Policy Status API

The Policy Status sends notifications when a policy is effectuated, cancelled (i.e., never took effect) or terminated (i.e., ended after being in force).

On-exchange notifications provide less detail than off-exchange plans due to regulatory restrictions. Below are links to hop to documentation for On-Exchange and Off-Exchange plans:

• On-Exchange Plans

• Off-Exchange Plans

On-Exchange Plans

post

Body

application/json

Payload for On-Exchange Sync Events

transaction_idintegerRequired

Unique confirmation ID from the managed application

Example: 123456789

policy_statusstring · enum | nullableOptional

Status of the FFM policy

Example: effectuatedPossible values:

event_typestring · enumRequired

Type of event being processed

Example: syncPossible values:

event_timestampstring · date-time | nullableRequired

Timestamp of the last EDE synchronization

Example: 2023-06-15T14:30:00Z

external_idstring | nullableOptional

External identifier for the enrollment lead

Example: a1b2c3d4e5f6g7h8i9j0

policy_aor_npnstring | nullableOptional

National Producer Number (NPN) on defined assistor for the policy

Example: 12345678

submitter_npnstring | nullableOptional

National Producer Number (NPN) of the agent

Example: 87654321

npn_used_at_submissionstring | nullableOptional

National Producer Number (NPN) used during application submission

Example: 87654321

Responses

200

Successful response

No content

post

/your-endpoint-url

HTTPcURLJavaScriptPython

POST /your-endpoint-url HTTP/1.1
Host: 
Content-Type: application/json
Accept: */*
Content-Length: 527

{
  "transaction_id": 123456789,
  "policy_status": "effectuated",
  "event_type": "sync",
  "event_timestamp": "2023-06-15T14:30:00Z",
  "external_id": "a1b2c3d4e5f6g7h8i9j0",
  "policy_aor_npn": "12345678",
  "submitter_npn": "87654321",
  "npn_used_at_submission": "87654321",
  "payment": {
    "payment_status": "paid",
    "payment_status_updated_date": "06/15/2025",
    "grace_period_start_date": "06/10/2025",
    "paid_through_date": "07/31/2025",
    "past_due_member_responsibility_balance_due": "0.00",
    "current_member_responsibility_balance_due": "50.50",
    "autopay_indicator": true
  }
}

200

Successful response

No content

Off-Exchange Plans

post

Body

application/json

transaction_idintegerOptional

Unique identifier for the transaction (confirmation ID)

Example: 123456789

application_idstringOptional

Canonical identifier for the off-exchange application

Example: HSA000000000

policy_statusstring · enumOptional

Current status of the active health policy

Example: effectuatedPossible values:

event_typestring · enumOptional

Type of event that triggered the webhook

Example: syncPossible values:

event_timestampstringOptional

Date when the application was last submitted (MM/DD/YYYY format)

Example: 07/01/2025

external_idstringOptional

External identifier for the enrollment lead

Example: f7a8b9c0d1e2f3g4h5i6j7k8l9m0n1o2

policy_aor_npnstringOptional

National Producer Number of the Agent of Record on the policy

Example: 1234567890

submitter_npnstringOptional

National Producer Number of the agent who submitted the application

Example: 17169718

npn_used_at_submissionstringOptional

NPN recorded at the time of submission

Example: 17169718

issuer_hios_idstringOptional

HIOS ID of the insurance issuer

Example: 12345

Responses

200

Successful response

No content

post

/your-endpoint-url

HTTPcURLJavaScriptPython

POST /your-endpoint-url HTTP/1.1
Host: 
Content-Type: application/json
Accept: */*
Content-Length: 1113

{
  "transaction_id": 123456789,
  "application_id": "HSA000000000",
  "policy_status": "effectuated",
  "event_type": "sync",
  "event_timestamp": "07/01/2025",
  "external_id": "f7a8b9c0d1e2f3g4h5i6j7k8l9m0n1o2",
  "policy_aor_npn": "1234567890",
  "submitter_npn": "17169718",
  "npn_used_at_submission": "17169718",
  "issuer_hios_id": "12345",
  "members": [
    {
      "member_id": "HSM000000000",
      "first_name": "John",
      "last_name": "Doe",
      "date_of_birth": "05/10/1980"
    }
  ],
  "policies": [
    {
      "policy_id": "HSP000000000",
      "effective_date": "08/01/2025",
      "expiration_date": "12/31/2025",
      "status": "effectuated",
      "plan_hios_id": "12345LA0123456",
      "gross_premium": 750.25,
      "members": [
        {
          "member_id": "HSM000000000",
          "effective_date": "08/01/2025",
          "removed_date": null
        }
      ],
      "agent_of_record": {
        "npn": "1234567890",
        "first_name": "Tom",
        "last_name": "Doe",
        "state_license_number": "GA123456",
        "email": "[email protected]"
      },
      "payment": {
        "payment_status": "paid",
        "payment_status_updated_date": "06/15/2025",
        "grace_period_start_date": "06/10/2025",
        "paid_through_date": "07/31/2025",
        "past_due_member_responsibility_balance_due": "0.00",
        "current_member_responsibility_balance_due": "50.50",
        "autopay_indicator": true
      }
    }
  ]
}

200

Successful response

No content