HealthSherpa now offers tools to help you with pre-enrollment verification for consumers who are eligible for a Special Enrollment Period (SEP). As a reminder, SEP verification issues (SVIs) must be resolved before plans can be effectuated and started.
With our latest updates, you can now:
Quickly identify clients with SVIs
Download a file of SVIs to work on
Email clients so they can upload follow-up documents directly
Read more below about how to access these new features, a refresher on DMI and SVI definitions, and why this is timely.
Why this matters
CMS recently announced that as of May 16, 2025, pre-enrollment verification for consumers reporting a loss of health coverage will once again be actively enforced. While many agents have continued verifying SVIs all along, this announcement is a signal that enforcement will be more consistent going forward. See which documents are accepted to confirm loss of coverage.
See which clients need follow-up documents in HealthSherpa:
Go to your Clients page and select the Documents due tab to view clients with pending follow-ups. Filter or sort by Status or Deadline to prioritize what’s most urgent.
NEW! This list now includes SVIs in addition to DMIs.
Need a file to work from? Use the new SVI follow-ups export, available from the Exports page.
If you have an Agency Admin account, go to your Agency page and choose the Exports tab.
Upload or collect follow-up documents:
Send a secure upload link to your client so they can submit documents directly. Find the link to share:
- Clients page → Actions
- Documents due tab → Actions
- Client details → Follow-ups
Upload files yourself: Go to your Clients page and select a consumer’s name to open the Client details page. Read How to upload follow-up documents or watch the video.
Consumers typically need to upload documents to resolve DMIs and SVIs. Getting documents uploaded on time ensures your client keeps their subsidy and/or coverage. In short:
DMI = There’s a question about the data on the application
SVI = The reason for SEP eligibility needs to be verified
A Data Matching Issue (DMI) means the information entered on a consumer's subsidy application doesn't match what is on file with the government (or may not be available within their records) and therefore needs to be verified. DMIs do not prevent coverage from starting, but can end coverage or change APTC eligibility if not resolved.
An SEP Verification Issue (SVI) occurs when a consumer is eligible for an SEP due to a Qualifying Life Event (QLE), such as losing coverage, and is asked to verify they have experienced the QLE. SVIs must be resolved before the plan can be effectuated and started. See our Guide to SEP and qualifying life events.
We hope these updates help you stay organized, act quickly, and help your clients get and keep their coverage.
If you have any questions, our Agent Support team is here to help! Contact us at agent_support@healthsherpa.com, (888) 684-1373, or by chat from within your account.
Sincerely, Team HealthSherpa
HealthSherpa, 1215 19th St. 2nd Floor, Sacramento, California 95811, United States
