Why Some ACA Clients Switch Agents (And How to Prevent It)

Losing clients is frustrating, especially when you’ve spent time helping them enroll and ensuring they get the best coverage. Yet, many ACA agents experience client churn without fully understanding why. The average churn rate we see with ACA agents is around 1-3% of their book per month. Some very fragile and poorly managed books have attrition rates as high as 5-10%, making it difficult to maintain steady growth. Let’s dive into the most common reasons clients switch agents—and, more importantly, how you can prevent it.

1. Lack of Communication & Follow-Up

One of the biggest reasons clients leave is that they don’t hear from their agent after enrollment. If you’re only reaching out once a year during Open Enrollment, you’re leaving the door wide open for another agent to swoop in.

How to Fix It:

• Implement automated check-ins throughout the year (birthday messages, holiday greetings, subsidy reminders, etc.). With PolicySync, you can visualize all client enrollment data from HealthSherpa, giving you insights into upcoming renewals, policy changes, and potential at-risk clients.

• Send educational content about policy changes, renewal deadlines, and tips to maximize coverage.

• Regularly check in with clients to ask how their coverage is actually working for them—Are their medications covered? Are their doctors in-network? PolicySync’s full client lookup feature allows agents to see every detail of a client’s enrollment, helping them make informed decisions before reaching out and preventing unexpected policy issues.

• Always be the first to provide updates, so clients aren’t hearing from another agent before they hear from you.

Losing clients doesn’t always happen directly. It can happen quietly, when a client starts enrolling their friends or family members with a different agent simply because they haven’t heard from you. Staying top-of-mind ensures your clients remember that you're not just their agent—but also the go-to resource for the people they care about.

2. Another Agent Offered Them “Better” Coverage

Sometimes, clients switch because another agent convinced them they could get a better plan—even if the plan wasn’t actually better. This is common when competitors use misleading marketing tactics.

How to Fix It:

• Educate your clients upfront about how ACA plans work and why switching plans isn’t always the best move.

• Make sure they understand that switching plans mid-year will reset their deductible and out-of-pocket maximum (OOPM), which could cost them more—especially if they’ve already been using their benefits and building toward those limits.

• Keep track of your clients' needs and proactively reach out if a better plan option does become available. With PolicySync, agents can easily identify which clients are up for renewal, track potential data mismatches, and address outstanding document issues before they become problems.

• Offer an annual policy review to ensure your clients always feel like they’re getting the best deal.

3. Clients Don’t See Value in Staying with You

If a client only sees you as someone who enrolls them once a year, they may not think twice about working with a different agent next time.

How to Fix It:

• Position yourself as their trusted advisor, not just an agent. Offer year-round support and answer any questions they have—even when it’s not Open Enrollment.

• Provide additional services like guidance on dental/vision plans, life insurance, or even Medicare transitions.

• Stay engaged on social media, post helpful content, and remind clients that you’re always available. PolicySync provides a detailed overview of your book of business, showing you client retention trends, renewal rates, and AOR losses to help you make strategic decisions.

4. Poor Customer Service & Availability

A major reason clients switch agents is simply not being able to reach them. If a client feels like they can never get a hold of you, they won’t hesitate to find another agent who is more responsive.

How to Fix It:

• Make yourself available via multiple communication channels (phone, text, email, social media, etc.).

• Set clear expectations for response times and be consistent.

• If you’re too busy to handle all inquiries, consider outsourcing administrative tasks or using automation tools like PolicySync helps agents track lost enrollments, identify policies at risk of termination, and monitor data matching issues, ensuring they can intervene before a client switches agents.

5. Fraud & Unauthorized Policy Changes

Unfortunately, fraudulent activity is another growing reason clients switch agents. In the current CMS environment, almost all enrollments require a three-way call with the marketplace or the consumer completing their enrollment through a resume link. Some bad actors, however, have been known to impersonate clients on calls with the marketplace, switching their plans to take over as the Agent of Record (AOR).

If a client tells you they haven’t spoken to anyone and they have no idea why their policy was changed, it could be a case of fraudulent activity. Keeping a watchful eye on your enrollments is critical.

How to Fix It:

• Regularly audit your book of business for unauthorized AOR changes. PolicySync gives agents visibility into AOR losses, making it easy to identify when a client has been switched to another agent without their consent.

• Follow up immediately with clients if their policy is switched, canceled, or terminated.

• Educate clients on how to verify changes and encourage them to reach out to you first if they receive unexpected enrollment notifications.

6. They Simply Forgot About You

With so many agents reaching out to potential clients, it’s easy for someone to forget who originally helped them—especially if you don’t stay top-of-mind.

How to Fix It:

• Regularly send emails, texts, and social media updates to maintain your presence. PolicySync’s data-driven insights help agents identify inactive clients and re-engage them before they consider switching to another agent.

• Offer a referral program that encourages clients to stay engaged with you.

• Use branding consistently (your name, photo, and contact info should always be included in emails and messages).

Keeping ACA clients isn’t just about selling them a plan—it’s about building a long-term relationship. By improving communication, providing consistent value, staying engaged, and actively monitoring for fraudulent activity, you can reduce client churn and create a loyal book of business.

For agents looking to automate their follow-ups, monitor policy changes, track lost AORs, engage clients year-round, and prevent fraud, PolicySync is the perfect tool to help. Learn more at www.policy-sync.com.