Volume 2 • November 2025
ON THE PULSE
Monthly Insights for Agents, Partners and Industry Insiders
Your November toolkit for Open Enrollment success: insights, product updates, and agent resources to keep you ahead.
Open Enrollment is Here
Now through January 15
Table of Contents
From the Desk of the CEO
Todd Baxter
Welcome to Volume 2 of On The Pulse. As we head into November, we move into one of the most pivotal seasons for agents: Open Enrollment. This is your opportunity to shine, deepen client relationships, and make a lasting impact.
At Heathos, we are not just observers in this season. We are committed partners. Our team is dedicating every resource to support your success through expanded support hours, new training opportunities, improved platform features, and clear lines of communication.
In this issue, you will find practical tools and insights designed to help you act with confidence during this busy season. Think of this newsletter as a toolkit, and please share any feedback or ideas for future editions.
Here's to a strong, smooth Open Enrollment. Let's win this season together.
Warm regards,
Todd Baxter
CEO, Heathos
Agent Essentials
November 2025
Products Launched in October
Everest CI
Ancillary ProductLump-sum cash benefits for covered critical illnesses (heart attack, cancer, stroke, coma) plus $50/day hospital confinement. Four plan levels ($2,500–$10,000). Includes recurrence and additional occurrence benefits. No medical exam required.
Everest AD&D
Ancillary ProductSet benefit amounts for accidental death and dismemberment (loss of limbs, sight, hearing, speech). Nine plan levels ($50,000–$250,000). Family coverage available (spouse 50%, children 25%). No medical exam required.
Everest AD&D/AME
Ancillary ProductAD&D coverage plus Accident Medical Expense reimbursement ($5,000–$10,000 AME with $250 deductible). Two plan levels with $10,000 member AD&D coverage. Family coverage available. No medical exam required.
Open Enrollment Kickoff
Open Enrollment for 2026 plans is now live from November 1 through January 15. Many states have a December 15 deadline for January 1 coverage. Now is the time to act:
- Confirm your Marketplace or exchange registrations
- Refresh client messaging and marketing materials
- Audit your client list for renewals or new opportunities
- Pre-book appointments with prospects
- Double-check your support systems and workflows for high-volume weeks
- Make sure to stay up-to-date on state and federal law changes
- Ensure all required agent/agency licenses are active and current.
Heathos Pulse Highlight - Persistency Reporting
Understanding your client retention metrics is crucial for agency growth, especially during Open Enrollment. Our new Persistency Reporting feature in Heathos Pulse gives you real-time visibility into how well you're maintaining client relationships over time.
This powerful tool helps you identify patterns in client retention, spot at-risk accounts before they churn, and make data-driven decisions about where to focus your outreach efforts. During the busy Open Enrollment season, knowing which clients need extra attention can make all the difference in maintaining long-term relationships and maximizing your agency's growth potential.
With persistency reporting at your fingertips, you can proactively engage with clients, address concerns early, and demonstrate the value you bring to their coverage decisions—all while operating more efficiently and strategically.
Agent Tip of the Month
Ask the Unasked Question
At the end of every client meeting, ask: "Is there anything about your health or life that concerns you that we have not covered?" This small question builds trust and often opens the door to address other potential needs of the consumer such as critical illness, hospital indemnity, or life riders.
On the Radar
CMS Finalizes 2026 Exchange Payment Rule Changes
The Centers for Medicare and Medicaid Services (CMS) has released updated guidance on Advance Premium Tax Credits (APTC) and reconciliation rules for 2026. Key updates include:
- Stricter income verification requirements
- Revised timelines for PTC reconciliation
- Clarifications on treatment of zero-income filers
Agents should review how these changes might affect client eligibility and communication strategies.
Telehealth Expansion Continues
Several states are expanding telehealth reimbursement and parity laws.
- Some states now require coverage parity for telehealth visits
- Interstate telemedicine licensing discussions are gaining traction
These developments reflect a continued shift toward integrated and accessible care delivery models, underscoring the importance of staying informed about evolving benefit designs and regulatory trends.
Spotlight: Consumer Financial Stress
Recent surveys show rising medical debt and delayed care are top concerns for insured adults.
- About 35 percent of insured adults report difficulty paying medical bills
- Many are now more open to supplemental coverage options
These insights highlight the growing importance of clear communication and education around protection and plan benefits.
Partner Pulse
This month, the spotlight is on Everest – Summit Ancillaries, featuring protection that climbs higher.
Everest – Summit Ancillaries
Protection That Climbs Higher
When life's unexpected moments hit, Everest stands tall with a portfolio designed to help individuals and families stay financially secure when they need it most. This month, we're spotlighting their Summit Ancillary Products, a trio of products that elevate coverage for accidents, illnesses, and critical life events: Summit AD&D, Summit AD&D + AME, and Summit CI.
Summit AD&D
For many families, an accident can create both emotional and financial strain. The Summit AD&D plan provides a fixed benefit for accidental death or qualifying dismemberment, ensuring protection that goes beyond the unexpected.
Coverage: $50,000 to $250,000
Proportional benefits for spouses and dependents
Summit AD&D + AME
Building on the foundation of Summit AD&D, this plan adds Accidental Medical Expense (AME) coverage for out-of-pocket medical costs resulting from accidents.
Provides short-term financial assistance for accidental injuries and lump-sum protection for accidental death or dismemberment.
Coverage Options:
$10,000 (AD&D) $5,000 (AME) / $10,000 (AD&D) $10,000 (AME)
Summit CI
When a major health diagnosis strikes, quick access to financial support can make all the difference. The Summit Critical Illness (CI) plan provides lump-sum cash benefits for covered conditions.
Coverage: $2,500 to $10,000
Covers: heart attack, stroke, cancer, ALS, kidney failure, major organ failure
The Everest Advantage
Underwritten by Everest Reinsurance Company, a globally recognized provider
Partnership with National Congress of Employers for member perks
Straightforward policy structures and flexible coverage levels
Each Summit plan is underwritten by Everest Reinsurance Company, a globally recognized provider known for financial strength and customer-first service. Through its partnership with the National Congress of Employers, Everest also offers a suite of member perks, from dental and vision savings to telehealth, nutrition, and wellness programs.
These benefits, combined with straightforward policy structures and flexible coverage levels, make Everest's Summit Series a powerful complement to any agent's portfolio, helping clients prepare, protect, and persevere.
Why We're Excited
The Summit products embody what we value most at Heathos: practical protection, flexible options, and partnerships that truly empower agents to meet clients where they are in life. Whether it's an accident, illness, or recovery period, Everest's Summit Series helps ensure that financial stability remains within reach.
*Product information and highlights in this article were provided by Everest and are shared with permission.
Behind the Pulse
FirstEnroll Blog - Practical insights and resources to help you navigate Open Enrollment and beyond
For more insights and articles, visit Behind the Pulse regularly. We're constantly sharing new content to help agents and agencies stay ahead and thriving.
On the Calendar
November 2025 - Important dates and upcoming events
01
NOV
ACA Open Enrollment Begins
Open Enrollment for 2026 plans is now live from November 1 through January 15.
15
NOV
Deadline to Complete CMS Agent Training for 2026
Ensure you've completed all required CMS training to sell plans on the exchanges.
25
NOV
Thanksgiving
Take time to recharge and prepare for the final push of Open Enrollment.
15
DEC
Final Day for Many State Enrollments
Final day for many state enrollments to start January 1 coverage.
NOV
JAN
Expanded Business Hours
Dedicated agent support line with extended hours during open enrollment:
- • Mondays & Tuesdays: 7 AM – 7 PM ET (Nov-Jan)
- • Extra coverage Friday, Jan 2 & Saturday, Jan 3: 7 AM – 7 PM ET
- • Help members stay covered by reprocessing failed payments
Telephone: 732-440-8600
Email: agents@firstenroll.com
Agent Toolbox
Important links and resources - Quicklinks to bookmark
Heathos LMS Training
Access over 30 training modules covering product knowledge, compliance, and sales techniques. Complete certifications at your own pace.
Heathos Pulse
Real-time data & compliance tools. Your centralized command center for performance tracking, training, and compliance management.
NIPR
National Insurance Producer Registry - Streamlined insurance licensing and compliance monitoring for insurance professionals across all states.
Agent Support
Get personalized assistance from our dedicated agent support team. Whether you need help with enrollment processes, commission questions, or technical support, we're here to help.
📞 Telephone: 732-440-8600
📧 Email: agents@firstenroll.com
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