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:

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

2023 – All Groups – GHMSI and CFMI

Group Size Employee Eligibility and Election Group Contract Application
2-50 View Form View Application