Notice
We will be closed on Thursday, June 19, in observance of Juneteenth. This federal holiday marks June 19, 1865, when slavery officially ended in the United States. To learn more about this important historical day, please visit this resources page.
From Friday May 23rd through Friday, August 29, 2025: Customer Service hours will be 8:00 AM – 6:30 PM EST Monday through Thursday and 8:00 AM - 1:00 PM EST on Friday.
To view benefit information and claim status at any time, you can sign into your account or use our Interactive Voice Response System 24/7 at 800-452-9310.
Small Group Forms for Brokers
Easily access and download all the small group forms and applications.
Small Business Dental Plan Forms for 2-50 Enrolled Employees
Easy employer application (PDF, 9 pages, 1,930 KB)
Download our easy group application for 2-50 business
Simple dental employee enrollment (PDF, 1 page, 204 KB)
Download our easy dental group enrollment form for 2-50 business
Simple vision employee enrollment (PDF, 1 page, 204 KB)
Download our easy vision group enrollment form for 2-50 business
Enrollment spreadsheet (Excel)
Download our easy group enrollment spreadsheet guide for 2-50 business
