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Playbookfor health and aca insurance brokers

ACA insurance calling playbook for broker teams

Updated September 28, 20265 min read4 primary sources

An insurance agent taking notes on a pad during a headset call

The short answer

This playbook organizes ACA enrollment calling around documented inquiries: a first callback inside the hour, five attempts over two weeks, morning and evening blocks inside quiet hours, and dispositions that keep consent evidence on every lead. KPI targets are given as ranges against production reference numbers measured on 3-line sessions, presented as reference points rather than promises.

Step by step

  1. 1

    Route every inquiry into the callback queue with its evidence

    Each form submission imports with source, timestamp and the consent language the person saw. The inquiry record is your evidence that the person asked to be contacted, so it stays attached to the lead forever, not in a separate inbox.

  2. 2

    Set the first callback inside the hour

    Inquiry leads decay fast in enrollment season. The block structure puts fresh inquiries at the top of the next block, and inside the hour when volume allows. Speed matters more than script polish on attempt one.

  3. 3

    Scrub cold rows before they enter the dialer

    Any aged or purchased portion of the list gets National DNC scrubbing refreshed at least every 31 days, because 47 CFR 64.1200(c)(2) requires a registry version no older than 31 days. Calling hours stay inside 8 a.m. to 9 p.m. local at the called party's location under 16 CFR 310.4(c) and 47 CFR 64.1200(c)(1).

  4. 4

    Run attempts in two blocks with an evening window

    Morning block 9 to 11 for seniors and shift workers, lunch block 11:30 to 1 for hourly workers, evening block 5:30 to 8 for people at work during the day. All inside quiet hours at the lead's local time, which the dialer computes per row.

  5. 5

    Cap the cadence at five attempts over two weeks

    Attempt one same or next day, then day 2, day 4, day 8 with a voicemail, day 14 final. A lead with no contact after five attempts goes to a renewal-season requeue, not a sixth attempt this month.

  6. 6

    Keep PHI out of the phone conversation until the consultation

    Income specifics, medical history and immigration details belong in the consultation, not on a recorded marketing line. Recording requires all-party consent in several states; use a disclosure and be deliberate about which calls are recorded and stored.

  7. 7

    Disposition in enrollment terms after every call

    Consultation booked, Callback, Documents needed, Already enrolled, Not eligible window, Unreachable, Left voicemail, Do not call. Documents needed leads get a text with the exact list the same hour.

  8. 8

    Review KPIs weekly as ranges

    Track dials per active hour, contacts, consultations booked per 100 contacts, and show rate. Compare against the production reference points, then fix list or offer before coaching pace.

What this playbook covers

ACA enrollment calling succeeds on speed and evidence: speed to the first callback, and evidence that every number you dial asked to be called. This playbook covers the inquiry pipeline, block structure, cadence, dispositions, PHI boundaries, and KPI targets as ranges against production reference points. It is written for broker teams running three lines per rep in DialBreeze during open enrollment and special enrollment windows.

List building and hygiene

The core asset is the inquiry list: forms, landing pages, and event sign-ups where a consumer asked about coverage. Every inquiry row imports with source, timestamp and consent language. That record is the lead’s provenance and your evidence; it never lives in a separate inbox where it can be lost.

Hygiene rules:

  • Internal do-not-call entries suppress before import, every time.
  • Cold or aged rows require National DNC scrubbing with a registry version refreshed at least every 31 days, per 47 CFR 64.1200(c)(2). Consumer calling here is telemarketing under 16 CFR 310.4, so DNC discipline, honest disclosures and abandonment limits all apply.
  • Bad numbers get one strike on inquiry lists, because a mistyped digit is common and re-dialing a stranger twice reads badly.
  • Keep carrier-arrangement questions out of the calling workflow entirely unless your privacy review cleared the data path; if any arrangement touches protected health information, HIPAA rules at 45 CFR 164.502 and 164.508 govern use and disclosure, and marketing communications generally require authorization.

Call block structure

Three blocks sized to when consumers actually answer:

Morning block, 9:00 to 11:00. Seniors, shift workers, and parents after school drop-off. Fresh inquiries land at the top of this block.

Lunch block, 11:30 to 1:00. Hourly workers answer on breaks. This block runs the highest connect rates on working-age lists in many teams; watch your own numbers and confirm.

Evening block, 5:30 to 8:00. Salaried people who could not take a daytime call. Evening also has the best two-way confirmation behavior: people who answer at night will text back.

All blocks respect quiet hours at the lead’s local time. The dialer computes local time per row, which matters the moment a list crosses time zones.

Attempt cadence

Five attempts over two weeks, then stop:

  1. Attempt 1, inside the hour or same day. Live callback, provenance opener, book the consultation.
  2. Attempt 2, next day, different daypart. If a gatekeeper or voicemail hit first, this attempt usually reaches the person.
  3. Attempt 3, day 4. Short voicemail naming the inquiry date; no plan talk.
  4. Attempt 4, day 8, evening. Last live-focused attempt. Two-way text if the person ever replied by text.
  5. Attempt 5, day 14, final. A closing voicemail that names the deadline math: windows close, and you will requeue them for renewal season.

After five attempts without contact, the lead requeues for the next season with its evidence intact. Attempt caps in the dialer enforce the stop.

Dispositions and what they mean

  • Consultation booked: date, time, documents list, confirmation sent. The task exists before the rep moves on.
  • Documents needed: person is ready but missing paperwork; text the exact list the same hour and date the follow-up.
  • Callback: a dated promise, never an open later. The date goes on the lead before the next dial.
  • Already enrolled: logged with coverage type; these leads become renewal-season reviews, not re-pitch targets.
  • Not eligible window: special enrollment trigger absent or window closed; requeue for open enrollment with a dated task.
  • Unreachable / Left voicemail: attempt counts with daypart logged.
  • Do not call: internal suppression same day, before the next block. A revocation of consent can come by any reasonable means under 47 CFR 64.1200(a)(10) and must be honored within a reasonable time not to exceed ten business days, so same-day is the operating standard.

The three-line workflow and AI summaries

Three lines turn the rep into a connect handler. The working rhythm:

  • Fresh inquiries first in every block; the queue order is the strategy.
  • Provenance opener, situation question, income range, household, close on two dates. Under four minutes.
  • Edit the AI summary before the next connect: situation category, income range, household, enrollment trigger, consultation slot, documents promised. The consultation is run from these fields.
  • Confirmations go out same-hour by text from the dialer number, which also gives the consumer a real callback path.

Summaries export with the CSV so producers walk into consultations prepared, and compliance reviews can trace every lead from inquiry to disposition.

KPI targets

Express targets as ranges against production reference points. In production use across 3-line sessions over 90 days, the median was about 85 dials per active hour and roughly 600 dials per operator day, with person connects around 17.8 percent. Planning ranges:

  • Dials per active hour: 60 to 90. Enrollment lists with many night connects can run at the top of the range in evening blocks.
  • Dials per operator day: 350 to 600 across three blocks.
  • Person connects: 10 to 25 percent; inquiry-heavy days run above that and are the reason attempt one gets the best rep hour.
  • Consultations booked: 15 to 30 per 100 person contacts on clean inquiry lists. Below that, fix the provenance opener or the document ask before coaching pace.
  • Show rate: 60 to 80 percent with same-hour text confirmations; below 60 percent usually means the documents list was too long.

These figures are measured in production use, 3-line sessions, 90 days; they are reference points, not a promise of results for any team.

Compliance guardrails

Callbacks to documented inquiries are the safest workflow, and the inquiry record is the evidence, so it stays with the lead. Outbound consumer campaigns remain telemarketing: 16 CFR 310.4 governs disclosures, 8 a.m. to 9 p.m. local hours, DNC and abandonment, and TCPA rules at 47 CFR 64.1200 apply on top. The FCC’s consent definition sits in 47 CFR 64.1200(f); the 2024 one-to-one consent requirement was vacated in January 2025 and is not current law. Recording rules are stricter here because calls can touch health details: several states require all-party consent, so use a disclosure and record deliberately. DialBreeze applies your internal DNC list, quiet hours and attempt caps; eligibility, consent and PHI decisions are yours. This guide describes rules, not legal advice.

FAQ

What dials per hour should the team expect?
In production use across 3-line sessions over 90 days, the median operator ran about 85 dials per active hour and roughly 600 per operator day, with a person-connect rate around 17.8 percent. Plan on ranges instead: 60 to 90 dials per active hour, 350 to 600 per day, and person connects from 10 to 25 percent depending on list mix. These are production reference points, not a promise.
How fast must we call a new inquiry?
Inside the hour when staffing allows, and always the same day. Enrollment inquiries are comparison shopping; the first useful conversation tends to book the consultation, and later attempts fight a memory of a form they barely remember submitting.
What documents should the confirmation text list?
Last year's tax return or recent pay stub, dates of birth for everyone seeking coverage, and the names of doctors or prescriptions that must stay covered. Three items is the ceiling; longer lists depress show rates.
Are special enrollment leads different from open enrollment leads?
Yes, and the summary should record the trigger. A job loss or marriage gives a dated window, so cadence compresses: the person must act within the event window, so attempts run tighter and the documents question comes earlier.
What is the PHI line during a callback?
Situation category, rough income range and household size are enough to book the consultation. Anything that identifies a medical condition, or any payment detail, waits for the consultation environment where your privacy rules and storage controls actually apply.

Sources

  1. ecfr.gov /current/title-16/chapter-I/subchapter-C/part-310/section-310.4
  2. ecfr.gov /current/title-47/chapter-I/subchapter-B/part-64/subpart-L/section-64.1200
  3. ecfr.gov /current/title-45/section-164.502
  4. ecfr.gov /current/title-45/section-164.508

Operational guidance, not legal advice. Rules vary by state and by campaign.

Related guides.

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Put the script to work.

Three lines, a recording of every connected call and the notes written after you hang up.

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