Forms & Resources

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

Request for Proposal

Request for Proposal Information Form

Business Forms for Group Select (2-99 Employees)

Group Select Packet – 2020
Application for Group Select Product – 2020
Group Select Checklist – 2020
Group Select Packet – 2021
Application for Group Select Product – 2021
Group Select Checklist – 2021
Application for Group Select Contract Patient Direct Discount Program
Employee Enrollment Form for Patient Direct Discount Program – English
Employee Enrollment Form for Patient Direct Discount Program – Spanish

Select Benefit Summaries – English – 2020
Select Benefit Summaries – Spanish – 2020
Select Benefit Summaries – English – 2021
Select Benefit Summaries – Spanish – 2021
EyeMed Plan Summary 

Business Forms For Groups (26+ Employees)

Group 26+ Packet – 2020
Application for Group Contract PDF (26+ Employees) – 2020

Group Application Checklist (26+ Employees) – 2020
Group 26+ Packet – 2021
Application for Group Contract PDF (26+ Employees) – 2021
Group Application Checklist (26+ Employees) – 2021
EyeMed Plan Summary

Health through Oral Wellness® (HOW®)

Summary of HOW® Enhanced Benefits
Finding a HOW® participating dentist
 

Retiree Conversion Form

Retiree Conversion Overview
Retiree Conversion Enrollment Form

Individual & Family Plans

Individual & Family Plans

Federally Compliant Plans

Federally Compliant Plans Packet – 2020
Application for Group FCP – 2020
Federally Compliant Plans Packet – 2021
Application for Group FCP – 2021

Forms

Automatic Draft Authorization Form
Employee Enrollment Form – English
Employee Enrollment Form – Spanish

General Change Form for Groups (editable)
Group Application for Online Resources (editable)

Broker Application for Online Resources (editable)

Supply Request

Order Group Supplies (email to request)

Web Links

Online Resources (Please login to Online Resources to generate a proposal)
Delta Dental Dentist Search
EyeMed Vision Care



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