Forms & Resources

Find the useful forms to assist you with selling and administering Delta Dental of Oklahoma products and services.

Individuals & Families

Application for individuals & Families – 2017
Individual & Family Plan Comparisons – 2017

Business Forms for Group Select (2-99 Employees)

Group Select Packet – 2017
Application for Group Select Product – 2017
Application for Group Select Contract Patient Direct Discount Program
Group Select Checklist – 2017
Employee Enrollment Form Group Select – English
Employee Enrollment Form Group Select – Spanish
Employee Enrollment Form for Patient Direct Discount Program – English
Employee Enrollment Form for Patient Direct Discount Program – Spanish
Select Benefit Summaries – English
Select Benefit Summaries – Spanish
EyeMed Plan Summary
 

Business Forms For Groups (26+ Employees)

Group 26+ Packet – 2017
Request for Proposal PDF (26+ Employees)
Application for Group Contract PDF (26+ Employees) – 2017
Group Application Checklist (26+ Employees) – 2017
Employee Enrollment Form (26+ Employees) – English
Employee Enrollment Form (26+ Employees) – Spanish
EyeMed Plan Summary

Federally Compliant Plans

Federally Compliant Plans Packet – 2017
Application for Group FCP – 2017

Retiree Conversion Form

Retiree Conversion Overview – 2017
Retiree Conversion Enrollment Form – 2017

 

Forms

Automatic Draft Authorization Form
Employee Enrollment Form – English
Employee Enrollment Form – Spanish
General Change Form for Groups (editable)
Application for Online Resources (editable)
 

Supply Request

Order Group Supplies (email to request)

Web Links

Broker Exchange (Please login to Broker Exchange to generate a proposal)
Delta Dental National Dentist Directory
EyeMed Vision Care



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