I, hereby give my consent on this date for LIOR Agency, LLC to carry out functions related to my enrollment, Periodic eligibility updates (clients will be notified of all eligibility updates) plan selections, and ongoing account and enrollment maintenance. I agree to inform LIOR Agency, LLC of any changes regarding my phone number, email, income, job, household size, address or contact with any other insurance company offers. I explicitly authorize LIOR Agency, LLC to automatically renew my plan for the upcoming year 2026 or select a similar, most suitable plan available (client will be notified of any changes). I understand that my consent remains valid until I revoke it by calling LIOR Agency, LLC or providing a written notice to LIOR Agency, LLC at 17350 State Hwy 249, Ste 220, Houston, TX 77064-1132, Office 210-441-7184 or by calling the Market Place directly. By consenting to this agreement, I authorize the above-mentioned Agency/Agents to view and use the confidential information provided by me in writing, electronically, or by phone only for one or more of the following:
Searching for an existing Marketplace application
Completing an application for eligibility and enrollment in a Marketplace Qualified Health Plan or other government insurance affordability programs, such as Medicaid and Chip or advance tax credits to help pay for Marketplace premiums.
Providing ongoing account maintenance and enrollment assistance, as necessary.
Responding to inquiries from the Marketplace regarding my application.
