Terms & Disclosures
By submitting this referral form, you acknowledge and agree to the following:
Permission to Share Information
You confirm that you have permission to provide the referred individual’s or business’s contact information to Insurance Solutions USA for the limited purpose of discussing insurance or employee benefits options.
Permission to Contact
You understand that we may contact the referred individual or business using the information submitted through this form for follow up regarding available coverage options and enrollment assistance, subject to applicable federal and state rules.
Medicare Compliance
For Medicare referrals, we will follow applicable Medicare communications, marketing, and enrollment requirements. Referral submissions do not create unlimited permission to contact a Medicare beneficiary, and any required beneficiary protections will be obtained as applicable before sales or enrollment activity occurs. CMS guidance continues to cap Medicare Advantage referral or finder’s fees paid to agents and brokers at $100.
ACA / Marketplace Compliance
For ACA and Marketplace referrals, we will follow applicable CMS, Marketplace, carrier, and state requirements. Consumer consent is required before Marketplace enrollment activity or certain account or agent changes occur, and some actions may require direct consumer participation through HealthCare.gov, the Marketplace Call Center, or another approved pathway.
No Guarantee of Eligibility or Enrollment
Submitting a referral does not guarantee that the referred person or group will qualify for any plan, subsidy, carrier, or effective date. Eligibility is based on applicable program, carrier, underwriting, participation, and enrollment requirements.
No Obligation to Enroll
The referred individual or group is under no obligation to enroll in any product, carrier, or plan. They will have the opportunity to review available options and decide what best fits their needs.
Privacy and Confidentiality
Information submitted through this form will be handled in accordance with applicable privacy and data protection requirements, including HIPAA where applicable. Please do not submit unnecessary sensitive personal information through this form.
Accuracy of Information
You agree that the information submitted is accurate, current, and complete to the best of your knowledge. We are not responsible for delays or inability to assist caused by incomplete, inaccurate, or outdated information.
Referral Compensation Conditions
Referral compensation is payable only if the application or case is submitted through an approved ISUSA process, is issued or placed with an eligible carrier or vendor, remains active and in force, all required premiums are paid, and the 90-day qualification period is satisfied.
No Payment on Ineligible Referrals
Referral compensation will not be paid on duplicate referrals, referrals already being worked, declined applications, canceled or withdrawn coverage, unpaid policies, or cases that do not meet carrier, CMS, Marketplace, contractual, or state requirements.
Group Referral Compensation
Group referral compensation is paid pursuant to the applicable written ISUSA referral agreement or other written arrangement for that specific case. ISUSA’s internal referral structure reflects agreement-based compensation rather than one universal public group fee.
Right to Decline
We reserve the right to decline any referral that falls outside our licensing, appointment, carrier availability, compliance requirements, or operational scope.
Agreement to Terms
By submitting this referral, you confirm that you have read and agree to these terms.
