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Before working with you, California State regulations mandate that we provide you with a copy of the IPNCD and maintain in our files your acknowledgement of your receipt of a copy of the IPNCD . Additionally, Medicare places further requirements on us when we talk with Medicare eligible individuals.
Of course we can do it the dependable old fashion way and mail you a copy. Just let us know your address.
DISCLOSURE OF COMPENSATION INFORMATION
PRIVACY POLICY OF
(a sole proprietorship operated as a community by Jackie & Jim Spahr, a married couple) California Department of Insurance Licenses
PURPOSE Medicare Eligible Individuals - Scope of Appointments Medicare requires that when talking with Medicare eligible individuals we only discuss products that you and we have agreed to talk about when initial contact was made. If, during the course of a conversation, it becomes evident that the product information you and we initially agreed to explore is not about the product best suited to your circumstances, we must terminate our conversation and reschedule your and our conversation for a time at least 48 hours later. This rule creates an impossibly clumsy basis for our work together. Therefore, to avoid running afoul of Medicare rules, Medicare eligible individuals agree that by by their signatures below, they accept this IPNCD as the scope of our appointments and they direct us to be prepared to discuss with them all products related to Medicare Parts A, B, C and D and Medigap (Medicare Supplement) Plans during any meeting or telephone conversation.
INITIAL NOTICE We gather two types of protected information about you. 1) Nonpublic Personal Information (“NPI”) and 2) Nonpublic Personal Financial Information (“NPFI”). NPI includes any list, description or grouping of consumers that is derived using any personally identifiable information that is not publicly identifiable. It includes the medical, financial and character information that we gather to provide you with insurance as well as your name and address. NPFI is the protected financial information we gather about you. OUR PRIVACY POLICIES AND PROCEDURES
1) Categories of NPI We Collect
2) Categories of NPI We Disclose
3) Categories of Affiliates and Nonaffiliated Third Parties
4) Former Customers
5) Disclosure to an Affiliate for Marketing Purposes
6) Opting Out of Disclosure to Nonaffiliated Third Parties
7) Disclosures Made of NPFI Protected by the Federal Fair Credit Reporting Act
8)
How We Protect the Confidentiality and Security of NPI and NPFI
9) Your Right to Access, Copy Review and Request Correction of NPI
10) Disclosure of NPI and NPFI Under Specific Exceptions COMPENSATION INFORMATION DISCLOSURE As a result of insurance purchases you may make with our assistance, JJSIS may receive compensation (cash or otherwise) that is based in part on factors such as total deposits, assets or premium volume and persistency or profitability of the business (insurance product(s)) you purchase with the assistance of JJSIS acting as an agent of the insurance company or other entity that offers such products. The cost of this compensation may be directly or indirectly reflected in the premium or fee for this product. JJSIS may receive this compensation from the insurance company and/or broker through which JJSIS places your business. Further, compensation may consist of either or both compensation based upon first year and/or renewal premiums. Generally, products that you may purchase using the services of JJSIS that require ongoing service to be provided by JJSIS pays JJSIS compensation for providing you that service. JJSIS does not require compensation in the form of fees or otherwise from you for any product or service you may purchase with our assistance without requesting that you to join with JJSIS in a specific fee for service agreement prior to the initiation of any such purchase or service work. Any such agreement will be an agreement in writing separate from and not related to this disclosure document. DISCLAIMER OF QUALIFICATIONS Jackie and Jim are not qualified to nor do they provide tax or legal advise. Please consult with your attorney or tax advisor. Please contact us if you have any additional questions concerning this disclosure and privacy notice. Regulations require us to keep on file evidence that you have received this document. By clicking on either
Jackie or
Jim and sending us the email the email that is generated with your comment telling us that you have read and retained a copy of this privacy notice that requirement will be met. We look forward to working with you. Thank you for taking the time to read this notice. Regards, Jackie & Jim Spahr If you wish, print this page, sign below and mail to us at: PO Box 751180, Petaluma, CA 94975-1180
X________________________________________________________ date: ___________
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