Notice
Monday, May 25: Our Customer Service center will be closed in observance of Memorial Day.
May 22 - September 4: Our call center hours on Fridays are 8 AM to 1 PM EDT. Monday through Thursday our call center hours are 8 AM to 6:30 PM EDT.
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).
Dental Forms Library for Employers
Authorization Form Granting Access to PHI (PDF, 1 page, 52kb)
Eligibility Enrollment Change Form (Dental and Vision) (PDF, 2 pages, 22kb)
Use this form to submit new adds, changes, and terminations.
Disabled dependent verification certification (PDF, 1 page, 13kb)
This form officially certifies the dependency status of a disabled dependent. To be signed by the child's physician.
