Everyone Is Arguing About Who Keeps AOR. Nobody Is Asking What It Is.

The most common question we get

If you're in the ICHRA business for more than five minutes, you're going to hear the big question. Before a broker asks about carrier availability or compliance, they want to know do I keep AOR?

When I first got into the insurance space, I didn't understand what all the fuss was about, but after talking to hundreds of brokers I think I understand why. The industry has trained brokers to hear "agent of record" as a synonym for "my client." It's the name the carrier recognizes, the designation you defend at renewal, the thing that historically has made an account yours. In group insurance that instinct is basically correct, because in group there is one policy, one carrier, and one relationship, and whoever's name is on it owns the economics and the conversation.

ICHRA quietly breaks every assumption in that sentence. Most of the argument about AOR is still running on group instincts, and those instincts don't survive the way ICHRA scales. So before anyone argues about who should hold it, it's worth asking the question that almost never gets asked out loud: what is this thing, exactly, and what does holding it require of you?

First, the case where keeping it makes sense

Every rule has an exception and this is no different. Picture a 12-life employer in a one-metro market. Two carriers write individual coverage there, the broker holds appointments with both, and he's been the account's guy for nine years. He knows which employee is managing a kid's type 1 diabetes and which one just adopted.

Situations like this can make complete sense for the broker to want to keep AOR. He can service every policy, the carriers will take his calls, and his members may well be better off with him than with anyone's service team, including ours. He also has a second defensible option, which is handing AOR to a platform so that the enrollment support, the carrier phone calls, and the January fire drills become someone else's full-time job while he stays the advisor on the account. Both choices can be right. What separates them is an honest answer about who is actually equipped to do the work.

I want that on the table early, because the rest of this piece isn't about the single-state, small employee account businesses. When I first started working in the ICHRA space, it was precisely for mid to large sized businesses that were struggling to get the support and customer service; not just during enrollment, but throughout the year. Very few brokers are ready to handle larger groups moving to ICHRA, and by insisting on retaining AOR, you're not doing those companies any favors.

A designation with a job attached

Here is what AOR actually is, stripped of the industry connotation. It is a per-person designation, attached to an individual insurance policy, authorizing one agent to represent that individual with their carrier. Carriers generally won't discuss a policyholder's account with anyone else. That's the entire mechanism. It doesn't attach to the employer, because the employer isn't the policyholder. In an ICHRA the employer doesn't buy insurance at all; it funds an allowance, and each employee buys their own policy in the individual market.

So AOR in an ICHRA comes down to one question: when this member's claim gets denied in month seven, who takes the call, and can they actually fix it? The designation and the job are the same thing. A broker asking to keep AOR is volunteering to be that person for every covered member of the group, and the carrier lockout that makes AOR valuable is exactly what makes it binding. If you hold it and can't do the job, nobody else is allowed to do it for you, including that platform doing enrollment that promised you can keep AOR.

What keeping it requires

Three things, and they escalate.

You have to be licensed everywhere your members live. Not where the employer is headquartered, where the members live. A resident health line of authority stops at your state line, and every state where a member lives is a nonresident license to acquire and maintain. And don't count on ICHRA's off-exchange tilt to spare you the exchange certifications. Most carriers require annual FFM registration, or the separate certification each state-based exchange runs on its own rules, as a condition of granting and keeping an individual-market appointment at all, and CMS is blunt that agents without the right credentials can't access Marketplace systems or assist consumers with enrollment. A 60-life group with people in six states is six licensing obligations, plus the certifications behind every appointment, before you've helped a single member.

You have to be appointed with every carrier a member might choose. Not the two or three you work with today. This is the assumption group instincts get most wrong. In group, you place the group with a carrier you're appointed with, done. In an ICHRA, sixty members shopping the individual market can land on any issuer writing coverage where each of them lives, and appointment is issuer by issuer. An employee who picks a carrier you're not appointed with is a member you're AOR for in title and a stranger to in fact: the carrier won't pay you and most likely will not talk to you.

And you have to be able to actually support members, which is the requirement that dwarfs the other two. Licensure and appointments are paperwork and compliance, this is supporting actual people with the most important benefit they have, their healthcare. It means knowing the plans well enough to advise a hundred different people on a hundred different situations across multiple carriers' networks and formularies. It means chasing effectuation in December and hunting down ID cards in January, when every carrier's queue is at its worst. It means working denied claims in March, sitting on hold with carrier escalation lines, and knowing which desk at which issuer can fix which problem. It means handling the mid-year events group brokers never see, the special enrollment periods, the subsidy reconciliations, the member who moves across a state line in July and needs a new plan, and, if you're doing the job at the level members deserve, getting the new carrier to honor the deductible that member already burned down. We negotiate those accumulator credits at Kyra, carrier by carrier, and I can tell you it's a fight even with full-time staff and standing relationships. It doesn't happen when you send an email to a carrier that you're a stranger to.

There's one more thing worth knowing, because it removes the shortcut everyone reaches for. AOR can't be granted by the employer, since the employer was never the policyholder. It's established member by member, with documented consent from each one, and the rules there have been tightening. Since mid-2024 CMS has blocked agents from touching a Marketplace enrollment they aren't already associated with, and GAO spent this summer pushing for even stronger consent verification. The practical meaning for a broker is simple. There is no clause in a service agreement that hands you sixty members. You earn the designation sixty times, one consenting person at a time, and then you owe each of them the job described above.

Which sets up the question this piece is actually about. AOR is a fiduciary posture toward specific human beings: their carrier will speak to you and, functionally, only you. So before asking to keep it, ask what you're asking for. If you hold the licenses, the appointments, and the service operation, you're asking to do a hard job you're equipped for, and you should keep it. If you don't, then the request is for the designation without the job, and it's fair to ask whose interest that request serves: yours, or the client you tell people you're a fiduciary for.

The math is different

Appointments produce income. The designation produces nothing. That single fact undercuts most AOR requests before anything else enters the picture, because most brokers asking us about AOR aren't appointed with the individual-market carriers their members would actually choose, in the states those members live in. The paycheck the request is meant to protect doesn't exist as structured.

Where the appointments are real, the subtler mistake is pricing ICHRA like group business. Group pays on the account, a percentage of a premium stream tied to employees. Individual pays on the person, policy by policy, and the person is the covered member, not the employee. Spouses and kids push the member count well past the employee count, and it scales with the group. Depending on the census and the carriers, the total can come out behind group or ahead of it. What it can never come out is lighter. Every one of those per-member dollars arrives attached to someone you now owe the job described above. Group commission is revenue on one relationship. Individual commission is revenue on every covered member, each with their own ID card, their own bill, their own claims, their own renewal.

That's the honest frame for the AOR decision, whether you're built to earn it member by member at whatever scale the census implies. A broker with a real individual-market operation can do very well in this business. A broker without one is holding revenue that costs more to service than it returns, and the rational move is to take the operational leverage. Let a specialist carry the servicing duty while you keep the account and the advisory relationship that actually made the client yours.

Releasing the designation, though, does not mean releasing the income, and that part of the conversation always gets skipped. Broker compensation in ICHRA doesn't have to run through carrier appointments at all. Ours runs two ways: we pay brokers a PMPM commission on every member they bring to our platform, no appointments required, and brokers who want to charge an advisory fee on top set their own PEPM on the account. There's a case that the advisory fee is the healthier structure anyway. A percentage of premium, the way commission works in most employer-sponsored arrangements, pays the broker more every time the client's costs go up, which is a strange incentive for the person hired to control them. A flat fee the client can see pays you for what actually makes you valuable in this model, the strategy, the market analysis, the renewal answer, and it doesn't grow when the problem does. When a broker tells me "I need AOR to get paid," what I actually hear is that the compensation conversation hasn't happened yet.

The strongest objection

The serious case against platform-held AOR is structural, and brokers who raise it are asking a fair question: doesn't concentrating AOR at a platform just recreate the same problem one level up? One party holding the servicing duty for thousands of members, with every incentive to claim more capacity than it has?

It would, except servicing individual policies is work that improves with volume, and the reasons are mechanical. A generalist broker touches a carrier's individual-market desk a few times a year and reaches whoever picks up. A platform aggregating thousands of lives with that same carrier gets named contacts and standing escalation paths, plus real leverage when a member's effectuation is stuck, for the same reason FMOs and general agencies have always existed in this industry: carriers organize around volume. Specialization compounds the effect. ICHRA is the entire business, so the plan knowledge, the January surge staffing, and the carrier relationships are the product. None of that is a knock on brokerages. A brokerage's core competency is winning accounts and advising them, and that's a division of labor, not a hierarchy. But it does mean the party structurally positioned to hold a servicing duty for thousands of members is the one built for exactly that.

What the objection should change is the standard of proof. Capacity claims are cheap, ours included, and a platform that can't back them up hasn't earned the designation any more than an unlicensed broker has. So demand evidence. Ask for case studies with real employers. Ask what the member NPS is and how it's measured. Ask what actually happens in January, how fast claims escalations resolve, and what renewal retention looks like.

The six questions

Which brings this down to something a broker can settle in an afternoon, because the test is composition and capacity, and both are facts. Before asking to keep AOR on an ICHRA group, have answers ready for six questions:

1. In which states do my client's employees live, and do I hold an active health line of authority in each?

2. Which carriers write individual coverage in those markets, on and off the exchange, and which of them am I appointed with?

3. Am I registered with the federal Marketplace, and certified with each state-based exchange in play? ICHRA runs mostly off-exchange, but that rarely exempts you, because most carriers require these certifications to grant and keep the appointments in question 2, and any member who does land on an on-exchange plan needs them directly. Enrollment platforms don't route around this either. EDE tools like HealthSherpa still require an active FFM integration to submit applications under your NPN, and their full-service alternative processes enrollments under HealthSherpa's NPN instead. Read that carefully. The workaround for not being registered is letting the platform become the agent of record. You didn't keep AOR, you handed it to your enrollment tool.

4. When members call in, what level of service can I actually deliver at this scale? And they will call, because nothing in the individual market is uniform. Every carrier has its own billing, its own portal, its own ID card timeline, its own formulary, and members discover the differences at the worst possible moments. Service needs in this model run higher than group.

5. What is my January capacity? Effectuation failures and missing ID cards across every carrier in the census hit in the same three weeks, every year. And unlike group, where renewals spread across twelve months, every ICHRA group lands on a calendar-year renewal regardless of its original effective date, because the underlying individual policies all renew January 1. An entire book of ICHRA business stacks its renewal load into Q4 open enrollment and the January effectuation window at once. Who is doing that work, and what else are they supposed to be doing at the same time?

6. When something goes wrong mid-year, do I have the carrier relationships to fix it? The claim denied in month seven, the member who moves states in July and needs their deductible honored. Not "can I submit a ticket": who, by name or by desk, do I reach, and why would they move for me?

None of these are trick questions. A broker whose footprint and operation match the census answers all six in minutes, and has earned the designation.

And if you're an employer watching this debate, you don't need to referee it. You need to understand what's actually being negotiated, because the designation everyone is fighting over decides who your employees will depend on, by name, when something goes wrong with their coverage. ICHRA done right is a better employee experience than group, because the personalization and the choice are real; your employees pick plans that fit their lives instead of inheriting the one plan someone picked for the average. But the model only delivers that if someone competent is standing behind the complexity that comes with it, and the wrong arrangement guarantees it won't. So put the same test to whoever wants that job, broker or platform, ours included: who exactly holds AOR on our employees' policies, what happens when an employee's claim is denied, and what are the outcomes, satisfaction scores, and case studies that prove it?

The broker in the one-metro market keeps AOR, because for him the answers hold. That was never in dispute. The dispute the industry keeps having assumes AOR is something a broker possesses. It's something a broker owes, to every covered member of the group, most of whom will never know the designation was negotiated on their behalf until the day they need the person holding it. Ask the six questions before you ask to keep it. Your members will end up asking them anyway.