Disclosure Statement
By enrolling with the office of The “REAL” Insurance Lady Agency, LLC, you are granting any agent of this office explicit consent to perform any and all duties and functions related to enrollment, eligibility applications, plan selection and ongoing account and enrollment maintenance. You acknowledge that you must report changes to income, household, address, or offers of insurance. You acknowledge that this office will automatically renew your current plan or a similarly best-suited plan available. You acknowledge that on average our agency receives $25 per member per month as direct and/or indirect compensation. You may revoke this consent at any time, by sending a written letter to The “REAL” Insurance Lady Agency, LLC 4401 Griggs Rd. Houston, TX 77021