User Accepted Version

I authorize Danelsy Castro con NPN: 18873789 and whom is affiliated as an independent agent to Sunshine life & Health Advisors to do the next tasks with the purpose of assisting me:

- Perform consumer application searches using approved Classic Direct Enrollment / Enhanced Direct Enrollment Marketplace websites

- To do market rates in the heath market using my personal information.

- To assist me in the maintenance of my membership.

- To provide with information that benefits the plan.

- To help with the selection and registration of the plan.

- Help complete the request of eligibility.

- To help with the maintenance of the account.

- To have access to my protected health information (PHI), related with the functions of the insurance suppor.

- To update documents and the status of my registration, and the maintenance of it in the Health Market

- When signing this document, I vouch that the producer mentioned previously is my acting agent.

- Furthermore, when signing this form, I understand it can be revoked at any giving time in which I apply the assistance of any other qualified producer.