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ACA Privacy & Compensation Consent

By asking Michael Malasnik, a licensed health insurance broker, for assistance with selecting and/or enrolling in a new plan - I hereby give consent to Michael to gather any private information necessary to assist me and/or my family with comparing plans and enrolling in an ACA Marketplace or other insurance plan. 

 

This consent begins when I request help and has no expiration date unless withdrawn by either party, or your ceasing to be a client. All personal information gathered will remain private and confidential. 

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I also understand and agree that Michael is compensated for his time and skill helping me by the insurance companies at no cost to me. With rare exception each company pays $20 per month

per member enrolled. Companies at their discretion may or may not offer periodic sales bonuses.  

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                                               I Agree - Back to Individual & Family Plans 

© 2017 by Michael J Malasnik: AZ Benefits Connection, LLC

DBA Helpyourselfinsurance.com

This website is operated by Michael Malasnik, AZ Benefits Connection, LLC DBA Helpyourselfinsurance.com and is not the Health Insurance Marketplace website. In offering this website, Michael Malasnik is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on the Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at Healthcare.gov  

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