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We are authorized to collect personally identifiable information (PII) from you by Essential Insurance Benefits, LLC. Any PII we collect is used to apply for insurance benefits.

If you choose to give us PII, we may share this information with the insurance company in order to apply for insurance and it will be submitted to CMS (a federal agency) and will be maintained in a federal system of records. PII is used or disclosed only under the following circumstances: to assist in applying for insurance benefits.

PII is mandatory under the applicable law. If you choose not to provide us with the PII requested, or not to respond to certain questions, it could result in your application for insurance of being declined.

iNSURANCE AND SAFETY FIRE COMMISSIONER'S MAILING ADDRESS:

Two Martin Luther King, Jr. Drive
West Tower, Suite 704 Atlanta, Georgia 30334
Main Telephone: 404-656-2070
Toll Free: 800-656-2298
Fax: 404-657-8542

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