Checklist
Use this enrollment checklist
to ensure all required information is submitted for processing.
Forms
| Form | Purpose |
|---|---|
| Group Enrollment Agreement |
To be signed and completed for coverage |
| Small Group Certification Form |
To be completed for small group enrollment |
| Group Enrollment Form |
Used to enroll new members or to change, or cancel membersip. |

The enrollment process typically takes 5-7 business days.
Enrollment is a first-in, first-out process.