Everything Agents Need to Know About Selling in State-Based Marketplaces

Agents who actively sell Affordable Care Act (ACA) insurance plans typically do business through either the federal exchange or state-based marketplaces. You’re likely familiar with HealthCare.gov, the federal exchange, but what are state-based marketplaces and how do they work?

Let’s review the information you need to know to effectively reach this demographic of your business and expand your sales!

Note: Throughout this post we may use “exchange” and “marketplace” interchangeably when referring to the platforms used to purchase ACA health plans.

State-Based Marketplaces Explained

A state-based marketplace (SBM) is a health insurance exchange that’s independently orchestrated by a state’s government. These exchanges offer plans that are supported in a specific state and available for purchase.

States that haven’t established their own exchange will participate in the Federally Facilitated Marketplace (FFM), aka the federal exchange. Clients who enroll in a marketplace plan in states that do not have an SBM enroll in coverage through HealthCare.gov or an approved Enhanced Direct Enrollment (EDE) site.

State-Based Marketplace-Federal Platforms

There’s an additional category of SBM that deserves to be recognized — State-Based Marketplaces on the Federal Platform (SBM-FP). In this type of marketplace, the state is responsible for conducting all usual business for an individual marketplace but relies on the federal exchange for eligibility and enrollment functions. Clients in SBM-FP states enroll in coverage through HealthCare.gov.

The states participating in SBM and SBM-FP exchanges are noted on the map below.

Which States Utilize SBMs?

Currently, there are 21 states and D.C. that use SBMs and two states (AR and OK) that use SBM-FPs. Illinois and Oregon are now fully state-based marketplaces. Use the map below to see if your state participates in an SBM, and if Ritter supports products in your state!

Significant Changes That May Affect SBMs in 2027

As of the republishing of this post, agents who are selling in SBMs for the first time for plan year 2027 are in a great position for success!

We will continue to update agents about the important changes that affect the independent health insurance market. The Centers for Medicare & Medicaid Services (CMS) have issued a temporary moratorium on new federal marketplace agent registrations for plan year 2027. Agents seeking to complete FFM certification for the first time in 2027 or who did not complete FFM certification in 2026 cannot complete the training at this time. This moratorium is in place until February 1, 2027, unless it is extended, lifted, or otherwise modified.

For more information about the pause, read our post on the subject or read the full moratorium here. We will continue to update agents about the important changes that affect the independent health insurance market.

Agent Training Requirements

Agents who are looking to sell Under-65 plans in SBMs should be aware that there are training requirements for each exchange. These training requirements vary by state; we recommend checking with each exchange you’d like to sell through and completing training through their platform.

Ritter works with the following states that have special training requirements:

• Maryland: Agents must apply and complete initial training to receive their authorization to sell. Broker authorization expires after two years. The exchange will send a renewal notice no later than 60 days prior to expiration date. Annual certification is also required.
• New Jersey: Agents must first complete the Broker Intent to Sell form. Annual certification is also required.
• New York: Agents are not required to certify annually but must certify every two years from their initial certification date.

These training requirements vary by state; we recommend checking with each exchange you’d like to sell through and completing training through their platform.

Note: Agents who sell ACA products in FFM states must complete FFM training through HealthCare.gov or an approved EDE such as IntegrityCONNECT. Due to the existing CMS moratorium on new FFM registrations, you cannot currently complete the FFM certification if it would be your first time taking it in 2027 or if you did not complete FFM certification in 2026._

State-Based Marketplace Enrollments

Agents enrolling clients residing in SBM states should complete enrollments through the state’s platform. Find the right exchange here

Here are the links to the SBMs Ritter currently works with:

• MyArkansas Insurance
• Covered California
• Connect for Health Colorado
• Access Health CT
• Georgia Access
• Get Covered Illinois
• Kentucky Health Benefit Exchange
• Maryland Health Connection
• GetCoveredNJ
• NY State of Health
• Oklahoma Insurance Department
• Pennie
• Virginia’s Insurance Marketplace

The process of enrolling a client in one SBM may vary from enrolling them in another SBM or the federal exchange. We recommend taking your time and following the instructions on the state’s platform.

Coverage Effective Dates

The Open Enrollment Period (OEP) runs from November 1 to January 15 in most states. Be aware that some states can set their own OEP dates.

Current marketplace enrollment timelines remain subject to ongoing litigation and regulatory guidance. State-based marketplaces may continue to issue guidance based on court rulings and evolving regulatory requirements.

Applications submitted during the OEP will have a January 1 effective date.

Please note that state exchanges can choose their own OEP dates

Any client who misses the OEP is only able to enroll in coverage by being eligible for a Special Enrollment Period (SEP). In these cases, coverage is effective the first of the month after the application is submitted.

Remember, coverage will not be effectuated until the binder payment is made. This payment is typically the first month’s premium and is due 30 days after enrollment.

Selling ACA plans is a great opportunity to reach new customers and expand your business. The different exchanges don’t have to be as scary as they may seem.

At Ritter, we’re committed to helping you understand SBMs, SBM-FPs, the federal exchange, and all changes and transitions that happen in the Under-65 market.

If you’re not already a Ritter agent, register today to utilize all of our resources such as guides and eBooks, exclusive webinars and trainings, and our experienced Sales team.