This notice explains how David M. Smith, Independent Agent may collect, use and share your information. Please read it carefully and contact David at 269-598-8227 if you have any questions.

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We are legally required to provide this notice by applicable law.  We respect your personal information and want you to fully understand how we may use and share your information.

 

We must collect certain information about you, called Personally Identifiable Information (“PII”) in order to help you complete your application for health, life, or disability insurance. PII is information that can be used to identify you or trace your identity.

 

These are a few examples of PII. This is not a complete list:

name, address, date of birth, telephone number, household income, and marital status.

 

We will use only the information that we need to help you obtain insurance or quotes and to provide authorized functions approved by the Federally Facilitated Exchange, or other services as permitted under applicable law.

These are a few of the authorized functions that we may conduct. This is not a complete list:

Helping with your application for insurance

Answering questions about your eligibility

Helping to enroll you in a qualified health plan

Helping with filing appeals of eligibility determinations

Correcting errors in your application

Getting you reliable quotes

 

We may only share your information as described in this notice.

We may share your information with certain Federal or State agencies, the insurance issuer that you select, or subcontractors that help us to provide services to you.

 

By providing this information, you agree that you may be contacted by an agent to confirm your information and to further assist you.  If you do not want to share your information, you may not be able to enroll in an insurance plan or receive a quote.

 

We are required to keep your information safe. We have developed privacy and security policies that we must follow to make sure that we protect your PII.

 

Legal Authority for Collection of PII - Agents, Brokers, and other Entities (ABE’s) have been granted the legal authority to collect this information by Section 1312(e) of the Affordable Care Act (ACA), which required that the Secretary of the U.S. Department of Health and Human Services establish procedures under which ABE’s may participate in the Federally-facilitated Marketplace (or Exchange). ABE’s are further permitted by federal regulation (45 C.F.R. 155.220) to enroll individuals in a Qualified Health Plan offered on the Federally-facilitated Marketplace (or Exchange) and to assist individuals in applying for Enrollment, Advance Payments of the Premium Tax Credits (APTC’s), and Cost-Sharing Reductions (CSR’s) to the extent permitted to do so under state law and regulation.