Your broker. Your permission.

Before you begin

Permission is voluntary and lasts one year unless you revoke it sooner. It covers the named agency and its appropriately licensed assisting producers. Your selected coverage path, signature and dates are recorded. It does not authorize a plan change or replace your review of the actual application.

Read enrollment privacy & HIPAA information · Compensation disclosure

Please sign for yourself, or as a legally authorized representative. Employers and brokers must not sign for employees merely because they administer benefits. Need a paper or accessible option? Call 303-903-2054.

Revoke permission

Use the reference and private revocation code in your downloaded receipt, or contact brad@ichra.shop / 303-903-2054. Do not send your receipt or private code to anyone who should not control this permission. Revoking broker permission does not cancel your insurance.

Application review happens later.

Before a Marketplace application or change is submitted, your producer must explain the relevant attestations and document your review and confirmation of the actual application. No advance checkbox on this page certifies that review. When enrolling through a carrier or enrollment partner, complete its required confirmation steps.