In-network with Ascension St. John, Hillcrest, OSU Medical and Saint Francis (other providers are available in our network).

Submit an Application

Ready to submit an Application?

Online Enrollment

Enroll your clients through the portal by clicking the Broker Login button. You will be able to download a copy of your client’s application at any time and track the applications progress. Don’t forget that you can complete your Scope of Appointment with your Broker Login!

Remember that your clients that you enroll by phone or fax will NOT be in your broker portal.

Phone Enrollments

To complete an enrollment by phone, you and your client can three-way call into our enrollment team at (918) 594-5275. One of our representatives will help you and your client complete their enrollment into our plan quickly over the phone. Don’t forget to fax or email your SOA.

Email or Fax

Email us your application here! If you do not have secure email, please fax your application to 918-878-5978. Please include the application, a Scope of Appointment and any comments/questions you may have. We will confirm receipt of the application via email.

CommunityCare requires a Scope of Appointment form (SOA) with all applications. You can fax or email your SOA, use our online SOA or submit through the Sunfire Enrollment Platform.