Forms & Resources

Find the forms and resources to assist you in administering Delta Dental of Oklahoma benefit products and services. PDF forms may be downloaded.

 

Forms

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

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

Individuals & Families

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

Request for Proposal

Request for Proposal Information Form

Supply Request

Order Group Supplies (email to request)

Web Links

Delta Dental Dentist Search
EyeMed Vision Care