Useful Forms for Brokers & Consultants
Find the useful forms to assist you with selling and administering Delta Dental of Oklahoma products and services.
PDF forms may be downloaded.
Get Adobe Acrobat
Request for Proposal Form (10+ Employees):
- Request for Proposal
View
Request for Proposal PDF
Our Products
Small Business Programs (2-9 Employees):
- Delta Dental PPO & PPO Plus
View PPO & PPO Plus Rates and Benefits PDF
Small Business Forms:
- Application for Contract - Small Business
View Application PDF
- Employee Enrollment Form
View Enrollment PDF
- Small Group Checklist
View Checklist PDF
Employer Sponsored/Voluntary Forms (10+ Employees)
- Application for Group Contract
View
Group Contract Application PDF
- Employee Enrollment Form
View
Enrollment PDF
- (10+) Application Checklist
View
Application PDF
- (10+) Request for Proposal Checklist
View
Checklist PDF
Retiree Conversion Program
Retiree benefits are becoming more important as baby boomers enter retirement. Delta Dental provides you a way to offer
retiree dental benefits to your employees at no cost or administration to your group.
If an employee is currently enrolled in your dental plan and retires from your company, simply provide them with the attached paperwork to submit to our offices within 30 days of leaving your employment.
DDOK will permit them to convert to an individual retiree dental policy.
Dependents of the retiree must be enrolled at that time.
Payments are made monthly via a DDOK draft from the retirees checking or savings account or one-time payment for the calendar year.
Rate adjustments, if necessary, occur January of each year.
View Retiree Overview PDF
View Retiree Conversion Form PDF
Additional Program Options
Web Links:
EyeMed Summary:
Business Forms:
Compliance:
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