| Group Size | Employee Eligibility and Election | Group Contract Application | Enrollment Checklist |
|---|---|---|---|
| 2-50 | View Form | View Application | View Checklist |
Due to a planned data migration beginning Friday, July 11 at 11:00 p.m., and continuing through Monday, July 14 at 8:00 a.m., you may experience a delay in your information appearing on CareFirst portals. We expect that changes to member data will be reflected on the portals by Tuesday, July 15. Your patience is appreciated.
Change Healthcare notifying individuals of data breach. Learn more here.
Maryland Small Group On-SHOP - Direct Enrollment Forms
A variety of applications and other forms are available.
Please contact your Account Manager or Broker Representative to ensure that you have the correct forms. Please choose from the list below:
2025 – All Groups – GHMSI and CFMI
2024 – All Groups – GHMSI and CFMI
| Group Size | Employee Eligibility and Election | Group Contract Application | Enrollment Checklist |
|---|---|---|---|
| 2-50 | View Form | View Application | View Checklist |