EmployeeEnrollingPageMed

Employee Enrolling in Employer Freedom Plan

Your employer will instruct you to fill out a paper application by hand,
or fill out the interactive pdf application and submit electronically.

Download and Complete Electronically

Interactive PDF
Enrollment Application

Completed electronically by each enrolling Employee
and submitted to Employer

OR

Download and Print

Paper
Enrollment Application

Completed on paper by each enrolling Employee
and submitted to Employer