhancer Accident Medical Expense (without Optional Riders) plans: CA, CO, DC, GA, KS, MI, TN, and VA.
• AHS Cancer and Heart/Stroke plans: AK, AL, AR, AZ, CO, FL, IA, IL, IN, KS, LA, MI, MN, MO, MS, MT, NC, ND, NE, NV, OH, OK, SC, TN, TX, UT, WA, WI, WV, and WY.
• AHS Term Life Insurance plans: AK, AL, AR, AZ, CA, CO, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WI, WV, and WY.

See all of the state availability here as well.

Here’s what you need to make clear:

• Supplemental products are only offered outside of Covered California (and not offered by the Exchange).
• The premiums and costs of all supplemental products before they purchase a supplemental plan.
• They don’t need to purchase any supplemental products to get health coverage through the Exchange.

While explaining these details is only required in the state of California, it’s also helpful for all of your clients to know.

You can sell AHS Select Dental PPO, Dental Indemnity, Cancer and Heart/Stroke, Term Life, or Plan Enhancer plans. See the ‘Product and State Availability PDF’ for more info.

Oscar provides a fully digital, self-service tool for brokers and their teams to have access to everything they need to work with Oscar.

Your Broker account (opens in new tab) allows you to easily:

• Enroll and manage your individual business
• View your individual clients’ bills and payments
• View your individual clients’ engagement with their health plans
• View your commission statements
• Edit your contact information
• Edit your payment preferences
• View current appointments
• Request appointment for a new state

Plan Enhancers fill gaps that primary health insurance doesn’t cover. These affordable, high value plans start with Accident Medical Expense coverage and have optional Cancer & Heart/Stroke (CHS) and Sickness Hospitalization (SIP) riders available in some states.

Check out the commission schedule for all the details. (You’re gonna like it.)

Oscar releases commission payments monthly around the third week of the month. You should receive an email confirming your payment was released. If you do not receive your monthly commissions, please check the Commissions page in your Broker account (opens in new tab) or reach out to commissions@hioscar.com.

If you are appointed through Oscar directly (not through an agency), you can view your commission payment statements through the Commissions page in your Broker account (opens in new tab). You can also update your commission payment method (opens in new tab) in your Broker account.

If you are appointed through an agency, your commission payments are sent to your agency. If you’re not sure if you are appointed through an agency, you can check your appointments on your Broker account (opens in new tab).

If you are the principal of your agency, then you will be able to access your agency’s commissions information via your Broker Account.

Oscar requires your completed and most up-to-date W-9 on file in order to pay commissions.

If you are writing business directly with Oscar, we will need your personal W-9 with your personal Tax ID Number (Social Security Number). You can upload this by logging in to your Broker Account (opens in new tab) and clicking on ‘My account’ in the top right Menu bar. In your ‘My account’ page, click on ‘Payment requirements’ in the ‘My details’ section, then submit your W-9 and update your Tax Identification Number.

If you are an agency principal, we will need your business’s W-9 with your agency’s Tax ID Number (Employer Identification Number). You can upload this by logging in to your Broker Account (opens in new tab) and clicking on ‘My account’ in the top right Menu bar. In your ‘My account’ page, click on ‘Payment requirements’ in the ‘Agency details’ section , then submit your W-9 and update your agency’s Tax Identification Number.

Log in to the Oscar Broker Portal (opens in new tab) using your email and password. From there, you can manage quotes, enrollments, appointments, commissions, and your book of business.

Having trouble logging in? Contact Broker Support at brokers@hioscar.com.

Please don’t create a new account if you already have one.

Log in to the Oscar Broker Portal (opens in new tab) and go to My Account > Basic Information to update your details.

For legal name changes, make sure your information matches your National Insurance Producer Registry (NIPR) record.

Can’t update something? Contact Broker Support at brokers@hioscar.com. Don’t create a new account.

The Oscar Broker Portal (opens in new tab) is your one-stop shop for quoting and enrolling clients, managing your book of business, viewing policies and commissions, and updating your account information.

You can also access separate tools for Allstate Health Solutions supplemental coverage. Available features depend on your account and appointments.

First, check your spam or junk folder. You can also visit the Oscar Broker Portal (opens in new tab) to see if there’s an option to resend the email.

Still haven’t received it? Reach out to Broker Support at brokers@hioscar.com with your name, National Producer Number (NPN), email address, and any error message. Please don’t create a new account.

Yes. Employers can offer a CHOICE Arrangement to one class of employees and a traditional group health plan to another.

However, they generally can’t offer employees in the same class a choice between the two. Certain federal requirements also apply.

No. Employers aren’t required to use a third-party administrator, but they’re still responsible for managing the arrangement and meeting applicable federal requirements.

Many employers choose to work with a third-party administrator to help manage enrollment, reimbursements, and compliance.

Eligibility depends on two factors: which employees the employer includes and whether those employees have qualifying health coverage.

Employer eligibility: Employers can offer a CHOICE Arrangement to all employees or specific employee classes, such as full-time, part-time, salaried, hourly, or geographic groups. 1099 independent contractors are not eligible.

Health coverage requirements: Eligible employees and any participating dependents must have qualifying individual health insurance or eligible Medicare coverage to receive reimbursements.

Employers cannot offer employees in the same class both a CHOICE Arrangement and a traditional group health plan.

We do not display bonuses in the Broker Account tool. For a copy of your bonus statement or general questions, please reach out to brokers@hioscar.com.

Log in to your Broker account (opens in new tab). Once you have logged in, click on top right ‘Menu’ bar, then click on the Commissions option. You can also access the Commission view page directly at https://business.hioscar.com/commissions (opens in new tab).

The Commission view page will show all of the monthly direct commission payments you have received from Oscar. Click on any month to expand and display payment details. If you assigned commissions to an agency, please reach out to the agency for commission details.

In the expanded view, click on ‘Download statement’ to access your commission statement.

Your statement will detail approved and blocked commissions (opens in new tab). Blocked commissions also include an error reason, such as the member did not pay their monthly bill.

If you are a broker, you can do this by logging in to your Broker Account (opens in new tab) and clicking on ‘Payment requirements’ in the My details section. If you need to update any information, you can enter it on this page and then hit ‘Save changes’.

If you are an agency principal, you can do this by logging in to your Broker Account (opens in new tab) and clicking on ‘Agency payment setup’ in the Agency details section. If you need to update any information, you can enter it on this page and then hit ‘Save changes’.

The Commission view shows details and statements for all commissions paid directly from Oscar. There is no limit to the number of statements shown, but will not include any commissions paid indirectly. If you are looking for help with commissions paid through an upline agency or General Agency, please reach out to your upline.

Please contact brokers@hioscar.com. If you elected for ACH payments, there is a chance that the payment was returned in our bank due to invalid ACH account information. If you elected for check payments, there is a chance your check was mailed to a dated address. To avoid this, please ensure your payment information is up to date in your Broker Account (opens in new tab).

• Paid: For ACH payments, this means your payment has successfully posted to the account on file. For check payments, this means that we have mailed your check.
• Released: For ACH payments, this means your payment has been released from our bank and is on the way to your account. This process typically takes 1-3 business days.
• Unpaid: This means your payment was blocked. We are either missing your tax information (completed W-9) or payment information. You can update this information (opens in new tab) in your Broker account (opens in new tab).
• If you are writing through an agency, your payment may show as Unpaid if your agency principal hasn’t completed the agency’s payment details.

Oscar will provide a 1099 form in early February. This will include details for your commissions earned from the previous year and Oscar’s EIN information.

Soon! We’re working on this product and will let the broker community know once it’s live.

Commissions may be blocked for a variety of reasons, like the member did not pay their monthly premium on time or we’re missing the broker’s information on the enrollment application. As a reminder, members must pay their premium by the first of the month in order for commissions to be remitted in a timely fashion. If Oscar receives the member’s premium payment late, commissions for the policy will remit during the following month. You can check the block reason on your most recent commission statement. If you are missing commissions for a policy or need more information on blocked commissions, please reach out to brokers@hioscar.com.

Commissions are automatically paid to your affiliated agency, whether you’re a downline agent or the agency’s principal agent.

If you’re the principal agent, you can view commission statements and update the bank account used for payments in the Oscar Broker Portal.

No. Bonus statements are not displayed in the Oscar Broker Portal’s commission tools. For a copy of an Oscar bonus statement or a question about a bonus, contact brokers@hioscar.com.

For bonuses paid by an agency or another product administrator, contact that organization.

Commissions for Allstate supplemental policies are handled separately from Oscar medical commissions.

Payment terms depend on your Allstate appointment and contract. For commission statements or payment questions, contact the organization responsible for paying your commissions.

Log in to the Oscar Broker Portal and select Commissions. Choose a payment period to view or download your statement.

If your commissions are paid through an agency or another administrator, contact them directly for your statements.

Log in to the Oscar Broker Portal and go to your payment settings to review or update your payment information.

If you’re an agency leader, use your agency’s payment settings.

Need help? Contact Broker Support at brokers@hioscar.com.

There’s no limit to the number of Oscar-paid commission statements you can view.

Log in to the Oscar Broker Portal and select Commissions to access your statements.

For commissions paid through an agency or another organization, contact them directly. If an Oscar statement is missing, contact Broker Support at brokers@hioscar.com.

Here are the payment statuses you’ll see in the Oscar Broker Portal:

Paid: Your payment has been deposited into your bank account or a check has been mailed.

Released: Your payment is on its way. Bank transfers typically take 1–3 business days.

Unpaid: Your payment is blocked, often because required tax or payment information is missing.

Log in to the Oscar Broker Portal and select Commissions to review your payment status and resolve any issues.

Log in to the Oscar Broker Portal and select Commissions to review any payment errors or issues.

Commissions may be missing or blocked because of incomplete tax or payment information, unpaid member premiums, or missing broker information.

If you can’t resolve the issue, contact Broker Support at brokers@hioscar.com. Include your National Producer Number (NPN) and relevant policy or statement details.

Oscar generally pays commissions monthly, around the third week of each month.

Log in to the Oscar Broker Portal and select Commissions to view your statements and payment details.

Missing a payment? Contact commissions@hioscar.com for help. Include your NPN and the relevant statement or policy details.

Oscar sends Form 1099-NEC in early January for commissions paid during the previous tax year.

Forms are issued to eligible payees who received at least $2,000 in commissions.

If you haven’t received your form, contact commissions@hioscar.com.

Oscar uses your W-9 to verify your tax information and report commission payments to the IRS.

You can submit your W-9 through the payment section of the Oscar Broker Portal.

Check the Oscar Broker Portal (opens in new tab) or the applicable Marketplace for updates on your client’s application.

If additional documents are needed, you’ll receive instructions on what to submit and when. Once approved, confirm the coverage start date and any required first payment.

First, confirm that your client qualifies for a Special Enrollment Period and is within the enrollment deadline.

Then, follow the appropriate enrollment process through the Oscar Broker Portal (opens in new tab), HealthCare.gov, or your client’s state Marketplace.

You may also need to submit documentation to verify the qualifying life event.

Having a baby qualifies your client for a Special Enrollment Period.

Help your client report the birth through the Marketplace or wherever they enrolled. Make sure they submit any required documents and confirm the baby’s coverage start date.

Enrollment deadlines vary, so encourage your client to act promptly. Get more details at Healthcare.gov’s Special Enrollment Period guidance page (opens in new tab).

Before applying, confirm plan availability, the coverage year, start-date requirements, and any required documents using our Broker Toolkit or in the Oscar Broker Portal (opens in new tab).

It depends on the qualifying life event. Your client may need to provide proof of lost coverage, marriage, birth, adoption, or a move.

Oscar will let you know which documents are required and how to submit them after the application is received.

CHIP provides low-cost health coverage for children in families who earn too much to qualify for Medicaid but may not be able to afford private insurance. In some states, it also covers pregnant people.

Visit HealthCare.gov’s Medicaid and CHIP guidance page (opens in new tab) to learn more about eligibility requirements and find out how to apply.

We recommend submitting your client’s required qualifying life event documents within 14 days of their coverage start date. This allows time to review and resubmit documents if needed.

If the required documents aren’t received within 30 days of your client’s coverage start date, the policy will be terminated.

Upload documents through the Oscar Broker Portal (opens in new tab) or follow the submission instructions in your client’s request.

If the portal will not accept a file, contact Broker Support at brokers@hioscar.com.

Once the enrollment is completed, it takes the Marketplace 24-48 hours to send the enrollment back to Oscar. You can expect to see the client in your book of business 1-2 days after completing the EDE application.

Create an account (opens in new tab) and log in to the Oscar Broker Portal. If you plan to enroll members through Oscar’s EDE platform, you will need to take additional steps to verify your identity within the platform to complete your registration.

If you see the following message at the top of the screen within your Broker Portal account, you have not yet verified your identity. You will be unable to enroll clients until you complete your broker registration and verify your identity. These additional steps are easily completed once you select “Click here” in the banner.

!verify identity

We can help! Watch a Oscar EDE Platform 101 recorded webinar training at hioscar.com/brokers/training (opens in new tab) or read our Quick Start Guide (opens in new tab).

After you enter the electronic signature to confirm the client’s plan selection, you’ll see a page with the plan name, start date, and premium amount with the option to Pay the first premium now. This will direct you to Oscar’s secure payment site to make the binder payment.

Enrolling a client in their health plan should take 10-30 minutes. The more information you have on hand and ready to go, the faster the enrollment process.

Your entire book of Oscar business will be viewable in your Oscar Broker Portal book of business. However, you will not be able to manage enrollment activities for any applications submitted through HealthSherpa directly. Only the Oscar Broker Portal gives you the ability to manage both your book of business and your enrollment/renewal application statuses.

Even with an existing Broker Portal account, you may still need to complete your registration on Oscar’s EDE Platform. To do this you will need to:

• Enter all the client information and click ‘Next: Enrollment’
• The following “heads up” page gives a short list of what additional information will be needed to complete the enrollment. Click ‘Next: Get Savings’
• If you have not yet registered with Oscar’s EDE platform, you will be presented with a Broker Registration where you will:
• Confirm your name and NPN
• Enter your FFE username
• Answer a few questions to confirm your identity with the marketplace

Once you complete these steps, you’ll be routed back to your enrollment in progress.

As of Tuesday morning, November 5, 2024, we have resolved a reported Florida Plan Display issue within the Oscar Renewal Flow in which subsidies were being applied yet eligible CSR & CSR $0 deductible plans were not populating. Please follow your standard processes.

To report new issues, submit a Broker Support Request. Log in to your Oscar Broker Portal (opens in new tab) account and navigate to ‘Report an issue’ in the top right Menu bar. A new page will open for you to submit a Broker Support Request. Complete all required fields accurately to help us process your request. Attach any relevant documents, and click Submit. Oscar’s Broker Support Team will respond as soon as possible.

Log in to your Broker Account (opens in new tab) and click on ‘My Account’ in the top right Menu bar. On your ‘My Account’ page, click on ‘Basic details’ in the ‘My Details’ section. Review the existing information, including FFE ID and name to confirm they are correct. If any of these identifiers do not match the identifiers in your error message, navigate to ‘Report an issue’ in the top right Menu bar of your Broker Account. A new page will open for you to submit a Broker Support Request.

In the Broker Support Request, enter your name, email address, and NPN. Select and enter the following details:

• Case Reason: Tech Issue
• Specific Case Reason: Quoting/Enrollment Portal Access
• Line of Business: Individual
• Subject: FFE User ID Error
• Description: Copy & paste the error message you’re seeing within Oscar’s EDE Platform. (For example: Error Message: {“status”:”ERROR”,”message”:”Agent FFM ID does not match Okta token FFM ID”,”name”:”BAD_REQUEST”,”errors”:{}})

Click Next. Upload any files that may be useful to the Broker Support team. Click Submit.

This submission will be confirmed through an email response with an assigned case number and Broker Support will advise on a resolution. !Screenshot 2024-11-03 at 3.04.47 PM

If you are in the Explore Other Plans experience for a renewing member, you will not see the member’s subsidy amount carry over. You will need to confirm and add your client’s income to ensure the qualifying subsidy is reflected in the plan quote.

!unnamed (18)

No action is needed! Your member will enroll into plan year 2025 automatically and be notified by both Oscar and CMS.

To submit the enrollment, you will need the following client information:

• Social security number for each applicant - this is a CMS mandate
• General household information like contact details, date(s) of birth, address, and employer (if applicable)
• Income information for everyone in your client’s household (including employer contact information and EIN)

Brokers must complete registration and required training for the upcoming plan year in order to assist consumers with the Marketplace.

If you are new to the Marketplace, you’ll want to create an account with CMS and register for training. You can view more information for new agents here (opens in new tab).

The preferred EDE or “Enhanced Direct Enrollment” streamlines the subsidy application by enabling individuals and brokers to complete a health plan enrollment application without visiting healthcare.gov (opens in new tab).

Oscar’s EDE platform is integrated within the Oscar Broker Portal to help brokers guide clients through the process of selecting and enrolling in an Oscar plan.

Visit hioscar.com/brokers/plans (opens in new tab) for information about Oscar’s plans and networks.

Your FFM or FFE username is the username you used to register your portal with CMS at portal.cms.gov. If you cannot remember your CMS username, navigate to the CMS portal at portal.cms.gov (opens in new tab) and select *Forgot your User ID or your Password?*.

If you run into trouble recovering your username or if you are unsure if you have an account with CMS, please contact the Marketplace Service Desk at 1-855-267-1515 or CMS_FEPS@cms.hhs.gov for assistance, rather than creating a new account.

Brokers must complete registration and required training for the upcoming plan year in order to assist consumers with the Marketplace.

If you are new to the Marketplace, you’ll want to create an account with CMS and register for training. You can view more information for new agents here (opens in new tab).

The first time you enter the EDE flow, you’ll be required to go through broker registration. You’ll be prompted to register automatically, and you’ll only have to do this once. To complete registration, brokers will need to confirm their agent information, including their FFM username, and pass identity proofing.

IMPORTANT: It is important to confirm your registration and verify your identity. You must complete this step before you’re able to enroll clients.

If you see the following message at the top of the screen within your Broker Portal account, you have not yet verified your identity. You will be unable to enroll clients until you complete your broker registration and verify your identity. !verify identity

Note: Experian is CMS’s identity proofing partner. If you do not answer Experian’s identity proofing questions correctly on the site, you will need to call Experian at 1-866-578-5409 with the provided reference number. Experian will ask additional questions to verify your identity. Once verified, then you can return back to the registration page and continue.

CMS now requires brokers to reintegrate their CMS accounts with EDE partners every 12 hours. If you receive an error in your Oscar Broker Portal when logged in for more than 12 hours, you will need to re-sync your CMS account.

Within the the Oscar enrollment dashboard, if the enrollment status of a client is listed as “Permissions Lost”, this is because an application for the same client has been accessed by the broker on another enrollment surface and Oscar no longer has permissions to fetch data on that enrollment.

If this was intentional, you should ignore the status. If you would like to continue with the application within the Oscar enrollment dashboard, clicking ‘Resume’ will re-enable the application, remove the “Permissions Lost” status, and allow you to submit the application.

Yes. The FFM requires that all brokers are certified before writing business through the FFM. If you are not certified prior to writing a FFM policy, Oscar will not be able to pay you commissions on that policy. Additionally, you must renew your certification every year prior to Open Enrollment in order to receive commissions on new business.

Oscar has different underwriting guidelines and participation requirements across states. Please check the Underwriting Guidelines for your market on the Broker Resources Page (opens in new tab).

Individuals & Families

You may enroll members a few different ways depending on whether you are enrolling them on-exchange or off-exchange. Please note you must be appointed with Oscar in the state you’re enrolling to receive commissions. For FFM on-exchange policies, you must be FFM-certified to receive commissions.

Off-exchange (no subsidies) enrollment options:

• Online enrollment: We recommend all enrollments be submitted via your Broker account (opens in new tab). Use the ‘Forgot Password’ feature to reset your password if needed.
• Paper enrollment via GA: You may also submit paper enrollment forms to your GA for processing, if your GA accepts paper applications. Please access the Forms and Notices Resource Page (opens in new tab) to download your market’s form.

On-exchange (subsidy eligible) enrollment options:

• Direct online enrollment (FFM only): We have an integration with the FFM (healthcare.gov), so you enroll any FFM on-exchange clients directly through your Broker account (opens in new tab) instead of healthcare.gov.
• Online enrollment for non-FFM states: For state-based exchanges (e.g., NYSoH, Pennie), please visit the exchange website to submit on-exchange enrollments.
• Your platform of choice: Your preferred platform that sits on top of the FFM (INSX, etc.)

Currently, we only support personalized broker enrollment links for Individual & Family plans.

To generate your custom enrollment link to share with IFP clients: Simply add your NPN to the end of this link: hioscar.com/get-quote/[your NPN here]

Example: hioscar.com/get-quote/0123456789

You can get a quote by going to your book of business (opens in new tab) and clicking ‘Enroll new policy’. Once you enter the required subscriber information (zip code, tax household size, and coverage type), you will be directed to the plan selection page.

On the Plan Selection page, you’ll be able to see premium, deductible, max out of pocket, Rx costs, and link to the summary of benefits and coverage per plan. Once you’ve selected a plan, you can email the quote to your client by clicking the ‘Email plan’ button.

Oscar has created a Standardized BOR Letter. Please email brokers@hioscar.com for a copy of the letter. Once you’ve filled out the letter with your client, email it to brokers@hioscar.com for processing.

We require that recently formed businesses submit additional documentation, including payroll, to show eligibility if they don’t have quarterly tax documentation. Please refer to the notice you received for specifications on what documentation is required. The required documentation must be submitted to brokers@hioscar.com within 30 days of the enrollment.

We review these applications on a case-by-case basis. Please email brokers@hioscar.com for what documentation will be required.

We ask for income level in order to identify whether your client is subsidy eligible. If they are subsidy eligible based on their income, we will direct them to contact their broker in order to enroll on-exchange.

We ask for a contribution amount during the enrollment process so we can show employees what they’ll be asked to pay for coverage during the employee enrollment process. We strongly encourage brokers to enter accurate amounts here. However, if you are not email employees to let them select their plans you may select “No Contribution” or an estimated contribution amount to continue forward in the application.

We will allow FMO changes up until September 1, 2019. To make this change, please contact our Broker Support Team by calling 1-855-672-2713 or emailing brokers@hioscar.com. Please allow up to two weeks for this change to be processed once requested.

Oscar Medicare Advantage plans are available in Florida (Broward County).

Learn more about getting certified to sell Oscar Medicare Advantage here (opens in new tab).

Please contact Oscar’s Commissions Team at commissions@hioscar.com or 1-855-672-2713 for a copy of your Medicare commission statement.

Starting on October 15, 2019, you can enroll your clients to Oscar’s 2020 Medicare Advantage plans. Online enrollments are the preferred and fastest method, but we also accept enrollments via mail and fax. You can enroll clients online through your Oscar Broker account at business.hioscar.com (opens in new tab) through your “Medicare book” (top right of the page).

Prior to October 15, you can add leads to the Oscar Medicare enrollment portal. For full instructions, see page 4 of our Guide to Oscar Medicare Certification.

Oscar is aiming to launch 2020 Medicare Advantage plans. The first step to making sure you’re ready to sell on October 15, 2019 is to get certified:

1. Create an Oscar Broker account or log in at business.hioscar.com (opens in new tab).
2. Click on Medicare book at the top right of the page.
3. Click the Get certified button to access the Oscar Medicare Advantage Certification Checklist.
4. Complete all six (6) required steps of the Certification Checklist.

For more information, check out our Guide to Oscar Medicare Certification.

Please note: For 2020, Oscar Medicare Advantage will be available in New York and Texas only.

Visit business.hioscar.com (opens in new tab) and log in with your Broker account credentials.

From the home page, you will see “Medicare book” on the top right of the page. Click this link to load your MA book of business.

Our Broker Support Team is here to help! Call 1-855-672-2713 or email brokers@hioscar.com and someone will be able to assist you.

On the Medicare book of business main page, you will see:

• Policy holder - the name of the enrolled client.
• Plan name - which plan your client is enrolled in.
• Effective date - your client’s effective date of coverage (coverage start date).
• Policy status
• Active - policy is active and premium is paid to date. If premium is $0, policy will automatically become active on the coverage effective date.
• Inactive - policy was terminated or the member disenrolled.

You can see full details per client by clicking into their client details page. Learn more here (opens in new tab).

If you click into each Medicare Advantage client’s page, you will be able to see:

• Your client’s contact information, including mailing address, resident address, phone number, and email address.
• Under your client’s name, you can also find their Oscar member ID number (OSC #).
• Click “View ID card” next to the OSC ID # to view their digital member ID card. You can also download and/or print to share with your client.
• Your client’s engagement with their plan. You can also encourage your client to engage with their Oscar plan by sending them instructions on how to set up their account, download the app, activate step tracking, and use Doctor on Call.

• You are only able to see policies for which you are the broker of record. Unless you are the principal agent of your agency, then see below.
• If you are an agency principal, you will be able to see policies for which you are the broker of record in the “Personal” tab. To see your agency’s full book of business, click on the “Agency” tab.
• Please note that only your inactive clients whose plan was terminated after their scheduled coverage start date will appear in your book of business.

If you are missing policies that you believe are active and for which you are the broker of record, please contact Oscar’s Broker Support Team at brokers@hioscar.com or 1-855-672-2713.

Absolutely. You can easily route your payouts straight to your agency during the digital portal onboarding process.

Unfortunately not.

All producers must complete the Appointment request process available through business.hioscar.com (opens in new tab). Because the application must be electronically signed, it cannot be completed via email or fax.

For Individual: You must write under only one GA per state. If you are appointed in multiple states, you may write under multiple GAs across states. As part of the appointment request process, you’ll select one of our GA partners for each state in which you’re getting appointed.

Yes, appointments are state-specific. The good news: You don’t have to fill out paperwork for each. Just request multiple states right on your initial application. If you want to add new markets later, simply submit a quick update request in the portal.

You can sell Oscar plans in Alabama, Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, and Virginia.

For the status of your appointment application, log in (opens in new tab) to your Broker account and find the appointment dropdown. Your status will be listed there.

Starting your appointment takes just minutes. Here’s what to expect:

1. Create an account.
2. Apply: Submit your NPN, state licenses, and E&O proof here (opens in new tab).
3. Get certified: Complete your 2026 FFM or SBE certification online.
4. Sign: Digitally sign your broker agreement and W-9 to secure your writing number and ensure you can receive commission.
5. Sell: Once you’re approved, you’re cleared to write business. Log into the portal to grab sales assets, pull up provider networks, and start earning.

Yes, you can. If you’re appointed with Oscar to sell in a state, your appointment covers any lines of business (Individual and/or Small Group) underwritten by the Oscar Insurance entity within that state.

No, if you have an existing appointment, you do not need to renew your state appointments. Action is only needed to get appointed in a new state. However, there are a couple of exceptions:

• If your appointment was previously terminated due to non-production, you may need to get reappointed. If you’d like to get reappointed, please reach out to brokers@hioscar.com.
• If your Oscar appointment has been terminated for fraud, misconduct, or other similar reasons, Oscar will not process your reappointment.

Oscar’s Broker Support team is here to assist. You can reach them at brokers@hioscar.com.

Oscar reviews every appointment request, so there will be a lag between when you submit your appointment and when Oscar has processed it. You will see “pending” while we are reviewing your request. Once Oscar has reviewed your appointment request and you have written your first policy in a state, Oscar will approve or reject the request.

You will receive an Oscar writing number after your first appointment is approved. Your writing number can be found in the approval email or by logging into your Broker account (opens in new tab) and looking at the top right corner of your ‘My Account’ page.

We’ll email you the second you’re cleared to start selling (usually within about two weeks of applying). If you want to check your progress before then, simply log into your broker account and click the “Appointments” link on your profile page to view your live status.

Oscar may reject appointments for various reasons. Please reach out to brokers@hioscar.com to understand why your appointment request was not approved.

Yes, but generally only one general agency (GA) per state for Individual & Family Plans. You can work with different GAs in different states.

Log in to the Oscar Broker Portal (opens in new tab) to review your GA affiliations. If you want to make a change, contact Broker Support at brokers@hioscar.com to understand how it may affect your commissions.

es. You’ll need an appointment for each state where you want to sell Oscar plans.

You can request appointments for multiple states through the Oscar Broker Portal (opens in new tab). Just make sure you have the required licenses and certifications and are cleared to sell before enrolling clients.

Usually, no. Your Oscar appointment generally stays active, but you may need to complete annual Marketplace or product training to remain cleared to sell.

Log in to the Oscar Broker Portal (opens in new tab) to check your status.

Need help? Reach out to Broker Support at brokers@hioscar.com.

Yes. Oscar works with approved general agencies (GAs) in certain markets. These agencies can provide training, marketing, contracting, and other support to brokers.

Available GAs vary by state and product. You can review your options and select a GA during the appointment process in the Oscar Broker Portal (opens in new tab).

Create an Oscar Broker Account (opens in new tab) or log in to your existing account to get started.

Submit an appointment request for each state and product you want to sell. You’ll need your National Producer Number (NPN), active license information, and any required documents.

Complete the required training and confirm you’re ready to sell before enrolling clients.

Need help? Reach out to Broker Support at brokers@hioscar.com.

Log in to the Oscar Broker Portal (opens in new tab) to check your appointments and see which products you’re cleared to sell in each state.

Allstate Health Solutions products have separate licensing, appointment, and training requirements.

Compare the information in your Oscar Broker Portal (opens in new tab) account with your NIPR license and Marketplace training records. Check your National Producer Number (NPN), state, product, training, and agency affiliation, then complete any missing steps shown in the portal.

If the records still do not match, contact Broker Support at brokers@hioscar.com with the details and screenshots. Ask support before submitting another appointment request.

Log in to the Oscar Broker Portal (opens in new tab) to request a change to your agency or general agency (GA) affiliation.

You’ll need your National Producer Number (NPN) or Oscar writing number, current and new affiliation, state, and requested effective date.

Make sure your change is approved before writing business under your new affiliation.

It depends on where you sell Oscar plans.

• HealthCare.gov states: Follow the required CMS registration and Marketplace training.
• State-based Marketplaces: Complete the Marketplace’s annual training requirements.

You’ll also need an active state license and Oscar appointment before enrolling clients.

Log in to the Oscar Broker Portal (opens in new tab) to find your writing number or Broker ID in your appointment details. You may also find it in your appointment confirmation email.

Can’t find it? Contact Broker Support at brokers@hioscar.com and include your name and National Producer Number (NPN).

Visit the CMS Enterprise Portal (opens in new tab) to find or recover your username. Select Sign In and follow the account recovery instructions.

You can also visit the CMS agent and broker resource page (opens in new tab) for registration and training information.

Our dedicated Broker Support Team is here to support you with any issues or questions you have about working with Oscar. Email brokers@hioscar.com to get in touch with us.

Visit Oscar’s Broker Training Resources for EDE training and guidance.

If you’re having trouble with an enrollment, contact Broker Support at brokers@hioscar.com. Include the error message and a screenshot, if possible.

Visit Oscar’s regional sales executive directory to find your sales representative.

You can also contact your general agency or email Broker Support at brokers@hioscar.com for help.

Follow any troubleshooting instructions displayed in the portal.

If you still need help, contact Broker Support at brokers@hioscar.com. Include the error message and a screenshot, if possible.

Providers should submit referrals for TX Guided Care HMO members through the Oscar portal for review. Referrals are active immediately upon validation and can always be viewed in the Oscar portal.

Hmm, yes and no. Here’s why: Employers can offer CHOICE Arrangements to one segment of employees while offering a traditional group plan to a different segment of employees.

However, employers are not allowed to offer both CHOICE Arrangements and a traditional group plan to the same segment of employees. To determine allowable class distinctions, just refer to official IRS CHOICE Arrangements regulations or talk to a tax professional.

No, it’s not a legal requirement. That said, it is strongly advised to administer an ICHRA through a third party to ensure compliance with IRS regulations such as HIPAA.

To learn more about ICHRA compliance, please refer to official IRS ICHRA regulations or talk to a tax professional.

CHOICE Arrangements (previously known as ICHRA) stands for Custom Health Option and Individual Care Expense. It’s a type of Health Reimbursement Arrangement (HRA) created in 2020. It’s great because it allows businesses of any size to provide tax-free reimbursements to employees for health insurance premiums and qualified medical expenses.

Employers of any size can offer CHOICE Arrangements so long as they have at least one employee who isn’t a self-employed owner or the spouse of a self-employed owner. If designed correctly, an ICHRA satisfies the Affordable Care Act (ACA) employer mandate for Applicable Large Employers (ALEs).

To determine if CHOICE Arrangements is right for your business, take a look at the official IRS CHOICE Arrangements regulations or talk to a tax professional.

You can filter by clicking on the ‘Outstanding bills’ dropdown, and selecting one of the following filter views:

• Outstanding bills - This is the default view on the page, displaying bills that have been posted, but not yet paid. If your member is paid to date, you will see: “This member has no outstanding bills”.
• Paid bills - This view will display all posted and paid bills. If you click into the bill, you’ll be able to see the payment details, such as payment date, payment method, payment ID, and a link to the bill.
• Payments - This view will display all posted payments. If your client has paid his/her bill, but it’s not displaying here, this means it is not yet posted.
• All activity - This view will display all posted and unpaid (outstanding) bills, as well as posted and paid (paid bills).

Yes, you can enter the your client’s name (first, last, or full) OR OSC number (OSC followed by a string of numbers) in the search field in your book of business (opens in new tab).

Yes, you can submit one-time premium payments on behalf of your Individual clients in your Broker account. Here’s how:

• Log in to your Oscar Broker account at business.hioscar.com (opens in new tab)
• Click on Individual book (opens in new tab) at the top right

To find which clients need to submit premium payments:

• Find the ‘Filter by status’ drop-down menu and select ‘Delinquent’ or ‘Grace period’. These clients are at risk because they are past due on premium payments.
• Find the ‘Filter by status’ drop-down menu and select ‘Not effectuated’. These clients have not yet submitted a binder payment and their coverage start date is in the future.
• To find your client’s premium amount: The column labeled ‘Premium’ (third from the left) will show each client’s monthly premium amount.

To make a payment on behalf of your client, either:

• Click into any client from your Individual Book and select the ‘Billing & payments’ tab (learn more (opens in new tab)). On this tab, you’ll see a ‘Make a payment’ button to make a one-time payment on their behalf. This will take you to a pre-filled form, so you only need to enter payment information.
• Find the Main Menu and click ‘Make a payment’. This will be a blank form and you must fill in all details including client’s name, SSN, birthdate, premium amount, and payment information.

Your clients can get the most value from their health plan by taking advantage of all of the special benefits included with every Oscar plan.

You can check which of the benefits your clients have activated with the ‘Engagement’ tab on their Member details page (opens in new tab). The first step is to create a member account, and from there they will be able to access the Oscar app, step tracking, and Virtual Urgent Care.

Learn more about the ‘Engagement’ tab here (opens in new tab).

You can filter your individual book of business (opens in new tab) by policy status with the ‘Filter by status’ button to the right of the search bar. Click on the drop-down, and select the status you’d like to see.

You can also sort by policy status by clicking the ‘Policy status’ column header on the right, or you can export (opens in new tab) your book of business to CSV and sort by policy status in the CSV.

You can view your clients’ member information through your individual book of business (opens in new tab) in your Broker account. From there, click on any client’s name to access their Member details page and find the ‘Member info’ tab.

Under the ‘Member info’ tab, you can:

• View personal and contact information for all enrolled members (subscriber and dependents)
• View and print ID cards for all enrolled members

You can view your clients’ plan details through your individual book of business (opens in new tab) in your Broker account. From there, click on any client’s name to access their Member details page.

Once you’re on the Member details page, you’ll see top-level details of the current active plan directly underneath your client’s name:

• Plan name and exchange status
• Plan details and link to SBC
• If you click on the plan name, plan details and a link to SBC will appear to the right side of the page

Underneath that, the Member details page is split into three tabs. Click below to learn more about each section:

• Plan details (opens in new tab)
• Renewals options (opens in new tab) (available in October)
• Member info (opens in new tab), including ID cards
• Billing and payment history (opens in new tab)
• Plan engagement (opens in new tab) (benefits activation)

From your Broker account homepage, click on Individual book (opens in new tab) on the top right corner of the page. Then click on a client’s name to head to the Member details page. Click on the tab labeled ‘Billing & payments’.

From there, you will be able to:

• View your client’s current outstanding balance.
• Check if your client has autopay turned on.
• If your client has an outstanding balance and does not have autopay on, you’ll see an option to make a payment on their behalf.
• View your client’s billing & payment history for as long as your client has been an Oscar member.
• Filter on the page to view outstanding bills, paid bills, and payment history. Learn more here (opens in new tab).

Please note: There may be a delay with on-exchange bills due to batch processing.

You can export your book of business (opens in new tab) to CSV to see all policy details for your book. Simply click on the blue ‘Export CSV’ button on the top right of the page. Once you export, it may take a few seconds to download the file.

You can view your individual book of business by logging into your Broker account (opens in new tab). Once you’ve logged in to your Broker account, you will see “Individual” on the top right of the page. Click this button to view your book of business.

You can also access the individual book of business directly at https://business.hioscar.com/book/ivl (opens in new tab).

You will be able to see your client’s billing & payment history (opens in new tab) for as long as your client has been an Oscar member.

The payment grace period is typically 30 days from the bill post date. However, this depends on your client’s enrollment status (on- or off-exchange, subsidized or unsubsidized). The payment due date is shown in the box on the right side of the ‘Billing and payments’ page (opens in new tab).

To find out more about a specific client, please contact Oscar’s Broker Support team at brokers@hioscar.com or 1-855-672-2713.

Grace period and termination rules for Individual policies vary by subsidy status and state. Partial payments do not extend the grace period and will be refunded once the member is terminated.

Is this an Initial Binder Payment or ongoing payment?

Initial Binder Payment: Individual members initial premium payment is due on the first day of coverage. If payment is not received by the due date, members have a 30 day binder payment extension before risk of termination. During this period:

• Pharmacy claims will not be paid
• Medical claims will be placed on hold
• Virtual Care services are not available

For plans in NY, members have a 10 day binder payment extension before risk of termination.

Ongoing Payments: Please see the section for either “Subsidized Individuals” or “Unsubsidized Individuals” below.

Subsidized Individuals

Subsidized individual members enter a 3-month grace period if their premium bill is not paid by the 1st of month. Oscar will continue paying claims for the first calendar month of grace period (payment due date counts as day 1).

Starting on the first day of the second calendar month through the end of the third month, the member will be in delinquency. During delinquency period:

• Pharmacy claims will not be paid
• Medical claims will be placed on hold
• Virtual Care services are not available

If the full outstanding premium payment isn’t made by the end of the delinquency period, the policy will be terminated and any claims on hold will become the members responsibility to pay in full.

Unsubsidized Individuals

Unsubsidized individual members enter a one month grace period if their premium bill is not paid by the 1st of the month (payment due date counts as day 1). During grace period:

• Pharmacy claims will not be paid
• Medical claims will be placed on hold
• Virtual Care services are available, member cost-sharing may apply.

If the full outstanding premium payment isn’t made by the end of the grace period, the policy will be terminated and any claims on hold will become the members responsibility to pay in full.

Your book of business (opens in new tab) is updated every 8 hours, you can find the last update date/time, on the title page within your Individual Book of Business.

• Off-exchange enrollments will display within 2-3 days of submission.
• On-exchange enrollments will display within 2-3 days of submission.

The premium you see in your book of business (opens in new tab) is the premium after any applied subsidies.

We’re working on speeding up the load time for your book of business (opens in new tab). The best way to see all details is to export (opens in new tab) your book of business through the top right button “Export CSV” – this may take a few minutes if you have more than 100 policies enrolled. Once it’s downloaded, you will be able to view all details.

If your client’s status shows as ‘Grace period’ or ‘Delinquent’ or a bill shows as ‘Past due’, that means your client has not paid their full bill amount by the posted due date (typically, the first day of the premium month).

To see details about how much of the bill is unpaid, click on the box on the right side of the ‘Billing & payments’ page (opens in new tab). Once a bill is in ‘Past due’ status, Oscar requires full payment before updating the bill status to ‘Paid’ and removing your client from an ‘At Risk’ enrollment status.

• Active: premiums are paid to date, and the coverage effective date is in the past.
• Effectuated: premium is paid, and the coverage effective date is in the future.
• Unpaid Binder: policy is enrolled, but the first premium is not yet paid. The coverage effective date is in the future.
• Grace Period or Delinquent: policy is active, but is past due on a premium and is at risk for termination.
• Inactive: policy is terminated or canceled. This shows inactive policies for the current plan year and the previous plan year.

• Effective date: The start of coverage on a policy.
• Enrollment date: The date a new policy was enrolled or submitted.
• Effectuation date: The date your client paid their first premium on a given policy.

Please note this feature is available to you only for clients enrolled in Oscar Individual & Family (IFP) plans only.

The ‘Engagement’ tab in the Member details page (opens in new tab) shows how your clients have been utilizing their Oscar plan benefits. We’ve identified four key milestones:

• Member account creation
• App download
• Step tracking rewards
• Doctor on Call

Below is an overview of the main features of the ‘Engagement’ tab:

• Talking points: You can click on any of the “talking points” on the page to learn more about each benefit and find setup instructions. Feel free to use these to guide your conversation with clients to make sure they’re making the most out of their Oscar plan.
• Task completion: Within each of the “talking points”, you can use the “Task completed” button to track your progress while you’re talking with your clients. If you click the button by accident, you can always click “Undo Task Completion” for a clean slate.
• Send email: If your client has not activated all four benefits, you can use the blue “Send email” button at the top right to send them a pre-filled email with benefit details and setup instructions. You can preview the email before sending.
• Track your clients’ progress: Once your client has activated a benefit, the “Engagement” tab will reflect so within one day and show a timestamp of when the benefit was activated.

You can view your clients’ details through your individual book of business (opens in new tab) in your Broker account. From there, click on any client’s name to access their Member details page.

On this page, you’ll find the following sections (click below to learn more):

• Plan details (opens in new tab)
• Renewals options (opens in new tab) (available in October)
• Member info (opens in new tab), including ID cards
• Billing and payment history (opens in new tab)
• Plan engagement (opens in new tab) (benefits activation)

Renewal information is generated for all active policies prior to or during Open Enrollment.

If a renewal is available for your client, you can view the details of the renewal plan and benefits changes using the following steps:

• Open your individual book of business (opens in new tab)
• Search for a client using their name or OSC number (policy number) in the search bar
• Click on the client’s name to access the additional details page
• Select the ‘Renewals’ tab

If you do not see the ‘Renewals’ tab, then the renewal information is not yet available and will be coming soon.

You can also view upcoming renewals by exporting (opens in new tab) your book of business using the ‘Export CSV’ button at the top right.

For individual brokers not writing business through an agency, only you can view your book of business.

For individual brokers writing business through an agency, you will be able to view the policies for which you are the writing agent. You will not be able to see all of your agency’s business.

For agency principals, you will be able to see all of your brokers’ enrolled policies. You will also be able to export a CSV (opens in new tab) with your agency’s full individual book of business.

For GA users, you will be able to see all policies that are attributed to your GA. You will also be able to export a CSV (opens in new tab) with your GA’s full individual book of business.

If you, or anyone at your GA, don’t have an account, please email brokers@hioscar.com a list of the names, email addresses, and roles of the people who need an account created.

Currently, your individual book of business (opens in new tab) shows active, inactive (terminated or cancelled), and not effectuated policies. If your individual book of business is missing policies you’ve enrolled, please contact brokers@hioscar.com for assistance.

*Important to note enrollment transmission to your Broker portal display does have a delay.

• Off-exchange enrollments will display within 2-3 days of submission.
• On-exchange enrollments will display within 2-3 days of submission.

Yes. Open the book of business in the Oscar Broker Portal. Use the search box for the client’s name or Oscar policy number.

If the policy does not appear, add the right year, status, or product filters. Then check the enrollment channel and broker-of-record details. Contact Broker Support at brokers@hioscar.com if it is still missing.

No. Oscar doesn’t provide brokers with access to clients’ healthcare utilization data.

However, you can view certain account activities and engagement information in the Engagement section of a client’s Member Details page in the Oscar Broker Portal.

Open your book of business in the Oscar Broker Portal, select the relevant year and policy filters, and choose Export CSV.

The file contains private member and policy information. Store it securely and limit access to authorized users. If the export fails, review the filters or contact Broker Support at brokers@hioscar.com.

Contact Broker Support at brokers@hioscar.com to request the Broker of Record change instructions and any required forms.

You’ll need your client’s approval to complete the change. Marketplace plans may also require your client to approve the change through the Marketplace.

Log in to the Oscar Broker Portal (opens in new tab) and open your book of business.

From there, you can search for clients, filter policies, and review enrollment, coverage, renewal, and billing information. You can also export your book of business to a CSV file.

Your book of business in the Oscar Broker Portal updates as Oscar receives and processes enrollment, payment, and policy information. A recent enrollment, payment, termination, or broker-of-record change may take time to appear.

If a change is missing, check the policy filters and source application or notice. Contact Broker Support at brokers@hioscar.com with the policy details and submission date if you need help.

No. Your Oscar book of business won’t automatically appear in HealthSherpa.

Only Oscar enrollments submitted through HealthSherpa will appear in your HealthSherpa account. For those members, you’ll see basic information, including their policy and payment status.

For more complete member information, use the Oscar Broker Portal.

The Engagement tab lets you track certain client milestones, view talking points, and find opportunities to connect with your clients.

To get started, log in to the Oscar Broker Portal open a client’s Member Details page, and select Engagement.

Available features may vary by plan.

Here are the most common policy statuses you’ll see in the Oscar Broker Portal:

Active: The policy’s coverage is currently in effect.

Effectuated: The first premium payment has been received, and the policy is set to take effect.

Unpaid binder: The policy is awaiting its first premium payment.

Grace period or delinquent: A payment is overdue, and coverage may be at risk.

Inactive: The policy has been canceled or ended.

You can review each policy’s details in the Broker Portal for more information.

Enrollment date: The date the client’s application or plan selection was submitted.

Effective date: The date the client’s coverage is scheduled to begin.

Effectuation date: The date the client’s first premium payment is processed, allowing their coverage to take effect.

These dates may differ. You can check your client’s enrollment, payment, and coverage details in the Oscar Broker Portal.

Enrollments appear in your book of business after Oscar receives and processes them. Processing times may vary.

If a policy is missing, check that the application was submitted and review your filters in the Oscar Broker Portal.

Still can’t find it? Contact Broker Support at brokers@hioscar.com with the application or policy details.

Log in to the Oscar Broker Portal open your client’s record in your book of business, and select Renewals to review their plan details and any next steps.

If renewal information isn’t available yet, check Oscar’s renewal materials for your client’s state and coverage year.

A producer usually sees policies that list them as the approved writing or servicing broker. An agency principal may see eligible business linked to the agency. An approved general agency user may see business linked to that general agency.

Access depends on contracts, roles, and permissions. Share member details only with approved users. Contact Broker Support at brokers@hioscar.com to request access for a specific user.

Good news - you can continue to complete your Oscar enrollments through the Oscar Broker Portal - and just a reminder that any client with no plan changes will automatically renew. No action needed.

Oscar’s enrollment dashboard activity will not be reflected on HealthSherpa. You will not be able to see the status of pending applications you’ve submitted through Oscar directly. If an application has been started in the Oscar Broker Portal but is not yet complete and you want to continue in HealthSherpa, you will have to start a new application.

For Individual plans: Our pediatric vision partner is Davis Vision, and our pediatric dental partner is Liberty Dental. You can find more information about what’s covered in the Schedule of Benefits found on our Forms (opens in new tab) page.

We’re here to support your Individual client needs!

For individual: For general support, please email our Broker Support Team at brokers@hioscar.com. This is your go-to source for any questions related to our plans, policies, or general inquiries.

You can enroll your HSA-eligible client in a health savings account through our partner, HealthEquity (opens in new tab).

1. Your client’s policy covers their newborn baby for the first 31 days¹
2. You have 60 days from the baby’s birth to formally add their newborn to their policy.

If the baby isn’t added within 60 days, claims for care between days 31 and 60 will be denied, and your client will be responsible for 100% of those costs (Let’s avoid that!)

a. After 60 days, the client will need to wait until Open Enrollment or another Qualifying Life Event (like moving) to add their baby to a plan.

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Note: Before enrolling their baby on their coverage, check to see if they are eligible for CHIP (opens in new tab).

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¹ Infant coverage dates vary for New York (NY) and New Jersey (NJ). If you live in NY, baby is only automatically covered for the first 48 hours post a vaginal birth, or 96 hours after a c-section birth. In New Jersey, baby is automatically covered for 60 days.

As a growing company, we love receiving feedback - both positive and constructive! Please email any feedback to brokers@hioscar.com.

What is the Children’s Health Insurance Program (CHIP)?

After your client’s baby is born, your client has up to 60 days (opens in new tab) to add them to their health insurance plan.

Before doing that, check if your client’s baby can get health insurance through CHIP. CHIP is a health insurance program run by the government that provides low-cost health coverage to children and pregnant women in families that earn too much money to qualify for Medicaid.

Each state has its own CHIP program and works with Medicaid. To see if your client’s baby can get CHIP, visit: https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/

In the event of an emergency that impacts Oscar’s normal processes, Oscar will send an email outlining any changes to normal operating procedures relevant to the sale and service of Oscar products. This email will be sent to all appointed agents who are affected. In addition, a copy will be sent to all GA partners with a request that they should distribute to their brokers/agents.

No. Clients can use their Oscar member ID card for medical, dental, and vision services.

They can also log in to their Oscar account or the Oscar app to access information about their dental and vision benefits.

It depends on the age of the dependent. Dependents ages 19 and older receive adult dental and vision benefits when enrolled in an eligible Oscar medical plan.

Dependents under 19 receive pediatric vision coverage, but pediatric dental isn’t included.

Visit Oscar’s Plans & Network page (opens in new tab) for plan details.

It depends on their plan. Texas Guided Care HMO plans require referrals for most specialist visits. Referrals must come from the client’s selected or assigned primary doctor’s office.

Some types of care don’t require referrals, including OB-GYN visits, urgent care, emergency care, and behavioral health services.

Visit Oscar’s Plans & Network (opens in new tab) to review referral requirements for your client’s plan.

Yes. Oscar offers select medical plans with built-in adult dental and vision benefits.

Availability varies by market and plan year. Eligible plan names include “with Adult Dental & Vision.”

We also partner with Allstate Health Solutions to offer separate supplemental plans, including dental and vision coverage.

No. Clients don’t need to enroll in dental and vision benefits separately when they choose an Oscar medical plan with built-in adult dental and vision benefits. It’s one plan with one bill.

Open Oscar’s Broker Training Resources (opens in new tab) for product training and enrollment guidance. Use Plans & Network (opens in new tab) for plan and network materials, and Forms & Notices (opens in new tab) for official forms.

Select materials for the client’s state, product, and coverage year. If the training you need is not listed, contact your general agency or Oscar sales representative. Share only materials approved for external use.

Oscar Unlocks lets eligible members earn rewards for completing certain activities, like creating an Oscar account or switching eligible prescriptions to a 90-day supply.

You can direct clients to their Oscar account (opens in new tab) to see which rewards they’re eligible for, how to earn points, and how to redeem them.

For questions about missing rewards, clients can contact their Oscar Care Team at (855) 672-2755.

Use Oscar’s Find Care (opens in new tab) and choose the client’s coverage year, plan, network, and location. Search for the providers you need, then click the print icon on to top right of the results page. To print more than one page of results, repeat this for each page.

If you need help getting a printed provider list, contact Broker Support at brokers@hioscar.com.

Networks can change. Confirm that the provider and care location participate in the client’s plan before care.

Starting January 1, 2027, clients can log in to their account or the Oscar app to access their dental and vision benefits, review claims, and find providers.

They can also use Find Care (opens in new tab) to search for in-network dental and vision providers.

Need help? Clients can call their Oscar Care Team at (855) 672-2755.

Use Oscar’s Find Care (opens in new tab) tool to search for providers by your client’s plan and location. Make sure both the provider and the care location are in network.

You can also use Find Care (opens in new tab) to search for dental and vision providers. You’ll be directed to the appropriate directory based on your client’s plan and benefits.

Look for plans that include “with Adult Dental & Vision” in the exact plan name, and verify the market and plan year on the Broker plan documents page (opens in new tab). For enrolled members, Broker Support can also confirm the active policy internally.

Use Oscar’s Find Care (opens in new tab) tool and select your client’s state and plan. Search for dental or vision providers, and you’ll be directed to the appropriate directory.

Since networks can change, confirm that the provider accepts your client’s plan before scheduling an appointment.

Clients get medical, dental, and vision benefits in one plan, with one monthly premium and one bill. They can also access their dental and vision benefits through their Oscar account starting January 1, 2027.

Be sure to explain what’s covered, what clients can expect to pay, and which providers are in network.

Use these resources:

Plan & Network materials: Oscar’s Plans & Network
Official forms: Forms & Notices (opens in new tab)
Training & Enrollment: Broker Training Resources (opens in new tab)

Choose the correct coverage year, state, and product. Your Oscar Broker Portal (opens in new tab) may have additional resources. If a needed item is not available, contact Broker Support at brokers@hioscar.com. Share only materials approved for external use.

Visit Oscar’s Plans & Network (opens in new tab) page to review coverage and costs for medical plans with built-in adult dental and vision benefits.

You can also use Find Care (opens in new tab) to find in-network dental and vision providers for your client’s plan.

Visit Oscar’s Plans & Networks page (opens in new tab) to review benefits, coverage, and costs for each plan.

For 2027, select Oscar plans in Arizona, Florida, Georgia, North Carolina, Ohio, South Carolina, Tennessee, and Texas include embedded adult dental and vision benefits. Look for “with Adult Dental & Vision” in the plan name.

Availability varies by location and plan. Check the client’s options and coverage year at Oscar’s Plans & Network (opens in new tab).

Anyone who meets the plan’s enrollment requirements can enroll. However, the built-in adult dental and vision benefits are only available to members ages 19 and older.

Check the plan documents for any additional eligibility requirements.

Yes! Oscar has sales teams that cover our various markets and product lines. Please reach out to your GA or email our Broker Support Team at brokers@hioscar.com, or call 1-855-672-2713 who can put you in touch with the Oscar Sales Executive in your market.

You can get information about Oscar’s products a few ways:

• Visit our Broker Resources page (opens in new tab) and navigate to the ‘Plans & Network’ page. Select the market you’re interested in from the drop-down menu at the top of the page for training materials, plan information, etc. If you are looking for plan documents (like SBCs, EOCs, SOBs, or forms) check out hioscar.com/forms (opens in new tab)
• Contact your GA (if you’re working with one). Our GAs are great resources for training and marketing materials.
• Attend a webinar or in-person training. Oscar holds webinars throughout the year and in-person trainings that tend to coincide with the Open Enrollment season. Check out our Broker Resources page (opens in new tab) to find any upcoming webinars or trainings.
• Reach out to Broker Support (brokers@hioscar.com) and they can connect you with a Sales Executive in your market.

To find and print a list of providers, follow these steps:

• Visit hioscar.com/care-options (opens in new tab)
• Click “Search Network”. Select your coverage year and area
• Search by type of provider
• On a Mac, hold the ⌘Command key and press P to print out the list of providers
• If you’d like multiple pages of results you will have to repeat the above on each page

This solution is not supported on PCs, we’re working on a solution and will update this resource when available.

Check out our Doctor and Drug Search Tool (opens in new tab) where you can find providers by name or speciality. You can find a summary of our network by state on the Broker Resource page (opens in new tab).

If you are already appointed with Oscar, your Writing Number/Broker ID can be found in the top right corner of your Broker account (opens in new tab) home page. You should have also received an email from us with your writing number.

If you are having trouble logging into your account or locating your unique email, please contact our Broker Support Team at brokers@hioscar.com.

There are three ways to make client payments:

• Online or through the Mobile app: Pay with a checking account or debit card at www.hioscar.com/member/payment (opens in new tab). This is the easiest, fastest, and most secure way. Set up autopay via ACH with a checking account, or make a one-time payment with a debit card.
• Phone: Pay with a checking or savings account by calling our Care Team at 1 (855) 672-2755. We can accept one-time payments and set up autopay.
• Check or money order: This is the least preferred method and will take longer to process. Your clients can follow the instructions provided on their bill to mail in payments.

The Forms Section (opens in new tab) of our website is your go-to source for SBCs, SOBs and HIPAA Auth forms.

Visit our Brokers Resource Page (opens in new tab) for rate sheets, member experience one-pagers, enrollment forms, network information, and more.

You can learn more about our networks on the Plans & Network portion of our Broker Resources Page (opens in new tab).

Our Rates and Plan Grids are posted on the Broker Resources Page (opens in new tab).

Yes. To make changes, you’ll need to complete an active renewal through the Oscar Broker Portal or the applicable Marketplace.

With your client’s consent, you can update their information or plan selection before completing the renewal.

Log in to the Oscar Broker Portal and follow the instructions to create your personalized enrollment link.

Before sharing it with clients, make sure your broker information is correct.

Need help? Contact Broker Support at brokers@hioscar.com.

Log in to the Oscar Broker Portal to get started.

Select your client’s state and coverage type, then follow the steps to compare plans, complete the application, and submit their enrollment.

Log in to the Oscar Broker Portal (opens in new tab) and use the quoting tool to explore available plans for your client.

Enter their location, household information, and coverage needs to compare plans, benefits, and estimated costs.

You’ll need your client’s name, date of birth, address, contact information, and details for anyone else enrolling.

Depending on the application, you may also need household income, Social Security numbers, immigration status, and current coverage information.

Make sure you have your client’s consent before starting the enrollment process.

An Enhanced Direct Enrollment (EDE) platform lets brokers enroll clients in Marketplace health plans without leaving the platform to apply separately through HealthCare.gov.

The Oscar Broker Portal (opens in new tab) offers EDE functionality, so you can help clients complete their Marketplace enrollment directly through Oscar.

Starting around mid-October, you can review your clients’ 2027 renewal plans in the Oscar Broker Portal (opens in new tab).

If a client is happy with their renewal plan, no action is needed. They’ll automatically renew into the plan shown for 2027.

If no renewal plan appears, the client’s current plan may be discontinued without an automatic replacement. You’ll need to help them shop for a new plan for 2027.

Your client’s household income helps determine whether they qualify for financial help that could lower their monthly premium.

Use your client’s best estimate of their annual household income when preparing a quote. The Marketplace determines their final eligibility for financial help.

If you need to edit any member detail, like an income adjustment or the number of dependents, you will have to start a new application for the member and it is no longer a “passive” renewal.

If your client has a Qualifying Life Event (QLE) and qualifies for a Special Enrollment Period (SEP), you can work with them to submit an application and the QLE documentation in the following ways:

Off-exchange (no subsidies) enrollment options:

• Online enrollment: We recommend all enrollments be submitted via your Broker account. Use the “Forgot Password” feature to reset your password if needed.
• Paper enrollment via GA: You may also submit paper enrollment forms to your GA for processing, if your GA accepts paper applications. Please access the Forms and Notices Resource Page (opens in new tab) to download your market’s form.

On-exchange (subsidy eligible) enrollment options:

• Direct online enrollment (FFM only): We have an integration with the FFM (healthcare.gov), so you enroll any FFM on-exchange clients directly through your Broker account instead of healthcare.gov
• Online enrollment for non-FFM states: For state-based exchanges (e.g., NYSoH, Pennie), please visit the exchange website to submit on-exchange enrollments.
• Your platform of choice: Your preferred platform that sits on top of the FFM (INSX, etc.)

Please note you must be appointed with Oscar in the state you’re enrolling to receive commissions. For FFM on-exchange policies, you must be FFM-certified to receive commissions.

For small group: To see if your client is eligible to enroll in our Small Group product, please check the Underwriting Guidelines for your market on the Broker Resources Page (opens in new tab).

For individual: To be eligible for off-exchange policies, your client must have their primary residence in one of our Coverage Areas. During Special Enrollment Period (SEP) other restrictions apply. Please see your market’s online (opens in new tab) or paper application (opens in new tab) for a list of Qualifying Life Events. If your client is enrolling on-exchange, other restrictions may apply.

Qualifying documents must be provided to sepdocuments@hioscar.com within 14 days of the effective date. All documents must be dated within the past 60 days from submission.

You can enroll clients online through your Broker account (opens in new tab). Afterwards, you and your client will receive an email providing further guidance on what documentation is required.

SEP documentation for on-exchange policies must be submitted directly to the exchange. The exchange will send you and your client instructions regarding the required SEP documentation.

After Oscar has processed the SEP enrollment application, you and your client will receive an email providing further instructions on what documentation is required and how to submit documentation.

Below you can find a list of the most common Qualifying Life Events and the required documentation for each. Please note that this is not an all-inclusive list.

!SEP documentation requirement examples

If you have questions regarding a different QLE, you can contact our Broker Support Team at brokers@hioscar.com.

SEP documentation for on-exchange policies must be submitted directly to the exchange. The exchange will send you and your client instructions regarding the required SEP documentation.

After Oscar processes the SEP enrollment application, you and your client will receive an email providing further instructions on how to submit required documentation. After you’ve submitted documentation, you and your client will either an approval or a request for additional documentation within 2-3 days.

If we do not accept the documentation provided, you and your client will receive a notice of cancellation by email along with clear instructions on how to provide additional documentation and request reinstatement.

If we do not receive any documentation following the enrollment, you and your client will receive several reminders to submit the appropriate documentation. If nothing is submitted within 14 days, the enrollment will be canceled.

SEP documentation for on-exchange policies must be submitted directly to the exchange. The exchange will send you and your client instructions regarding the required SEP documentation.

Yes. For 2027, clients in Florida and Texas can purchase optional Allstate supplemental coverage alongside their Oscar medical plan.

Supplemental coverage is sold separately, with its own benefits, costs, and eligibility requirements.

Log in to the Oscar Broker Portal and select Supplemental Coverage to explore available products.

Yes. Allstate Health Solutions has separate tools for managing supplemental coverage.

Log in to the Oscar Broker Portal and select Supplemental Coverage to access the appropriate Allstate or Lucie platform for your account.

No. Allstate Health Solutions products have separate appointment and licensing requirements.

Log in to the Oscar Broker Portal and select Supplemental Coverage to get started with the Allstate appointment process.

For 2027, clients in Florida and Texas can pair their Oscar medical plan with optional supplemental coverage from Allstate Health Solutions.

These are separate policies with their own premiums, benefits, and billing. Clients can purchase Allstate supplemental coverage without changing their Oscar medical plan.

Sign in to the Oscar Broker Portal and select the supplemental coverage link. It routes you to Lucie or the Allstate Health enrollment site, depending on whether you have a Lucie account.

Complete the required licensing, appointment, and account setup before selling. Oscar medical and Allstate supplemental policies use separate enrollment and payment processes.

Plan Enhancer is supplemental insurance from Allstate Health Solutions that provides cash benefits to help cover out-of-pocket expenses following an accident. Depending on the state, coverage may also be available for certain critical illnesses or hospital stays.

Plan Enhancer is sold separately and doesn’t replace comprehensive medical insurance.

For 2027, supplemental coverage through Oscar’s partnership with Allstate Health Solutions is available in Florida and Texas.

Availability may vary by product. Log in to the Oscar Broker Portal and select Supplemental Coverage to explore your options.

It depends on your state and appointment. For 2027, Allstate supplemental coverage is available through Oscar’s partnership in Florida and Texas.

Log in to the Oscar Broker Portal and select Supplemental Coverage to access the available products and sales tools.