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Scope of Appointment:
 I consent to meeting with a licensed insurance agent to discuss Medicare Advantage and/or Prescription Drug Plans in my area after 48 hours from now, or sooner, if an exception applies. The conversation will have no effect on future health coverage, unless I enroll in a plan. I am not obligated to enroll, and automatic enrollment will not occur.

Permission to Contact: I consent to receive e-mails, telephone calls, text messages, and artificial or pre-recorded messages from licensed insurance agents with InsBenefitsPlaza, Insurance Benefits Group LLC, regarding Medicare Advantage plans and/or Prescription Drug Plans and related products and services, at the e-mail address and telephone number provided above, including my wireless number (if provided), and regardless of whether it is on any do not call list, using an automated telephone dialing system. I understand that my wireless carrier’s standard message and data rates apply. I understand that I may revoke this consent at any time.

I understand that I have the option to speak with a licensed insurance agent or enroll without granting this consent by calling 866-508-1222 tty 711.

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