Notice

May 22 - September 4: Customer Service hours are Monday through Thursday 8:00 AM to 6:30 PM EDT and Friday 8:00 AM to 1:00 PM EDT.


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