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Enrollment Information

All the information you need to enroll a new group.

 

Checklist
 

Use this enrollment checklisticon-pdf to ensure all required information is submitted for processing.

 

Forms

 

Form Purpose
Group Enrollment Agreementicon-pdf To be signed and completed for coverage
Small Group Certification Formicon-pdf To be completed for small group enrollment
Group Enrollment Formicon-pdf Used to enroll new members or to change, or cancel membersip.

 

 

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The enrollment process typically takes 5-7 business days.

 

Enrollment is a first-in, first-out process.