Renewal Consent

I authorize LIOR Agency, LLC and its licensed agents to assist me with my Marketplace application and enrollment, including searching for my existing application, submitting or updating eligibility information, reviewing available plans, and providing ongoing enrollment and account assistance.

I authorize LIOR Agency, LLC to assist with my 2027 Marketplace coverage renewal. Before making any change to my plan selection, LIOR Agency, LLC will review available options with me and obtain my authorization to proceed. I understand that my plan, premium, benefits, eligibility, or financial assistance may change from year to year.

I agree to promptly notify LIOR Agency, LLC of changes to my income, employment, household size, address, phone number, email address, or other health coverage that may affect my Marketplace eligibility or financial assistance.

I authorize LIOR Agency, LLC and its authorized agents to access and use my information as necessary to:

• Locate or access my existing Marketplace application;

• Complete, update, and submit Marketplace eligibility and enrollment information;

• Assist with Qualified Health Plan, Medicaid, CHIP, and/or financial assistance eligibility;

• Review and compare available Marketplace plans with me;

• Provide ongoing account and enrollment assistance; and

• Respond to Marketplace inquiries regarding my application or enrollment.

I understand that I am responsible for reviewing and confirming that my application information is accurate and complete before it is submitted or updated. I understand that my consent does not guarantee eligibility, enrollment, coverage, or financial assistance.

This consent remains in effect until I revoke it in writing or by contacting LIOR Agency, LLC at 210-441-7184.