Notice
Monday, June 5, 2023 through Friday, September 8, 2023: Customer Service hours will be 8:00 AM - 6:30 PM ET Monday through Thursday and 8:00 AM - 1:00 PM ET on Friday.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 2-50 enrolled employees
Easy employer application (PDF, 7 pages, 377 KB)
Download our easy group application for 2-50 business
Simple employee enrollment (PDF, 1 page, 204 KB)
Download our easy group enrollment form for 2-50 business
Enrollment spreadsheet (Excel)
Download our easy group enrollment spreadsheet guide for 2-50 business
Delta Dental of Connecticut is a part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.
