ACA Script for Call Centers: Fronter and Verifier
An ACA script screens callers for an Affordable Care Act marketplace plan: current coverage, household size, estimated yearly income and state. Callers who may qualify are transferred live to a licensed agent who can review plans and enroll them. Below: the full script, objections, handoff, verifier steps and rejection reasons.
ACA fronter script
This is a sample. Run the script and disclosures your compliance team has approved for your campaign and your states.
- 01
“Hi, is this [Caller first name]? This is [Agent name] from [Agency name] on a recorded line. How are you today?”
- 02
“You recently asked about health coverage, and I can check whether a licensed agent can help you in about a minute. Is now a good time?”
- Read your approved consent and disclosure word for word. Marketplace rules change, so confirm the wording with your buyer and compliance counsel.
- 03
“[Your required disclosure: for example, who you are, that you work with licensed agents, and that this call is recorded.]”
- 04
“Just so you know, we're a licensed agency, not Healthcare.gov or the government.”
- 05
“Do you currently have health insurance, through work, Medicare, Medicaid or on your own?”
- Covered through an employer, Medicare or Medicaid, if your buyer excludes them: thank the caller, disposition and end politely.
- 06
“How many people are in your household, including yourself?”
- 07
“And roughly what is your household's yearly income? An estimate is fine.”
- 08
“Which state and ZIP code are you in?”
- Outside Open Enrollment, ask about a recent qualifying life event, such as losing coverage or moving. None: end politely.
- 09
“Thanks. Based on that, a licensed agent can check the plans available to you. It's free to talk with them and there's no obligation. I'll connect you now, please stay on the line.”
ACA objections and rebuttals
What callers say most often, and a compliant answer for each. Acknowledge, answer briefly, then move the call forward or end it.
Caller: “Is this Obamacare? Are you the government?”
“I'm with [Agency name], a licensed agency that helps people with Affordable Care Act plans. We're not Healthcare.gov or the government.”
Caller: “Why do you need my income?”
“Good question. Household income affects which plans and savings may apply to you. An estimate is fine, and the licensed agent will confirm everything with you.”
Caller: “I can't afford health insurance.”
“I hear that a lot. I can't promise a price, but the licensed agent can show you what's available for your household and income, and you can decide from there.”
Never promise a free plan, a premium or a subsidy amount.
Caller: “How did you get my number?”
“[State your lead source exactly as your compliance team approves it, for example: You requested health coverage information on [source] on [date].]”
Caller: “I don't want to give you my Social Security number.”
“You don't need to. I won't ask for it. I only need a few basic details to see if a licensed agent can help you.”
Caller: “I'm busy right now.”
“No problem. When's a better time today or tomorrow? I'll set a callback so you don't have to start over.”
Caller: “Take me off your list.”
“Of course. I'm marking your number as do not call right now, and you won't hear from us again. Have a good day.”
End the call straight away. Do not rebut, do not ask why. Mark the number DNC before the next dial.
The transfer handoff
- 01
“Hi [Closer name], I have [Caller first name] from [State] on the line. They're not covered through work, have a household of [number], and gave an estimated yearly income. They've heard the disclosure.”
- 02
“[Caller first name], [Closer name] is a licensed agent who can go over your options. Thanks for your time today.”
- Stay on until the closer greets the caller, then drop. No answer means a booked callback.
What gets a transfer rejected
- The caller already has employer coverage, Medicare or Medicaid and your buyer excludes them
- Household income is outside the range your buyer accepts
- The call is outside Open Enrollment and the caller has no qualifying life event
- The disclosure or consent was skipped or incomplete
- The caller thought they were speaking with Healthcare.gov or the government
- The caller lives outside the agent's licensed states
- Dead air or the caller dropped before the closer said hello
- It breaks your buyer's duplicate or minimum-duration rules
ACA verification script
The verifier confirms the details on a recorded line, one statement at a time, and saves every answer.
Verification steps
- 01Confirm the caller's identity: full name, date of birth and address
- 02Confirm they understand they spoke with a licensed agency, not Healthcare.gov or the government
- 03Capture any consent your compliance team requires, such as consent for the agent to help with the application
- 04Read back household members and income as the agent recorded them
- 05Read back the plan and monthly amount exactly as the agent wrote them, without adding or rounding
- 06Capture a clear yes or no to each statement, then mark the verification passed or failed
Verifier script
- 01
“Hi, this is [Agent name] with [Agency name] on a recorded line. I'm confirming the details from your enrollment call.”
- 02
“Can you confirm your full name, date of birth and address?”
- 03
“You understand that [Agency name] is a licensed agency and not Healthcare.gov or the government. Is that correct?”
- Read each required consent and statement, one at a time. Unclear answers fail.
- 04
“Thank you, your information is confirmed.”
Before you run it
- Never present yourself as Healthcare.gov or a government agency
- Read the approved consent and disclosure, and recheck it each season because the rules change
- Only a licensed agent discusses plans, prices or subsidies
- Never promise a free plan or a subsidy amount
- Record every call
- Honor do-not-call requests immediately
Run this script on a bot
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ACA script questions
Put your ACA script on a bot this week
Send us the script your fronters read today. We set the bots up on it, you approve a test call, and your 3-day free trial starts.