Agents & Brokers
Forms and FAQ's
Change Forms
Miscellaneous
IDP Association Application Form
Helpful Benefit Hints - Get the most out of your dental plan.
Online Forms
FAQ’s
How do I request a new agent kit?
Simply fill out the online form or call us at 1-800-999-9789.
A new agent kit, including appointment information and marketing materials will be promptly mailed to you.
How do I become appointed to sell Dental Select products?
Dental Select’s insured plans are underwritten by ACE USA, an "A+" rated company.
You can begin selling Dental Select’s products immediately; however, some states require agents to be appointed with our underwriter prior to receiving commissions.
How do I request a quote?
It’s easy to request a quote from Dental Select!
Chose the most convenient method for you:
- Fax a completed Broker Quote Request form (available under "Forms" above) to (888) 673-5328 or (801) 290-5135.
- Email your request to
Utah: utahquotes@dentalselect.com or
Texas:
texasquotes@dentalselect.com
Please include your customization requirements including:
- Waiting periods
- Deductibles
- R&C
- Benefit structure
- Maximums
- Voluntary or Contributory
- Commission desired (if not standard)
How soon can I expect to receive my quote?
Dental Select has a 24 hour turnaround time on quotes for groups under 100 lives, and less than 72 hour turnaround time on larger group quotes.
To assist us in providing you with an accurate and competitive quote, please submit the following information with your quote request, if applicable:
- Current and renewal rates
- Claims history/experience
- Census information
- Number of participating employees
- Employer contribution
- Copy of current summary of benefits
- Bill from prior carrier
What do I need to submit with a new group?
The following information is required when submitting a new group application for benefits:
- Group Application
- Company check (for first month’s premium)
- Employee enrollment forms
- Proof of prior coverage (not applicable for Co-pay and Discount plans)
- Summary of benefits from prior plan
- Last month’s invoice from prior plan
- Employee effective dates on prior plan
- Census (Contributory plans & Voluntary Indemnity plans (Utah & Texas) or PPO plans (Utah only) with less than 5 enrolled)
- Waiver enrollment forms (Contributory plans only)
For your convenience, a New Group Submittal Checklist is available under Forms.
When will my group receive renewal information?
Renewal letters are sent to the group no later than 45 days prior to their renewal date.
You will receive a copy of this letter approximately one week prior to the date the group’s copy is mailed.
How can I obtain additional information on HIPAA?
Dental Select is HIPAA compliant.
For more information on HIPAA, please visit the following websites:
US Department of Health & Human Services
http://www.dhhs.gov/ocr/hipaa/
Center for Medicaid Services
www.cms.hhs.gov/hipaa/
Enrollments / Downloadable Forms
Employee Enrollment Card - Employee enrollment form for Group Plans.
Employee Enrollment Card (Spanish) - Employee enrollment form for Group Plans.
Group Forms
All Plans Application - Contributory / Voluntary Group Dental Plan Application
Change Forms
Miscellaneous
IDP Association Application Form
Helpful Benefit Hints - Get the most out of your dental plan.
FAQ's
How do I request a new agent kit?
Simply fill out the online form or call us at 1-800-999-9789. A new agent kit, including appointment information and marketing materials will be promptly mailed to you.
How do I become appointed to sell Dental Select products?
Dental Select's insured plans are underwritten by ACE USA, an "A+" rated company.
You can begin selling Dental Select's products immediately; however, some states require agents to be appointed with our underwriter prior to receiving commissions.
How do I request a quote?
It's easy to request a quote from Dental Select! Chose the most convenient method for you:
- Fax a completed Broker Quote Request form (available under "Forms" above) to (888) 673-5328 or (801) 290-5135.
- Email your request to
Utah: utahquotes@dentalselect.com or
Texas: texasquotes@dentalselect.com
Please include your customization requirements including:
- Waiting periods
- Deductibles
- R&C
- Benefit structure
- Maximums
- Voluntary or Contributory
- Commission desired (if not standard)
How soon can I expect to receive my quote?
Dental Select has a 24 hour turnaround time on quotes for groups under 100 lives, and less than 72 hour turnaround time on larger group quotes.
To assist us in providing you with an accurate and competitive quote, please submit the following information with your quote request, if applicable:
- Current and renewal rates
- Claims history/experience
- Census information
- Number of participating employees
- Employer contribution
- Copy of current summary of benefits
- Bill from prior carrier
What do I need to submit with a new group?
The following information is required when submitting a new group application for benefits:
- Group Application
- Company check (for first month's premium)
- Employee enrollment forms
- Proof of prior coverage (not applicable for Co-pay and Discount plans)
- Summary of benefits from prior plan
- Last month's invoice from prior plan
- Employee effective dates on prior plan
- Census (Contributory plans & Voluntary Indemnity plans (Utah & Texas) or PPO plans (Utah only) with less than 5 enrolled)
- Waiver enrollment forms (Contributory plans only)
For your convenience, a New Group Submittal Checklist is available under Forms.
When will my group receive renewal information?
Renewal letters are sent to the group no later than 45 days prior to their renewal date. You will receive a copy of this letter approximately one week prior to the date the group's copy is mailed.
How can I obtain additional information on HIPAA?
Dental Select is HIPAA compliant. For more information on HIPAA, please visit the following websites:
US Department of Health & Human Services
http://www.dhhs.gov/ocr/hipaa/
Center for Medicaid Services
Enrollments / Downloadable Forms
Employee Enrollment Card - Employee enrollment form for Group Plans.
Employee Enrollment Form (Spanish) - Employee enrollment form for Group Plans.
Group Forms
All Plans Application - Contributory / Voluntary Group Dental Plan Application
Change Forms
Miscellaneous
IDP Association Application Form
Helpful Benefit Hints - Get the most out of your dental plan.
FAQ's
How do I request a new agent kit?
Simply fill out the online form or call us at 1-800-999-9789. A new agent kit, including appointment information and marketing materials will be promptly mailed to you.
How do I become appointed to sell Dental Select products?
Dental Select's insured plans are underwritten by ACE USA, an "A+" rated company.
You can begin selling Dental Select's products immediately; however, some states require agents to be appointed with our underwriter prior to receiving commissions.
How do I request a quote?
It's easy to request a quote from Dental Select! Chose the most convenient method for you:
- Fax a completed Broker Quote Request form (available under "Forms" above) to (888) 673-5328 or (801) 290-5135.
- Email your request to
Utah: utahquotes@dentalselect.com or
Texas: texasquotes@dentalselect.com
Please include your customization requirements including:
- Waiting periods
- Deductibles
- R&C
- Benefit structure
- Maximums
- Voluntary or Contributory
- Commission desired (if not standard)
How soon can I expect to receive my quote?
Dental Select has a 24 hour turnaround time on quotes for groups under 100 lives, and less than 72 hour turnaround time on larger group quotes.
To assist us in providing you with an accurate and competitive quote, please submit the following information with your quote request, if applicable:
- Current and renewal rates
- Claims history/experience
- Census information
- Number of participating employees
- Employer contribution
- Copy of current summary of benefits
- Bill from prior carrier
What do I need to submit with a new group?
The following information is required when submitting a new group application for benefits:
- Group Application
- Company check (for first month's premium)
- Employee enrollment forms
- Proof of prior coverage (not applicable for Co-pay and Discount plans)
- Summary of benefits from prior plan
- Last month's invoice from prior plan
- Employee effective dates on prior plan
- Census (Contributory plans & Voluntary Indemnity plans (Utah & Texas) or PPO plans (Utah only) with less than 5 enrolled)
- Waiver enrollment forms (Contributory plans only)
For your convenience, a New Group Submittal Checklist is available under Forms.
When will my group receive renewal information?
Renewal letters are sent to the group no later than 45 days prior to their renewal date. You will receive a copy of this letter approximately one week prior to the date the group's copy is mailed.
How can I obtain additional information on HIPAA?
Dental Select is HIPAA compliant. For more information on HIPAA, please visit the following websites:
US Department of Health & Human Services
http://www.dhhs.gov/ocr/hipaa/
Center for Medicaid Services
