Terms of Enrollment

Please read and accept these terms.

I am at least 18 years old or the head of case and I am authorized to make this change. I am not impersonating any other person or submitting false or misleading information.
My health plan will send me a welcome letter in the mail with plan benefits and effective date.
I can change my health plan at my next open enrollment period.
I can change my PCP once a month by calling my plan. My provider choice is not guaranteed. If the provider is not available, my plan may select a different provider for me.
I have read this information, or had it read to me in a language I understand.