Individual Enrollment Tools and Forms

If your client is interested in an Individual plan, provide them with a quick online quote and attach required enrollment forms.  

All Rocky Mountain Individual and Family plans are offered both inside and outside the marketplace.

The RMHP Individual and Family Sales Team is certified to assist you with enrolling your clients through the marketplace and to answer any questions you have around your clients options.We are available Monday through Friday, 8:00 a.m. to 5:00 p.m. to help you. 

Call us at 800-453-2981, Option 4. Alternatively, you can Email us at individualsales@rmhp.org

Application and Enrollment Forms

Triggering Events 2016

Rocky Mountain RIO PPO Individual and Family Flyer 2016

New West Focus HMO Flyer 2016

Colorado Springs Health Partners HMO Flyer 2016

Rocky Mountain Range HMO Flyer 2016

Monument Health PPO Individual and Family Flyer

Adult Dental Plan Comparison

Individual Adult Dental Enrollment/Change Form

Individual RIO Application 2016  English | Español

New West Focus Application 2016  English | Español

Colorado Springs Health Partners Application 2016  English | Español

Rocky Mountain Rio-Range Application 2016  English | Español

Monument Health - Rio Application 2016  English | Español

Individual Billing Change Form   English | Español

Employer Reimbursement Affidavit

Individual Change Form

Individual Plan Change Form  English | Español

Individual Disenrollment Form  English | Español


Notice of Replacement Coverage  English | Español