Obamacare | ACA

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*By clicking the Get My Free Quotes button and submitting this form, I agree that I am 18+ years old and I provide my signature expressly consenting to receive emails, calls, postal mail, text messages and other forms of marketing communication regarding Health Insurance, or other offers from the elocal USA LLC and agents to the number(s) I provided, including a mobile phone, even if I am on a state or federal Do Not Call and/or Do Not Email registry. The list of companies participating are subject to change. I will receive calls and/or texts from multiple companies in the list. Such calls and text messages may use automated telephone dialing systems, artificial or pre-recorded voices. I understand my wireless carrier may impose charges for calls or texts. I understand that my consent to receive communications is not a condition of purchase and I may revoke my consent at any time by calling us at 866-899-1312.

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Subsidy Eligibility

Reason for New Coverage

I am authorizing a licensed Health Insurance Agent to review, to submit into a free plan or to refer my Health Insurance enrollment to a qualified entity whenever deemed necessary. I as a customer allow access to my Healthcare.gov or Medicaid accounts to make any updates/uploads as necessary and also to review and advise year to year, using any and all reasonable efforts to ensure that I the customer have a sound decision in my Healthcare plan for the year. I as the customer agree that I qualified for one of the many SEP’s during the year of 2022. (Ex: qualified for unemployment, Covid 19, Etc) I as a customer acknowledge receipt of HIPPA Privacy Information at the time of enrollment. By filling out and providing my personal information and signing, I certify that all of the above information is correct to the best of my knowledge and I give authorization to be enrolled into a free health insurance plan.