One page enrollment process allows you to collect all the info for the order in a single page.

The information needed on the one page enrollment is:

• First Name
• Middle Initial
• Last Name
• Suffix
• Date of Birth
• Email
• Medicaid Number
• Address
• Penalty of Perjury consent
• E-Sign Certification

The plan is a default plan that this process uses and customer's will not get the option to select from the plan.