There are three ways to apply for HIBI benefits.

Submit your application and documents by:

Toll-free fax: (855) 226-4424
Fax coversheet

Mailing Address:
Colorado HIBI Program
5615 High Point Dr.
Ste 100
Irving, TX 75038

This is not a physical address – please do not deliver applications in person


To process your application, you will need to send in the following information before you can officially be determined HIBI eligible and receive payments:

  • A copy of the front and back of your insurance card
  • Summary of benefits for your policy plan or desired policy plan
  • Your health insurance rate sheet
  • A recent paystub or other verification to show proof of your premium payment

Your employer must provide you group health coverage if you are eligible for HIBI, regardless of whether or not their open enrollment period has passed.  Contact us for assistance.