PII Received. Subject to the terms and conditions of this Agreement and applicable laws, in performing the Authorized Functions under this Agreement, Staff Member/ Volunteer may create, collect, disclose, access, maintain, store, and use the following data and PII from Consumers, including but not limited to: Access to or enrollment in employer or other health coverage American Indian/Alaska Native status APTC percentage and amount applied Auto disenrollment information Applicant Name Applicant Address Applicant Birthdate Applicant Telephone number Applicant Email Applicant spoken and written language preference Applicant Medicaid Eligibility indicator, start and end dates Applicant Children’s Health Insurance Program eligibility indicator, start and end dates Applicant QHP eligibility indicator, start and end dates Applicant APTC percentage and amount applied eligibility indicator, start and end dates Applicant household income Applicant Maximum APTC amount Applicant Cost-sharing Reduction (CSR) eligibility indicator, start and end dates Applicant CSR level Applicant QHP eligibility status change Applicant APTC eligibility status change Applicant CSR eligibility status change Applicant Initial or Annual Open Enrollment Indicator, start and end dates Applicant Special Enrollment Period eligibility indicator and reason code Citizenship Status Contact Name Contact Address Contact Birthdate Contact Telephone number Contact Email Contact spoken and written language preference Enrollment group history (past six months) Enrollment type period FFE Applicant ID FFE Member ID Gender Immigration document type and document numbers Issuer Member ID Membership in a Federally recognized tribe Net premium amount Pregnancy indicator Premium Amount, start and end dates Race/ethnicity Sex Special enrollment period reason Subscriber Indicator and relationship to subscriber Social Security Number Tax filing status (tax filer, tax dependent, non-filer) Tobacco use indicator and last date of tobacco
PII Received. Subject to the terms and conditions of this Agreement and applicable laws, in performing the tasks contemplated under this Agreement, WBE may create, collect, disclose, access, maintain, store, and use the following data and PII from Consumers, Applicants, Qualified Individual, or Enrollees: APTC percentage and amount applied Auto disenrollment information Applicant Name Applicant Address
PII Received. Subject to the terms and conditions of this Agreement and applicable laws, in performing the tasks contemplated under this Agreement, ABE may create, collect, disclose, access, maintain, store, and use the following data and PII from
PII Received. Subject to the terms and conditions of this Agreement and applicable laws, in performing the tasks contemplated under this Agreement, WBE may create, collect, disclose, access, maintain, store, and use the following PII from Consumers, Applicants, Qualified Individuals, or Enrollees, including but not limited to: APTC percentage and amount applied Auto disenrollment information Applicant name Applicant address Applicant birthdate Applicant telephone number Applicant email Applicant Social Security Number Applicant spoken and written language preference Applicant Medicaid Eligibility indicator, start and end dates Applicant Children’s Health Insurance Program eligibility indicator, start and end dates Applicant QHP eligibility indicator, start and end dates Applicant APTC percentage and amount applied eligibility indicator, start and end dates Applicant household income Applicant maximum APTC amount
PII Received. Subject to the terms and conditions of this Agreement and applicable laws, in performing the tasks contemplated under this Agreement, Web-broker may create, collect, disclose, access, maintain, store, and use the following data and PII from Consumers, Applicants, Qualified Individuals, Enrollees, Qualified Employers, and Qualified Employees including, but not limited to:
