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Online Enrollment Tool

We’ve made it easy to use our online enrollment tool with your clients to submit CCA PPO and CCA HMO D-SNP enrollments in Rhode Island.

On the “Let’s get to know you” page, please select I’m an Agent/Broker supporting a person enrolling in CCA. Then, enter your National Producer Number (NPN) and full name to continue with the enrollment process.

Once the enrollment has been submitted, a confirmation number will be displayed (i.e., “CCA123456”). Please save the confirmation number for your records. This confirmation number will not be your client’s CCA ID.

Paper/PDF Enrollment Forms & Scope of Appointment (SOA)

For instructions on submitting completed paper/PDF enrollment forms and Scope of Appointment (SOA) forms, please contact your agency.

Please log in here to order or download our enrollment forms and SOA.

Please Note: Your National Producer Number (NPN) must be included on all completed paper/PDF enrollment forms to ensure you are assigned as the agent/broker of record.

SunFire

If you have access to the SunFire platform, our products are available for quoting and enrollment, as long as you’re Ready To Sell (RTS). If you have any questions or need any assistance, please reach out to your agency.

Contact Us

For all broker-related inquiries, please email [email protected] or call Broker Concierge Services at 888-858-8320 (available 7 days a week, 8:00 AM – 6:00 PM).