By submitting this form I am requesting assistance/quote from an insurance or insurance related product and authorize Health Benefits Center, Health Benefits One Simple Insurance Leads, Insurance Services, Health Insurance Services, Simple Health, Simple Health Plans Inc, to contact me.
This also includes if I am on the state or national DO NOT CALL registry using the the email, mobile phone and/or landline that was provided in the in the form. I am also aware that this company may contact me through the use of an automated dialer or by use of a prerecorded message. I fully acknowledge that I am not required to authorize such marketing calls as a condition of purchasing a policy.