Ready to Enroll? It's Simple!
Complete and submit the following to enroll a group:
- Enrollment Form—English
- Enrollment Form—Spanish
- ACH Authorization Form (required for groups of 2–9 enrolled)
- ACH & Wire Transfer Instructions
- Website Authorization Form
Attn: Small Group Sales
Delta Dental of Colorado
6465 Greenwood Plaza Blvd., Suite 900
Centennial, CO 80111
If the completed application, enrollment forms, and binder check are received before the 20th of the month, the group will be eligible for the first of the next month. The group will receive a welcome letter once the application and enrollment forms have been processed.
Please contact our sales department at email@example.com for questions or support.