Private health insurance leads vs ACA marketplace leads

Side by side

The two leads can come from the same ad. What separates them is what the consumer answered, and whether anyone asked before the lead was sold.

• Income: ACA lead is subsidy-eligible; private lead is above the subsidy range
• Health: ACA plans accept any health history; private plans review it, so the private lead has reported no major conditions
• What they need: ACA lead needs a subsidized marketplace plan; private lead needs a private plan
• When they can enroll: ACA during open or special enrollment; private any month
• Agent economics: ACA commissions are small and subject to chargeback; private-plan first-year commissions are typically several times higher
• Who else has the lead: most ACA leads are shared or aged; U65 private leads are exclusive to one agent permanently

Why vendors do not separate them

Separating them means asking disqualifying questions before the lead exists and then not selling the ones who fail. That reduces the number of leads a vendor can sell from the same ad spend. Most vendors are paid per lead, so they sell every response and let the agent sort it out.

What this means for an agent who sells private plans

If your book is private, short-term, indemnity, or association coverage, a marketplace-heavy lead file is mostly waste. You pay for every lead and can write a fraction of them. A screened private lead file costs the same per lead and nearly all of them are people you can help. Two or three written private policies typically cover a full week of fifty U65 leads.