Request Enrollment Assistance A Health Coverage Guide who has been trained and certified through Connect for Health Colorado will contact you with more information about your health insurance options. First name: * Last name: * Company: * Phone: Email: * Street: City: * State: * ZIP: No. of full-time employees: Self-employed Fewer than 10 employees 10-24 employees 25-49 employees 50-74 employees 75-100 employees I offer insurance to my employees?: Yes No End of plan year: Preferred method of contact: Email Phone Standard mail Preferred language: Message: Type the text shown: * * These fields are required.