Overview
A Health Risk Assessment (HRA) is a required post-enrollment step for many Medicare Advantage plans. It is a standardized set of questions used to understand a beneficiary’s health status, care needs, and potential risk factors.
HRAs are typically completed with the beneficiary and are often required within a specific timeframe after enrollment. In many cases, the HRA should be completed during the same appointment as the enrollment, immediately after the application is submitted.
What an HRA Is Used For
HRA responses are used by plans to:
Identify chronic conditions and care needs
Trigger care management and support programs
Connect beneficiaries to supplemental benefits
Support plan funding and risk adjustment
Because of this, completing HRAs on time is an important part of the enrollment process.
When an HRA Is Required
Not all plans require an HRA, but many do—especially:
Medicare Advantage plans
Dual Eligible Special Needs Plans (D-SNPs)
Other Special Needs Plans (SNPs)
Each carrier sets its own deadline for completion. These timeframes are often short and are intended to capture information as soon as possible after enrollment.
HRAs must be completed by or in the presence of the beneficiary.
Common Challenges
HRAs are often missed due to:
Limited visibility into which enrollments require an HRA
Separate systems or carrier portals needed for completion
Tight deadlines after enrollment
Lack of centralized tracking
Because HRAs are tied to compliance and member experience, missed assessments can create downstream issues.
HRA Visibility and Tracking
HRA requirements and completion status are now surfaced directly within the platform, making it easier to identify which enrollments require an HRA—especially those that may have been missed during the enrollment call. The platform also provides visibility into HRA completion rates for agency principals.
How It Works
HRA Requirement and Status
Each enrollment is automatically categorized as:
Not Completed– HRA is required but not yet completed
Completed – HRA has been completed
Not Required – No HRA is required
Note: For Aetna enrollments that require an HRA, the status may display as Unknown. This is due to limitations in the SunFire/Aetna HRA integration, which may prevent HRA completion status from being reported.
Agent Prompts and Follow-Up
For recent enrollments (within ~3 days) with incomplete HRAs:
A “Complete HRA” prompt is displayed in the Sunfire Applications Dashboard (only the agent assigned to the enrollment will see this link)
A follow-up activity is created to track the outstanding task, which automatically expires after ~3 days.
Activities are automatically cleared when:
The HRA is completed
The activity is dismissed
The activity expires
Clicking HRA not completed will take you to the page below. For more information on completing an HRA, please see Complete a Health Risk Assessment (HRA).
Centralized Dashboard
HRA data is available within the applications dashboard, where you can:
View which enrollments require an HRA
Track completion status
Filter by agent, carrier, status, or date
This allows agents to manage outstanding HRAs and stay on top of required follow-up, and enables agency principals to identify coaching opportunities and work toward improved completion rates.
Important Notes
HRA data is updated on a recurring basis and may not reflect real-time completion
Some carriers require HRAs to be completed outside of integrated systems
HRA links and activities are only shown for enrollments submitted within the last 3 days, regardless of the carrier’s specific HRA completion window. In some cases, this means links and activities may no longer be visible, even though the HRA can still be completed through the carrier or Sunfire. In rare cases, an HRA may expire while the link is still active. For more information on carrier-specific timelines, refer to Complete a Health Risk Assessment (HRA).
Aetna enrollments requiring an HRA will display with a completion status of “Unknown” due to limitations in the Sunfire and Aetna HRA integration, preventing accurate completion status reporting.