CRM, dialer and texting for ACA health insurance agents

APEX is a CRM, dialer and texting platform for agents who sell ACA Marketplace health insurance. It puts inbound lead capture, a power dialer, two-way SMS, automations and appointment booking in one system, and runs Do-Not-Call, quiet-hours and consent checks before outreach goes out.

ACA selling is a volume problem squeezed into a short calendar. Most of the year's enrollments land in a few weeks, leads arrive faster than one agent can call them back, and the people on the other end are comparing options with several agents at once. The tools that matter are the ones that keep you first to respond without letting the pace break your outreach rules.

The ACA calendar: open enrollment and special enrollment

Marketplace open enrollment starts on 1 November each year. When it ends depends on the plan year and on whether your state uses HealthCare.gov or runs its own exchange, so confirm the current dates for every state you are licensed in before you plan a campaign. Outside open enrollment, consumers generally qualify for a Special Enrollment Period only after a qualifying life event — losing other coverage, moving, marriage, a new child — and usually have 60 days from that event to pick a plan.

That gives an ACA book three distinct working modes:

• Before open enrollment: clean and import your lists, re-contact last season's clients about renewal, and schedule reminders so the first week is not spent on data entry.
• During open enrollment: answer new inbound leads within minutes, work the callback queue on the dialer, and keep text follow-up running for the people who did not pick up.
• The rest of the year: fewer, time-sensitive SEP leads, where the consumer's 60-day window is the deadline you are working against.

Responding while the lead is still shopping

An ACA lead who filled out a form is usually filling out more than one. The agent who calls or texts first gets the conversation. APEX is built around shortening that gap: web forms and webhooks from lead capture and smart forms create the contact the moment it is submitted, inbound routing sends calls and texts to the right agent, and the lead lands in a pipeline stage you can work from immediately. Our guide to speed to lead for insurance agents covers how to set that first response up.

Once the lead is in, the calling suite dials from your own numbers with local presence, records calls, and writes the outcome back to the contact, so a callback made on day three starts with everything that happened on day one.

High-volume outreach with the checks still running

Open enrollment is exactly when agents are most tempted to skip steps: a bought list goes straight into a text blast, or a callback goes out after hours because the queue is long. APEX runs its checks on every send rather than relying on someone to remember them under pressure:

• DNC checks against federal, state, internal and litigator lists before a call or text goes out.
• Quiet hours applied in the contact's local time, which matters when one open enrollment campaign spans several time zones and states with their own calling windows.
• Consent capture, so the opt-in is recorded with the contact rather than in a separate spreadsheet.
• Landline removal before a text campaign, and multi-number rotation to protect sender reputation when volume spikes.

State rules differ on calling hours, consent and registration. Our state telemarketing and SMS rules hub summarises them state by state, and importing a clean lead list walks through list hygiene before the season starts.

Open enrollment compresses a lot of calling and texting into a few weeks, so the states that cap frequency or require written consent matter most:

• Florida: 8 a.m.–8 p.m. and three calls per 24 hours.
• Oklahoma: 8 a.m.–8 p.m. and three calls per 24 hours.
• Maryland: 8 a.m.–8 p.m. and no more than three solicitations per 24 hours on the same subject.
• Connecticut: 9 a.m.–8 p.m. and prior express written consent for sales calls and texts.
• Tennessee: its own Do Not Call/Text Register.
• Washington: 8 a.m.–8 p.m.

Follow-up across a compressed window

Most ACA prospects do not enroll on the first call. They need a document, a household member, or a subsidy estimate, and then the deadline arrives. The follow-up problem is not a months-long nurture — it is making sure nobody falls through during a few busy weeks. SMS automation sequences stop when the lead replies, scheduled messages let you queue deadline reminders in advance, and the two-way texting inbox keeps every reply attached to the right contact. For volume sends to opted-in clients, see bulk texting.

Which APEX plan fits an ACA workflow

Because ACA follow-up leans heavily on text, most ACA agents will want Professional at $147/month, which adds SMS messaging, AI features, automations, a messaging inbox across SMS, WhatsApp and email, and appointment booking. Starter at $97/month covers calling, the autodialer, pipelines, contact lists, calendar and lead source integrations, and quiet-hours and DNC checks — but no texting, AI or automations — so it suits an agent who works the season entirely by phone. Agencies staffing up for open enrollment should look at Enterprise, priced for your team, which adds agency tools: team hierarchy, round-robin lead routing, a team inbox and team analytics. Full details are on the pricing page.

See it before open enrollment

The best time to set up an ACA workflow is before 1 November, not during the first week. Book a demo and we will walk through lead intake, the dialer and follow-up automations against the way your book actually runs.