Enrollment Tools and Forms
Click here for the Change Form.
Click here for the Change Form Spanish Version.
Click here for the Disenrollment Form.
Click here for forms for The Bancorp Bank.
Click here for the Authorization to Release Information Form.
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SOLO Individual and Family Health Plans
SOLO offers flexibility in individual and family health care coverage, giving your clients the freedom of choice they want and deserve.
SOLO offers a range of deductible levels, prescription drug coverage, and HSA-eligible plans to fit a variety of health care coverage needs. An optional accident rider is available to cover the first $1,000 of care due to an accident.
The RMHP SOLO Sales Team is available Monday through Friday, 8:00 a.m. to 5:00 p.m. to help you with any questions you may have on SOLO benefits, the SOLO application process, or pending SOLO application status..
Call us at 800-453-2981, Option 4. E-mail us at SOLO_Sales_Team@rmhp.org
For more information and forms you may need, click on the appropriate description.
Application and enrollment forms are available for download here along with broker appointment paperwork and underwriting guidelines. For an online quote and application, click here.
SOLO Brochure
SOLO Application
SOLO Application Checklist
SOLO Billing Change Form
SOLO Change Form
SOLO Plan Change Form
SOLO Producer Underwriting Guidelines
SOLO Term Form
SOLO Producer Appointment Kit
SOLO Prescreening Questionnaire
Employer Affidavit for Reimbursement of Individual/Family Health Plan
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BUSINESS GROUPS OF ONE
If your client qualifies as a Business Group of One, you have on-line access to application and enrollment forms required to apply for coverage with RMHP. Please click on the links below to download these forms. If you need additional information or assistance, please contact your RMHP Account Executive.
Application Forms for Business Groups of One
Click on the links below to download application forms.
Uniform Employee Application
Uniform Employee Application Spanish Version
Attestation Form - Business Group of One
Open Enrollment Certification - Business Group of One
New Group Checklist
Request for Enrollment of Common Law Spouse
Transition of Care
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SMALL GROUPS
If your client qualifies as a Small Employer Group (2 to 50 employees), provide them with a quick Online Quote. You also have on-line access to application and enrollment forms required to apply for coverage with RMHP. If you need additional information or assistance, please contact your RMHP Account Executive.
Application Forms for Small Groups
Small Group Enrollment Guidelines
Uniform Employee Application
Uniform Employee Application Spanish Version
Application for Health Benefits - For groups with 2 or more employees
New Group Checklist
Group Census Request
Request for Enrollment of Common Law Spouse
Transition of Care
Affidavit of Domestic Partnership
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LARGE GROUPS
If you qualify as a Large Employer Group (51+ employees), you have on-line access to application and enrollment forms required to apply for coverage with RMHP. Please click on the links below to download these forms. If you need additional information or assistance, please contact your insurance agent or an RMHP Sales Office near you.
Application Forms for Large Groups
Click on the links below to download application forms.
Large Group Proposal Request Form
Application for Health Benefits - For groups with 2 or more employees
Group Risk Questionnaire
New Group Checklist
Enrollment Form - Group Coverage
Enrollment Form - Group Coverage - Spanish
Affidavit of Domestic Partnership
Individual Health Questionnaire
Request for Enrollment of Common Law Spouse
Transition of Care
Employee-Dependent Waiver
Medigap plans work alongside your clients Original Medicare coverage. Some of the benefits to you for selling our Medicap plan include:
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Medigap Medicare Supplement Plans
Medigap plans work alongside your clients Original Medicare coverage. Some of the benefits to you for selling our Medigap plan include:
- You get choice – the right plans (A, C, F, G and N) at the right price; choices your clients deserve.
- You get customer service – located right here in Colorado, RMHP has local operations dedicated to high-quality benefit administration and customer service.
- You get peace of mind – backed by a strong and stable company with an established reputation and more than 35 years of experience serving Coloradans.
- RMHP Medigap plans are available for people with Medicare, regardless of their age.
Call us for more information at 888-334-7886.
For more information and forms you may need, click on the appropriate description.
Medigap Application
Medigap Application Checklist
Medigap Underwriting Guidelines
Plan Comparison Chart
Plan Rates
Plan A
Plan C
Plan F
Plan G
Plan N
Outline of Coverage
Medigap Guide
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