Privacy Acknowledgements and Consent:
Marketplace Application Privacy Notice: We are authorized to collect personally identifiable information (PII) from you by Centers for Medicare & Medicaid Services (CMS). Any PII we collect will be used to assist you in the enrollment into a Marketplace Qualified Health Plan (QHP) (and other related products you select, if applicable). If you choose to provide PII, we may share this information with CMS and the insurer you select. CMS will maintain records of this information.
PII is used or disclosed only under the following circumstances:
-To enroll in coverage;
-In order to provide the services Central Health Advisors are designed to offer;
-To compare insurance plans based on costs, benefits, and other important features;
-To determine eligibility for health coverage and cost-sharing reductions through Affordable Care Act Marketplace;
-To choose a plan;
By choosing to enroll in a Qualified Health Plan (QHP), you agree to the following statements:
-To make it easier to determine your eligibility for help paying for coverage in future years, you consent to allow the program to use your income data, including information from tax returns, for the next 5 years. The program will send you a notice and let you make changes. You can opt out any time.
-You are aware that you must tell the program if any information listed on the application changes. You are aware that you can make changes in the Marketplace account or by calling the Marketplace directly at (800)318-2596. You are aware that a change in the information could affect eligibility for the members on the application.
-If anyone on the application is enrolled in Marketplace coverage and is later found to have other qualifying health coverage (like Medicare), you are aware that the Marketplace will automatically end this coverage. This will help ensure that anyone who’s found to have other qualifying coverage won’t stay enrolled in this plan or pay full cost.
-You have provided true answers to all questions to the best of your knowledge. Youare aware that you could be subject to penalties if you intentionally provide false information.
-You are authorizing Central Health Advisors and their agents to assist you and your family (if applicable) in the health insurance enrollment process, to manage your health insurance plan, and to submit documents on your behalf for the calendar years of 2024 and 2025.