Enroll In No-Cost Health Insurance in Less than 1 Minute

First Name *

Last Name *

Phone *

Email *

Please enter your Projected Annual Household Income for 2023 *

Who referred you? (If no one please ignore this form field)

I agree to receive marketing communications from Candace Abbott as described in our Privacy and Marketing Communications Policy. I understand that I can unsubscribe at any time."

I authorize Candace Abbott to be my health insurance agent for myself and my household. This allows Candace Abbott to enroll me, or my family, in a Qualified Health Plan on the Federally Facilitated Marketplace. By agreeing to this, I give permission for Candace Abbott to use my confidential information for the following purposes:

Search for an existing Marketplace application.
Complete applications for eligibility and enrollment in a Marketplace plan or other government insurance programs.
Provide ongoing account maintenance and enrollment assistance.
Respond to inquiries from the Marketplace regarding my application. The Agent will keep my personal information private and secure, using it only for the purposes listed above. I confirm that the information I provide on my application will be accurate to the best of my knowledge. I understand that I am not obligated to share additional personal information beyond what is required for the application. I can revoke or modify my consent at any time by emailing candace@your-aca.com.
I acknowledge your request to enroll me in the most suitable health plan available based on your expertise. If zero premium plans are unavailable, I authorize you to enroll me in the next best available plan. I grant you access to my healthcare.gov account for submitting necessary information. By signing below, I confirm my understanding and agreement to the terms outlined in this attestation.

Agent of Record: Candace Abbott NPN: 20312958 Phone Number: 865-205-2945 Email Address: candace@your-aca.com

By signing below I have read and agree to the text above. I also agree to the privacy policy that is linked above *

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Don't need Health Insurance?

But know someone who does?

Referral ProgramEarn $10 for each person you refer

Don't need Health Insurance?

But know someone who does?

Referral ProgramEarn $10 for each person you refer

If you need health insurance & want to earn in our referral program. You can submit the application above and you will automatically be directed to our referral program after you complete your Health Insurance Application.