MARYLAND INSURANCE ADMINISTRATION TITLE LETTER OF CREDIT Except as expressly stated herein, this undertaking is not subject to any condition or qualification. We recently reviewed your application for health coverage through Maryland Health Connection.Frequently asked questions regarding eligibility, enrollment, financial help, health plans, user accounts, and Medicaid. This form is optional. No one is required to fill it out, and other forms may be used and are just as valid legally. The Maryland Economic Loss protections Law Cover letter provides information for benefit entitlement and the application for the benefits. Filling out this application doesn't mean you have to buy health coverage. Get help with this application. If you wish to enroll in the NGI Rap Back Service please complete the CJIS-CR Authorization Update Form and follow its return instructions. Complete Form 502CR, following the instructions provided.