CONSENT
CONSENT
Your Signature is Now Required !
(new regulations for 2024 from cms/healthcare.gov REQUIRES Us, AGENTS, TO HAVE YOUR SIGNATURE BEFORE WE CAN ENROLL YOU)
Por favor llene esta forma para que yo pueda tener acceso o crear una cuenta en el Mercado de Salud por usted. Nuevas reglas requiren que obtenganmos su firma antes de que podames ayudarlos a inscribrirse en los planes de Healthcare.Gov
New 2024 Regulations by Healthcare.gov!
Healthcare.gov is now requiring us, web-brokers, to get a signature from you before we can enroll you electronically. The Adobe Signature App, will allow you to review before you fill the form and get an electronic email copy. To complete this consent section, there are three steps.
1) Adobe Signature: You will see the terms and conditions for the consent.
2) Web-Form Consent: You will allow both of us agents: Maria Lopez and Jacob Lopez to help you find a suitable plan, thus keeping you as the agent of record and follow up if necessary. Keep in mind that we get an email notification as soon as you finish this, thus alerting us that you have giving us consent to start shopping for you.
3) Healthcare.gov Authorized Representative: You will be required to call at your convenience the Marketplace to authorized me as the AUTHORIZED REPRESENTATIVE for 365 days with no LIMITS.
If you have any questions please feel free to text me @ (210)875-2267
“STEP ONE: ADOBE SIGNATURE”
“Step Two: Web-Form Consent”
BEFORE WE CAN HELP YOU ACCESS YOUR HEALTHCARE.GOV ACCOUNT PLEASE CONSENT BY CLICKING YES
Antes de poder ayudarle con la aplicacion del mercado de salud por favor marque si/Yes a las preguntas de abajo.
“Step Three: Healthcare.gov Authorized Representative”