Notice

Our Call Center is experiencing an outage associated with the Amazon Web Services global outage. We are working to resolve it as quickly as possible and apologize for any inconvenience this may cause.


To view benefit information and claim status, self-service by signing into your account. We are unable to answer calls at this time.

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