In alignment with Executive Order 14168, Molina Healthcare has updated all Medicare enrollment forms to exclude information about sexual orientation and gender identity (SOGI).

• Paper enrollment forms for Molina Healthcare in English and Spanish are now available for download on the Molina Marketing Store and on our public website at www.MolinaHealthcare.com.
• These forms are available for all lines of business, including Molina Medicare, Senior Whole Health, Passport and CHP.
• Old paper applications inclusive of SOGI should be destroyed. We can accept these if submitted but use of old forms risks delayed or rejected processing.
• Electronic enrollment forms are also updated in Connecture.

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Agents must be ready to sell, which means certified, contracted, licensed in the applicable states and appointed by Molina Healthcare Inc. in accordance with state law prior to engaging in the sale of Molina Healthcare products. Any dissemination or distribution of this material is strictly prohibited and may result in corrective action up through termination of your contract with Molina Healthcare Inc.