Written Consent and Privacy Notice

By signing below, you give The HIP Group ("the Agency") explicit permission to collect, store, and use your personally identifiable information (PII) to assist you with obtaining health insurance quotes and eligibility determinations through Pennie, Pennsylvania’s health insurance marketplace.

1. Scope of Authorized Actions
You authorize the Agency to perform the following actions on your behalf:

  • Collect personal and financial information required to generate accurate health and dental insurance quotes.

  • Create, access, and maintain your account on the Pennie portal.

  • Search for existing marketplace applications and eligibility determinations.

  • Input and update your information on your Pennie application, including reporting life changes.

  • Assist you with selecting, enrolling in, or renewing a Qualified Health Plan (QHP) or Standalone Dental Plan (SADP).

  • Assist with filing eligibility appeals or submitting required verification documents to Pennie.

2. Types of Information Collected
To provide accurate quotes and determine your eligibility for financial assistance (such as Advance Premium Tax Credits), you agree to provide accurate information regarding:

  • Full names, dates of birth, and Social Security Numbers (SSNs) or document numbers for all household members.

  • Residential and mailing addresses.

  • Expected household income, tax filing status, and employment details.

  • Current health insurance coverage details (if applicable).

3. Privacy and Protection of Data
The Agency agrees to keep your information strictly confidential. Your personal data will only be used for the purposes specified above and will be protected in accordance with CMS, federal, and Pennie privacy and security standards. Your information will never be sold or shared with unauthorized third parties.

4. Revocation and Duration
This consent is voluntary and remains effective until you revoke it. You have the right to revoke this consent at any time by providing written notice to the Agency at melissa@hipgroupllc.com. Revoking consent will end the Agency's ability to assist you with your Pennie marketplace account and quotes.