Notice to Insurance Provider
Colorado · Colorado Judicial Branch · Effective July 1, 2024
This form is a notice sent to a health insurance company. It tells the insurance company that a court has ordered one person to provide health insurance coverage for a child.
Where this fits in a case
General & infoInformation / general use — not tied to one step of a case
This form is used in family cases when a court has ordered that one person must provide health insurance coverage for a child.
Either party may file.
Common questions
- Who fills out this form?
- The Obligee or the Obligee’s Representative fills out this form.
- What does this form do?
- It notifies the health insurance provider that a court order requires one person to provide health insurance for a child.
Revision history
No changes recorded since we started tracking this form on October 10, 2026. The current version took effect July 1, 2024.
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