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

Request for Proposal

Business Forms for Group Select (2-99 Employees)

Group Select Packet – 2019
Application for Group Select Product – 2019
Group Select Checklist – 2019
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
Select Benefit Summaries – Spanish
EyeMed Plan Summary 

Business Forms For Groups (26+ Employees)

Group 26+ Packet – 2019
Application for Group Contract PDF (26+ Employees) – 2019
Group Application Checklist (26+ Employees) – 2019
EyeMed Plan Summary

Business Forms For Group PPO - No Max (100+ Employees)

PPO - No Max 100+ Packet – 2018 and 2019
Application for PPO - No Max PDF (100+ Employees) – 2018 and 2019
Group Application Checklist PPO - No Max PDF (100+ Employees) – 2018 and 2019

Retiree Conversion Form

Retiree Conversion Overview – 2019
Retiree Conversion Enrollment Form – 2019

Individual & Family Plans

Individual & Family Plans

Federally Compliant Plans

Federally Compliant Plans Packet – 2019
Application for Group FCP – 2019

Forms

Automatic Draft Authorization Form
Employee Enrollment Form – 2019 – English
Employee Enrollment Form – 2019 – 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 Dentist Search
EyeMed Vision Care

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