Subject to the penalties set forth in § 10-2-801, C.R.S., I certify, through this notice, that I do not receive commission for the sale of this individual health benefit plan from the carrier offering this individual health benefit plan. I also certify that I will charge the same fee for the sale of an on-exchange individual health benefit plan as an off-exchange individual health benefit plan.
If I am paid commission for the sale of this individual health benefit plan in the future, I agree to refund the full amount of the fee that you have paid.
I will not charge a fee for assisting in enrollment in Medicaid or the Children’s Basic Health Plan.
The fee that I will charge you for the sale of an individual health benefit plan will be:
Individual consultation fee (1 person), up to 1 hour: $20/month ($25/month if billed monthly by credit card)
Any additional time billed at $180/hour (in 15 minute increments)
Family consultation fee (2+ people), up to 1 hour: $40/month ($45/month if billed monthly by credit card)
Any additional time billed at $180/hour (in 15 minute increments)