Notice

Saturday, 10/17 through Sunday, 10/18, due to system maintenance, the following services Claims Submissions, Eligibility Updates, and Procedure Code Lookup will be current as of Friday 10/16 and updated once maintenance is complete. 

 

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).

NJSBA 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