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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
Onetime Load Enrollment Template
General Change Form for Groups (editable)
Application for Online Resources (editable)
Business Forms for Group Select (2-99 Employees)
Group Select Packet - 2023
Application for Group Select Product - 2023
Group Select Checklist - 2023
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 - 2023
Application for Group Contract PDF (26+ Employees) - 2023
Group Application Checklist (26+ Employees) - 2023
EyeMed Plan Summary
Health through Oral Wellness® (HOW®)
Summary of HOW® Enhanced Benefits
Finding a HOW® participating dentist
Retiree Conversion Form
Retiree Conversion Overview - 2023
Retiree Conversion Enrollment Form - 2023
Individuals & Families
Federally Compliant Plans
Federally Compliant Plans Packet - 2023
Application for Group FCP - 2023
Request for Proposal
Request for Proposal Information Form
Supply Request
Order Group Supplies (email to request)