This article explains the Carrier Policy Status Feed (CPSF): what it is, why carriers participate, and what carrier teams provides to enable it. It is written for carrier operations and technical teams.
What is the Carrier Policy Status Feed?
The Carrier Policy Status Feed is a recurring data feed your organization sends to HealthSherpa containing the policy statuses your systems hold for your members. Carriers often know things before HealthSherpa or the agent can see them from CMS: who is behind on payment, who never made a binder payment, and who has terminated. CPSF brings that knowledge into the platform so agents can act on it. Our data shows a dramatic increase in effectuation and retention for carrier partners who implement CPSF with us.
CPSF is complementary to the Data Exchange Postback. Postbacks send HealthSherpa enrollment data to your systems; CPSF sends your policy status data to HealthSherpa. |
Why carriers participate
Member retention: A carrier may know a member is delinquent well before termination, while the agent still sees "active" from CMS. With CPSF data, agents can step in during grace periods and binder windows, before the member is lost.
Effectuation: Policies sitting in pending effectuation represent members who selected a plan but never paid. Surfacing payment status gives agents a reason and a window to convert those signups into paying members.
Fewer disputes and false alarms: Accurate, current status data reduces mismatches between carrier and platform views of the same policy, which means fewer billing disputes and less noise for your service teams.
Renewal visibility: Status data also supports renewal-season workflows, including visibility into members who were passively renewed, often into a different plan or price, before the member realizes it.
Single source of truth for agents. Agents overwhelmingly prefer a single dashboard to manage their entire book. Carriers who don't provide this feed risk being the one plan an agent has to check somewhere else, which means less attention and less advocacy for your membership.
How it works
Your team delivers a recurring policy status file to HealthSherpa, typically on a nightly cadence. HealthSherpa matches your records against marketplace enrollment data and surfaces the resulting status information to the agents servicing those members. Match quality depends on two things being true at once: your file breaks statuses out by real coverage periods rather than flattened summaries, and HealthSherpa's marketplace baseline is freshly synced. HealthSherpa works with each carrier during onboarding to validate both.
What carriers provide
A recurring policy status file covering your HealthSherpa-relevant membership, broken out by coverage period
The exchange-assigned subscriber ID on each record, which enables person-level matching and materially improves match rates
A consistent delivery cadence agreed with HealthSherpa during onboarding
A named technical contact for file format questions and data quality follow-ups
Data quality matters more than data volume. A wrong "active" hides an at-risk member; a wrong "terminated" creates false alarms. HealthSherpa applies quality checks during onboarding and holds feeds to accuracy standards before statuses are broadly surfaced to agents. |
Onboarding at a glance
Kickoff with your HealthSherpa team to review the file specification and agree on cadence and delivery.
Establish SFTP delivery and send sample files for validation.
HealthSherpa runs match rate and accuracy analysis against marketplace data and works through any formatting or mapping issues with your team.
Once quality clears the bar, the feed goes live and statuses begin flowing to the platform.
Getting started
If you are interested in enabling the Carrier Policy Status Feed, or in improving an existing feed's match rate, contact your Technical Account Manager (TAM). They will share the current file specification and coordinate onboarding with HealthSherpa's data operations team.