Are you sure you want to logout?
If you navigate away from this page, you will lose unsaved data. Are you sure you want to logout?
Tuesday 05/21/2019 12:15 PM CST
Initiate a New Enrollment or Re-Enroll application.
Resume an existing application that you previously started or begin your Re-Validation application if you have received your Re-Validation letter.
Check the current status of an enrollment application.
Completing an Online Application
Watch this video to see step by step instructions on how to complete an online Enrollment Application.
Print an Application for Mailing
Pay Application Fee (new window)
Provider User Manual