Texas Marketplace Privacy Notice Statement 

 Privacy Notice Statement 

The information I provide will be used by my agent, broker, or web-broker to assist with my application for health insurance coverage through the Federally facilitated Marketplace (HealthCare.gov). This information may include, but is not limited to, my name, address, date of birth, Social Security Number, income, and immigration status.

My information will be used only for the purposes of determining my eligibility for health coverage and financial assistance, enrolling me in a health plan, and for ongoing administration of my coverage. My information will not be shared with unauthorized third parties.

I understand that I must provide accurate information, and I will have the opportunity to review and confirm the accuracy of my application information before it is submitted.

I give my consent for my agent, broker, or web-broker to collect, use, and retain my PII for these purposes.

“The information I provide will be used by Rola Khwais/ Khwais Financial LLC, acting as my agent/broker, to assist with my application…”

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