Privacy and Security Practices

Why did you give me this notice?

I am/We are legally required to give you this notice by applicable law and our agreement with the federal government.

I/We respect your personal information and want you to fully understand how I/we may use and share your information.

What information will you ask me to give you?

I /We must collect certain information about you, called Personally Identifiable Information (“PII”) in order to help you complete your application for health 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, social security number, household income, marital status, race or ethnicity, credit or debit card numbers.

How will you use my information?

I/We will use only the information that we need to help you obtain health insurance through the Federally-facilitated Exchange (“FFE”) and to provide Authorized Functions approved by the FFE, or other service 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 question about your eligibility.
• Helping to enroll you in a qualified health plan.
• Helping with filing appeals of eligibility determinations.
• Correcting errors in your application.

Will you share my information with anyone?

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

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

Personally Identifiable Information (or PII) means that information which can be used to distinguish or trace an individual’s identity, such as their name, social security number, biometric records, among others, alone or when combined with other personal or identifying information that is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc.

Legal Authority for Collection
ABEs have been granted the legal authority to collect this information by Section 1312(e) of the Affordance Care Act (“ACA”), which required that the Secretary of the U.S. Department of Health and Human Services establish procedures under which Agents and Brokers may participate in an Exchange. ABEs are further permitted by federal regulation (45 C.F.R. 155.220) to enroll individuals in a QHP offered on an Exchange and to assist individuals in applying for enrollment in a…