Ready to enroll? It's simple!
Complete and submit the following to enroll a group:
Full new group application and packet
If you need to access the individual forms from the application packet, please use the links below:
Group health plan certification
ACH authorization form (required for groups of 2–9 enrolled)
Website authorization form
Mail your completed paperwork, plus a premium check to:
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.