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Forms for employers that are offering group Delta Dental plans to employees.

For the full range of 2022 Open Enrollment instructions, see Kelley Avery's April 18, 2022 memo.

Documents: 
PDF icon Group Dental Enrollment and Change Form
PDF icon Group Dental Employee Termination Form
PDF icon Delta Dental Non-Discrimination Policy
File Dental Group Contract Application Form — download to fill in electronically
PDF icon Delta Dental Group Admin Portal Authorization Form
PDF icon Delta Dental Group Admin Portal How-To Guide

Resource Category:

  • Contract or Agreement

Pertains to Roles:

  • VERB Health Contact