The above-mentioned Agent can view and use the confidential information provided by me in writing, electronically, or by telephone only for the purposes of one or more of the following:

• Searching for an existing Marketplace application

• Completing an application for eligibility and enrollment in a Marketplace Qualified Health Plan or advance tax credits to help pay for Marketplace premiums

• Providing ongoing account maintenance and enrollment assistance, as necessary

• Responding to inquiries from the Marketplace regarding my Marketplace application.