How to Generate Health Insurance Leads: An ACA Agent's Guide

Why It Pays to Generate Your Own Leads in 2027

According to KFF's analysis of individual market enrollment through mid-2026 (opens in a new tab), enrollment in the individual market fell 18% between June 2025 and June 2026, from 25.2 million to 20.5 million people. KFF also notes that roughly nine in ten people in that market are enrolled through the ACA Marketplaces. That is the pool you are selling into.

A smaller pool means more agents chasing each shopper. Shared leads get split more ways, and vendor quality matters more than ever. When you generate your own leads, you control the message, the timing and the consent trail, and nobody else is calling the same household.

The framework is simple. HubSpot's beginner guide to lead generation (opens in a new tab) defines it as attracting prospects and capturing their contact information so you can build a relationship and convert them, and notes that high-performing teams typically use both inbound and outbound channels. For an ACA agent, inbound means referrals, local content and community presence; outbound means paid ads and fast, direct follow-up.

Still weighing bought leads against built ones? Our comparison of lead sources for health insurance agents lays out the tradeoffs side by side.

Step One: Confirm You Can Enroll for Plan Year 2027

Lead generation is wasted money if you cannot write the business. According to the Federal Register notice on the temporary agent and broker registration moratorium (opens in a new tab), CMS paused registration, effective September 22, 2026, for agents and brokers who do not have Plan Year 2026 agreements with the Federally-facilitated Exchanges and want to assist consumers for Plan Year 2027.

The same notice says the moratorium remains in effect until February 1, 2027, unless CMS lifts it earlier, extends it or otherwise modifies it, and that it does not affect registrations on State-based Exchanges. Here is what to do this week:

• If you held Plan Year 2026 FFE agreements, finish your Plan Year 2027 training and registration now.
• If you did not, focus on State-based Exchange states where you are licensed, after confirming that exchange's own certification steps.
• Check carrier appointments in every state you plan to advertise in.
• Exclude any state where you cannot enroll from your ad targeting and quote page.

Registration rules can change mid-season. Recheck CMS agent and broker communications before you launch or expand any campaign.

Claim No-Cost Referrals Through Help On Demand

Help On Demand is the most overlooked source of health insurance leads. According to CMS's Help On Demand overview (opens in a new tab), it is a consumer assistance referral system that connects consumers seeking help with Marketplace-registered, state-licensed agents and brokers in their area, and referrals are provided to consumers and agents at no cost.

Consumers select Get Contacted on HealthCare.gov. The system matches them with an agent who is available, speaks their language and is licensed in their state, and routes to the geographically closest agent if more than one qualifies. Only agents who completed Marketplace training and registration and signed the applicable CMS agreements for the current plan year can participate. You are notified by email, text and/or app and have 15 minutes to accept or reject before the referral moves to the next agent.

Help On Demand runs through HealthCare.gov, so if you mainly serve a State-based Exchange state, check what referral options that exchange offers.

Set Up Your Help On Demand Profile to Win More Referrals

CMS's tips for maximizing Help On Demand participation (opens in a new tab) amount to a short checklist:

• Choose Email, Text & App Notification. CMS warns that email-only notifications can cause delays and lost referrals.
• Set your hours deliberately. If you select none, availability defaults to Monday through Friday, 8 a.m. to 5 p.m.; CMS suggests adding weekends or longer hours to get more referrals.
• List every language you can genuinely serve, since matching considers language.

After you accept, CMS expects you to contact the consumer as soon as possible, preferably within 15 minutes and no longer than 30. If they do not answer, CMS encourages three attempts before you mark the referral Not a Good Referral. You are not penalized for rejecting, so decline anything you cannot call promptly.

Opening script: "Hi, this is [name], a licensed agent. You asked for help with Marketplace coverage on HealthCare.gov and I was matched to you. Do you have ten minutes to look at your options now?"

Turn Your Book of Business Into a Referral Engine

Your existing clients already trust you, which makes them the cheapest health insurance lead generation channel you have. Most agents ask for referrals at enrollment, when the client is tired. Ask after a win instead: a claim sorted out, a reconciliation question answered, a renewal that kept their doctors.

1. Tag clients in your CRM who had a good outcome in the last 12 months.
2. After renewal, text them: "Glad we got your plan set for next year. If a friend or family member needs help with Marketplace coverage, I'd be happy to look at their options too."
3. Include a link to your quote page so the friend can start without a phone call.
4. Thank every referrer personally. Check your state's anti-rebating and referral rules before offering anything of value.

Layer in local inbound. Claim and update your Google Business Profile, and show up where self-employed people and early retirees gather: chamber events, small business groups, gig-worker meetups. Bring printed pieces from CMS's official Marketplace education and enrollment resources (opens in a new tab), some available in multiple languages, alongside your own card.

How to Generate Health Insurance Leads With Paid Social Ads

Paid ads are the outbound channel you can scale up or down by the week. For ACA, Meta is the usual starting point because you can target by location and test creative cheaply. Our guide to Facebook ads for ACA agents covers targeting and budgets. One rule up front: run ads on your own ad account so the pixel data, audiences and history stay yours.

Send Traffic to a Quote Page, Not a Bare Form

Instant forms are fast to fill out, which is also their weakness: plenty of people submit without real intent. A quote-first page, where shoppers enter ZIP, household and income and then see real plans with the tax credit applied, filters out curiosity clicks and gives you a warmer conversation. Here is why quote-first ACA landing pages convert.

Capture consent properly. Ask for permission to contact and permission to act on the Marketplace for the consumer as separate, signed steps, and store the records. Name yourself on the form so the shopper knows exactly who will call. Then hold paid leads to the same standard as Help On Demand: call within 15 minutes.

This is the system FastTrack builds for agents: a branded quote funnel on your domain under your NPN, separate consents signed and filed as PDFs, a GoHighLevel CRM configured for ACA, a prefilled HealthSherpa handoff, and Meta ads launched and tuned daily on your own ad account. Ad spend is billed by Meta directly, and your leads are never resold or shared.

Keep Your Health Insurance Lead Generation Compliant

This section is general information, not legal advice. Confirm specifics with your compliance resources, carriers and state regulator.

According to CMS's fact sheet on the 2027 Payment Notice final rule (opens in a new tab), effective July 20, 2026, prohibited marketing practices for agents and brokers include offering cash, monetary rebates or cash equivalents to induce enrollment; falsely asserting consumers will always qualify for zero-dollar insurance or zero-dollar premiums; and miscommunicating enrollment timelines and deadlines. CMS also finalized requirements for timely production of marketing materials for monitoring, audit and enforcement.

• Replace any "$0 plans for everyone" language with "you may qualify for lower costs."
• Drop gift cards or rewards for completing a quote.
• Match every date in your ads to official deadlines for the state you target.
• Archive every ad version, landing page and consent form with dates so you can produce them quickly.
• Avoid anything implying you are the government or HealthCare.gov.

Track Cost per Enrolled Household by Channel

Leads are not the goal; enrolled households are. Write the source on every lead, then track whether it was contacted within 15 minutes, quoted, and enrolled.

Hypothetical example: you spend $1,000 on ads, get 40 completed quotes and enroll 8 households. That is $25 per quote and $125 per enrolled household. Help On Demand costs nothing in cash but takes your availability, so log the hours too.

Decision rule: every two weeks, compare each channel's cost per enrolled household against what you have decided a household is worth to your agency. Fix speed-to-lead first, then creative, then cut what still misses.

Start Generating Leads You Own

This week: confirm your registration, set up Help On Demand with full notifications and wider hours, text your best clients for referrals, and audit your ads against the CMS prohibitions. Then point paid traffic at a quote page you control.

If you would rather have the quote funnel, consent capture, CRM and Meta ads built and managed for you, set up your own ACA lead generation system online, no sales call required.