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Intake Form

Authorization & Terms
By submitting payment through this page, you acknowledge and agree to the following:

1. Purpose of Payment

The payment submitted on this page is your first premium payment for the insurance policy you selected.

Aaronson Insurance Group is facilitating this payment on behalf of the insurance carrier in order to complete your enrollment and activate your policy.

Aaronson Insurance Group does not retain or keep any portion of this premium payment.
 

2. Payment Processing

Your payment will be applied toward the initial premium required by the insurance carrier in order to issue your policy.

Coverage will only begin once:

  • The insurance carrier approves the application, and

  • The policy is officially issued and activated by the carrier.

Submitting payment does not guarantee approval of coverage.
 

3. Carrier Authority

All underwriting decisions, policy terms, premiums, and effective dates are determined solely by the insurance carrier.

Aaronson Insurance Group acts only as a licensed insurance broker assisting with enrollment and policy placement.
 

4. Free-Look Period

Most policies include a 10-day free-look period (or the period specified by the carrier).

During this time, you may review your policy and cancel it for a full refund of the premium, subject to the carrier’s cancellation procedures.

Refunds are issued by the insurance carrier, not Aaronson Insurance Group.
 

5. Accuracy of Information

By submitting payment, you confirm that all information provided during the enrollment process is true, accurate, and complete.

Providing incorrect or incomplete information may result in policy denial, cancellation, or rescission by the carrier.
 

6. Payment Authorization

By submitting payment, you authorize the insurance carrier to charge the payment method provided for the premium amount shown.

You confirm that you are the authorized cardholder or account holder.
 

7. Broker Role

Aaronson Insurance Group is a licensed insurance broker and assists clients in selecting and enrolling in insurance coverage.

Aaronson Insurance Group:

  • Does not issue insurance policies

  • Does not control underwriting decisions

  • Does not control claims or benefits

  • Does not hold or retain premium payments

All insurance policies are issued and administered by the insurance carrier.

8. Agreement

By submitting payment and proceeding with enrollment, you acknowledge that:

  • You understand this payment is for the insurance carrier premium

  • You authorize Aaronson Insurance Group to complete your enrollment

  • You understand coverage is subject to carrier approval

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304 E Pine St #1381
Lakeland, FL 33801

2025 Aaronson Insurance Group. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 888-498-0128), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by Aaronson Insurance Group. and is not the Health Insurance Marketplace® website. Aaronson Insurance Group is licensed as an insurance agency nationwide. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

Aaronson Insurance Group offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces. This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

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