CONSENT:
All calls may be monitored or recorded. I give permission to Atlant Insurance Consultants Agency LLC (NPN 15743514), Sal Barone (NPN 8070984) and its affiliates, principal office Atlanta Georgia to serve as my health insurance broker(s) for myself and entire household, for purposes of enrollment in a Qualified Health Plan and / or other related products.
By consenting to this agreement, I authorize the mentioned brokers and agency to view and use confidential information provided in writing, electronically, or by telephone from any applicant, household member or their authorized representative for the following tasks:
Searching for an existing marketplace application, completing an application, processing initial or ongoing premium payments, updating data, adding or removing household members, submitting income documents, submitting immigration documents, providing ongoing assistance, responding to inquires regarding your application, reviewing renewal plan options, renewing plan coverages, and any other related tasks as needed.
VERIFICATION:
I have provided all information to the best of my knowledge, and verified to be accurate on my eligibility notice - including but not limited to household income estimates. It is my responsibility to contact my broker to update my application with any changes in income or household information, and the insurance premiums (if applicable).
COMPENSATION:
Compensation from health insurance carriers on average is about $20 per member per month with possible additional compensation based on production. We are also compensated on ancillary products including dental, vision, medicare, life insurance and other products.
SMS / TEXT NOTIFICATIONS:
By submitting this form and signing up for texts, you consent to receive marketing and / or account related text messages (i.e renewing coverage, coverage changes, price changes, product changes, etc.,) from AtlantaInsuranceConsultants .Com Agency LLC, Sal Barone and its affiliates at the number provided, including messages sent by autodialer. SMS Consent is not a condition of purchase. Msg & data rates may apply. REPLY STOP to unsubscribe at anytime.
We do NOT charge any agency fees. The premium you pay is the same whether you use our services or not; therefore, our services come at no additional cost to you.
This agreement will remain in effect until explicitly revoked by faxing 678-868-2888.