Notice

Holiday Hours: 
Friday, 12/12 - our call center will be closed
Wednesday 12/17 - our call center will be closed from 12:30 PM to 1:30 PM ET
Happy Holidays! Cheers to a year ahead full of health, happiness, and confident smiles. Full holiday hours schedule
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