Sign in
Search

Alert

Dismiss alert message panel
i
Attention Dental Insurance Company providers: Protect your practice and patient data with multi-factor authentication. As of October 20, 2025, all users will need their password and an additional way to confirm their identity to log in to their Dental Insurance Company of Connecticut account. See how MFA works.
i
Customer Service Summer Hours (through Friday, 8/29/2025): 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, please sign into your account or use our Interactive Voice Response System 24/7 at 800-452-9310.

Broker Forms for Individual & Family Plans

Easily access and download all the forms you need

Producer Appointment Forms (pdf, 26 pages, 789KB)
Use this packet to get appointed to sell Individual & Family Plans and earn commission.