EFT/ERA Authorization Agreement Instructions

The EFT/ERA Authorization web form and notification emails are currently offline for maintenance. To complete an authorization, please download the EFT-ERA Authorization Agreement and follow the instructions below that are most relevant to your needs. We appreciate your patience.

Instructions for completing the EFT/ERA Authorization Agreement can be downloaded below.

New or Adding to Existing Enrollment

Instructions for completing the EFT/ERA Authorization Agreement

Changing an Existing Enrollment

Instructions for completing a change to the EFT/ERA Information

Canceling an Existing Enrollment

Instructions for canceling an existing enrollment

EFT-ERA Enrollment


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