From Prospect to Policyholder: Converting 26-Year-Olds Losing Health Coverage

How to Convert, Support, & Retain Clients Turning 26

For young people in their early 20s, this time can be filled with change  — from graduating college to finding employment to moving and so much more. But what else comes with this era is uncertainty. 

Losing access to health insurance coverage under their parents’ plans at age 26 can significantly add to this feeling of uneasiness. As mandated by the Affordable Care Act (ACA), since 2010, children are allowed to stay on their parents' health insurance until age 26. This is true even if they:

• Are married
• Have children
• Can access employer-based coverage

As a health insurance agent, you have the unique opportunity to guide 26-year-olds through this critical transition. With the right approach, you can convert these prospects into loyal policyholders. And by leveraging targeted communication strategies, automation tools, and industry-specific technology, you'll be well-equipped to support, sell to, and retain clients aging out of their parents' plans.

Keep reading to discover practical tips and actionable insights to navigate the challenges of this pivotal age group and how you can grow your business in the process.

What Happens When a Prospect Turns 26?

During this time of transition, 26-year-old prospects have a lot to consider. What happens next? How do they make sure they don’t experience a gap in insurance coverage? How much are they willing to spend on coverage?

One of the first things young people should consider is what insurance coverage options are available: 

• Employer-sponsored plans
• ACA Marketplace options
• Medicaid (if income-eligible)
• Catastrophic health plans
• COBRA continuation coverage

Each option has unique benefits and considerations, so it’s vital to help your turning-26 prospects and clients assess their needs and situations carefully before providing recommendations.

When Does a 26-Year-Old Lose Parental Health Coverage?

Knowing the end date for their parents’ insurance is vital to avoid coverage gaps. For the majority of cases, 26-year-olds will lose coverage during one of the following two times:

1. If they were covered under their parents’ employer-based plan, they typically have until the end of their birth month to find coverage. 
2. If they were covered under their parents’ ACA Marketplace plan, that deadline usually isn’t until the end of the calendar year (December 31st) — regardless of when they turn 26 during the year.

Additionally, some states do allow young adults to stay on their health plan for an extended amount of time, or even indefinitely, if they have a qualifying health diagnosis or disabilities.

Key Strategies for Assisting & Selling to Prospects Turning 26

When it comes to assisting these potential clients, there are many tools and tactics available to you and your team.

Provide Educational Opportunities & Resources

The turning-26 transition can be an excellent opportunity to establish lasting client relationships with young adults. One of the best ways to do that is by providing valuable information and educational resources to help them navigate their options.

Educate your clients about the implications of turning 26 and the changes that come with it through informative content, webinars, and personalized consultations. You can address common questions, explain available options clearly, and give sound advice as an expert in the subject matter. Not sure how to talk to Millennials and Generation Z? Check out our blog: Tips for Marketing & Selling to Different Generations.

By positioning yourself as a knowledgeable advisor, you'll build trust and increase the likelihood of retaining them as clients as they navigate this critical transition. This can set the foundation for future policy renewals and referrals.

Offer a Variety of Personalized Options

Before you recommend plans, you must get to know your potential clients,  their specific needs, and situation. A needs assessment can be a great way to gather this information efficiently and cohesively.

Then, offer a range of plans that fit what would work best for them. Include ACA Marketplace plans, catastrophic options, COBRA continuation coverage, and more.

Cost is also significant to consider when recommending options to your prospects. Many young adults are price-sensitive but also value comprehensive benefits. Most Americans, regardless of age, cite the price of health insurance as the reason why they don’t have coverage. You might also consider highlighting subsidies and tax credits that can make coverage more affordable.

By proactively engaging prospects and offering personalized guidance, your team can better their odds of converting more 26-year-olds into clients during this critical period.

Offer Complete Coverage Options with Ancillary Services

By offering more than just health insurance to your turning-26 prospects, you can stand out from your competitors and provide more value. A one-stop shop can be more appealing than piecing together coverage options from multiple places. Some ancillary products you can consider adding to your agency include:

• Dental insurance
• Vision insurance
• Life insurance
• Critical illness insurance
• Pet insurance
• Accident insurance

Being a one-stop shop for these young people can also boost your odds of retaining them as clients. This is likely the first time many of these prospective clients are shopping for health insurance. By starting this relationship off strong and providing all the coverage options they need, the possibility of keeping them as lifelong clients is much higher.

Take Advantage of Technology

There are often many tools, especially in an industry-specific agency management system (AMS) or CRM, that can do a lot of the work for you and your team. Use technology to:

• Identify clients or prospects in your system that are approaching 26. Pro Tip: Tie families together via relationships to make it easy to find notes about the young adult and have more informed conversations. 
• Set up an automated email to reach out to these folks before their coverage lapses. 
• Add educational resources and additional information to address their needs and concerns about turning 26 and what that means for them.

Technology can also help track essential dates, send timely reminders, and streamline the transition process automatically. Use activities to be reminded of important dates or tasks, and set up automated workflows to automatically send emails to prospects about the enrollment process. Let’s dive into that topic a little more.

Leveraging Communication & Automation to Be More Efficient & Effective

Now that you know the basic strategies you can use to successfully convert turning-26 prospects, how can you use communication and automation to take it to the next level?

We know that communication is paramount to converting leads that ultimately turn into loyal, long-term clients. Why? Because a lack of meaningful communication is the #1 reason clients leave their insurance agencies. When you and your team consistently communicate to and with your prospects and clients, they feel supported and cared for.

It can be hard to know where to start. Some examples of touchpoints you can easily set up today might include:

• Turning 26
• Welcome emails
• Birthday wishes
• Policy renewal reminders
• Cross-selling opportunities

But how can you make these interactions less time-consuming? That’s where automation comes in. With automation, you can streamline communication between your team, prospects, and clients. Set up the workflow to meet the criteria you determine, and once you turn it on, it will run indefinitely.

For your turning-26 clients, utilize automation to communicate with them in various ways. Set up an automated email or text message to send out as prospects approach age 26. This communication can include timely information about the upcoming transition and how your agency can help. Then, send another email or text message a few days later to ensure they received the information and to see if you can help answer any questions.

You can move into client retention-focused workflows once you've successfully converted your turning-26 prospects. Consider automated welcome emails when they become clients that introduce your agency and provide them with any pertinent information they may need. Cross-selling emails can also be automated and can show your clients how you can provide more value to them. When your clients are delighted with your services, set up an automated referral or testimonial email to gather more interested leads and social proof.

The Benefits of Using an Industry-Specific AMS or CRM

Now that we know how powerful combining communication and automation can be, take it further with an industry-specific AMS or CRM. A solution like this can be a game-changer when converting your turning-26 prospects.

First, leverage an industry-specific AMS or CRM to centralize client data and automate communication. A tool like this makes it easy to identify who in your system is approaching 26. Then, as we mentioned earlier, you can set up a workflow to automatically reach out a few months prior. Your workflow can be as sophisticated or as simple as you’d like them to be. You can create a multi-step workflow that includes emails, text messages, and phone calls at various points. This allows your team to be proactive and get in front of prospects before your competitors do. However, it can also position your agency as the trusted advisor for all things health insurance.

With built-in compliance features, an insurance-focused AMS or CRM helps ACA agents navigate the complex regulatory landscape. Turning-26 prospects that choose the ACA Marketplace route must complete some regulatory steps. A system like this can help you seamlessly gather attestations from Marketplace consumers and signed Consent to Contact forms. This ensures compliance and improves operational efficiency, allowing agents to focus on client needs rather than administrative tasks. Plus, most systems save and store signed compliance documents automatically. If you ever need to reference them, they can be easily and quickly located.

How AgencyBloc's Plus Suite of Solutions Can Help You Convert More Turning 26 Prospects Into Clients

At AgencyBloc, our Plus Suite of industry-specific solutions has you covered when reaching out to and converting your turning 26 prospects.

The workflow automation features in AgencyBloc’s AMS+ solution are built to help you stay connected and set up a workflow that triggers as a prospect or client approaches 26. Here’s what this could look like:

• 6 months before the individual turns 26: Send an automated email or text message introducing yourself and providing more information about the upcoming transition. Make sure to include valuable educational material that positions your agency as the subject matter expert.
• 5 days after the email is sent: Create an automated task assignment reminding the agent of record to call the individual to ensure they received the information and to ask if they have any questions.
• 3 months before the individual turns 26: Send an automated text message reminding them that their 26th birthday is approaching, and if they haven’t considered their options, now would be the time to do so. Include a link to AMS+’s built-in appointment scheduler that makes it easy for them to set up a time to meet with you at their convenience. 

This is just an example workflow; you can add more steps that make sense for your team and agency. Consider adding deadline reminder emails, date reminders for your team, referral incentive emails, and more.

AMS+ also makes staying compliant with ACA regulations more effortless than ever before. You can generate and send both ACA attestation and Consent to Contact forms directly from the individual’s record in AMS+. Then, once the individual signs the forms, they are stored in AMS+ for easy reference should you ever need them. Even better — this can all be done from a digital device, like a smartphone. 

More than ever, young people expect to quickly complete these types of tasks from their phones. With AMS+, no printing, scanning, or in-person visits are required.

You can also use the reporting tools in AMS+ to keep track of your turning 26 pipeline. See who in your system has a 26th birthday coming up, who’s currently in the sales process, and who has recently converted. Analyzing this data can help you identify bottlenecks in your processes and determine areas of improvement.

By implementing these strategies and tools, your team will be well-equipped to support and convert 26-year-olds. Remember to leverage communication tools and automation to streamline your outreach efforts. An industry-specific AMS or CRM will prove invaluable in managing this client segment, allowing you to track important dates, personalize interactions, and nurture long-term relationships.

By positioning yourself as a trusted advisor during this pivotal time, you'll boost conversions and lay the foundation for client retention and referrals. Stay proactive, empathetic, and informative in your approach, and you'll successfully guide young adults from prospects to loyal policyholders.

Posted by Sarah Rosonke on Tuesday, May 13, 2025 in Lead Nurturing & Automation Software

1. client retention
2. compliance management
3. data management
4. insurance automation
5. lead nurturing
6. prospecting
7. selling