ACA
Stop Sampling. Audit Every ACA Call.
Calladhere is AI call auditing software for ACA Marketplace agencies and call centers. It checks 100% of your recorded calls for consumer consent, application review, and plan accuracy, for a fraction of the cost of manual QA.
Consumer Consent
Application Review
Income & Household
Plan Switching
Premium Tax Credits
Enrollment Confirmation
The Problem
Where ACA Enrollment Compliance Breaks Down
What we hear from ACA agency owners and compliance officers before they switch. Selling Medicare plans too? See Medicare call compliance.
Most Calls Go Unheard
Sampling covers 10 to 20% of calls. The rest go unheard until a complaint.
No QA in Place at All
Many agencies have no call auditing at all, and nothing to show a carrier when asked.
Suspensions End Sales
Unauthorized enrollments can get an agent suspended from the Marketplace.
Manual QA Doesn’t Scale
Every new agent means more hours of listening. Coverage shrinks as your floor grows.
Consent Without a Record
If consent isn’t documented on the call, you can’t prove it was given when CMS asks.
Commissions on the Line
Carriers can withhold or claw back commissions on noncompliant enrollments, or end your contract.
Results
From a Floor of Reviewers to Three People
One agency had a floor of agents listening to 15 to 20% of its sales calls. Today three compliance agents cover every call across 3,000 to 5,000 deals a week, for about 64% less.
Call Auditing
Every Marketplace call, scored against CMS rules
Manual QA means reviewers listening in real time to a fraction of your calls. Calladhere audits every recorded sales call against your ACA scorecard, so consent never depends on sampling.
Consent captured before any enrollment
Application details reviewed with the consumer
Plan details checked against the enrolled policy
Violation Review
Stop unauthorized enrollments early
On a sampled floor, a plan switch made without documented consent can go unnoticed until the consumer complains. With Calladhere, every flag lands in a review queue with the transcript moment and the AI’s reasoning, and the agent gets a clear next step.
Jump to the exact moment in the recording
Corrective actions your team defines
Agent acknowledgment on every violation
Agent Performance
Coach the misses that create CMS risk
Without data, coaching is guesswork and low performers fly under the radar. See scores and repeat misses for every agent, so managers coach the behaviors that lead to suspensions.
Scores by agent, team, and question
Repeat misses like undocumented consent
Manager views scoped to their own agents
Reporting
The documentation CMS expects, on demand
When CMS or a carrier asks for proof, most agencies dig through recordings and notes. Calladhere shows consent was captured, every violation handled, and every agent coached, with exports ready for review.
Live compliance and violation dashboards
Filter by agent, team, carrier, or date
One-click exports for carrier audits
The Difference
Manual ACA QA vs. Calladhere
What changes when every call is audited automatically.
FAQ
What does CMS require for consumer consent on Marketplace calls?
Agents and brokers must get and document a consumer’s consent before helping them enroll through HealthCare.gov or apply for premium tax credits or cost-sharing reductions. The record must show the scope, purpose, and duration of consent, the date, the consumer’s name, the agent or agency being granted consent, and how the consumer can rescind it.
How long must ACA consent and application review records be kept?
At least 10 years. CMS rules at 45 CFR 155.220(j) require agents, brokers, and web-brokers to keep both the consent record and the application review record for a minimum of ten years and to produce them on request. For plan years ending before 2028, a consumer’s verbal confirmation captured in a call recording is one acceptable form of documentation.
What is the ACA application review requirement?
Before a Marketplace application is submitted, the agent must document that the consumer reviewed the eligibility application information and confirmed it is accurate. The record must include the review date, the consumer’s name, an explanation of the attestations at the end of the application, and the assisting agent’s name. Calladhere can check every recorded call for this step.
What changes for ACA consent documentation in 2028?
For plan years beginning on or after January 1, 2028, consent and application review must be documented by having the consumer take an action to execute an HHS-approved and HHS-created consumer consent form. That action can be a written or electronic signature or initials, an email, or a recorded verbal conversation. A typed name or a checked box is not enough.
What happens if an agent enrolls a consumer without consent?
Under 45 CFR 155.220, HHS can suspend an agent’s Marketplace agreements for up to 90 days over suspected fraud or abusive conduct, terminate them for cause, and seek civil money penalties. Depending on the carrier contract, commissions on noncompliant enrollments can also be withheld or clawed back. Calladhere flags calls where consent is not documented and assigns a corrective action your team defines.
How does Calladhere audit ACA calls?
Calladhere transcribes and audits 100% of your recorded Marketplace calls against your ACA scorecard, checking consumer consent, application review, income and household details, plan switching, and premium tax credit discussions. Every flag lands in a review queue with the transcript moment and the AI’s reasoning, and exports are ready for carrier or CMS review.
Does Calladhere connect to my dialer or CRM?
Yes. Calladhere has native integrations with TLD CRM and Convoso, ingests call and sale rows from Google Sheets, and accepts customers, policies, and recordings from any other dialer or CRM through webhooks and its API. AI tools like Claude, ChatGPT, and Cursor can connect through a read-only MCP server. EnrollHere is next on the integration list.
Ready to Audit
Every ACA Call?
See how Calladhere can transform your
compliance workflow in a single demo.