Ready to go digital with ACA Consent and Review Forms?
ACA Consent and Review Forms are now available online in a simple to use digital format. Read on…
Attention ACA Insurance Agents!
Say goodbye to the hassle of paper forms and embrace the future of digital solutions for your ACA Healthcare sales. It's an all in one solution for Consent and Review Forms, right at your fingertips! Here's how:
Simplified Process:
Lincoln Street Media and Lopez Life & Health Insurance Services have partnered to create a cutting-edge digital solution for required ACA consent and review forms (consumer review of the attestations). Our platform will revolutionize the way you enroll clients, saving you valuable time and effort. These forms have been created by Insurance Agents for Insurance Agents and have been reviewed for compliance. The forms can be used on a mobile phone or desktop, now featuring E-signature where the client can sign the form with their finger or mouse. No need to have the client present in person!
Customization at Your Fingertips:
With our platform, each form is tailored specifically to you. Your agent name and NPN will be seamlessly integrated into every form, showcasing your professionalism and personal touch. Each account holder will have their own individual web application with their own URL, as well as an individual email address using the account URL. This email address can be used with an email provider such as Microsoft Outlook. However, we recommend using the FREE email application called Thunderbird. Using one of these email apps can help ensure that the submitted form(s) will be instantly delivered to you and not go to spam.
English and Spanish Support:
We understand the importance of catering to diverse audiences. That’s why our forms are available in both English and Spanish, allowing you to connect with a wider range of clients and break language barriers.
Affordable Pricing:
We believe in providing exceptional value for your investment. This is a subscription based service where we host and set up the forms at just $10.99/month (billed annually), and enjoy peace of mind as we handle all the technicalities on our reliable servers. The yearly fee is for hosting the web application, maintenance, updates to the software, website security, SSL Certificate and the use of the E-signature feature. One agent/NPN per account.
Click on this link to see sample forms. This is my personal ACA forms site (Ernesto Lopez).
Click on this link to see how sample submission forms will look like in your email.
The Forms included in this offer are:
Consent Form: English and Spanish
Consumer Review of Eligibility Application Information and Attestations Form: English and Spanish
Unlimited Form submissions.
Up to date with all the CMS changes/requirements for the consent form (updated 11/2024 for the process through which the consumer may
rescind the consent).
Set Up Time:
We value website security and functionality. In an effort to make sure that each web application is set up correctly and all security features are placed in each account, set up time may be up to two (2) weeks. Please plan accordingly while we make great efforts to provide you with an exceptional product.
Here's how it works.
We do all the work.
We will create a website for you using our domain digitalACAforms.com. Examples of how your URL may look include:
Youragency.digitalacaforms.com
consent7654.digitalacaforms.com
agentNPN.digitalacaforms.com
The name that goes in front of digitalacaforms.com will depend on the information provided. Once created, the customized forms will be found at the URL. This URL will be exclusive to your account. Your personalized email address associated with your URL will be receiving all submission forms once they are sent by the client.
How to use the forms.
Once the account is established and the URL has been created, your job as an agent is to send the client the link to the form that you want signed and walk them through it. You can send it to them via email or via text. After that, you simply walk them through it to fill it out.
When it comes time to sign, they can sign with their finger if they are using their cell phone. If they are using a touch screen computer, they can sign with their finger, a mouse, or with a signature pen. We find that using a finger to sign works best.
Once the client has submitted the form, you should receive the form within seconds to your personalized email. If you can’t find the form, it may have been sent to spam. In this case, please check your spam folder.
Customization
Your agent name and NPN will be added to all the forms. One agent per account. All the consent and review forms submitted from the client(s) will be sent to your personalized email address.
Don't miss this opportunity to transform your enrollment process with digital forms.
Order your customized forms today and witness the power of innovation firsthand.
Let's get started.
If you are renewing your subscription click below. Same price for renewing. Just $10.99/Month (billed annually).
Just $10.99/Month (billed annually)
New Subscriptions
- Includes all ACA Consent and Review Forms
- One year subscription service
- Subdomain Setup
- Form customization with your info
- No Set Up Fee
- SSL Certificate included
- Unlimited Form Submissions
- e_Signature feature included
- One Agent per account
- Tax Not included
Lincoln Street Media has been an Exhibitor at the 2023 and 2024 NABIP SOTX
Summit at South Padre Island, Texas
Brand Partners
Lisa Lopez is a life and health insurance agent in the Rio Grande Valley and is owner of Lopez Life & Health Insurance Services. Ernesto Lopez Jr is also a Life and Health Insurance agent in the Rio Grande Valley and is owner of Lincoln Street Media and Ernesto Lopez Insurance. They are a father and daughter team dedicated to finding insurance solutions for both clients and agents alike. If you have any questions about this site please call Ernesto Lopez Jr at 956-533-0177. Both are members of NABIP South Texas.
Lincoln Street Media
PO Box 2214
San Juan, Texas 78589
956-533-0177