Please complete this form to apply for the Basalt Chamber's SALA Healthcare Program. The Basalt Chamber will verify your membership and follow up with additional instructions for completing enrollment.

Before completing this application, please make sure you have viewed the webinar and supporting documents available at https://youtu.be/f9cBHI5FUsg.

Disclaimer: This is not insurance and the State’s consumer protections or oversight of the operation of the plan do not apply.  The amounts to be paid to the plan are not Insurance premiums and therefore are not regulated.  The promise of future benefits is not guaranteed and thus the State of Colorado’s Guarantee Fund does not apply